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Hazardous Substances Releases Causing Fatalities and/or People Transported to Hospitals: Rural/Agricultural vs. Other Areas

Published online by Cambridge University Press:  28 June 2012

Zahava Berkowitz ,
D. Kevin Horton  and
Wendy E. Kaye
Zahava Berkowitz*
Affiliation:
Agency for Toxic Substances and Disease Registry, Atlanta, Georgia
D. Kevin Horton
Affiliation:
Agency for Toxic Substances and Disease Registry, Atlanta, Georgia
Wendy E. Kaye
Affiliation:
Agency for Toxic Substances and Disease Registry, Atlanta, Georgia
*
Agency for Toxic Substances and Disease Registry, Division of Health Studies, Epidemiology and Surveillance Branch, 1600 Clifton Road, MS E-31, Atlanta, GA 30333, USA E-mail: zab3@cdc.gov
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Abstract

Introduction:

Mass-casualty and hospital preparedness has been analyzed widely. However, information regarding the types of areas where these events occur is limited. Therefore, the characteristics of acute hazardous substances releases resulting in death/multiple-victim events occuring in rural/agricultural areas and in all other areas were studied and compared. Methods: Data reported to the Hazardous Substances Emergency Events Surveillance (HSEES) system from 16 state health departments during 1993–2000 were used to examine factors associated with events with death/multiple victims involving acute release of hazardous substances. A death/multiple-victim event is defined as any event resulting in a death and/or at least five people being transported to a hospital.

Results:

Of a total of 43,133 events, 6,661 occurred in rural/agricultural areas. Of these, 107 were death/multiple-victim events with 632 victims, of whom 91 died and 77 were hospitalized. All other areas had 472 death/multiple-victim events with 7,981 victims, of whom 116 died and 413 were hospitalized. Death/multiple-victim events in rural/agricultural areas were more likely to be associated with transportation (Proportional Ratio (PR) = 4.1, 95% CI = 3.1–5.4) and fires and/or explosions (PR = 1.4, 95% CI = 0.95–2.0) than were death/multiple-victim events in all other areas. Among transportation-related events in rural/agricultural areas, 19 were associated with air transport—mainly crop dusters—and resulted in 18 deaths. Responders were three times more likely to be injured in rural/agricultural areas. Of responders, volunteer firefighters constituted 52% compared with 6.7% in all other areas. The most frequently released chemicals in rural/agricultural areas were ammonia, chlorine, and pesticides. In all other areas, ammonia, chlorine, hydrochloric acid, carbon monoxide, and 0-chlorobenzylidene malononitrile, a tearing agent often associated with an illegal or unauthorized act, were released most frequently.

Conclusions:

Findings from this analysis suggest that remedial actions should address safety measures in both transportation and fixed facilities containing acute hazardous substances. These include regular maintenance of equipment, education of workers about the substances used in their facility, rigorous training and licensing of drivers and crop duster operators, and education and training of employees and first responders in the use of protective equipment. These activities may reduce the number of events, casualties, and costs associated with hazardous substance events.

Keywords

acute releasescrop dusterexplosionfirefixed facility eventshazardous substancesrural/agricultural areatransportation related events
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 19 , Issue 3 , September 2004 , pp. 213 - 220
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2004

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References

1.National Response Center: Statistics: Incidence type, 1997–2002. Available at http://www.nrc.uscg.mil/incident97-02.html. Accessed 17 September 2003.Google Scholar
2.Tur-Kaspa, I, Lev, EI, Hendler, I et al. : Preparing hospitals for toxicological mass-casualties events. Crit Care Med 1999;27:1004–1008.CrossRefGoogle ScholarPubMed
3.Wetter, DC, Daniell, WE, Treser, CD: Hospital preparedness for victims of chemical or biological terrorism. Am J Public Health 2001;91(5):710–716.Google ScholarPubMed
4.Koelher, GA, Van Ness, C: The emergency medical response to the Cantara hazardous materials incident. Prehosp Disast Med 1993;8:359–365.CrossRefGoogle Scholar
5.Walter, FG, Dedolph, R, Kallsen, GW et al. : Hazardous materials incidents: A one-year retrospective review in central California. Prehosp Disast Med 1992;7:151–156.CrossRefGoogle Scholar
6.Hall, HI, Haugh, GS, Price-Green, PA et al. : Risk factors for hazardous substance releases that result in injuries and evacuations: Data from 9 states. Am J Public Health 1996;86(6):855–857.CrossRefGoogle ScholarPubMed
7.Berkowitz, Z, Barnhart, HX, Kaye, WE: Factors associated with severity of injury resulting from acute releases of hazardous substances in the manufacturing industry. J Occup Environ Med 2003;45(7):734–742.CrossRefGoogle ScholarPubMed
8.US Department of Transportation: 1996 North American Emergency Response Guidebook: A Guidebook for First Responders During the Initial Phase of a Hazardous Materials/Dangerous Good Incident. Washington: US Department of Transportation, Research and Special Programs Administration, 1996.Google Scholar
9.Federal Emergency Management Agency: A needs assessment of the US fire service. December 2002 [160 screens]. Available at http://usfa.fema.gov/inside-usfa/media/2003releases/03–014/shtm. Accessed 17 September 2003.Google Scholar
10.Burgess, JL, Kovalchick, DF, Siegel, EM et al. : Medical surveillance of clandestine drug laboratory investigators. J Occup Environ Med 2002; 44:184–189.CrossRefGoogle ScholarPubMed
11.Hanowski, RJ, Wierwille, WW, Dingus, TA: An on-road study to investigate fatigue in local/short haul trucking. Accid Anal Prev 2002;824:1–8.Google Scholar
12.Kuncyté, R, Laberge-Nadeau, C, Crainic, GT et al. : Organization of truckdriver training for the transportation of dangerous goods in Europe and North America. Accid Anal Prev 2002;829:1–9.Google Scholar
13.Clifton, JC, Leikin, JB, Hryhorczuk, DO et al. : Surveillance for carbon monoxide poisoning using a national media clipping service. Am J Emerg Med 2001;19:106–108.CrossRefGoogle ScholarPubMed
14.Ghiladucci, DP, Pirralo, RG, Hegmann, KT:Hazardous materials readiness in United States level 1 trauma centers. J Occup Environ Med 2000;42:683–692.CrossRefGoogle Scholar