SAN FRANCISCO — It was a typical afternoon for pharmacists answering the Toxic-Info hot line at San Francisco General Hospital--a woman had been sprayed in the face when a tenant in her apartment house went bonkers with a fire extinguisher, a restaurant employee had become dizzy after her boss poured an unidentified chemical down the drain, a small boy had eaten a flower petal, a child had drunk from a glass of water left out when a flea "fogger" was set off.
The statewide hot line--1-800-233-3360--was established two years ago by the UC San Francisco School of Pharmacy as a service of the San Francisco Bay Area Regional Poison Control Center.
12,000 Calls a Year
It had its baptism by fire during last summer's watermelon poisoning scare and now handles 12,000 calls each year, most of these from private citizens worried about health hazards of toxic wastes and spills and job-site hazards as well as those of commonly used household chemicals.
Toxics are being widely perceived as a potentially major health problem, and apparently with good reason. Frank J. Mycroft, an environmental toxicologist who is director of Toxic-Info, points out that there are 65,000 organic compounds used to a significant extent in industry and "of those, perhaps 3,000 are commercially important. Of those, about 700 have standards set for the workplace."
Further, Mycroft points out, of 7 million known chemical compounds, "perhaps several hundred have been tested for carcinogenicity. What we're describing is an immense ignorance of chemicals and what they can do."
Although the San Francisco-based hot line was conceived primarily as a service for health professionals and for agencies, "first responders" such as police and fire departments that deal with accidents involving hazardous wastes, the bulk of the callers are concerned individuals and their most frequently voiced concerns are about home flea bombs and the possible effects of paint fumes on fetuses.
The nuclear plant accident at Chernobyl had a "very significant" impact on Toxic-Info, according to Dr. Charles E. Becker, UCSF professor of medicine, head of the division of occupational medicine / toxicology at San Francisco General and medical director of the regional poison center that serves a Northern California population of 6 million.
"This morning," Becker said during a recent interview in his hospital office, "I was called by one of my former students who has a brain tumor." As a registered nurse, she had been repeatedly exposed to radiation on the job and she wondered if that might have been the cause.
Making such a determination "is always very hard," Becker said, and a case such as the above presents a double dilemma to the victim. "People are most frustrated when it's an involuntary risk," he said, "and when the medical community itself is not certain how to deal with it."
For example, he said, "We don't have good environmental measures" when it comes to hazard-waste dump sites. "All that people have are smells. It's frustrating. (As medical professionals) we depend very much on being able to have a dose of something. So people smell things, but we haven't been able to determine exactly what they're smelling. We're left with smells and symptoms and a health professional saying, 'I don't think . . . . ' "
He added, "That's why Chernobyl is so interesting. If the Russians would give us all the information, then we could get to the dose."
Some of the calls that come into the Toxic-Info hot line are tragic. Pharmacists recall the case of a toddler who drank a fatal dose of paraquat, a herbicide, from a Coke bottle, and the man who died when a Berkeley family, bringing home its new baby, turned on a faulty heater for the first time and the father died of carbon monoxide poisoning.
Other calls may seem ridiculous, but pharmacists on hot-line duty work on the theory that, if someone is concerned enough to call, the problem is real to them. The job is both rewarding and stressful, explained Olga Woo, a pharmacist who has been on the poison center staff for five years. On this particular day, Woo was sharing with a visitor the little black book of memorable calls, a guaranteed stress-reliever.
Entries included the caller who wanted to know if she could be fatally poisoned by contact with garlic on a finger cut, the one who asked whether bubble gum stuck in the air vent of a car could give off toxic fumes, the one who wondered if there was something wrong with his soup because his coffee mug shattered when he poured the soup into it.
Then there was the mother worried that her toddler had developed an addiction to eating Crest toothpaste, the woman who regularly ate contraceptive cream to prevent exposure to AIDS, the doctor whose patient had drunk an intravenous solution when the doctor was out of the room. The doctor pointed out that his patient was an attorney.