Persons injured during acute chemical incidents—Hazardous Substances Emergency Events Surveillance, nine states, 1999-2008.

Problem/condition: Persons exposed to chemicals during acute chemical incidents (i.e., uncontrolled or illegal release or threatened release of hazardous substances lasting <72 hours) can experience both acute and chronic health effects. Surveillance of toxic substance incidents provides data that can be used to prevent future incidents and improve the emergency response to those that occur, leading to a decrease in morbidity and mortality from chemical releases.

Reporting period: 1999-2008 DESCRIPTION OF SYSTEM: The Hazardous Substances Emergency Events Surveillance (HSEES) system was operated by the Agency for Toxic Substances and Disease Registry (ATSDR) during January 1991-September 2009 to describe the public health consequences of chemical releases and to develop activities aimed at reducing the harm. This report summarizes the data collected on injured persons from the nine states (Colorado, Iowa, Minnesota, New York, North Carolina, Oregon, Texas, Washington, and Wisconsin) that participated in HSEES during its last 10 full years of data collection (1999-2008).

Results: A total of 57,975 chemical incidents were reported by these states during the 10-year surveillance period. In 4,621 (8%) of these incidents, 15,506 persons were injured. Among them, 354 deaths occurred. The most commonly reported category of injured persons included employees of the responsible party (7,616 [49%]), members of the general public (4,737 [31%]), students exposed at school (1,730 [11%]), and responders to the incident (1,398 [9%]). Deaths occurred among members of the general public (190 [54%]), employees (154 [44%]), and responders (10 [3%]). The most frequent health effects experienced as a result of these incidents included respiratory irritation (7,443), dizziness or central nervous system problems (3,186), and headache (3,167). The three chemicals associated with the largest number of persons injured were carbon monoxide (2,364), ammonia (1,153), and chlorine (763).

Interpretation: Company employees, followed by members of the general public, are frequently injured in acute chemical incidents. The chemicals most often associated with these injuries are carbon monoxide, ammonia, and chlorine, all of which are hazardous gases that can be found in various locations including schools and homes. Respiratory irritation is the most common health effect. PUBLIC HEALTH IMPLICATIONS: By understanding the types of persons injured in chemical release incidents, as well as how they are injured and the injuries sustained, prevention outreach activities can be focused to protect the health of these groups in the future. Improved awareness among and training for not just employees but also the public is needed, particularly regarding carbon monoxide, ammonia, and chlorine. Appropriate measures to provide protection from respiratory effects of chemical incidents could prevent injuries.