Poison Control Centers (PCCs) play an integral role in the preparation for and management of poison emergencies. Large-scale public health disasters, caused by both natural and human factors, may result in a drastic increase in the number of inquiries received and handled by Poison Control Centers (PCCs) in short periods of time. In order to plan and prepare for such public health emergencies, it is important for PCCs to assess their ability tohandle the surge in call volume and to examine how the unusually large number of calls could affect the level of services. On 26 January 2006, the New York City Poison Center experienced a sudden loss of telephone service.The disruption in telephone service led to the need to reroute calls from that geographical catchment area to the New Jersey Poison Information and Education System (NJPIES) for several hours.

Data from the New Jersey Poison Information and Education System was abstracted from the telephone switch's internal reporting system and the New Jersey Poison Information and Education System's electronic record system and processed with a standard spreadsheet application.

Compared to the same time and day in the previous week, the total number of calls received by the New Jersey Poison Information and Education System during the four hours after the disruption increased by 148%. A substantial rise in the number of calls was observed in almost every 15-minute increment during this four-hour (h) time period (with some of these increments increasing as much as 525%). Meanwhile, the percentage of calls answered by the New Jersey Poison Information and Education System decreased, and the percentage of calls abandoned during a 15-minute increment reached as high as 62%. Furthermore, the average time for handling calls was longer than usual in most of these 15-minute increments.

Limitations of the telephone technology, which impacted the ability of the New Jersey Poison Information and Education System to respond to the surge of calls, were observed. While the New Jersey Poison Information and Education System was able to handle the unusual increase of incoming calls using available poison specialists and staff, the experience gained from this natural experiment demonstrates the need for Poison Control Centres to have a pre-planned surge capacity protocol that can be implemented rapidly during a public health emergency. A number of challenges that Poison Control Centres must meet in order to have adequate surge capacity during such events were identified.