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Medical Response to a Vinyl Chloride Release From a Train Derailment: New Jersey, 2012

Published online by Cambridge University Press:  06 March 2017

Alice M. Shumate ,
Jamille Taylor ,
Elizabeth McFarland ,
Christina Tan  and
Mary Anne Duncan
Alice M. Shumate*
Affiliation:
Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia New Jersey Department of Health, Trenton, New Jersey
Jamille Taylor
Affiliation:
CDC Experience Fellowship, Centers for Disease Control and Prevention, Atlanta, Georgia Division of Toxicology and Human Health Sciences, Agency for Toxic Substances and Disease Registry, Atlanta, Georgia
Elizabeth McFarland
Affiliation:
Inspira Medical Center, Woodbury, New Jersey
Christina Tan
Affiliation:
New Jersey Department of Health, Trenton, New Jersey
Mary Anne Duncan
Affiliation:
Division of Toxicology and Human Health Sciences, Agency for Toxic Substances and Disease Registry, Atlanta, Georgia
*
Correspondence and reprint requests to Alice M. Shumate, PhD, Centers for Disease Control and Prevention, 315 E. Montgomery Ave, Spokane, WA 99207 (e-mail: [email protected]).
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Abstract

Objective

The objective of this investigation was to examine the health impact of and medical response to a mass casualty chemical incident caused by a vinyl chloride release.

Methods

Key staff at area hospitals were interviewed about communication during the response, the number of patients treated and care required, and lessons learned. Clinical information related to the incident and medical history were abstracted from hospital charts.

Results

Hospital interviews identified a desire for more thorough and timely incident-specific information and an under-utilization of regionally available resources. Two hundred fifty-six hospital visits (96.2%) were at the facility closest to the site of the derailment. Of 237 initial visits at which the patient was examined by a physician, 231 patients (97.5%) were treated in the emergency department (ED) and 6 patients (2.5%) were admitted; 5 admitted patients (83.3%) had preexisting medical conditions. Thirteen of 14 asymptomatic ED patients were children under the age of 10 years. One hundred forty-five patients (62.8%) discharged from the ED were diagnosed solely with exposure to vinyl chloride.

Conclusions

Continuous emergency response planning might facilitate communication and better distribution of patient surge across hospitals. Individuals with multiple medical conditions and parents and caretakers of children may serve as target groups for risk communication following acute chemical releases. (Disaster Med Public Health Preparedness. 2017;11:538–544)

Keywords

chemical hazard releasevinyl chlorideemergency responsehospital response
Type
Original Research
Information
Disaster Medicine and Public Health Preparedness , Volume 11 , Issue 5 , October 2017 , pp. 538 - 544
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2017 

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References

1. US Census Bureau. Census data for Paulsboro, NJ. https://www.census.gov/quickfacts/table/PST045216/3457150,00. 2010. Cited December 8, 2014.Google Scholar
2. Agency for Toxic Substances and Disease Registry. Medical Management Guidelines for Vinyl Chloride (C2H3Cl). ATSDR website. http://www.atsdr.cdc.gov/MMG/MMG.asp?id=278&tid=51. Last updated October 21, 2014. Accessed June 27, 2016.Google Scholar
3. Centers for Disease Control and Prevention. Biological and chemical terrorism: strategic plan for preparedness and response. recommendations of the CDC Strategic Planning Workgroup. MMWR Morb Mortal Wkly Rep. 2000;49(RR-4):1-14.Google Scholar
4. Greenfield, RA, Slater, LN, Bronze, MS, et al. Microbiological, biological, and chemical weapons of warfare and terrorism. Am J Med Sci. 2002;323(6):326-340. https://doi.org/10.1097/00000441-200206000-00005.CrossRefGoogle ScholarPubMed
5. Langauer-Lewowicka, H, Kurzbauer, H, Byczkowska, Z, et al. Vinyl chloride disease neurological disturbances. Int Arch Occup Environ Health. 1983;52(2):151-157. https://doi.org/10.1007/BF00405418.CrossRefGoogle ScholarPubMed
6. Spirtas, R, McMichael, AJ, Gamble, J, et al. The association of vinyl chloride exposures with morbidity symptoms. Am Ind Hyg Assoc J. 1975;36(10):779-789. https://doi.org/10.1080/0002889758507339.CrossRefGoogle ScholarPubMed
7. Clark, DG, Tinston, DJ. Correlation of the cardiac sensitizing potential of halogenated hydrocarbons with their physicochemical properties. Br J Pharmacol. 1973;49(2):355-357. https://doi.org/10.1111/j.1476-5381.1973.tb08382.x.CrossRefGoogle ScholarPubMed
8. Oster, RH, Carr, CJ, Krantz, JC Jr, et al. Anesthesia XXVII. Narcosis with vinyl chloride. Anesthesiology. 1947;8(4):359-361. https://doi.org/10.1097/00000542-194707000-00003.CrossRefGoogle Scholar
9. Agency for Toxic Substances and Disease Registry. Toxicological profile for vinyl chloride. ATSDR website. http://www.atsdr.cdc.gov/ToxProfiles/tp.asp?id=282&tid=51. Last updated January 21, 2015. Accessed June 27, 2016.Google Scholar
10. Bosetti, C, La Vecchia, C, Lipworth, L, et al. Occupational exposure to vinyl chloride and cancer risk: A review of the epidemiologic literature. Eur J Cancer Prev. 2003;12(5):427-430. https://doi.org/10.1097/00008469-200310000-00012.CrossRefGoogle Scholar
11. Gennaro, V, Ceppi, M, Crosignani, P, et al. Reanalysis of updated mortality among vinyl and polyvinyl chloride workers: confirmation of historic evidence and new findings. BMC Public Health. 2008;8(1):21. https://doi.org/10.1186/1471-2458-8-21.CrossRefGoogle ScholarPubMed
12. Agency for Toxic Substances and Disease Registry. ACE ToolKit. ATSDR website. http://www.atsdr.cdc.gov/ntsip/ace_toolkit.html. Last updated June 21, 2016. Accessed June 27, 2016.Google Scholar
13. New Jersey Department of Health. Health Consultation: Surveys of Residents of Paulsboro, New Jersey Following a Train Derailment and Vinyl Chloride Gas Release. September 5, 2014 http://www.state.nj.us/health/ceohs/documents/eohap/haz_sites/gloucester/train_derail/survey_report.pdf. Accessed June 27, 2016.Google Scholar
14. Epi Info 7 [computer program] Atlanta, GA: Centers for Disease Control and Prevention, 2012.Google Scholar
15. Microsoft Excel [computer program] Redmond, WA: Microsoft, 2010.Google Scholar
16. Christensen, BE, Duncan, MA, King, SC, et al. Challenges during a chlorine gas emergency response. Disaster Med Public Health Prep. 2016;10(4):553-556. https://doi.org/10.1017/dmp.2016.6.CrossRefGoogle ScholarPubMed
17. Centers for Disease Control and Prevention. Assessment of emergency responders after a vinyl chloride release from a train derailment — New Jersey, 2012. Morb Mortal Wkly Rep. 2015;63(53):1233-1237.Google Scholar
18. Wilken, JA, Graziano, L, Vaouli, E, et al. Exposures and symptoms among workers after an offsite train derailment and vinyl chloride release. Am J Disaster Med. 2015;10(2):153-165. https://doi.org/10.5055/ajdm.2015.0198.CrossRefGoogle ScholarPubMed
19. Thriene, B, Benkwitz, Φ, Willer, H, et al. The chemical accident in Schönebeck – an assessment of health and environmental risks [in German]. Gesundheitswesen. 2000;62:34-38. https://doi.org/10.1055/s-2000-10309.CrossRefGoogle Scholar
20. Wenck, MA, Van Sickle, D, Drociuk, D, et al. Rapid assessment of exposure to chlorine released from a train derailment and resulting health impact. Public Health Rep. 2007;122(6):784-792.CrossRefGoogle ScholarPubMed