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Annual Report 2009

Historical Document

This document is provided by the Agency for Toxic Substances and Disease Registry (ATSDR) ONLY as an historical reference for the public health community. It is no longer being maintained and the data it contains may no longer be current and/or accurate.

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    In 1980, Congress created the Agency for Toxic Substances and Disease Registry (ATSDR) to implement health-related sections of laws that protect the public from hazardous wastes and environmental spills of hazardous substances. The Comprehensive Environmental Response, Compensation, and Liability Act of 1980 (CERCLA), commonly known as the Superfund Act, designated ATSDR as the lead agency within the U.S. Public Health Service to help prevent or reduce further exposure to hazardous substances and the adverse health effects that might result from such exposures, and to expand the knowledge base about such effects.

    In accordance with this legislative mandate, this publication reports results and findings of health studies, registries, or other health-related activities supported by ATSDR.

    Comments regarding this report are welcome. Please send your comments to the following address:

    Agency for Toxic Substances and Disease Registry
    Attn: Director, Division of Health Studies (F-57)
    4770 Buford Highway, NE Atlanta, Georgia 30341

    Centers for Disease Control and Prevention
    Thomas Frieden, MD, MPH, Director

    Agency for Toxic Substances and Disease Registry
    Christopher Portier, PhD, Director

    Division of Health Studies
    G. David Williamson, PhD, Director
    Caroline McDonald, BS, Deputy Director
    Anne Sowell, PhD, Assistant Director for Science

    Surveillance and Registries Branch
    D. Kevin Horton, DrPH, MSPH, Branch Chief

    Hazardous Substances Emergency Events Surveillance Staff
    Ayana R Anderson, MPH
    Mary Anne Duncan, DVM, MPH
    Nelda Godfrey
    Natalia Melnikova, MD, PhD
    Maureen Orr, MS
    Perri Zeitz Ruckart, MPH
    Jennifer Wu, MS

    DISCLAIMER
    The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the Agency for Toxic Substances and Disease Registry.
     
     
     

    List of Figures and Tables



    Executive Summary


    Overview
    The Agency for Toxic Substances and Disease Registry (ATSDR) maintained the Hazardous Substances Emergency Events Surveillance (HSEES) system from 1990 to 2009. The program ended in June 2009 and was replaced by the National Toxic Substance Incidents Program (NTSIP). Six HSEES states funded by NTSIP continued to collect HSEES data through the end of 2009. Under HSEES, state health departments collected information on the public health consequences of acute hazardous substance incidents. These data facilitated national, state, and local preparedness activities for prevention of, and response to, hazardous substance threats. This report summarizes the 3,458 events reported by 13 states during the first half of 2009, the 1,352 events reported by 6 states during the second half of 2009, and the major activities performed by the state programs in 2009.

    Substances
    • From January 1 to June 30, 2009, 4,074 substances were released or threatened to be released during 3,458 events in 13 states. In this period, the categories of “Volatile organic substance,” “Other inorganic substance,” “Mixture across chemical category,” and “Acids.” accounted for 51.0% of the hazardous substances releases reported.
    • From July 1 to December 31, 2009, 1,673 substances were released or threatened to be released during 1,352 events in six states. In this period, the categories of “Volatile organic substance,” “Other inorganic substances,” and “Acids.” accounted for 50.3% of the hazardous substances releases reported.
    Victims
    • From January 1 to June 30, 439 of 3,458 events (12.7%) resulted in 1,050 victims, of whom 44 died. From July 1 to December 31, 129 of 1,352 events (9.5%) resulted in 319 victims, of whom 8 died.
    • Throughout the year, the four most frequently reported health effects attributed to events were
      • respiratory irritation,
      • headaches,
      • gastrointestinal symptoms, and
      • dizziness and other central nervous system symptoms.
    • From January 1 to June 30, 2009, 97 of 475 employee-victims (20.4%) and 33 of 59 responder-victims (55.9%) used personal protective equipment (PPE) during events. PPE use was unknown for 47 employee-victims and 4 responder-victims. Of the 1,008 victims for whom decontamination status was known, 748 (74.2%) were not decontaminated.
    • From July 1 to December 31, 2009, 1 of 133 employee-victims (0.8%) and 4 of 12 responder-victims (33.3%) used personal PPE during events. PPE use was unknown for 21 employee-victims. Of the 293 victims for whom decontamination status was known, 209 (71.3%) were not decontaminated.
    Evacuation and Sheltering
    • Evacuation was ordered in 260 (7.6%) events reported from January 1 to June 30 and in 121 (8.9%) events reported from July 1 to December 31.
    • In-place sheltering was ordered in 34 (1.0%) events reported from January 1 to June 30 and in 6 (0.4%) events reported from July 1 to December 31.

    Introduction


    Background
    The Centers for Disease Control and Prevention (CDC) defines surveillance as the

    "“ ...ongoing, systematic collection, analysis, and interpretation of health data essential to the planning, implementation, and evaluation of public health practice, closely integrated with the timely dissemination of these data to those who need to know. The final link of the surveillance chain is the application of these data to prevention and control. A surveillance system includes a functional capacity for data collection, analysis, and dissemination that is linked to public health programs.” [1]

    From 1990 through September 2009, the Agency for Toxic Substances and Disease Registry (ATSDR) maintained the active, state-based Hazardous Substances Emergency Events Surveillance (HSEES) system to determine the public health consequences of hazardous substance releases.

    The decision to initiate this surveillance system was based on a 1989 study about the reporting of hazardous substances releases to three national databases: the National Response Center Database, the Hazardous Material Information System (HMIS), and the Acute Hazardous Events Database.[2] The study revealed database limitations, among which were specific reporting requirements that excluded many events, (for example, the HMIS, did not record events involving intrastate carriers or fixed facilities). Other important information, such as the demographic characteristics of victims, types of injuries sustained, and number of persons evacuated, was not recorded. Subsequently, ATSDR implemented the HSEES system to describe more fully the public health consequences of hazardous substances releases and to support informed prevention activities.

    The HSEES goals were to:

    • describe the distribution and characteristics of acute hazardous substance releases,
    • describe illness or injuries and deaths among employees, responders, and the general public caused by hazardous substances releases, and
    • develop strategies that might reduce illness or injury and deaths caused by hazardous substances events.

    A surveillance system is more than a data repository; the data must be appropriate and useful for public health interventions. Each participating state was to use its collected data to promote public health within its jurisdiction by developing appropriate prevention outreach activities and developing evaluation tools to measure program effectiveness.

    Purpose
    This report provides an overview of HSEES activities in the states participating in 2009. It summarizes the characteristics of events surrounding acute hazardous substances releases and the associated public health consequences. It also demonstrates how the data were applied to prevention activities to protect public health.


    Methods

    Description
    From January 1, 2009 through June 30, 2009, 13 state health departments participated in HSEES: Colorado, Florida, Iowa, Louisiana, Michigan, Minnesota, North Carolina, New York, Oregon, Texas, Utah, Washington, and Wisconsin (Figure 1). From July 1, 2009 through December 31, 2009, the new NTSIP program funded six of the HSEES states. These states, Louisiana, North Carolina, New York, Oregon, Texas and Wisconsin, continued to collect data. This report presents results for the first and the second halves of 2009 separately. Information was collected about each event, including substance(s) released, victims, adverse health effects and illness symptoms, evacuations, sheltering in place, and decontamination.

    Figure 1. HSEES Participating States, 2009*

    Figure 1. HSEES Participating States, 2009*
    * States participants for January 1 -June 30, 2009 shown in pink. States participating January 1 – December 21, 2009 shown in textured pink

    Data Sources
    Event information came from various data sources, including records and oral reports of state environmental protection agencies, the U.S. Department of Transportation, the National Response Center, police and fire departments, and hospitals. U.S. Census Bureau data were used to estimate the number of residents in the vicinity of events. Using a standardized data collection form, all data were entered into an Internet-based system provided by ATSDR.

    Definitions
    A hazardous substances emergency event was an acute, uncontrolled, or illegal release or threatened release of hazardous substances. Threatened releases were imminent releases that did not occur but lead to a public health action (e.g., evacuation) potentially affecting the health of employees, emergency responders, or members of the general public.

    Transportation events occurred during surface, air, pipeline, or water transport of hazardous substances and before completion of unloading of the substances from a vehicle or vessel; all other events were considered fixed-facility events. An event could involve several types of releases: spill, volatilization/aerosolized (vapor), fire, explosion, or any combinations.

    A victim was a person who experienced at least one documented adverse health effect within 24 hours after an event or who died as a consequence of an event. Victims were categorized into one of four population groups: employees, general public, responders, and students. Responders were further subcategorized as firefighters, police officers, Emergency Medical Team and hospital personnel, members of company response team, third party clean up contractors, or not specified responders. Victims could have more than one symptom or type of adverse health effect.

    Personal Protective Equipment (PPE) is clothing and equipment worn to protect the wearer from exposures. There are four categories of PPE:

    • Level A: The most protective. This type of equipment is used when greatest level of skin, respiratory and eye protection is required.
    • Level B: Used when the highest level of respiratory protection is necessary, but a lesser level of skin protection.
    • Level C: Used when the concentration(s) and type(s) of airborne substance(s) are known, and the criteria for using air purifying respirators are met.
    • Level D: A work uniform affording minimal protection and used for nuisance contamination only.

    Firefighter turnout gear is a commonly reported type of protective gear. This is not part of the four OSHA categories of PPE. Firefighters wear this protective clothing during structural firefighting operations, and it is considered to be Level D protection. To obtain a detailed description of the different levels of personal protective equipment refer to www.osha.gov.

    Decontamination is the removal of contamination by removing contaminated clothing and rinsing the contaminated area with water (or another approved rinse agent). People need to be decontaminated only if they have chemicals on their clothing or bodies which could cause health effects or contribute to secondary contamination (i.e., spread of substance from person to person causing health effects).

    Reporting Requirements:
    States were required to report any release in which the amount of substance released—or that might have been released—was greater than 10 pounds or 1 gallon, or, for substances on the HSEES mandatory reporting list, the release of any amount.

    Smoke stack emissions with values of carbon monoxide (CO), sulfur oxides (SOX), and/or nitrogen oxides (NOX) above permitted levels were not reported: these emissions rarely cause acute public health effects. Petroleum-only releases (e.g., crude oil, gasoline) were also excluded.

    RESULTS

    Because different HSEES states collected data for the periods January 1 – June 30 and July 1 – December 31, 2009, the data are presented separately.

    PART I
    HAZARDOUS SUBSTANCES EMERGENCY EVENTS SURVEILLANCE,
    JANUARY 1-JUNE 30, 2009

    Events
    From January 1 to June 30, 2009 3,458 acute hazardous substances events in 13 states met the criteria for inclusion in HSEES. Over 68% (n=2,361) of these events, occurred in fixed facilities and about 32% (n=1,087) of events occurred during transportation. Washington did not report the type for 10 events. Three states, Texas, New York and Louisiana, accounted for about half, 50.7% (n=1,753) of all events (Table 1a).


    Table 1a. Number of Reported HSEES Incidents, by State and Type of Event. January 1 June 30, 2009

    STATE
    Fixed Facility
    Transportation
    Total Events
    Number of Events
    *%
    Number of Events
    *%
    Colorado
    32
    28.8
    79
    71.2
    111
    Florida
    208
    82.5
    44
    17.5
    252
    Iowa
    135
    74.2
    47
    25.8
    182
    Louisiana
    351
    83.6
    69
    16.4
    420
    Michigan
    132
    76.7
    40
    23.3
    172
    Minnesota
    167
    64.7
    91
    35.3
    258
    North Carolina
    61
    41.8
    85
    58.2
    146
    New York
    402
    75.7
    129
    24.3
    531
    Oregon
    61
    54.5
    51
    45.5
    112
    Texas
    597
    74.4
    205
    25.6
    802
    Utah
    62
    43.4
    81
    56.6
    143
    Washington
    90
    54.5
    75
    45.5
    *165
    Wisconsin
    63
    40.9
    91
    59.1
    154
    Total
    2,361
    68.3
    1,087
    31.7
    *3,448
    * Type of event missing for 10 events from Washington

    Fixed Facility Events
    For each fixed-facility event, reporters could select one or two areas (specific location at the fixed facility where the event occurred) or types of equipment involved in accordance with the North American Industry Classification System (NAICS)[3] industry categories. Of 2,361 fixed-facility events, single area was reported for 1,014 (42.9%) events and a combination of two areas was reported for 200 (8.5%) events. For 1,147 (48.6%) events, area type was not reported. The main areas of fixed facility events were ancillary processing equipment, piping, process vessel, storage above ground, and process vessel along with ancillary processing equipment (Figure 2a).

    Figure 2a. Areas of Fixed Facilities Involved in Reported HSEES Events. January 1 -June 30, 2009

    Figure 2a. Areas of Fixed Facilities Involved in Reported HSEES Events. January 1 -June 30, 2009

    Transportation Events
    Most (87.3%) transportation events occurred during ground transport (e.g., truck, van, tractor), and 8.7% occurred during rail transport. Fewer events occurred during water (2.0%), pipeline (1.1%), air (0.8%), or multiple transportation modes (0.1%).

    Most transportation-related events involved en route releases discovered after arrival at a fixed facility (37.2%), releases from a moving vehicle or vessel (27.8%), or occurred during vehicle/vessel unloading (24.3%). Fewer events involved a stationary vehicle or vessel (10.1%). The transportation phase during which the release occurred was not reported for 0.5% of events.

    Timing of Events
    The number of events per month ranged from 483 (13.9%) in February to 651 (18.8%) in May with the spring and summer months (April-June) having the highest number of events (Figure 3a).

    About 85% of events occurred on a weekday and 15% on the weekend. Most events occurred during daytime business hours. Of the 3,136 events for which time of day was reported:

    • 33.9% occurred from 6:00 a.m. to 11:59 a.m.
    • 32.9% occurred from 12:00 noon to 5:59 p.m.
    • 18.4% occurred from 6:00 p.m. to 11:59 p.m.
    • 14.7% occurred from midnight to 5:59 a.m.

    Figure 3a Number of Reported HSEES Events by Month.
    January 1 - June 30, 2009

    Figure 2a. Areas of Fixed Facilities Involved in Reported HSEES Events. January 1 -June 30, 2009

    Contributing Factors
    Contributing factors were reported as either primary (root) or secondary causes. Primary factors were reported for 3,401 (98.4%) events (Figure 4a). Equipment failure and human error were the leading primary factors. Primary factors differed by location: for fixed-facility events the leading factor was equipment failure; for transportation-related events the leading factor was human error.

    Secondary factors were reported for 1,859 events (Figure 4b). The most frequently reported secondary factor was improper filling, loading, or packing (n=439); the second most frequently reported secondary factor was system/process upset (n=266).

    Secondary factors were reported for 1,167 fixed facility events and 692 transportation events. For fixed-facility events, the most frequently reported secondary factor was system/process upset (n=258). For transportation-related events, the most frequently reported secondary factors were improper filling, loading, or packing (n=356) and forklift puncture (n=75).

    Figure 4a. Primary Factors Reported as Contributing to HSEES Events, by Type of Event, January 1– June 30, 2009

    Figure 2a. Areas of Fixed Facilities Involved in Reported HSEES Events. January 1 -June 30, 2009

    Figure 4b. Secondary Factors Reported as Contributing to HSEES Events, by Type of Event. January 1 - June 30, 2009

    Figure 2a. Areas of Fixed Facilities Involved in Reported HSEES Events. January 1 -June 30, 2009

    Industries
    Industries were categorized using NAICS classifications. The largest number of HSEES events was associated with manufacturing (NAICS 31-33, n=1,089) and transportation and warehousing (NAICS 48-49, n=990) (Table 2a).

    The largest proportion of events in a single industry category (27.2%, n=939) was associated with NAICS 32 (Manufacturing) that covers wood, paper, printing, petroleum and coal, chemical, plastic and rubber, and nonmetallic mineral manufacturing.

    The largest number of victims (n=228) was associated with NAICS 81 (Other services). The second largest number of victims (n=141) was associated with NAICS 31 (Manufacturing) that covers food, beverage, tobacco, textile, apparel, and leather and allied products manufacturing.

    Although the largest proportion of events was associated with the industry categories NAICS 32 (Manufacturing) and NAICS 48 (Transportation and Warehousing), only a small portion of those events (3.0% and 2.2% respectively) involved victims. By contrast, although NAICS 81 (Other Services) accounted for only 8.5% of all events, 51.4% of events from that industry involved victims, accounting for 21.7% of all victims.


    Table 2a. Industries Involved in Reported HSEES Events, by Category

    Industry Category
    Total Events
    Victims
    2-digit NAICS Classification*
    Number of events
    % of Events
    Number of events with victims
    Total number of victims
    (11) Agriculture, Forestry, Fishing and Hunting
    110
    3.2
    16
    17
    (21) Mining
    30
    0.9
    3
    3
    (22) Utilities
    166
    4.8
    12
    58
    (23) Construction
    26
    0.8
    6
    7
    (31) Manufacturing
    151
    2.1
    24
    81
    (32) Manufacturing
    85
    2.5
    20
    141
    (33) Manufacturing
    65
    1.9
    9
    9
    (42) Wholesale Trade
    103
    2.9
    9
    9
    (44) Retail Trade
    39
    1.1
    8
    28
    (45) Retail Trade
    14
    0.4
    4
    51
    (48) Transportation and Warehousing
    856
    24.8
    19
    29
    (49) Transportation and Warehousing
    134
    3.9
    5
    19
    (51) Information
    4
    0.1
    1
    7
    (52) Finance and Insurance
    5
    0.1
    2
    40
    (53) Real Estate and Rental and Leasing
    57
    1.7
    15
    32
    (54) Professional, Scientific, and Technical Services
    15
    0.4
    3
    11
    (55) Management of Companies and Enterprises
    3
    0.1
    0
    0
    (56) Administrative, Support, Waste Management  and Remediation Services
    52
    1.5
    7
    11
    (61) Educational Services
    71
    2.0
    25
    54
    (62) Health Care and Social Assistance
    44
    1.2
    15
    50
    (71) Arts, Entertainment, and Recreation
    23
    0.7
    8
    37
    (72) Accommodation and Food Services
    39
    1.1
    15
    36
    (81) Other Services
    294
    8.5
    151
    228
    (92) Public Administration
    36
    1.0
    5
    17
    Not an Industry
    248
    7.2
    56
    106
    Total
    3,458
    100.0
    439
    1,050
    * U.S. Census Bureau North American Industry Classification System 2002 www.census.gov/epcd/naics02/naicod02.htm).
    31 Includes food, beverage, tobacco, textile, apparel, and leather and allied products manufacturing
    32 Includes wood, paper, printing, petroleum and coal, chemical, plastic and rubber, and non-metallic mineral manufacturing
    33 Includes metal, machinery, electronics, appliances, transportation equipment, furniture and miscellaneous manufacturing
    44 Includes motor vehicle, furniture and home furnishings, electronics and appliances, building materials and garden equipment, food & beverages, health and personal care, gasoline, and clothing & accessories
    45 Includes sporting goods, hobby, book and music supplies, general merchandise, and miscellaneous
    48 Includes transportation by air, rail, water, truck, transit and ground passenger, pipeline, scenic and sightseeing, and transportation support activities.
    49 Includes postal service, couriers and messengers, and warehousing and storage.

    Substances
    Of the 4,074 substances involved in events reported to HSEES from January 1 to June 30, 2009, 92.1% actually were released and 7.9% were threatened releases. The majority of events, 3,189, involved only one substance. One hundred and fifty nine events involved two substances, and 100 events involved more than two substances (Table 3a). Two or more substances were released in 7.7% of fixed-facility events and in 7.2% of transportation events.

    Table 3a. Number of Substances Involved per Reported HSEES Event, by Type of Event, January 1 – June 30, 2009

    Number of substances

    Type of event

    All events

    Fixed facility

    Transportation

    Number of events

    %

    Total substances

    Number of events

    %

    Total substances

    Number of events

    %

    Total
    Substances

      1

    2,180

    92.3

    2180

    1,009

    92.8

    1009

    3,189

    92.5

    3,189

      2

    91

    3.9

    182

    68

    6.3

    136

    159

    4.6

    318

      3

    48

    2.0

    144

    5

    0.5

    15

    53

    1.5

    159

      4

    17

    0.7

    68

    2

    0.2

    8

    19

    0.5

    76

    >=5

    25

    1.1

    305

    3

    0.3

    17

    28

    0.8

    322

    Total

    2,361

    100.0

    2,879

    1,087

    100.1

    1185

    3,448*

    99.9 §

    4,064
    § Total percentage doesn’t equal 100 due to rounding
    *10 events are missing due to missing information on type of event.

    The five substances most frequently released or threatened to be released in the order of frequency were ammonia, carbon monoxide, sodium hydroxide, paint not otherwise specified, and hydrochloric acid (Table 4a).

    Table 4a. Substances Most Frequently Released or Threatened to Be Released in Reported HSEES Events, January 1-June 31, 2009

    Rank

    Substance

    Number Events

    1

    Ammonia

    239

    2

    Carbon monoxide

    169

    3

    Sodium hydroxide

    135

    4

    Paint  NOS*

    130

    5

    Hydrochloric acid

    123

    6

    Chlorine

    89

    7

    Ethylene glycol

    87

    8

    Mercury

    82

    9

    Paint or coating NOS*

    69

    10

    Sulfuric acid

    64

    11

    Sulfur dioxide

    62

    12

    Benzene

    61

    13

    Vinyl chloride

    59

    14

    Methamphetamine chemicals NOS*

    54

    15

    Chlorodifluoromethane

    52

    16

    Ethylene

    50

    17

    Hydrogen sulfide

    42

    18

    Volatile organic compounds NOS*

    41

    19

    Sulfuric acid

    34

    20

    Polychlorinated biphenyls

    32
                    *NOS=Not Otherwise Specified.

    The most frequent substance categories in fixed facility events were volatile organic compounds (20.2%), other inorganic substances (15.2%), and mixture across chemical category (12.9%), (Table 5a). In transportation-related events, the most common categories were acids (16.6%), volatile organic compounds (14.9%), and paints and dyes (13.6%).

    One release type was reported for 3,199 single substance releases: spills (n=1,911), air (n=1,163), threatened release (n=66), fire (n=27), and explosion (n=11). The release types for 21 substances were missing. Two release types were reported for 115 chemicals in the following combinations: spill and air (n=85), spill and fire (n=8), air and fire (n=10), fire and explosion (n=6), spill and explosion (n=3), air and explosion (n=3).

    Table 5a. Number of Substances Involved by Substance Category, and Type of Reported HSEES Event, January 1 - June 30, 2009


    Substance Category Type of Event All events

    Fixed facility

    Transportation

    Event type missing

    N

    %

    N

    %
    N

    %

    N

    %

    Acids

    203

    7.1

    197

    16.6
    0
    0.0

    400

    9.8

    Agricultural chemicals, pesticides

    106

    3.7

    109

    9.2
    0
    0.0

    215

    5.3

    Ammonia

    231

    8.0

    30

    2.5
    0
    0.0

    261

    6.4

    Bases

    92

    3.2

    156

    13.2
    0
    0.0

    248

    6.1

    Category not assigned

    12

    0.4

    2

    0.2
    0
    0.0

    14

    0.3

    Carbon monoxide

    156

    5.4

    4

    0.3
    9
    90.0

    169

    4.1

    Chlorine

    122

    4.2

    22

    1.9
    0
    0.0

    144

    3.5

    Formulations

    7

    0.2

    1

    0.1
    0
    0.0

    8

    0.2

    Hetero-organics

    16

    0.6

    14

    1.2
    0
    0.0

    30

    0.7

    Hydrocarbons

    44

    1.5

    20

    1.7
    0
    0.0

    64

    1.6

    Mixture across chemical category*

    370

    12.9

    32

    2.7
    0
    0.0

    402

    9.9

    Other †

    201

    7.0

    67

    5.7
    1
    10.0

    269

    6.6

    Other inorganic substances ‡

    438

    15.2

    79

    6.7
    0
    0.0

    517

    12.7

    Oxy-organics

    134

    4.7

    88

    7.4
    0
    0.0

    222

    5.4

    Paints and dyes

    61

    2.1

    161

    13.6
    0
    0.0

    222

    5.4

    PCB's

    31

    1.1

    8

    0.7
    0
    0.0

    39

    1.0

    Polymers

    75

    2.6

    19

    1.6
    0
    0.0

    94

    2.3

    Volatile organic compounds

    580

    20.2

    176

    14.9
    0
    0.0

    756

    18.6

    Total

    2,879

    100.1§

    1,185

    100.2§

    10

    100.0

    4,074

    100.0
    *Substances from different categories that were mixed or formed from a reaction before the event.
    †Not belonging to one of the existing categories.
    ‡All inorganic substances except for acids, bases, ammonia, and chlorine.
    § Total percentage doesn’t equal 100 due to rounding

    Victims
    There were 1,050 victims involved in 439 events (12.7% of all events) (Table 6a). Of these events, 299 had only one victim. One mass casualty event occurred, involving 53 victims. Most victims (90.9%) were injured in fixed-facility events. Transportation-related events were more likely to have two or more victims (44.0%) than fixed facility events (30.4%).

    Table 6a. Number of Victims per Reported HSEES Event, by Type,
    January 1 - June 30, 2009

    Number of Victims per Event Type of Event All Events
    Fixed Facility Transportation Number of Events % Total
    Victims

    Number of  Events

    %

    Total Victims

    Number of Events

    %

    Total Victims

    1

    271

    40

    271

    28

    56.0

    28

    299

    68.1

    299

    2

    40

    10.3

    80

    15

    30.0

    30

    55

    12.5

    110

    3

    21

    5.4

    63

    2

    4.0

    6

    23

    5.2

    69

    4

    17

    4.4

    68

    1

    2.0

    4

    18

    4.1

    72

    5

    8

    2.1

    40

    1

    2.0

    5

    9

    2.1

    45

    >=6

    32

    8.2

    432

    3

    6.0

    23

    35

    8.0

    455

    Total

    389

    §100.1

    954

    50

    100.0

    96

    439

    100.0

    1,050
    §Total percentage doesn’t equal 100 due to rounding

    Substance Category and Victims
    Events were classified by only one substance category, regardless of whether multiple substances were involved. If multiple substances from the same category were involved, that category was used for the event. If multiple substances from different categories were involved, the event was categorized as “multiple substances”.

    To judge the relative threat of a substance, we looked at the percentage of events in that substance category with victims (Table 7a). The most frequently released substances were not necessarily those most likely to involve victims. For example, events categorized as VOCs were reported more often than were events in any other category (13.8%), but only 3.1% of VOCs events involved victims. Chlorine accounted for only 4.0% of all events and 9.8% of all victims, yet 31.2% of chlorine events resulted in victims. Carbon monoxide accounted for 4.5% of events. However, 45.2% of all Carbone monoxide events resulted in victims. A high proportion of ammonia (19.4%) and acids (15.9) related events also resulted in victims.

    Table 7a. Frequency of Substance Categories in All Reported HSEES Events and Events with Victims, January 1 – June 30, 2009

    Substance Category

    All Events

    Events with victim

    Number

    %

    Number

    %  of all events
    with victims

    %  of events in substance category with victims

    Category not assigned

    13

    0.4

    2

    0.5

    15.4

    Acids

    328

    9.5

    52

    11.8

    15.9

    Ammonia

    247

    7.1

    48

    10.9

    19.4

    Bases

    212

    6.1

    30

    6.8

    14.2

    Carbon Monoxide

    157

    4.5

    71

    16.2

    45.2

    Chlorine

    138

    4.0

    43

    9.8

    31.2

    Formulations

    7

    0.2

    0

    0.0

    0.0

    Hetero-organics

    22

    0.6

    2

    0.5

    9.1

    Hydrocarbons

    30

    0.9

    1

    0.2

    3.3

    Mixture across chemical category

    391

    11.3

    55

    12.5

    14.1

    Multi-substance

    259

    7.5

    27

    6.2

    10.4

    Other&

    184

    5.3

    23

    5.2

    12.5

    Other inorganic substances&&

    312

    9.0

    25

    5.2

    12.5

    Oxy-organics

    188

    5.4

    19

    4.3

    10.1

    Paints and dyes

    180

    5.2

    1

    0.2

    0.6

    PCBs

    38

    1.1

    0

    0.0

    0.0

    Pesticides

    192

    5.6

    23

    5.2

    12.0

    Polymers

    82

    2.4

    2

    0.5

    2.4

    Volatile organic compounds

    478

    13.8

    15

    3.4

    3.1

    Total

    3,548

    99.9&

    439

    99.9&

    12.7
    & Not belonging to one of the existing categories.
    &&All inorganic substances except for acids, bases, ammonia, and chlorine.
    §Total percentage doesn’t equal 100 due to rounding

    Victim’s sex
    Sex was known for 955 (91.0%) of the 1,050 victims reported from January 1 to June 30, 2009. Of these, 555 (58.1%) were male. Of the 475 employees for whom sex was reported, 287 (60.4%) were male. Of the 390 members of the public for whom sex was reported, 203 (52.1%) were male. Of the 66 responders for whom sex was reported, 51 (77.3%) were male. Of the 24 students for whom sex was reported, 14 (58.3%) were male.

    Victim’s age
    The median age of the 755 victims for whom an exact age was reported was 36 years (range 0–95 years). The age distribution for these victims was:

    • 2.9% were < 5 years of age
    • 7.4% were 5–14 years of age
    • 5.6% were 15–19 years of age
    • 53.0% were 20–44 years of age
    • 26.5% were 45–64 years of age
    • 4.6% were = 65 years of age

    Figure 5a shows the distribution of victims by population group and type of event. Employees (n=522) constituted the largest proportion of the population groups affected, followed by members of the public (n=422).


    Figure 5a. Number of Victims, by Population Group and Type of Reported HSEES Event, January 1 – June 30, 2009

    Figure 5a. Number of Victims, by Population Group and Type of Reported HSEES Event, January 1 – June 30, 2009

    In fixed-facility events, 65 responders were injured, with volunteer firefighters being the most frequent (Figure 5b). In transportation-related events, 13 responders were injured: 10 EMT/Hospital personnel, 2 police officers, and 1 professional firefighter.

    Figure 5b. Distribution of Responders Injured in Reported Fixed Facility HSEES Events,January 1 – June 30, 2009

    Figure 5b. Distribution of Responders Injured in Reported Fixed Facility HSEES Events, January 1 –June 30, 2009

    Injuries
    A total of 1,682 injuries or symptoms were reported (Table 8a). Some victims had more than one injury or symptom. Of all reported injuries or symptoms, the most common in fixed-facility events were respiratory tract irritation (28.0%), headaches (14.3%), gastrointestinal symptoms (13.4%), dizziness or other central nervous system symptoms (11.8%), and eye irritation (10.7%). In transportation-related events, trauma (25.4%), respiratory tract irritation (23.1%), and eye irritation (13.4%) were reported most frequently.

    Table 8a. Frequency of Injuries and Symptoms, by Type of Reported HSEES Event,January 1 – June 30, 2009


    Type of Injury/Symptom

    Fixed facility

    Transportation

    All events

    Number of injuries/
    symptoms

    %

    Number of injuries/
    symptoms

    %

    Number of injuries/
    symptoms

    %

    Burns

    98

    6.3

    9

    6.7

    107

    6.4

    Dizziness/Central Nervous System Symptoms

    183

    11.8

    8

    6.0

    191

    11.4

    Eye Irritation

    166

    10.7

    18

    13.4

    184

    10.9

    Gastrointestinal

    208

    13.4

    9

    6.7

    217

    12.9

    Headache

    221

    14.3

    5

    3.7

    226

    13.4

    Heart Problem

    15

    1.0

    2

    1.5

    17

    1.0

    Other

    39

    2.5

    7

    5.2

    46

    2.7

    Respiratory Irritation

    433

    28.0

    31

    23.1

    464

    27.6

    Shortness of Breath

    40

    2.6

    0

    0

    40

    2.4

    Skin Irritation

    95

    6.1

    11

    8.2

    106

    6.3

    Trauma

    50

    3.2

    34

    25.4

    84

    5.0

    Total

    1,548

    §99

    134

    §99

    *1,682

    100.0
    *The number of injuries is greater than the number of victims (1,050) because a victim could have more than one injury.
    §Total percentage doesn’t equal 100 due to rounding

    Of the 1,050 victims, 642 were treated at hospitals without admission, 146 were treated at the hospital and admitted, 84 were treated at the scene, 66 were injuries experienced within 24 hours of event and reported by officials (e.g., fire department, EMT), 35 were observed at the hospital without treatment, 13 were seen by a private physician within 24 hours, and 44 were reported as deaths (Figure 6a). For 20 victims, disposition was unknown.

    Figure 6a. Injury Disposition in Reported HSEES Events,January 1 – June 30, 2009

    Figure 6a. Injury Disposition in Reported HSEES Events, January 1 –June 30, 2009

    Personal Protective Equipment
    Selection of appropriate personal protective equipment (PPE) is a complex process that should take into account identification of the hazards or suspected hazards, routes of potential hazards (e.g., inhalation, skin absorption, ingestion, and eye or skin contact), and the performance of the PPE materials in providing a barrier to these hazards. The amount of protection provided by PPE is material or hazard-specific.

    From January 1 to June 30, 2009, only 97 of 475 employee victims (20.4%) and 33 of 74 responder-victims (44.6%) wore PPE. Whether PPE was worn was unknown for 47 employee-victims and 4 responder-victims. Of the 97 employee-victims who wore PPE, most (n=11) wore level D, 4 wore level C, 1 wore level B, 2 wore level A, and 79 employee victims wore other types of protection. Among the 31 injured firefighters who wore PPE, 17 wore firefighter turnout gear with respiratory protection, and 14 wore firefighter turnout gear without respiratory protection. Only one police officer wore level D and none of the “responder not specified” category wore PPE.

    Nearby Populations
    The proximity of an event to selected vulnerable areas was determined either by use of geographic information systems (GIS) or, if more accurate data were available, by the health department. Industries or other businesses were within ¼ mile of 2,896 events, residences within ¼ mile of 2,619 events, schools were within ¼ mile of 356 events, licensed daycare centers were within ¼ mile of 367 events, recreational areas were within ¼ mile of 371 events, nursing homes were within ¼ mile of 118 events, and hospitals were within ¼ mile of 30 events. For 333 events, information about nearby population areas was not recorded.

    Evacuations and Sheltering
    Evacuations were ordered in 260 of 3,419 events for which evacuation status was reported. Of these evacuations, the majority (82.3%) were from the building or affected areas of the building. Fewer evacuations were from a circular area surrounding the event generated by computer or defined by investigator (10.4%), areas downwind or downstream (2.8%), or a circular and downwind or downstream area (1.2%). The criteria for evacuation area were not defined for 260 evacuations (3.2%). The number of persons evacuated was known for 157 (60.4%) of the events and ranged from 0 to 3,600 persons, with a median of 15. The median duration of evacuation was 2 hours (range: 0.2 hours to 30 days). For 50 events (19.2%), the duration of evacuation was missing. Sheltering-in-place was ordered in only 34 incidents (1.0%). Sheltering-in-place means to stay inside, seal the windows and doors, and shut off any ventilation from the outside. Sheltering-in-place is ordered when an exposure threat is imminent and the safest option is to stay in one place to avoid evacuating through a hazardous cloud.

    Decontamination
    Of the 3,458 events, decontamination status was known for 498 exposed uninjured people; 315 persons were decontaminated at the scene, and 183 were decontaminated at a medical facility.

    Decontamination status was known for 1,008 injured. Most people (748 [74%]) were not decontaminated. Of those who were decontaminated, 81 were decontaminated at the scene, 134 were decontaminated at medical facilities, and 45 were decontaminated both at the scene and at medical facilities.

    Most responders are trained to decontaminate. Thus, they may be more likely to do so, even if only as a precaution. Of the responder victims, 60.0% of EMTs, 23.1% of firefighters, and 30.0% of police were decontaminated. Neither of the two responders of unknown type was decontaminated. Non-responders may not be as aware of the need for decontamination. Of the non-responder victims, 24.7% of employees, 28.6% of students, and 72.6% of the public received decontamination.

    Response
    Information on responder type was known for 3,362 events. One responder category was reported for 2,358 events and multiple responder categories for 771 events. No responders were reported for 233 events. The most frequently reported responder group was the company response team, followed by fire departments, law enforcement agencies and certified HazMat teams (Table 9a).


    Table 9a. Distribution of HSEES Responder Categories, January 1 – June 30, 2009


    Responder Category

    Number of events

    Company’s Response Team

    2,202

    Fire Department

    576

    Law Enforcement Agency

    411

    Third Party Clean-up Contractors

    319

    Certified HazMat Team

    236

    EMT

    224

    Environmental Agency/EPA Response Team

    210

    Other

    231
    *Total (4,409) is greater than the total number of events with information on responder categories because multiple responder categories could be reported per event.

    Reporting Timeliness
    Of the 2,361 events that occurred in fixed facilities, 1,655 (70.1%) were reported to HSEES within 48 hours of the event; only 36.1% of the 1,087 transportation events were reported within 48 hours. The Department of Transportation is a primary reporting source for transportation events for many states. Transportation companies have to report incidents to the US Department of Transportation, but reports are not required within 48 hours, thereby delaying HSEES reporting.

     

    PART II
    HAZARDOUS SUBSTANCES EMERGENCY EVENTS SURVEILLANCE, JULY 1-DECEMBER 31, 2009

     

    Events
    From July 1 to December 31, 2009, six states, Louisiana, North Carolina, New York, Oregon, Utah and Wisconsin, funded under NTSIP continued to report events to the HSEES program (Figure 1b). During this time, a total of 1,352 acute hazardous substances events met the criteria for inclusion in HSEES.

    More than two thirds of these events (942) occurred in fixed facilities and 410 events occurred during transportation. Two states, New York and Louisiana, accounted for 65.2% of all events (Table 1b).

    Table 1b. Number of Reported HSEES Incidents, by State and Type of Event, July 1 – December 31, 2009.

    STATE Fixed Facility Transportation Total Events
    Number of Events % Number of Events %
    Louisiana 342 85.7 57 14.3 399
    North Carolina 47 41.2 67 58.8 114
    New York 356 72.7 127 26.3 483
    Oregon 90 82.6 19 17.4 109
    Utah 52 47.7 57 52.3 109
    Wisconsin 55 39.9 83 60.1 138
    Total 924 69.7 410 30.3 1,352

    Fixed Facility Events
    For each fixed-facility event, event reporters could select one or two areas (specific location at the fixed facility where the event occurred) or types of equipment involved, in accordance with the North American Industry Classification System (NAICS)[3]. Of 942 fixed-facility events, one area was reported for 484 (51.4%) events and a combination of two areas was reported for 30 (2.3%) events. For 428 (45.3%) events, area was not reported. The main areas of fixed facility events were classified as ancillary processing equipment, piping, storage above ground, process vessel, transformer or capacitor, and heating/cooling for building (Figure 2b).


    Figure 2b. Areas of Fixed Facilities Involved in Reported HSEES Events, July 1-December 31, 2009

    Figure 2b. Areas of Fixed Facilities Involved in Reported HSEES Events, July 1-December 31, 2009

    Transportation Events
    Most (92.2%) transportation-related events occurred during ground transport (e.g., truck, van, tractor), and 6.1% occurred during rail transport. Fewer events occurred during water (0.9%), air (0.5%), or pipeline (0.2%) transport. No multiple transportation modes were reported.

    Most transportation-related events were either discovered after arrival at a fixed facility (41.4%), occurred during vehicle/vessel unloading (24.8%), or involved releases from a moving vehicle or vessel (23.5%). Fewer events involved a stationary vehicle or vessel (10.1%). The transportation phase during which the release occurred was not reported for 0.3% of events.

    Timing of Events
    The number of events per month ranged from 173 (12.8%) in November to 282 (20.9%) in July. The highest number of events occurred in July (Figure 3b).

    Figure 3b. Number of Reported HSEES Events by Month, July 1- December 31, 2009

    Figure 3b. Number of Reported HSEES Events by Month, July 1- December 31, 2009

    About 85.9% of events occurred on a weekday and 14.1% on the weekend. Most events occurred during daytime business hours. Of the 1,314 events for which time of day was reported:

    • 36.9% occurred from 6:00 a.m. to 11:59 a.m.
    • 31.4% occurred from 12:00 p.m. to 5:59 p.m.
    • 17.1% occurred from 6:00 p.m. to 11:59 p.m.
    • 14.5% occurred from midnight to 5:59 a.m.

    Contributing Factors Contributing factors were reported as either primary (root) or secondary causes. Primary factors were reported for 1,343 (99.3%) events (Figure 3c). Equipment failure and human error were the leading primary factors. Primary factors differed by location: for fixed-facility events the leading factor was equipment failure; for transportation-related events the leading factor was human error.

    Secondary factors were reported for 759 events (Figure 3d). The secondary factors most often reported were improper filling loading or packing (n=242) and system/process upset (n=130).


    Figure 3c. Primary Factors Reported as Contributing to HSEES Events, July 1-December 31, 2009

    Figure 3c. Primary Factors Reported as Contributing to HSEES Events, July 1-December 31, 2009

    Figure 3d. Secondary Factors Contributing to Reported HSEES Events, July 1-December 31, 2009

    Figure 3d. Secondary Factors Contributing to Reported HSEES Events, July 1-December 31, 2009

    Secondary factors were reported for 464 fixed facility events and 295 transportation events. For fixed-facility events the most frequently reported secondary factor was system/process upset (129). For transportation-related events the most frequently reported factors were improper filling, loading, or packing (198).

    Industries
    The largest number of HSEES events was associated with Transportation and Warehousing (NAICS 48-49, n=442) and Manufacturing (NAICS 31-33, n=437) (Table 2b).

    The largest proportion of the events (29.7%, n=402) was associated with NAICS 48 (Transportation and Warehousing). The second largest number of events (27.2%, n=368) and the highest number of victims (n=47) were associated with NAICS 32 (Manufacturing segment consisting of wood, paper, printing, petroleum and coal, chemical, plastic and rubber, and nonmetallic mineral manufacturing).

    The highest number of events with victims (n=23) and the second largest number of victims (n=39) were associated with NAICS 81 (Other Services).

    Although NAICS 48 (Transportation and Warehousing) and NAICS 32 (Manufacturing) resulted in the largest proportion of events, only a small portion of those events (2.7% and 3.3% respectively) involved victims. By contrast, although NAICS 72 (Accommodation and Food Services) accounted for only 0.8% of all events, 81.8% of events from that industry involved victims, accounting for 12.2% of all victims.

    Table 2b. Industries Involved in Reported HSEES Events, by Category, June 1-December 31, 2009

    Industry Category

    Total Events

    Victims

    2-digit NAICS
    Classification*

    Number of
    Events

    % of Events

    Number of Events
    with Victims

    Total Number
    of Victims

    (11) Agriculture, Forestry, Fishing and Hunting

    20

    1.5

    3

    9

    (21) Mining

    15

    1.1

    1

    1

    (22) Utilities

    80

    5.9

    5

    6

    (23) Construction

    16

    1.2

    0

    0

    (31) Manufacturing

    29

    2.1

    4

    9

    (32) Manufacturing

    368

    27.2

    12

    47

    (33) Manufacturing

    40

    3.0

    3

    4

    (42) Wholesale Trade

    29

    2.1

    3

    6

    (44) Retail Trade

    14

    1.0

    4

    5

    (45) Retail Trade

    7

    0.5

    0

    0

    (48) Transportation and Warehousing

    402

    29.7

    11

    12

    (49) Transportation and Warehousing

    40

    3.0

    1

    6

    (51) Information

    3

    0.2

    0

    0

    (52) Finance and Insurance

    0

    0

    0

    0

    (53) Real Estate and Rental and Leasing

    33

    2.4

    7

    22

    (54) Professional, Scientific, and Technical Services

    4

    0.3

    0

    0

    (55) Management of Companies and Enterprises

    0

    0

    0

    0

    (56) Administrative, Support, Waste Management and Remediation Services

    28

    2.1

    0

    0

    (61) Educational Services

    28

    2.1

    5

    14

    (62) Health Care and Social Assistance

    12

    0.9

    7

    24

    (71) Arts, Entertainment, and Recreation

    18

    1.3

    8

    36

    (72) Accommodation and Food Services

    11

    0.8

    9

    30

    (81) Other Services

    75

    5.6

    23

    39

    (92) Public Administration

    6

    0.4

    1

    10

    Unknown

    74

    5.5

    22

    39

    Total

    1,352

    99.9§

    129

    319

    * U.S. Census Bureau North American Industry Classification System 2002 www.census.gov/epcd/naics02/naicod02.htm).
    § Total percentage doesn’t equal 100 due to rounding.
    31 Includes food, beverage, tobacco, textile, apparel, and leather and allied products manufacturing
    32 Includes wood, paper, printing, petroleum and coal, chemical, plastic and rubber, and non-metallic mineral manufacturing |
    33 Includes metal, machinery, electronics, appliances, transportation equipment, furniture and miscellaneous manufacturing
    44 Includes motor vehicle, furniture and home furnishings, electronics and appliances, building materials and garden equipment, food and beverages, health and personal care, gasoline, and clothing and accessories
    45 Includes sporting goods, hobby, book and music supplies, general merchandise, and miscellaneous 48 Includes transportation by air, rail, water, truck, transit and ground passenger, pipeline, scenic and sightseeing, and transportation support activities.
    49 Includes postal service, couriers and messengers, and warehousing and storage.

    Substances
    In most events (93.6%), all substances involved actually were released. Threatened releases accounted for 3.1% of events. In 3.3% of events, a release was both threatened and actually occurred. Of the 1,673 substances involved in events, 95.3% actually were released and 4.7% were part of a threatened release. In 1,179 events, one substance was involved, 102 events involved two substances, and 71 events involved more than two substances (Table 3b). Fixed-facility events were more likely to involve three or more substances than were transportation events (7.2% vs. 0.6%).

    Table 3b. Number of Substances Involved Per Reported HSEES Event, by Type of Event, July 1 – December 31, 2009.

    Number of substances Type of event All events
    Fixed facility Transportation
    Number of Events % Total substances Number of Events % Total Substances Number of Events % Total Substances
     1 814 86.4 814 365 89.0 365 1,179 87.2 1,179
     2 60 6.4 120 42 10.2 84 102 7.5 204
     3 34 3.6 102 1 0.2 3 35 2.6 105
     4 19 2.0 76 1 0.2 4 20 1.5 80
    >=5 15 1.6 100 1 0.2 5 16 1.2 105
    Total 942 100.0§ 1,212 410 99.8§ 461 1,352 100.0 1,673
    § Total percentage doesn’t equal 100 due to rounding.

    The five substances most frequently released or threatened to be released in the order of frequency were paint not otherwise specified, ammonia, carbon monoxide, ethylene glycol, and sodium hydroxide (Table 4b).

    Table 4b. Substances Most Frequently Released or Threatened to Be Released in Reported HSEES Events. July 1-December 31, 2009

    Rank

    Substance

    Number Events

    1

    Paint NOS*

    68

    2

    Ammonia

    63

    3

    Carbon monoxide

    62

    4

    Ethylene glycol

    55

    5

    Sodium hydroxide

    50

    6

    Sulfur dioxide

    44

    7

    Ethylene

    42

    8

    Hydrochloric acid

    42

    9

    Hydrogen sulfide

    42

    10

    Benzene

    35

    11

    Sulfuric acid

    33

    12

    Propylene

    29

    13

    Chlorodifluoromethane

    27

    15

    Mercury

    25

    17

    		 Chlorine

    23

    18

    Volatile organic compounds NOS*

    23

    19

    Isopropanol

    21

    20

    Acetone

    18
    *NOS=Not Otherwise Specified.

    The substance categories most frequently released in fixed facilities events were volatile organic compounds (VOCs) (28.6%), other inorganic substances (18.2%), and acids (7.5%), (Table 5b). In transportation-related events, the most common categories were VOCs (19.5%), acids (15.0%), and bases (15.0%).

    Table 5b. Number of Substances Involved by Substance Category, and Type of Reported HSEES Event, July 1 to December 31, 2009*

    Expanded Substance Category

    Type of Event

    All events

    Fixed facility

    Transportation

    Number of Substances

    %

    Number of Substances

    %

    Number of Substances

    %

    Acids

    91

    7.5

    69

    15

    160

    9.6

    Agricultural chemicals, pesticides

    32

    2.6

    14

    3.0

    46

    2.7

    Ammonia

    65

    5.4

    4

    0.9

    69

    4.1

    Bases

    49

    4.0

    69

    15.0

    118

    7.1

    Category not assigned

    5

    0.4

    2

    0.4

    7

    0.4

    Chlorine

    40

    3.3

    9

    2.0

    49

    2.9

    Carcon Monoxide 6.2

    5.1

    		 0 0.0 62 3.7

    Formulations

    4

    0.3

    1

    0.2

    5

    0.3

    Hetero-organics

    11

    0.9

    1

    0.2

    12

    0.7

    Hydrocarbons

    31

    2.6

    4

    0.9

    35

    2.1

    Mixture across chemical category*

    38

    3.1

    13

    2.8

    51

    3.0

    Other †

    72

    5.9

    27

    5.9

    99

    5.9

    Other inorganic substances ‡

    220

    18.2

    24

    5.2

    244

    14.6

    Oxy-organics

    65

    5.4

    41

    8.9

    106

    6.3

    Paints and dyes

    35

    29

    66

    14.3

    101

    6.0

    PCB's

    13

    1.1

    0

    0.0

    13

    0.8

    Polymers

    32

    2.6

    27

    5.9

    59

    3.5

    Volatile organic compounds

    347

    28.6

    90

    19.5

    437

    26.1

    Total

    1,212

    99.9§

    461

    100.1§

    1,673

    99.8§

    *Substances from different categories that were mixed or formed from a reaction before the event were not included. †Not belonging to one of the existing categories.
    ‡All inorganic substances except for acids, bases, ammonia, and chlorine.
    § Total percentage doesn’t equal 100 due to rounding

    One release type was reported for 1,178 single substance releases: spills (n=749), air (n=378), threatened release (n=33), fire (n=15), explosion (n=3). Two release types were reported for 33 chemicals in the following combinations: spill and air (n=19), spill and fire (n=6), air and fire (n=2), fire and explosion (n=4), spill and explosion (n=1), and air and explosion (n=1).

    Victims
    From July 1 to December 31, 2009, there were 319 victims in 129 events (9.5% of all events) (Table 6b). Of these events, 81 involved only one victim and 48 involved two or more victims. The event with the most victims involved 20 victims. Most victims (82.9%) were injured in fixed-facility events. Three or more victims per event were reported in 25.1% of fixed facility events and in 9.1% of transportation-related events.

    Table 6b. Number of Victims per Reported HSEES Event, by Type of Event, January 1 – June 31, 2009

    Number of Victims per Event

    Type of Event

    All Events

    Fixed Facility

    Transportation

    Number of Events

    %

    Total
    Victims

    Number of Events

    %

    Total Victims

    Number of Events

    %

    Total Victims

    1

    63

    58.9

    63

    18

    81.8

    18

    81

    62.8

    81

    2

    17

    15.9

    34

    2

    9.1

    4

    19

    14.7

    38

    3

    7

    6.5

    21

    0

    0

    0

    7

    5.4

    21

    4

    4

    3.7

    16

    0

    0

    0

    4

    3.1

    16

    5

    1

    0.9

    5

    0

    0

    0

    1

    0.8

    5

    >=6

    15

    14.0

    121

    2

    9.1

    37

    17

    13.2

    158

    Total

    107

    99.9§

    260

    22

    100.0

    59

    129

    100.0

    319

    § Total percentage doesn’t equal 100 due to rounding

    Substance Category and Victims
    Events were classified by only one substance category, even if multiple substances were involved. If multiple substances from the same category were involved, that category was used for the event. If multiple substances from different categories were involved, the event was categorized as “multiple substances.”

    To judge the relative threat of a substance, we looked at the percentage of events in that substance category with victims (Table 7b). The most frequently released substance was VOCs (18.6%), but only 4.0% of all VOC events involved victims. Formulations accounted for only 0.1% of all events, yet 50.0% of formulations events resulted in victims. Victims were also involved in high proportion of mixture-across-chemical-category (35.4%) and carbon monoxiderelated (31.5%) events.

    Table 7b. Frequency of Substance Categories in All Reported HSEES Events and Events with Victims, July 1 – December 31, 2009*

    Substance Category

    All Events

    Events with victim

    Number

    %

    Number

    % of all Events with Victims

    %  of Events in Substance Category With Victims

    Category not assigned

    4

    0.3

    0

    0.0

    0.0

    Acids

    119

    8.8

    13

    10.1

    109.9

    Ammonia

    59

    4.4

    8

    6.2

    13.6

    Bases

    95

    7.0

    10

    7.8

    10.5

    Chlorine

    43

    3.2

    13

    10.1

    30.2

    Carbon Monoxide

    54

    4.0

    17

    13.2

    31.5

    Formulations

    2

    0.1

    1

    0.8

    50.0

    Hetero-organics

    11

    0.8

    1

    0.8

    9.1

    Hydrocarbons

    19

    1.4

    1

    0.8

    5.3

    Mixture across Chemical Category

    48

    3.6

    17

    13.2

    35.4

    Multi-chemical category

    173

    12.8

    8

    6.2

    4.6

    Other&

    72

    5.3

    10

    7.8

    13.9

    Other inorganic substances&&

    143

    10.6

    7

    5.4

    4.9

    Oxy-Organics

    99

    7.3

    4

    3.1

    4.0

    Paints & dyes

    77

    5.7

    2

    1.6

    2.6

    PCB's

    13

    1.0

    0

    0.00

    0.00

    Pesticides

    33

    2.4

    4

    3.1

    12.1

    Polymers

    37

    2.7

    3

    2.3

    8.1

    VOC's

    251

    18.6

    10

    7.8

    4.0

    Total

    1,352

    100.0

    129

    100.3§

    9.5


    *Substances from different categories that were mixed or formed from a reaction before the event were not included
    & Not belonging to one of the existing categories.
    &&All inorganic substances except for acids, bases, ammonia, and chlorine.
    § Total percentage doesn’t equal 100 due to rounding

    Victim’s sex
    Sex was known for 268 of the 319 victims. Of these, 172 (64.2%) were male. Of the 133 of 154 employees for whom sex was reported, 73.7% were male. Of the 123 of 149 victims who were members of the public for whom sex was reported, 51.2% were male. All 11 responders for whom sex was reported were male. The one student for whom sex was reported was female.

    Victim’s age
    Age category was reported for 278 victims. Ninety-three were children younger than 18 years of age and 185 were adults 18 years or older. The median age of the 173 victims for whom an exact age was reported, was 34 years (range 0–77 years). The age distribution for these victims was

    • 4.6% were < 5 years of age.
    • 6.9% were 5–14 years of age.
    • 13.3% were 15–19 years of age.
    • 39.9% were 20–44 years of age.
    • 26.0% were 45–64 years of age.
    • 9.2% were = 65 years of age.

    Figure 4c shows the distribution of victims by population group and type of event. Employees (154) constituted the largest proportion of the population groups affected, followed by members of the general public (149).

    Figure 4c. Number of Victims, by Population Group and Type of Reported HSEES Event, July 1 – December 31, 2009.

    Figure 4c. Number of Victims, by Population Group and Type of Reported HSEES Event, July 1 – December 31, 2009.

    In fixed-facility events, 8 responders were injured: 4 police officers and 4 firefighters not specified category. In transportation-related events, 4 police officers were injured.

    Injuries
    A total of 422 injuries or symptoms were reported (Table 8b). Some victims had more than one injury or symptom. Of all reported injuries or symptoms, the most common in fixed-facility events were respiratory tract irritation (27.6%), dizziness or other central nervous system symptoms (24.7%), headaches (11.4%), and gastrointestinal problems (10.2%). In transportation-related events, respiratory tract irritation (67.1%), and trauma (11.4%) were reported most frequently.

    Table 8b. Frequency of Injuries and Symptoms, by Type of Reported HSEES Event, July 1 – December 31, 2009.

    Type of Injury/Symptom

    Fixed facility

    Transportation

    All events

    Number of Injuries/
    Symptoms

    %

    Number of Injuries/
    Symptoms

    %

    Number of Injuries/
    Symptoms

    %

    Burns

    25

    7.1

    1

    1.4

    26

    6.2

    Dizziness/Central Nervous System Symptoms

    87

    24.7

    3

    4.3

    90

    21.3

    Eye Irritation

    32

    9.1

    3

    4.3

    35

    8.3

    Gastrointestinal

    36

    10.2

    0

    0

    36

    8.5

    Headache

    40

    11.4

    1

    1.4

    41

    9.7

    Heart Problem

    3

    0.9

    1

    1.4

    4

    1.0

    Other

    11

    3.1

    1

    1.4

    12

    2.8

    Respiratory Irritation

    97

    27.6

    47

    67.1

    144

    34.1

    Shortness of Breath

    11

    3.1

    2

    2.9

    13

    3.1

    Skin Irritation

    6

    1.7

    3

    4.3

    9

    2.1

    Trauma

    4

    1.1

    8

    11.4

    12

    2.8

    Total

    352

    100.0

    70

    99.9§

    422

    99.9§

    *The number of injuries is greater than the number of victims (319) because a victim could have more than one injury per event.
    § Total percentage doesn’t equal 100 due to rounding

    Of the 319 victims, 200 were treated at hospitals without admission, 45 were treated at the scene, 35 were treated at hospital and admitted, 5 were observed at hospital without treatment, 2 experienced injuries within 24 hours of event and were reported by a response official (e.g., fire department, EMT), one was seen by a private physician within 24 hours, and 8 deaths were reported (Figure 5c). For 23 victims, disposition was unknown.

    Figure 5c. Injury Disposition in Reported HSEES Events, July 1 – December 31, 2009

    Figure 5c. Injury Disposition in Reported HSEES Events, July 1 – December 31, 2009

    Personal Protective Equipment
    Only 1 of 133 employee victims and 4 of 12 responder-victims were reported to have worn PPE. Whether PPE was worn was unknown for 21 employee-victims. The employee-victims wore level D type of protection. All four injured firefighters, wore fire fighter turn-out gear with respiratory protection. None of the injured police officers wore any type of protection.

    Nearby Populations
    Residences were within ¼ mile of 1,137 events, industries or other businesses within ¼ mile of 1,116 events, schools were within ¼ mile of 159 events, licensed daycare centers were within ¼ mile of 175 events, recreational areas were within ¼ mile of 130 events, nursing homes were within ¼ mile of 58 events, and hospitals were within ¼ mile of 19 events. For 77 events, information about nearby population areas was not collected.

    Evacuations and Sheltering
    From July 1 to December 31, 2009, evacuations were ordered in 121 events. Of these evacuations, 83.2% were from the building or affected areas of the building, 10.1% evacuations were from a circular area surrounding the event generated by computer or defined by investigator, 2.5% evacuations were from areas downwind or downstream, 3.4% from a circular and downwind or downstream area, and 0.8% had no defined criteria. The number of persons evacuated was known for 52 (42.9%) of the events and ranged from 2 to 15,000 persons, with a median of 18. The median duration of evacuation was 2 hours (range: 0.5 hours to 58 days). For 16 (13.2%) events, the duration of evacuation was missing. Sheltering-in-place was ordered in 6 incidents (0.4%).

    Decontamination
    In 1,352 events decontamination status was known for 112 exposed uninjured people; 69 of them were decontaminated at the scene and 43 at a medical facility.

    Of the 293 injured for whom decontamination status was known, 209 were not decontaminated, 33 were decontaminated at the scene, 43 were decontaminated at a medical facility, and 8 were decontaminated both at the scene and at a medical facility.

    No injured firefighters were decontaminated. Three of 8 injured police officers were decontaminated at a medical facility, one was decontaminated at both the scene and medical facility and 4 were not decontaminated. Of the non-responder victims, 57 (38.3%) employees, 20 (15.6%) members of the public and 3 (75%) students received decontamination.

    Response
    No responder types were reported for 22 events. A single responder category was reported for 768 events and multiple responder categories for 562. The most frequently reported responder group was the company response team, followed by fire departments, law enforcement agencies, certified HazMat teams, EMT and EPA response team (Table 9b).

    Table 9b. Distribution of HSEES Responder Categories, July 1 -December 31, 2009

    Responder Category

    Number of events

    Company's response team

    1093

    Fire department

    242

    Law enforcement agency

    160

    Certified Haz Mat team

    114

    EMT

    109

    Environmental agency/EPA response team

    109

    Third Party clean-up contractors

    89

    Other

    142

    *Total (2,058) is greater than the total number of events with information on responder categories because multiple responder categories could be reported per event.

    Reporting Timeliness
    Of the 942 events that occurred in fixed facilities, 73.3% were reported to HSEES within 48 hours of the event; only 34.4% of the 410 transportation events were reported within 48 hours. The Department of Transportation is a primary reporting source for transportation events for many states. Transportation companies have to report incidents to the US Department of Transportation, but reports are not required within 48 hours, thereby delaying HSEES reporting.

    CUMULATIVE RESULTS, 1993-2009
    HSEES was supported by a series of 5-year competitive, cooperative agreements funded by ATSDR with additional support in recent years from the Centers for Disease Control and Prevention’s Coordinating Office for Terrorism Preparedness and Emergency Response. States receiving funds changed over the years (Table 10). Due to the funding changes in July 2009, only 6 states continued collecting data from July1 to December 31, 2009.

    Table 10. Years of HSEES Participation, by State, 1993–2009*

    State Years Participated

    Alabama

    1993-2003

    Colorado

    1993-June 30, 2009

    Florida

    2005-June 30, 2009

    Iowa

    1993-June 30, 2009

    Louisiana

    2001-December 31, 2009

    Michigan

    2005-June 30, 2009

    Minnesota

    1995-June 30, 2009

    Mississippi

    1995-2003

    Missouri

    1994-2005

    New Hampshire

    1993-1996

    New Jersey

    2000-2008**

    New York

    1993-December 31, 2009

    North Carolina

    1993- December 31, 2009

    Oregon

    1993-December 31, 2009

    Rhode Island

    1993-2001

    Texas

    1993-July 30, 2009

    Utah

    2000-December 31, 2009

    Washington

    1993-July 30, 2009

    Wisconsin

    1993-December 31, 2009

    *1993-2008 annual reports may be found at the HSEES Website: http://www.atsdr.cdc.gov/HS/HSEES/index.html.
    **NJ was unable to collect complete data in 2006, 2008 and 2009.

    Year 2009 was the turning point for the HSEES program. Thirteen states collected data from January 1 to June 30, 2009. Due to the funding changes related to the transformation of the HSEES program to NTSIP in mid-2009, only six states continued collecting data from July 1 to December 31, 2009.

    From January 1 to June 30, 2009 a total of 3,458 acute hazardous substances events met the criteria for HSEES inclusion in 13 states. From July 1 to December 31, 2009 a total of 1,352 acute hazardous substances events met the criteria for HSEES inclusion in 6 states.

    During 2009, the largest proportion of events occurred in fixed facilities (Table 11). The percentage of fixed-facilities events decreased from 83.5% in 1993 to 69.7% at the end of 2009. The percentage of transportation related events increased from 16.5% in 1993 to 30.3% at the end of 2009.

    Table 11. Cumulative HSEES Data by Year

    Source: Hazardous Substances Emergency Events Surveillance, 1993–2009*

    Year

    Number of States Participating

    Type of Event

    Number of substances released

    Number of victims

    Number of deaths

    Events with victims

    Fixed Facility (%)

    Transportation Events (%)

    Total†

    Number

    %

    1993

    11

    83.5

    16.5

    3,833

    4,361

    2,230

    16

    464

    12.1

    1994

    12

    78.5

    21.5

    4,233

    5,072

    2,181

    21

    414

    9.8

    1995

    14

    80.5

    19.5

    5,310

    6,027

    1,688

    14

    402

    7.6

    1996

    13

    78.9

    21.1

    5,488

    5,861

    1,622

    33

    390

    7.1

    1997

    13

    79.5

    20.5

    5,513

    6,089

    1,896

    28

    372

    6.7

    1998

    13

    79.1

    20.9

    5,981

    6,486

    1,533

    36

    405

    6.8

    1999

    15

    74.1

    25.9

    6,260

    6,974

    1,912

    30

    504

    8.1

    2000

    16

    72.9

    27.1

    7,548

    8,342

    2,513

    44

    752

    10.0

    2001

    15

    75.0

    25.0

    8,978

    11,764

    2,168

    22

    710

    7.9

    2002

    15

    72.1

    27.9

    †9,013

    11,009

    2,150

    47

    739

    8.2

    2003

    15

    74.5

    25.5

    9,105

    12,018

    1,835

    51

    720

    7.9

    2004

    13

    73.4

    26.6

    7,744

    10,323

    1,838

    41

    620

    8.0

    2005

    15

    74.2

    25.8

    †8,603

    11,506

    2,034

    69

    778

    9.0

    2006

    13

    68.1

    31.9

    7,268

    9,462

    2,190

    69

    683

    9.4

    2007

    14

    68.5

    31.5

    7,947

    9,873

    2,337

    69

    778

    9.0

    2008

    13

    69.1

    30.9

    7,559

    9,227

    2,206

    56

    948

    12.5

    2009
    Jan-June

    13

    68.3

    31.7

    3,458

    4,074

    1,050

    44

    439

    12.7

    2009
    July-Dec

    6

    69.7

    30.3

    1,352

    1,673

    319

    8

    129

    9.5

    *Numbers in the table may differ from those reported in previous years because of edits.
    †The total number of events does not include one event in 2002 and one in 2005 for which the type of event was unknown.

    Employees and members of the public remained the groups most often injured (Table 12).

    Table 12. Percent of Cumulative HSEES Victims, by Population Group and Year

    Source: Hazardous Substances Emergency Events Surveillance, 1993-2009
    Year
    Employees
    Public
    Responders
    Students
    Unknown
    Total
    N
    %
    N
    %
    N
    %
    N
    %
    N
    %
    N

    1993

    1,285

    57.9

    788

    35.3

    143

    6.4

    n/a

    n/a

    		 14

    0.6

    		 2,230

    1994

    977

    44.8

    963

    44.2

    235

    10.8

    n/a

    n/a

    		 6

    0.3

    		 2,181

    1995

    907

    53.7

    482

    28.6

    218

    12.9

    81

    4.8

    		 0

    0.0

    		 1,688

    1996

    830

    51.2

    480

    29.6

    164

    10.1

    145

    8.9

    		 3

    0.2

    		 1,622

    1997

    1,102

    58.1

    580

    30.6

    121

    6.4

    79

    4.2

    		 14

    0.7

    		 1,896

    1998

    1,008

    65.4

    253

    16.5

    107

    7.0

    157

    10.2

    		 8

    0.5

    		 1,533

    1999

    1,125

    58.8

    330

    17.3

    159

    8.3

    297

    15.5

    		 1

    0.1

    		 1,912

    2000

    1,199

    47.7

    593

    23.6

    338

    13.5

    365

    14.5

    		 17

    0.7

    		 2,512

    2001

    1,085

    50.0

    613

    28.3

    291

    13.4

    178

    8.2

    		 1

    0.1

    		 2,168

    2002

    1,008

    46.9

    650

    30.2

    274

    12.7

    211

    9.8

    		 7;

    0.3

    		 2,150

    2003

    943

    51.4

    500

    27.2

    260

    14.2

    132

    7.2

    		 0

    0.0

    		 1,835

    2004

    837

    45.5

    640

    34.8

    219

    11.9

    142

    7.7

    		 0

    0.0

    		 1,838

    2005

    795

    39.1

    955

    47.0

    185

    9.1

    99

    4.9

    		 0

    0.0

    		 2,034

    2006

    1,003

    45.6

    774

    35.3

    159

    7.3

    237

    10.8

    		 17

    0.8

    		 2,190

    2007

    1,126

    43.0

    855

    36.6

    139

    5.9

    209

    8.9

    		 8

    0.3

    		 2,337

    2008

    1,006

    45.6

    887

    40.2

    132

    6.0

    180

    8.2

    		 1

    0.1

    		 2,206
    2009
    Jan-June    		 522 49.7 422 40.2 78 7.4 28 2.7 0; 0.0 1,050
    2009
    July-Dec    		 154 48.3 149 46.7 12 3.8 4 1.3 0 0.0 319
    *The student category was not available before 1995.


    USES OF HSEES DATA
    During 2009, ATSDR continued responding to requests for HSEES information from local, state, and federal agencies and organizations. ATSDR and state health department staff presented HSEES data at many local, state, national, and international conferences. The ATSDR HSEES Web site (http://www.atsdr.cdc.gov/HS/HSEES/) contains annual reports, published journal articles, public use datasets, and other information.

    Public Use Dataset
    ATSDR has created a public use HSEES dataset to enable public health professionals and other interested parties to analyze the data. A data dictionary provides users with detailed instructions for working with the dataset. This dataset resides on the HSEES public Web site. Data contained in the file are related to events that occurred in the 17 states participating in HSEES from 1996–2007. The dataset for 2008-2009 will also be placed on the website shortly. To date, 1356 requests for this data have been received.

    PREVENTION/OUTREACH ACTIVITIES
    The goal of HSEES was to develop strategies that might reduce future morbidity and mortality resulting from the release of hazardous substances. To accomplish this goal, the HSEES program made an important contribution to building capacity within each participating state health department to target prevention activities related to acute spills and their associated public health consequences. The HSEES system also built capacity to alert the proper authorities when a public health action needed immediate implementation.

    State HSEES coordinators often conducted activities in collaboration with other local and state agencies. The HSEES program has worked over the years with several CDC Public Health Prevention Specialists trying to build capacity to develop sound prevention activities that can be evaluated for their effectiveness. In 2006, a CDC Public Health Prevention Service fellow developed the “HSEES Prevention Outreach and Evaluation Activity Planning Guide” for use by states. During January 1 to June 30, 2009, HSEES states sponsored 12 prevention/outreach activities that targeted over 48,011 persons. During the period from July 1 to December 31, 2009, HSEES states sponsored 43 prevention/outreach activities that targeted more than 75,503 persons. The HSEES Web page contains links to state HSEES Web pages where many of the prevention/outreach materials are posted.

    Examples of prevention activities for 2009 include:

    Awareness-Promoting Activities
    Raising awareness of the public health significance of acute chemical releases and their impacts is important. This occurred mainly through presentations at meetings and distribution of HSEES materials. Increased awareness might result in reduction in hazardous substance releases and public health impact. Increased awareness also may produce better reporting leading to higher number of HSEES events collected. Thus, for these activities, states measured the effects of their activities mainly by the number of people they reached and whether that outreach resulted in changed knowledge or attitudes.

    • The New York State HSEES program published an article entitled “New York Hazardous Substances Emergency Events Surveillance (HSEES) data support emergency response, promote safety and protect public health” in the Journal of Loss Prevention in the Process Industries.
    • The North Carolina HSEES program presented the NC HSEES data at the 2009 Business and Environmental Safety Training conference, the 2009 All Hazards conference, the 2009 NC State Fireman’s Association Annual Conference, and the Guilford County LEPC & ASSE Safety & Environmental Conference.
    • The Utah State HSEES program together with Utah’s Environmental Public Health Tracking Program (EPHT), developed HSEES indicators to track environmental conditions and query modules for the Utah Indicator-Based Information System for Public Health (IBIS-PH). The indicators were published on a public portal of the IBIS-PH and may be found at http://ibis.health.utah.gov/.
    • The Washington State HSEES program prepared a 2009 HSEES calendar including messages promoting hazardous substances awareness and forwarded it to law enforcement and fire department officials and others interested in emergency management.
    • The Washington State HSEES program also developed and distributed a publication entitled “HSEES Highlights” to promote awareness of the program.

    Targeted Activities
    Identifying high-risk groups and their preferred channels for receiving information is important for effectively targeting prevention messages. Examples of targeted activities during 2009 included:

    • Using HSEES data, the New York HSEES program made several presentations to firefighters and published an article entitled, “Expect the Unexpected and Prevent Firefighter Injuries in HAZMAT events.”
    • North Carolina HSEES program distributed a fact sheet designed to show factors associated with the most releases and prevention measures to decrease the number of events at trucking terminals throughout the state.
    • The Texas HSEES program incorporated the county data into a query and mapping system maintained by the Texas Department of State Health Services Center for Health Statistics. Texas HSEES staff made three presentations to the Governor’s Division of Emergency Management training workshop for the county emergency managers and responded to data requests generated from presentations.
    • The Utah HSEES program developed a presentation that targeted the Hazardous Material Emergency Responders. This presentation, along with an interactive game section where key concepts were reviewed, was presented during two breakout sections of the Intermountain Hazardous Material Conference in August, 2009. It was also presented at five Local Emergency Planning Committees throughout state of Utah

    Substance-Specific Prevention Activities by HSEES States
    Participating states targeted common and dangerous substances including mercury, carbon monoxide, chlorine, sulfuric acid, sulfur dioxide, ammonia, pesticides, and other agricultural substances for prevention activities in 2009. States measured immediate effects (e.g., audience numbers) and mid-term effects (e.g., continued interest, requests for information, changes in behavior). Examples of 2009 state activities include:

    • The Michigan HSEES program prepared a manuscript entitled, “Compliance with a law banning mercury in Michigan schools” for publication at one of the public health journals. The Michigan HSEES program also collaborated with other HSEES states and ATSDR on a publication entitled, “State programs for surveillance of carbon monoxide releases using the HSEES system.”
    • The Minnesota, New York, Michigan, and ATSDR HSEES staff prepared a publication entitled, “Hazards of Illicit Methamphetamine Production and Efforts at Reduction” that was accepted for publication in the Healthy People/Healthy Homes supplement of Public Health Reports.
    • Upon request from University of Minnesota Extension Office, the Minnesota HSEES program wrote two reports entitled, “Summary of pesticide incidents reported to Minnesota HSEES, 1995-2008” and “Summary of antimicrobial incidents reported to Minnesota HSEES, 1995-2008”. The first report was posted on Minnesota’s HSEES Web page at http://www.health.state.mn.us/divs/eh/hazardous/surv/index.html. The second report was provided to the Extension Office.
    • The New York HSEES program supporting New York State‘s response to clandestine drug laboratories made several presentations to educate law enforcement and public health professionals on the recognition of clandestine drug labs, hazards associated with these labs, and the health department’s role in responding to identified labs.
    • The New York HSEES program worked closely with the Bureau of Community Environmental Health and Food Protection (BCEH&FP) targeting operation of public pools and water parks in New York State and promoting principles of green chemistry in the pool environment.
    • The Wisconsin HSEES program joined a State Agency Dialogue Pertaining to Implementation of Inherently Safer Technology and Green Chemistry Outreach Precepts and other related workgroups such as Green Tier Program, promoting Green technology.

    The Future of Hazardous Substance Surveillance

    An external peer review of the HSEES program in 2005 recommended the development of a national approach to chemical events surveillance. In addition to these recommendations, a series of meetings with interested parties including academia, other federal agencies, and chemical organizations has elicited gaps, overlaps, and needs. This process resulted in the development of the National Toxic Substance Incidents Program (NTSIP). The goal of NTSIP is to reduce the morbidity and mortality from toxic substance incidents. NTSIP employs three components: 1) national level surveillance, 2) state programs, and 3) incident investigations. Funding for HSEES ended in 2009 and NTSIP’s implementation began in fiscal year 2010. For more information on NTSIP, please visit http://www.atsdr.cdc.gov/ntsip/.

    References

    1. Centers for Disease Control and Prevention. Comprehensive plan for epidemiologic surveillance. Atlanta: US Department of Health and Human Services; 1986.
    2. Binder S. Death, injuries, and evacuations from acute hazardous materials releases. Am J Public Health 1989;70:1042–4.
    3. National American Industry Classification System, 2007. Bureau of the Census, United States, Washington, DC, 2007, 1400 pages.
    4. ATSDR HSEES Web site: http://www.atsdr.cdc.gov/HS/HSEES/.

    Acknowledgments

    We extend our grateful appreciation to our partners in the participating state health departments who, with diligence and dedication, researched and gathered much of the data for this report. Their assistance, ideas, and comments made this report possible.

    Appendix A. 2009 Publications

    Welles, W. L., Wilburn, R. E., Ehrlich, J. K. and J. M. Kamara. New York Hazardous Substances Emergency Events Surveillance (HSEES) Data Support Emergency Response, Promote Safety and Protect Public Health. Journal of Loss Prevention in the Process Industries, 22(6), 728-734. 2009.

    Welles, W. L. and R. E. Wilburn. EXPECT THE UNEXPECTED and Prevent Firefighter Injuries in Hazmat Events. NYS Association of Fire Chiefs. SIZE UP Issue 1: 44-49. 2009.

    Wattigney, W, Rice, N, Cooper, D. Drew, J, Orr, M. State Programs to Reduce Uncontrolled Ammonia Releases and Associated Injury Using the Hazardous Substances Emergency Events Surveillance System. Journal of Occupational and Environmental Medicine, Vol. 51, Number 3:356-363. March, 2009.

    Hughes N, Stanbury M. “Hazardous Substances Emergency Events Surveillance in Michigan”, Michigan Department of Community Health. October, 2009.

    Submitted Publications
    Melnikova N, Lizak W.W, Wilburn, R,E, Rice N, Wu J, Stanbury M. Hazards of Illicit Methamphetamine Production and Efforts at Reduction: Data from the Hazardous Substances Emergency Events Surveillance System. Accepted for publication at Public Health Reports, Special Supplement on Healthy People in a Healthy Environment, spring 2011. Abstract published at Public Health report, July 2010.
    Available at http://www.publichealthreports.org/EOH-abstracts/Exposures.cfm#26

    Stanbury M, Huges N, “Compliance with a law banning mercury in Michigan schools,” submitted for publication.

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