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Guidelines on the prevention of toxic exposures

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116

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3675

World Health Organization

2004

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Contents

1. Background 3

1.1 Activities developed by the IPCS 3

1.2 International recommendations 4

1.3 Regulatory measures 5

2. What is prevention? 6

2.1 Definition and purpose of prevention and toxicovigilance 6

2.2 Types of prevention 6

2.3 Benefits of prevention 7

2.4 Barriers to prevention 8

2.5 Education to prevent toxic exposures 9

2.5.1 Education aimed at individuals or communities 10

2.5.2 Education aiming at social and environmental change 10

2.5.3 Education of professionals 11

2.6 Other mechanisms for prevention of toxic exposures 11

2.6.1 Risk communication/alerts about chemical risks 11

2.6.2 Labelling 11

2.6.3 Technology and design 13

2.6.4 Operational control 14

2.6.5 Monitoring people and the environment 15

2.7 Legislation and regulation for prevention of toxic exposures 16

2.7.1 Legislation and chemical safety 17

2.7.2 How can legislation be used to control poisoning? 17

2.7.3 How effective are legislation and regulation in preventing poisoning? 18

2.7.4 Legislation and education 18

2.7.5 Product registration 19

2.7.6 Licensing 19

2.7.7 Standards 19

2.7.8 Notification systems 20

2.7.9 International conventions and recommendations 20

3. Planning educational programmes 22

3.1 Understanding poisons prevention needs of the community 22

3.2 Analysing and evaluating the problem 23

3.2.1 Obtaining information about occurrence of toxic exposures 23

3.2.2 Obtaining information about the target population 26

3.3 Programme planning and management 27

3.3.1 Defining aims and objectives, priorities 28

3.3.2 Identifying resources that will be needed 29

3.3.3 Training needs 30

3.3.4 Finding financial resources 31

4. Planning how to communicate the message 33

4.1 Face-to-face communication 34

4.1.1 With groups 34

4.1.2 One-to-one teaching 36

4.1.3 Telephone information services 37

4.2 Popular media 37

4.3 Mass media 38

4.3.1 Television and radio 38

4.3.2 Newspapers and magazines 39

4.4 Videos 39

4.5 Printed materials 39

4.5.1 Content and design 39

4.5.2 Distribution 40

iv GUIDELINES ON THE PREVENTION OF TOXIC EXPOSURES

4.6 Displays and exhibitions 41

4.7 Child-centred events 41

5. Who does prevention? 42

5.1 Role of poisons centres 42

5.2 Partners in prevention activities 42

5.2.1 Initiators vs. partners 43

5.2.2 Organizers and partners 43

5.3 Agents and agencies that are potential initiators and partners 44

6. Why do an evaluation? 48

6.1 Planning evaluation 48

6.1.1 Factors influencing the selection of an evaluation design 48

6.2 Barriers to conducting evaluations 49

6.3 Methods for evaluation 50

6.3.1 Impact evaluation 50

6.3.2 Process evaluation 54

SECTION II Poisons prevention in different environments

1 Programme overview 59

1.1 Addressing prevention in the home 59

1.2 Identifying who will be responsible 59

1.3 Defining the programme: what substances are included, who is exposed, and how it is going to

be accomplished 60

1.4 Identifying available resources and sources of support 61

1.5 Raising programme awareness in the community 61

2 Risk characterization 61

2.1 Identifying which agents are involved in unintentional exposures 61

2.2 Investigating risk factors and understanding their influence on unintentional exposures 62

2.3 The agent 62

2.4 The child 62

2.5 The environment 62

2.6 Circumstances of exposure 63

3 Exposure controls 63

3.1 Containers and packaging 63

3.2 Removal or modification of the poison 63

3.3 Labelling practices 64

3.4 Storage and handling guidelines 64

3.5 Supervison 64

3.6 Changing social, psychological and economic factors 64

4 Education and training 64

4.1 Individual counselling and group teaching 65

4.2 Literature, posters and exhibition material 65

4.3 Mass media campaigns 65

4.4 Providing information on the Internet 66

4.5 Training community workers and health workers 66

5 Evaluating and monitoring prevention efforts 66

6 Preparing for emergencies in the home 66

Prevention of toxic substance exposure in the workplace 67

1 Programme overview 67

1.1 Developing a mission 67

1.2 Planning prevention and defining responsibility 67

1.3 Defining the scope of the programme 67

1.4 Raising awareness 68

2 Risk characterization 68

2.1 Preparing an inventory of toxic substances 68

2.2 Determining risk 68

3 Exposure controls 68

3.1 Labelling 69

3.2 Storage and handling 69

3.3 Choosing toxic substance suppliers and disposers 69

4 Training and education 69

5 Emergency preparedness and response 70

6 Medical surveillance 70

7 Hazardous non-routine tasks 70

7.1 External contractors and consultants 70

8 Toxic substance and waste disposal procedures 71

Prevention of toxic substance exposure in the rural environment 72

1 Programme overview 72

1.1 Developing a mission 72

1.2 Committing to prevention 72

1.3 Defining the scope of the programme 72

1.4 Raising awareness 72

2 Risk characterization 73

2.1 Collecting inventory data 73

3 Exposure controls 74

3.1 Labelling practices 74

3.2 Storage and handling guidelines 74

4 Training and education 74

5 Responding to emergency situations 74

6 Medical surveillance 75

7 Toxic substance and waste disposal procedures 75

Annex 1: Examples of prevention activities of different partners in prevention 76

1 Prevention programmes in poisons centres in various countries 76

1.1 Belgium 76

1.2 Chile 77

1.3 India 77

1.4 Indonesia 78

1.5 New Zealand 79

1.6 Turkey 80

1.7 Switzerland 81

1.8 USA 82

2 Prevention programmes organized by governmental agencies 83

3 Prevention programmes led by nongovernmental bodies 84

4 Prevention programmes led by international organizations 84