Chemicals disaster management and public health

Abstract

The release of chemicals may be the result of a natural or a man-made disaster. Hazardous materials involved in public health incidents most frequently contain irritants, and respiratory irritation is the most common health effect. Usually the release of hazardous materials is detected in an early stage and emergency response is organized around an incident location. In a silent release, victims may refer to healthcare facilities without an apparent event. The involvement and coordination of poison centers is often required to identify a common cause. To some extent all chemical disasters have a sociogenic component, which may in part be triggered by social media and require some specific communication strategies to mitigate the consequences. Available information from the event and from the involved victims determines an effective emergency response and the resulting impact. Fires and explosions cause most chemical intoxications. Support from environmental measurements and modeling can provide valuable information that can be used for interventions on the scene such as an evacuation. When health effects occur, this information can support on-site triage, support, and decontamination, followed by transportation of victims to a healthcare facility. Environmental monitoring and modeling can be complemented by results of analysis of body tissues and assessment of symptoms of intoxication made upon arrival in the hospital’s emergency department. Information that the victim can provide or that is accompanying the victim can directly be used for medical care and treatment. If patients are presented without contextual information, treatment could be inappropriate or delayed. Often symptoms are difficult to interpret and only basic supportive care is provided. Analysis of biological tissues may support early decision making concerning targeted medical response in addition to supportive treatment. Exposure indicators from the incident scene should be combined with results of the physical exam, including biomarker levels that confirm the identity of the chemical hazard. All of these activities should be in the direct interest of a rapid assessment of the patient’s situation, targeted treatment and risk communication.