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In Reply: Drs Kirrane and Hoffman raise concerns about the validity of TESS data. TESS was used to identify most of the acute pesticide poisoning cases associated with school exposures that we reported. TESS data consist of telephone reports made to US poison control centers (PCCs). A vast majority of these calls are made by the patient or a family member. In our study, among the 2187 cases identified by TESS, only 7.5% involved reports made by health care professionals.

All PCC reports are initially handled by specialists in poison information (SPI) or poison information providers (PIP), who comprise 92% and 8%, respectively, of PCC staff who perform this function.¹ The SPIs are nurses, pharmacists, or physicians. The PIPs have less training and are often drawn from non–health-services backgrounds. However, both SPIs and PIPs are backed by medical toxicologists and quality assurance oversight. Additionally, the data are collected in a . . . [Full Text of this Article]

Geoffrey M. Calvert, MD, MPH; Walter Alarcon, MD
walarcon@cdc.gov
National Institute for Occupational Safety and Health
Centers for Disease Control and Prevention
Cincinnati, Ohio

Jerome M. Blondell, PhD
US Environmental Protection Agency
Washington, DC

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