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Effects on Local Emergency Departments of Large-Scale Urban Chemical Fire With Hazardous Materials Spill

Published online by Cambridge University Press:  28 June 2012

Edbert B. Hsu ,
Jurek G. Grabowski ,
Rashid A. Chotani ,
Jason A. Winslow ,
Donald W. Alves  and
Michael J. VanRooyen
Edbert B. Hsu*
Affiliation:
Center for International Emergency, Disaster and Refugee Studies, Departments of Emergency Medicine and International Health, The Johns Hopkins University Medical Institutions, Baltimore, Maryland, USA
Jurek G. Grabowski
Affiliation:
Center for International Emergency, Disaster and Refugee Studies, Departments of Emergency Medicine and International Health, The Johns Hopkins University Medical Institutions, Baltimore, Maryland, USA
Rashid A. Chotani
Affiliation:
Center for International Emergency, Disaster and Refugee Studies, Departments of Emergency Medicine and International Health, The Johns Hopkins University Medical Institutions, Baltimore, Maryland, USA
Jason A. Winslow
Affiliation:
University of Maryland Medicine, Department of Emergency Medicine, Baltimore, Maryland, USA
Donald W. Alves
Affiliation:
University of Maryland Medicine, Department of Emergency Medicine, Baltimore, Maryland, USA
Michael J. VanRooyen
Affiliation:
Center for International Emergency, Disaster and Refugee Studies, Departments of Emergency Medicine and International Health, The Johns Hopkins University Medical Institutions, Baltimore, Maryland, USA
*
The Center for International Emergency, Disaster & Refugee Studies, Department of Emergency Medicine, The Johns Hopkins School of Medicine, 201 N. Charles Street, Suite 1400 Baltimore, MD 21201, USA E-mail: [email protected]
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Abstract

Introduction:

On 18 July 2001, a train hauling hazardous materials, including hydrochloric acid, hydrofluoric acid, and acetic acid, derailed in the city of Baltimore, Maryland, resulting in a fire that burned under a downtown street for five days. Firefighters were stymied in their efforts to extinguish the fire, and the city was subjected to thick smoke for several days.

Objectives:

To determine whether an urban chemical fire with a hazardous materials spill resulted in a detectable public health impact, and to demo-graphically describe the at-risk population for potential smoke and chemical exposure.

Methods:

The United States Centers for Disease Control and Prevention (CDC) was consulted about possible side effects from chemical exposure. Total numbers of emergency department (ED) patients and admissions from 15:00 hours (h), 15 July 2001 to 15:00 h, 21 July 2001 were collected from five local hospitals. Patient encounters citing specified chief complaints from 15:00 h, 15 July to 15:00 h, 18 July (pre-accident) were compared with the period from 15:00 h, July 18 to 15:00 h, 21 July (post-accident). Data were analyzed using Fisher's exact test. The United States Census Bureau's Topologically Integrated Geographic Encoding and Referencing (TIGER) digital database of geographic features and ArcView Geographic Information Systems (GIS) were used to create maps of Baltimore and to identify populations at-risk using attribute census data. Results: There were 62,808 people residing in the immediate, affected area. The mean of the values for age was 33.7 ±3.2 years (standard deviation; range = 16 yrs) with 49% (30,927) males and 51% (31,881) females. A total of 2,922 ED patient encounters were screened. Chief complaints included shortness of breath, pre-event = 109 vs. post-event = 148; chest complaints = 90 vs. 113; burns and/or skin irritation = 45 vs. 42; eye irritation 26 vs. 34; throat irritation = 33 vs. 27; and smoke exposure = 0 vs. 15. There was a statistically significant increase (p <0.05) for shortness of breath and smoke exposure-related complaints. No statistically significant increase in numbers of admitted patients with these complaints was found.

Conclusions:

In the setting of a large-scale urban chemical fire, local EDs can expect a significant increase in the number of patients presenting to EDs with shortness of breath and/or smoke inhalation. Most do not require inpatient hospitalization. Careful assessment of impact on local EDs should be considered in future city-accident planning. Some official warnings were widely misinterpreted or ignored. Public education on potential hazards and disaster preparedness targeted to populations at-risk should receive a high priority. Geographic information systems (GIS) may serve as useful tools for identifying demographics of populations at-risk for disaster planning and responses.

Keywords

chemicalemergencyemergency departmentdisasterdisaster preparednessfireGIShazardous materialshazmattrain
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 17 , Issue 4 , December 2002 , pp. 196 - 201
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2002

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References

1. Baltimore Sun: Available at http://www.sunspot.net/news/local/balmd.train26jul26.story Accessed 08 August, 2001.Google Scholar
2. Interviews with Baltimore city officials, 08–15 August, 2001.Google Scholar
3. US Census Bureau: Available at http://factfinder.census.gov/servlet. Accessed 28 September, 2002.Google Scholar
4. Baltimore Sun: Available at http://www.sunspot.net/news/local/balmd.train08sep08,0,1506154. Accessed 14 December, 2001.Google Scholar
5. National Transportation Safety Board: Available at http://www.ntsb.gov/railroad/railroad.htm Accessed 26 October, 2002.Google Scholar
6. Kales, SN, Castro, MJ, Christiani, DC: Epidemiology of materials responses by Massachusetts district HAZMAT teams. J Occup Environ Med 1996;38(4):394–400.CrossRefGoogle ScholarPubMed
7. Lillibridge, SR: Industrial Disasters. In: Noji EK. The Public Health Consequences of Disasters. New York, NY: Oxford University Press; 1997:354–372.Google Scholar
8. McCunney, RJ: Emergency response to environmental toxic incidents: The role of the occupational physician. Occup Med 1996;46(6):397–401.Google Scholar
9. Department of Transportation: Available at http://www.dot.gov Accessed 15 September, 2002.Google Scholar
10. Koehler, GA, Van Ness, C: The emergency medical response to the Cantara hazardous materials incident. Prehosp Disast Med 1993;8(4):359–365.CrossRefGoogle Scholar
11. Greenberg, MI, Cone, DC, Roberts, JR: Material safety data sheet: A useful resource for the emergency physician. Ann Emerg Med 1996;27(3):347–352.CrossRefGoogle ScholarPubMed
12. Cone, DC, Davidson, SJ: Hazardous materials preparedness in the emergency department. Prehosp Emerg Care 1997;1(2):85–90.CrossRefGoogle ScholarPubMed
13. Kales, SN, Polyhronopoulos, GN, Castro, MJ, et al: Injuries caused by hazardous materials accidents. Ann Emerg Med 1997;30(5):598–603.CrossRefGoogle ScholarPubMed
14. Lichterman, JA: Community as resource strategy for Disaster Response. Public Health Reports 2000; 115: 262–265.CrossRefGoogle ScholarPubMed
15. United for a Stronger America: A Citizens’ Preparedness Guide. Available at http://www.ojp.usdoj.gov/ojpcorp/cpg.pdf Accessed 20 –October, 2002.Google Scholar
16. Leonard, RB: Hazardous materials accidents: Initial scene assessment and patient care. Aviat Space Environ Med 1993;64(6):546–551.Google ScholarPubMed
17. Burgess, JL, Kovalchick, DF, Harter, L, et al: Hazardous materials events: Evaluation of transport to health care facility and evacuation decisions. Am J Emerg Med 2001;19(2):99–105.CrossRefGoogle ScholarPubMed
18. Gallanter, T, Bozeman, WP: Firefighter illnesses and injuries at a major fire disaster. Prehosp Emerg Care 2002;6(1):22–26.CrossRefGoogle Scholar
19. Levitin, HW, Siegelson, HJ: Hazardous materials. Disaster medical planning and response. Emerg Med Clin North Am 1996;14(2):327–348.CrossRefGoogle ScholarPubMed
20. DeLorenzo, RA, Augustine, JJ: Lessons in emergency evacuation from the Miamisburg train derailment. Prehosp Disast Med 1996;11(4):270–275.CrossRefGoogle ScholarPubMed
21. Contini, S, Belleza, F, et al: The use of geographic information systems in major accident risk assessment and management. J Hazard Mater 2000;78(1–3):223–245.CrossRefGoogle ScholarPubMed
22. Zeitz, P, Berkoqitz, Z, Orr, MF, et al: Frequency and type of injuries in responders of hazardous substances emergency events, 1996 to 1998. J Occup Environ Med 2000;42(11):1115–1120.CrossRefGoogle ScholarPubMed
23. Orr, MF, Kaye, WE, Zeitz, P, et al: Public health risks of railroad hazardous substance emergency events. J Occup Environ Med 2001;43(2):94–100.CrossRefGoogle ScholarPubMed
24. Greenberg, MI, Jurgens, SM, Gracely, EJ: Emergency department preparedness for the evaluation and treatment of victims of biological or chemical terrorist attack. J Emerg Med 2002;22(3):273–278.CrossRefGoogle ScholarPubMed
25. Murray, V, Goodfellow, F: Mass casualty chemical incidents—Towards guidance for public health management. Public Health 2002;116(1):2–14.CrossRefGoogle ScholarPubMed
26. Laurent, JF, Richter, F., Michel, A: Management of victims of urban chemical attack: The French approach. Resuscitation 1999;42(2):141–149.CrossRefGoogle ScholarPubMed
27. Garshnek, V, Burkle, FM: Telecommunications systems in support of disaster medicine: Applications of basic information pathways. Ann Emerg Med 1999; 34: 213–218.CrossRefGoogle ScholarPubMed