Original Report

National surveillance of herbal dietary supplement exposures: the poison control center experience†

  1. Brian M. Gryzlak MA, MSW1,
  2. Robert B. Wallace MD, MSc1,*,
  3. M. Bridget Zimmerman PhD2,
  4. Nicole L. Nisly MD3

Article first published online: 6 JUL 2007

DOI: 10.1002/pds.1445

Issue

Pharmacoepidemiology and Drug Safety

Pharmacoepidemiology and Drug Safety

Volume 16, Issue 9, pages 947–957, September 2007

Additional Information

How to Cite

Gryzlak, B. M., Wallace, R. B., Zimmerman, M. B. and Nisly, N. L. (2007), National surveillance of herbal dietary supplement exposures: the poison control center experience. Pharmacoepidemiology and Drug Safety, 16: 947–957. doi: 10.1002/pds.1445

Author Information

  1. 1

    Department of Epidemiology, University of Iowa, IA, USA

  2. 2

    Department of Biostatistics, University of Iowa, IA, USA

  3. 3

    Department of Internal Medicine, University of Iowa, IA, USA

*C21N GH, Department of Epidemiology, University of Iowa, Iowa City, IA 52242, USA.

  1. †

    No authors report any interpretive, financial, or other conflicts of interest in any aspect of preparation of this manuscript. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIEHS, NIH.

Publication History

  1. Issue published online: 17 AUG 2007
  2. Article first published online: 6 JUL 2007
  3. Manuscript Accepted: 31 MAY 2007
  4. Manuscript Revised: 26 APR 2007
  5. Manuscript Received: 3 MAY 2006

Funded by

  • National Center for Complementary and Alternative Medicine (NCCAM). Grant Number: 9 p50 AT004155-06
  • National Institute of Environmental Health Sciences (NIEHS). Grant Number: P01 ES012020
  • Office of Dietary Supplements (ODS), NIH

SEARCH

SEARCH BY CITATION

ARTICLE TOOLS

Get PDF (137K)

Keywords:

  • herbal dietary supplements;
  • post-marketing surveillance;
  • alternative medicine;
  • complementary medicine;
  • integrative medicine

Abstract

Purpose

The purpose of this report is to characterize reports to poison control centers (PCCs) involving two widely used herbal dietary supplements (HDSs), Echinacea, and St. John's wort (SJW).

Methods

We purchased data from the American Association of Poison Control Center's (AAPCC) toxic exposure surveillance system (TESS®) on reports made to PCCs in 2001 involving Echinacea or SJW. Analyses were limited to those cases in which Echinacea or SJW were the only associated products, and in which these HDSs were deemed primary to observed adverse effects. Descriptive statistics were generated for selected demographic and exposure-related variables.

Results

During 2001, PCCs were contacted regarding 406 exposures involving Echinacea and 356 exposures involving SJW. Most of the reported exposures for both HDSs occurred among children 5 years and younger, and the majority of exposures were coded as unintentional. For both HDSs, exposures among patients ≥20 years old were more likely to be associated with adverse effects. Intentional exposures accounted for 21% of SJW cases and 3% of Echinacea cases, with 13% of SJW exposures reported as ‘suspected suicidal’.

Conclusions

TESS® represents a potentially important means of assessing and characterizing HDS-related adverse effects. Detailed studies validating the clinical events and outcomes of a sample of exposures reported to TESS® might offer substantial insights into adverse events (AEs) that could be systematically studied with other, established pharmacoepidemiological study designs. Copyright © 2007 John Wiley & Sons, Ltd.

Get PDF (137K)