Rapid assessment of exposure to chlorine released from a train derailment and resulting health impact
| Autor: | Mary Anne Wenck, James J. Gibson, Amy Belflower, Veleta Rudnick, David Van Sickle, Daniel Drociuk, Richard J. K. Taylor, M. David Whisnant, Claire Youngblood |
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| Rok vydání: | 2007 |
| Předmět: |
Adult
Male Adolescent South Carolina Poison control Suicide prevention Occupational safety and health 03 medical and health sciences 0302 clinical medicine Injury prevention Medicine Humans Mass Casualty Incidents 030212 general & internal medicine Railroads Aged 030505 public health Trauma Severity Indices business.industry Medical record Research Public Health Environmental and Occupational Health Emergency department Environmental Exposure Middle Aged medicine.disease Relative risk Accidental Accidents Female Medical emergency Chlorine 0305 other medical science business |
| Zdroj: | Public health reports (Washington, D.C. : 1974). 122(6) |
| ISSN: | 0033-3549 |
| Popis: | Objectives. After a train derailment released approximately 60 tons of chlorine from a ruptured tanker car, a multiagency team performed a rapid assessment of the health impact to determine morbidity caused by the chlorine and evaluate the effect of this mass-casualty event on health-care facilities. Methods. A case was defined as death or illness related to chlorine exposure. Investigators gathered information on exposure, treatment received, and outcome through patient questionnaires and medical record review. An exposure severity rating was assigned to each patient based on description of exposure, distance from derailment, and duration of exposure. A case involving death or hospitalization ≥3 nights was classified as a severe medical outcome. Logistic regression was used to examine factors associated with severe medical outcomes. Results. Nine people died, 72 were hospitalized in nine hospitals, and 525 were examined as outpatients. Fifty-one people (8%) had a severe medical outcome. Of 263 emergency department visits within 24 hours of the incident, 146 (56%) were in Augusta, Georgia; at least 95 patients arrived at facilities in privately owned vehicles. Patients with moderate-to-extreme exposure were more likely to experience a severe medical outcome (relative risk: 15.2; 95% confidence interval 4.8, 47.8) than those with a lower rating. Conclusions. The rapid investigation revealed significant morbidity and mortality associated with an accidental release of chlorine gas. Key findings that should be addressed during facility, community, state, and regional mass-casualty planning include self-transport of symptomatic people for medical care and impact on health-care facilities over a wide geographic area. |
| Databáze: | OpenAIRE |
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