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Biennial Report 1999-2000

    Historical Document

    This document is provided by the Agency for Toxic Substances and Disease Registry (ATSDR) ONLY as an historical reference for the public health community.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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    Note: While the original publication dates on some of ATSDR's documents may not appear to be current, the information in the documents is valid and may provide relevant information.

    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 Public Health Service to help prevent or reduce further exposure to hazardous substances and the adverse health effects that result from such exposures, and also to expand the knowledge base about such effects.

    This publication reports the results and findings of a health study, registry, or other health-related activity supported by ATSDR in accordance with its legislative mandate described above.

    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 (E-31)
    1600 Clifton Road, NE
    Atlanta, Georgia 30333

    Agency for Toxic Substances and Disease Registry
    Julie L. Gerberding, MD, MPH, Administrator
    Henry Falk, MD, MPH, Assistant Administrator
    Robert F. Spengler, ScD, Associate Administrator for Science

    Division of Health Studies
    G. David Williamson, PhD, Director
    Sharon S. Campolucci, MSN, Deputy Director
    Tom Wilson, Editor

    Epidemiology and Surveillance Branch
    Hazardous Substances Emergency Events Surveillance Staff
    Wendy E. Kaye, PhD, Chief
    Zahava Berkowitz, MSc
    Maureen Orr, MS
    Casetta R. Simmons
    Perri Zeitz, MPH
    Kevin Horton, MSPH
    Deana Manassaram, MPH
    Lori Hutwagner, MS

    DISCLAIMER

    Use of trade names and commercial sources is for identification only and does not imply endorsement by the Agency for Toxic Substances and Disease Registry or the U.S. Department of Health and Human Services.

    CONTENTS

    LIST OF TABLES

    • Table 1a-Number of events meeting the surveillance definition, by state and type of event, Hazardous Substances Emergency Events Surveillance, 1999
    • Table 1b-Number of events meeting the surveillance definition, by state and type of event, Hazardous Substances Emergency Events Surveillance, 2000
    • Table 2-Distribution of the number of substances released, by type of event, Hazardous Substances Emergency Events Surveillance, 1999-2000
    • Table 3-Distribution of the number of substances released, by substance category and type of event, Hazardous Substances Emergency Events Surveillance, 1999-2000
    • Table 4-Distribution of the number of victims, by type of event, Hazardous Substances Emergency Events Surveillance, 1999-2000
    • Table 5-Number of substances released in all events and events with victims, by substance category, Hazardous Substances Emergency Events Surveillance, 1999-2000
    • Table 6-Distribution of type of injury, by type of event, Hazardous Substances Emergency Events Surveillance, 1999-2000
    • Table 7-Profiles of events with =50 victims, Hazardous Substances Emergency Events Surveillance, 1999-2000
    • Table 8-Cumulative data for all states, Hazardous Substances Emergency Events Surveillance, 1993-2000


     

    LIST OF FIGURES

    • Figure 1-Areas of fixed facilities involved in events, Hazardous Substances Emergency Events Surveillance, 1999-2000
    • Figure 2-Distribution of transportation-related events, by type of transport, Hazardous Substances Emergency Events Surveillance, 1999-2000
    • Figure 3-Factors reported as contributing to the occurrence of fixed-facility events, Hazardous Substances Emergency Events Surveillance, 1999-2000
    • Figure 4-Distribution of victims, by population group and type of event, Hazardous Substances Emergency Events Surveillance, 1999-2000
    • Figure 5a-Distribution of responder victims for fixed-facility events, by population group, Hazardous Substances Emergency Events Surveillance, 1999-2000
    • Figure 5b-Distribution of responder victims for transportation-related events, by population group, Hazardous Substances Emergency Events Surveillance, 1999-2000
    • Figure 6-Distribution of type of injury for all events, Hazardous Substances Emergency Events Surveillance, 1999-2000
    • Figure 7-Injury outcome, Hazardous Substances Emergency Events Surveillance, 1999-2000
    • Figure 8-Distribution of victims, Hazardous Substances Emergency Events Surveillance, 1993-2000
    • Figure 9-Cumulative data for all participating states, Hazardous Substances Emergency Events Surveillance, 1993-2000


     

    LIST OF APPENDICES

    • Appendix A-The 100 Most Frequently Released Substances, Hazardous Substances Emergency Events Surveillance, 1999-2000
    • Appendix B-Profiles of events with fatalities in fixed facilities, Hazardous Substances Emergency Events Surveillance, 1999-2000
    • Appendix C-Profiles of events with fatalities in transportation events, Hazardous Substances Emergency Events Surveillance, 1999-2000
    • Appendix D-Hazardous Substances Emergency Events Surveillance-Related Publications

     

    EXECUTIVE SUMMARY

    The Hazardous Substances Emergency Events Surveillance (HSEES) system, maintained by the Agency for Toxic Substances and Disease Registry (ATSDR), actively collects information to describe the public health consequences associated with the release of hazardous substances. This report summarizes the characteristics of events reported to the 13 state health departments participating in 1999 and the 15 state health departments participating in 2000. Information on acute hazardous substances emergency events was collected, including the substance(s) released, number of victims, number and types of injuries, and number of evacuations. The data obtained were computerized using an ATSDR-provided Web-based data entry system.

    A total of 13,808 events was reported. In 13,215 (95.7%) of the events, only a single substance was released. The most commonly reported categories of substances were inorganic substances (excluding acids, bases, ammonia, and chlorine); volatile organic compounds (VOCs); mixtures involving more than one category; acids; ammonia; and pesticides. During this reporting period, 1,256 events (9.1% of all reported events) resulted in a total of 4,425 victims. The most frequently reported injuries sustained by victims were respiratory irritation, headache, eye irritation, dizziness or other central nervous system (CNS) symptoms, and gastrointestinal problems. A total of 74 persons died as a result of all events, and 622 (4.5%) events required evacuations.

    The findings regarding the distribution of the numbers of events with victims and evacuations, and the numbers and types of injuries reported have, overall, been consistent since HSEES inception. The distribution of transportation events has increased over the last couple years, in part, because of the use of new notification sources for transportation events.

    INTRODUCTION

    Since 1990, the Agency for Toxic Substances and Disease Registry (ATSDR) has maintained an active, state-based Hazardous Substances Emergency Events Surveillance (HSEES) system to describe the public health consequences associated with the release of hazardous substances. The decision to initiate a surveillance system of this type was made on the basis of a study published in 1989 on the reporting of hazardous substances releases to three national databases: the National Response Center Database, the Hazardous Materials Information System (HMIS), and the Acute Hazardous Events Database (1). A review of these databases indicated limitations. Many events were missed because of incomplete reporting (for example, the HMIS did not record events involving intrastate carriers or fixed-facility events). Other important information was not recorded, such as the demographic characteristics of victims, the types of injuries sustained, and the number of persons evacuated. As a result of this review, ATSDR implemented the HSEES system to more fully describe the public health consequences associated with the release of hazardous substances. The surveillance system has four goals:

    • To describe the distribution and characteristics of hazardous substances emergencies.
    • To describe the morbidity and mortality experienced by employees, responders, and the general public as a result of hazardous substances releases.
    • To identify risk factors associated with the morbidity and mortality.
    • To identify strategies that might reduce future morbidity and mortality resulting from the release of hazardous substances.

    This biennial report summarizes the characteristics of hazardous substances releases and the associated public health consequences of events reported to the surveillance system during 1999-2000.

    METHODS

    In 1999, 13 state health departments (Alabama, Colorado, Iowa, Minnesota, Mississippi, Missouri, New York, North Carolina, Oregon, Rhode Island, Texas, Washington, and Wisconsin) collected data for HSEES. In 2000, two additional state health departments (New Jersey and Utah) collected data for HSEES. For each event, information was collected about the event, substance(s) released, victims, injuries, and evacuations.

    Various data sources were used to obtain information about these events. These sources included, but were not limited to, records and oral reports of state environmental protection agencies, police and fire departments, the U.S. Department of Transportation, the National Response Center, and hospitals. Census data were used to estimate the number of residents living in the vicinity of the events. All data were computerized using a Web-based data entry system provided by ATSDR.

    Hazardous substances emergency events are defined by HSEES as uncontrolled or illegal releases or threatened releases of hazardous substances. Events involving petroleum and no other hazardous substances are not included. Events are included if (1) the amount of substance that was released (or that might have been released) needed (or would have needed) to be removed, cleaned up, or neutralized according to federal, state, or local law; or (2) there was only a threatened release of a substance, but the threat led to an action (for example, evacuation) that could have affected the health of employees, emergency responders, or the general public. Victims are defined as persons who suffered at least one adverse health effect or died as a consequence of the event. Victims who receive more than one type of injury are counted once in each applicable injury type. Events are defined as transportation-related if they occurred during surface, air, pipeline, or water transport of hazardous substances. All other events are considered fixed-facility events.

    For the data analyses in this report, the substances released were categorized into 11 groups. The category "mixtures" consists of mixtures of substances from different categories, and the category "other inorganic substances" comprises all inorganic substances, except for acids, bases, ammonia, and chlorine. "Other" refers to substances that could not be categorized.

    RESULTS

    A total of 13,808 hazardous substances emergency events was reported for 1999-2000 to the HSEES system; 182 (1.3%) of these events were threatened releases. In 1999, 74.0% of the events occurred at fixed facilities (Table 1a), and in 2000, 72.9% were at fixed facilities (Table 1b). This distribution is heavily influenced by Texas, which had 37% of all events and had a larger than typical percentage of fixed-facility events. Thus, the distribution of fixed-facility events excluding Texas events indicated 64.4% for 1999 and 66.4% for 2000. These percentages are slightly less than those found in previous years for fixed-facility events.

    For each fixed-facility event, one or two choices can be selected for type of area. Of all 11,030 fixed-facility area choices, 2,301 (20.9%) were classified as ancillary processing equipment, 2,199 (19.9%) as a process vessel (a reaction chamber in which chemicals are processed), 1,645 (14.9%) as storage areas above and below ground, and 1,386 (12.6%) as piping (Figure 1). Of the 3,675 transportation-related events, 3,142 (85.4%) occurred during ground transport (for example, truck, van, or tractor), and 277 (7.5%) involved transport by rail (Figure 2). Fewer events involved water, air, pipeline, or unknown transportation modes.

    The primary factors contributing to the 10,133 fixed-facility events were also reported (Figure 3). Equipment failure was the primary contributing factor in 4,511 (44.5%) events, followed by 2,140 events involving operator error (21.1%), 942 involving "other" uncategorized factors (9.3%), and 412 involving system process upset (4.1%).

    Ninety-six percent of all events involved the release of only one substance. Two substances were released in approximately 2% of the events, and 2% involved the release of more than two substances (Table 2).

    There were 15,316 substances either released or threatened to be released during the 13,808 events. Two types of releases could be reported for each chemical (e.g., spill and air). Spills were reported in 8,275 (54.0%) of the releases, followed by 6,393 air releases (41.7%), 1,047 fires (6.8%), 361 threatened releases (2.4%), and 181 explosions (1.2%).

    HSEES events were more likely when there was more industrial, commercial, or agricultural activity, e.g., in the 6 hours before noon (35.0%) and the 6 hours after and including noon (29.3%), compared with the 6 hours before midnight (14.2%) and the 6 hours after and including midnight (16.2%) (5.3% did not have a specified time). Additionally, 16%-17% of events occurred on each weekday as compared with 8%-9% on a weekend day. April through September, the peak agricultural season, had 56% of the events, and the other 6 months of the year had 44%.

    SUBSTANCES

    The 15,316 substances released were grouped into 11 categories. The number of substances released was greater than the number of events because more than one substance could be released per event. The categories of substances most commonly released in fixed-facility events (Table 3) were other inorganic substances (26.9%), volatile organic compounds (VOCs) (21.3%), mixtures (11.7%), acids (7.0%), and ammonia (6.7%). In transportation-related events, VOCs (15.9%), acids (14.3%), other inorganic substances (11.9%), pesticides (7.5%), and bases (7.3%) were most frequently released. The 100 substances most frequently reported for 1999-2000 are listed in Appendix A. Ammonia, sulfur dioxide, and sulfuric acid were the top released substances.

    Table 1a-Number of events meeting the surveillance definition, by state and type of event, Hazardous Substances Emergency Events Surveillance, 1999.
     

    State reporting event

    Type of event

    Total no. of events

    Fixed facility

    Transportation

    No. of events

    %

    No. of events

    %

    Alabama

    104

    61.5

    65

    38.5

    169

    Colorado

    148

    59.2

    102

    40.8

    250

    Iowa

    196

    68.1

    92

    31.9

    288

    Minnesota

    287

    82.5

    61

    17.5

    348

    Mississippi

    100

    45.3

    121

    54.8

    221

    Missouri

    166

    57.0

    125

    43.0

    291

    New York

    514

    85.8

    85

    14.2

    599

    North Carolina

    108

    34.0

    210

    66.0

    318

    Oregon

    80

    76.2

    25

    23.8

    105

    Rhode Island

    40

    80.0

    10

    20.0

    50

    Texas

    2,336

    86.8

    355

    13.2

    2,691

    Washington

    317

    74.9

    106

    25.1

    423

    Wisconsin

    238

    46.9

    269

    53.1

    507

    Total

    4,634

    74.0

    1,626

    26.0

    6,260

    Table 1b-Number of events meeting the surveillance definition, by state and type of event, Hazardous Substances Emergency Events Surveillance, 2000.
     

    State reporting event

    Type of event

    Total no. of events

    Fixed facility

    Transportation

    No. of events

    %

    No. of events

    %

    Alabama

    115

    67.6

    55

    32.4

    170

    Colorado

    99

    47.1

    111

    52.9

    210

    Iowa

    204

    70.3

    86

    29.7

    290

    Minnesota

    346

    82.6

    73

    17.4

    419

    Mississippi

    90

    43.5

    117

    56.5

    207

    Missouri

    199

    55.1

    162

    44.9

    361

    New Jersey

    457

    90.1

    50

    9.9

    507

    New York

    897

    84.3

    167

    15.7

    1,064

    North Carolina

    87

    28.9

    214

    71.1

    301

    Oregon

    178

    65.9

    92

    34.1

    270

    Rhode Island

    32

    74.4

    11

    25.6

    43

    Texas

    2,137

    86.0

    349

    14.0

    2,486

    Utah

    140

    46.2

    163

    53.8

    303

    Washington

    319

    72.7

    120

    27.3

    439

    Wisconsin

    199

    41.6

    279

    58.4

    478

    Total

    5,499

    72.9

    2,049

    27.1

    7,548

    Figure 1-Areas of fixed facilities involved in events, Hazardous Substances Emergency Events Surveillance, 1999-2000.

    *These areas were not available for the entire time period. Indoor @ res=an area inside a place where someone is residing. Indoor nonres=inside at a place that is not a residence (e.g., farm, industry, commercial business, and school). Outside nonind=outside at a place that is nonindustrial, or nonfarming (e.g., driveways, yards, roofs at residences, and schools). Outside ind=outside at an industry or farming area.

    Figure 2-Distribution of transportation-related events, by type of transport, Hazardous Substances Emergency Events Surveillance, 1999-2000.*

    *Four events had a combination of transportation types: one event, ground and rail; one event, water and rail; and two events, pipeline and water.

    Figure 3-Factors reported as contributing to the occurrence of fixed-facility events, Hazardous Substances Emergency Events Surveillance, 1999-2000.


     

    Table 2 -Distribution of the number of substances released, by type of event, Hazardous Substances Emergency Events Surveillance, 1999-2000.
     

    No. of substances released

    Type of event


    All events

    Fixed facility

    Transportation

    No. of events

    (%)

    No. of substances

    No. of events

    (%)

    No. of substances

    No. of events

    (%)

    No. of substances

    1

    9,715

    95.9

    9,715

    3,500

    95.2

    3,500

    13,215

    95.7

    13,215

    2

    216

    2.1

    432

    121

    3.3

    242

    337

    2.4

    674

    3

    105

    1.0

    315

    27

    0.7

    81

    132

    1.0

    396

    4

    44

    0.4

    176

    11

    0.3

    44

    55

    0.4

    220

    ?5

    53

    0.5

    722

    16

    0.4

    89

    69

    0.5

    811

    Total

    10,133

    100.0

    11,360

    3,675

    100.0

    3,956

    13,808

    100.0

    15,316

    Table 3-Distribution of the number of substances released, by substance category and type of event, Hazardous Substances Emergency Events Surveillance, 1999-2000.
     

    Substance  Category 

    Type of event

    All events

    Fixed facility

    Transportation

    No. of substances

    (%)

    No. of substances

    (%)

    No. of substances

    (%)

    Acids

    800

    7.0

    567

    14.3

    1,367

    8.9

    Ammonia

    757

    6.7

    80

    2.0

    837

    5.5

    Bases

    268

    2.4

    288

    7.3

    556

    3.6

    Chlorine

    182

    1.6

    7

    0.2

    189

    1.2

    Other inorganics*

    3,055

    26.9

    472

    11.9

    3,527

    23.0

    Paints and dyes

    219

    1.9

    208

    5.3

    427

    2.8

    Pesticides

    349

    3.1

    297

    7.5

    646

    4.2

    PCBs

    163

    1.4

    12

    0.3

    175

    1.1

    VOCs

    2,423

    21.3

    629

    15.9

    3,052

    19.9

    Mixtures†

    1,332

    11.7

    170

    4.3

    1,502

    9.8

    Other‡

    1,813

    16.0

    1,225

    31.0

    3,038

    19.8

    Total§

    11,361

    100.0

    3,955

    100.0

    15,316

    100.1

    PCBs=Polychlorinated biphenyls.
    VOCs=Volatile organic compounds.
    *All inorganic substances except for acids, bases, ammonia, and chlorine.
    †Mixtures of substances from different categories.
    ‡Not classified.
    §Total may not equal 100% due to rounding.

    VICTIMS

    A total of 4,425 victims were involved in 1,256 events (9.1% of all events) (Table 4). Of the 1,256 events with victims, 744 (59.2)% events involved only one victim, and 919 (73.2)% events involved either one or two victims. Of the 4,425 total victims, 3,787 (85.6%) were injured in fixed-facility events.

    The substances released most often were not necessarily the most likely to result in victims (Table 5). For example, other inorganic substances were released 3,527 times; however, only 340 (9.6%) of these events resulted in injury. Conversely, chlorine was released in only 189 events, but 62 (32.8%) of these events resulted in injury, which indicates chlorine's greater potential for immediate harm.

    Employees (2,365 or 53.4%) were the population groups most often injured, followed by the general public (919 or 20.7%), students (662 or 15.0%), and responders (460 or 10.4%) (Figure 4). The population group was unknown for 19 victims (0.43%). There were 366 emergency response personnel injured in fixed-facility events. Of those, 144 (39.3%) were police, 86 (23.5%) were professional firefighters, and 83 (22.7%) volunteer firefighters (Figure 5a). There were 94 emergency-responder victims injured in transportation-related events. Of these, 50 (53.1%) were police officers, 22 (23.4%) were professional firefighters, and 12 (12.8%) were emergency medical technicians (EMTs) (Figure 5b).

    The types of injuries sustained by victims are shown in Table 6 and Figure 6. Victims sustained a total of 6,970 injuries. Some victims had more than one injury. The most commonly reported injuries in fixed-facility events were respiratory irritation (32%), headache (13%), dizziness or other central nervous system (CNS) symptoms (11%), eye irritation (11%), and gastrointestinal problems (11%). In transportation-related events, trauma (30%), respiratory irritation (21%), headache (9%), and eye irritation (6%) were reported most frequently. Trauma was reported more frequently in transportation-related events (30%) than in fixed-facility events (3%). The trauma might have been caused by the sequence of events (for example, a motor vehicle accident) leading to the release of a hazardous substance, and not necessarily by exposure to the hazardous substance itself.

    The sex of 79% of the victims was known; of these, 54% were male. The mean age of the 63% of victims with a specified age was 40 years (range: 0-77 years). For the 37% of injured persons for whom specific age was unknown, 70% were adults (first responders or employees), 3% were children (students), and 27% could have been adults or children (general public or unknown victim category). Most (49%) victims were transported to a hospital and treated on an outpatient basis, and 1.6% died (Figure 7). Appendix B details the fixed-facility events in which deaths occurred, and Appendix C details the transportation events in which deaths occurred.

    Among victims, 34% of employees, 20% of emergency responders, and 99% of students had not worn any form of personal protective equipment. For injured employees reported as wearing personal protective equipment, a combination of gloves, eye protection, and a hard hat were worn (14%). Fourteen percent wore other type of protective equipment, 4% wore firefighter turnout gear, and 2% wore level "D" protection, as defined by the Occupational Safety and Health Administration (OSHA). Of the known personal protective equipment worn, the most frequently worn by emergency responders was firefighter turnout gear (5%) and OSHA level "A" protection (2%).

    Level "A" protection is worn when the highest level of respiratory, skin, and eye protection is needed. It includes supplied-air respirator, approved by the Mine Safety and Health Administration (MSHA), U.S. Department of Labor, and the National Institute for Occupational Safety and Health (NIOSH); pressure-demand, self-contained breathing apparatus; fully encapsulating chemical-resistant suit; coveralls; long cotton underwear; chemical-resistant gloves (inner); boots, chemical-resistant, steel toe and shank; hard hat; disposable gloves and boot covers; cooling unit; and two-way radio communications. Level "D" is worn as a work uniform and is not recommended for sites with respiratory or skin hazards. Level "D" includes coveralls, gloves, boots/shoes (leather or chemical-resistant, steel toe and shank), safety glasses or chemical splash goggles, and hard hat. Level "D" provides no protection against chemical hazards. Firefighter turnout gear is protective clothing normally worn by firefighters during structural fire-fighting operations, and is similar to level "D" protection.

    Table 7 lists all of the events in which 50 or more people were injured. There were eight such events during the 2-year period.

    EVACUATIONS

    Evacuations were ordered in 1,182 events, and the evacuation status of 64 events was unknown. Of known evacuations, 71% were of a building or the affected part of a building, 14% were of a defined circular radius surrounding an event, 6% were of a downwind/downstream area, 5% were reported as having a circular and downwind/downstream area, and 3% had no criteria. The median number of persons evacuated was 20. In 93 events, in-place sheltering was ordered by an official, and instructions regarding precautions to take during in-place sheltering were provided by an official in 18 of these events.

    CONTINGENCY PLANS

    A contingency plan was followed in 95% of events. The types of contingency or preparedness plans used during an event varied, with 72% involving the use of a company's operating procedures. Twenty-one percent of events were reported as using a (HAZMAT)/Response team's standard operating procedures, and 6% of events were reported as using an incident-specific ad hoc plan.

     

    Table 4-Distribution of the number of victims, by type of event, Hazardous Substances Emergency Events Surveillance, 1999-2000.
     

    No. of victims

    Type of event


    All events

    Fixed facility

    Transportation

    No. of events

    (%)

    No. of substances

    No. of events

    (%)

    No. of substances

    No. of events

    (%)

    No. of substances

    1

    526

    55.4

    526

    218

    71.0

    218

    744

    59.2

    744

    2

    136

    14.3

    272

    49

    16.0

    98

    175

    14.7

    370

    3

    79

    8.3

    237

    2

    3.9

    36

    91

    7.2

    273

    4

    54

    5.7

    216

    5

    1.6

    20

    59

    4.7

    236

    5

    33

    3.5

    165

    9

    2.9

    45

    42

    3.3

    210

    ?6

    121

    12.8

    2,371

    14

    4.6

    221

    135

    10.7

    2,592

    Total

    949

    100.0

    3,787

    307

    100.0

    638

    1,256

    100.0

    4,425

     

    Table 5-Number of substances released in all events and events with victims, by substance category, Hazardous Substances Emergency Events Surveillance, 1999-2000.

      Substance Category

    Total releases

    Releases with victims

    No.

     

     

    Percentage of total releases

    No.

    Percentage of all releases with victims

    Percentage of releases in substance category

    Acids

    1,367

    (8.9)

    238

    (13.3)

    17.4

    Ammonia

    837

    (5.5)

    169

    (9.4)

    20.2

    Bases

    556

    (3.6)

    63

    (3.5)

    11.3

    Chlorine

    189

    (1.2)

    62

    (3.5)

    32.8

    Other inorganics*

    3,527

    (23.0)

    340

    (19.0)

    9.6

    Paints and dyes

    427

    (2.8)

    27

    (1.5)

    6.3

    Pesticides

    646

    (4.2)

    107

    (6.0)

    16.6

    Polychlorinated biphenyls

    175

    (1.1)

    1

    (0.1)

    0.6

    VOCs

    3,052

    (19.9)

    302

    (16.9)

    9.9

    Mixtures†

    1,502

    (9.8)

    135

    (7.5)

    9.0

    Other‡

    3,038

    (19.8)

    348

    (19.4)

    11.5

    Total

    15,316

    (100.0)

    1,792

    (100.0)

    (100.0)

    VOCs=Volatile organic compounds.
    *All inorganic substances except for acids, bases, ammonia, and chlorine.
    †Mixtures of substances from different categories.
    ‡Not classified.


    Figure 4-Distribution of victims, by population group* and type of event, Hazardous Substances Emergency Events Surveillance, 1999-2000.

    *Population group was unknown for 19 persons injured in fixed-facility events.


    Figure 5a-Distribution of responders injured in fixed-facility events,* by population group, Hazardous Substances Emergency Events Surveillance, 1999-2000.

    *A total of 366 responders were injured during fixed-facility events.


    Figure 5b-Distribution of responder victims for transportation-related events,* by population group, Hazardous Substances Emergency Events Surveillance, 1999-2000.

    *A total of 94 responders were injured during transportation-related events.

    Table 6-Distribution of type of injury, by type of event,* Hazardous Substances Emergency Events Surveillance, 1999-2000.
     

    Type of injury 

    Type of event

    All events

    Fixed facility

    Transportation

    No. of injuries

    (%)

    No. of injuries

    (%)

    No. of injuries

    (%)

    Chemical burns

    207

    3.4

    33

    4.0

    240

    3.4

    Heart problems

    99

    1.6

    3

    0.4

    102

    1.5

    Dizziness/CNS†

    699

    11.4

    42

    5.1

    741

    10.6

    Eye irritation

    691

    11.2

    50

    6.1

    741

    10.6

    Headache

    776

    12.6

    75

    9.2

    851

    12.2

    Heat stress

    40

    0.6

    19

    2.3

    59

    0.8

    Gastrointestinal problems

    644

    10.5

    41

    5.0

    685

    9.8

    Respiratory system

    1,978

    32.1

    175

    21.4

    2,153

    30.9

    Shortness of breath

    198

    3.2

    37

    4.5

    235

    3.4

    Skin irritation

    187

    3.0

    37

    4.5

    224

    3.2

    Thermal burns

    119

    1.9

    21

    2.6

    140

    2.0

    Trauma

    168

    2.7

    242

    29.7

    410

    5.9

    Other

    328

    5.3

    21

    2.6

    349

    5.0

    Vomiting

    20

    0.3

    20

    2.5

    40

    0.6

    Total

    6,154

    100.0

    816

    100.0

    6,970

    100.0

    *The number of injuries is greater than the number of victims because a victim could have had more than one injury.
    †Central nervous system symptoms.


    Figure 6-Distribution of type of injury for all events, Hazardous Substances Emergency Events Surveillance, 1999-2000.

    *A total of 6,970 injuries was reported. The number of injuries was greater than the number of victims because some victims had more than one injury.
    **Central nervous system symptoms.

    Table 7-Profiles of events with =50 victims, Hazardous Substances Emergency Events Surveillance, 1999-2000.
     

    Victim Type

    No. of Victims

    Treatment(s)

    Chemical(s)

    Injuries(s)

    Employees,
    Responders

    54
    4

    Treated on scene

    Benzene

    Respiratory problems, dizziness or other CNS

    General public,
    Students

    1
    63

    Treated at hospital

    Carbon monoxide

    Gastrointestinal problems, carbon monoxide poisoning, dizziness or other CNS

    General public,
    EMTs,
    Volunteer firefighters,
    Professional firefighters 

    44
    8
    3
    10

    Treated at hospital, treated on scene

    Ammonia

    Respiratory problems,eye irritation, thermal burns, gastrointestinal problems, dizziness or other CNS, headache, heart problems

    Employees,
    General public

    86
    4

    Treated at hospital, treated on scene, death

    12 substances

    Trauma; respiratory, skin, and eye irritation; thermal burns; gastrointestinal problems; dizziness or other CNS; headache; heart problems; shortness of breath; coughing blood; alkylemia; ringing in ears; posttraumatic syndrome

    Students,
    General public

    98
    9

    Treated on scene, adverse health effects within 24 hours

    Pyridine

    Respiratory, skin, and eye irritation; headache; gastrointestinal problems; dizziness or other CNS; shortness of breath

    Students,
    General public

    118
    10

    Treated on scene, adverse health effects within 24 hours

    Pyridine

    Respiratory and eye irritation, Headache, Gastrointestinal problems, Shortness of breath, Dizziness or other CNS

    Employees

    141

    Treated on scene, treated at hospital

    Dichlorobenzene

    Respiratory problems, Dizziness or other CNS

    Students,
    General public

    191
    68

    Treated on scene, treated at hospital, adverse health effects within 24 hours

    Pyridine

    Respiratory, skin, and eye irritation, Gastrointestinal problems, Dizziness or other CNS, Headache, Metallic taste, Fatigue, Malaise

    Figure 7-Injury outcome, Hazardous Substances Emergency Events Surveillance, 1999-2000.

    *Within 24 hours.

    MANUFACTURING OF CHEMICALS AND ALLIED PRODUCTS

    HSEES industry codes are based on the 1990 Industrial Classification System of the Bureau of the Census, U.S. Department of Commerce. Additional analyses of events involving industries in the category Manufacturing of Chemicals and Allied Products (codes 180-Plastics, synthetics, and resins, 181-Drugs, 182-Soaps and cosmetics, 190-Paints, varnishes, and related products, 191-Agricultural chemicals, and 192-Industrial and miscellaneous chemicals) were conducted to determine the public health consequences of these events.

    The Manufacturing of Chemicals and Allied Products category was the second most frequently reported industry category in the surveillance system during 1999-2000. A total of 3,414 hazardous substances events (25% of all events and 33% of fixed-facility events) was reported to have occurred in this industry. Further classification by industry code found that 64% of these events occurred at manufacturers of industrial and miscellaneous chemicals, 28% in plastics, synthetics, and resins, 4% in agricultural chemicals, 2% in drugs, 2% in cosmetics, and approximately 1% in paints, varnishes, and related products manufacturing. Of the known primary contributing factors, 54% of the events occurred as a result of equipment failure and 11% were due to operator error. The category of substances most frequently released were VOCs (33%), other inorganic substances (22%), and mixtures (19%). Seventy-four percent of the releases were air emissions, 23% were spills, and the remainder involved mostly fire and explosions.

    Events involving the Manufacturing of Chemicals and Allied Products category accounted for the most (22%, n=981) injured persons of any industry category in the surveillance system during 1999-2000. Forty-one percent of injured persons were students, 40% employees, 15% were the general public, and the remainder were first responders. Seventy-one percent (n=644) of the victims were treated at the scene, 14% (n=130) were transported and treated in the hospital, and 3% (n=27) were admitted to the hospital. Events in the category Manufacturing of Chemicals and Allied Products resulted in 10 deaths (13% of all deaths), of which nine were employees, and one was a first responder.

    Twenty-five percent of events occurred within a quarter mile of a residential area. Evacuations were ordered in 105 (3%) of the events. The number of persons evacuated was available for 90% of events with known evacuation orders. Ordered evacuations resulted in the evacuation of a range of 0 to 4,493 persons, with a median of 20 persons. The length of the evacuation period, available for 84% of the events with known evacuation orders, ranged from 1 to 1,800 hours, with a median of 3 hours.

    One particular drug manufacturing facility accounted for three of the events for which evacuations were ordered. Two of these events resulted in the evacuation of more than 4,400 persons on each occasion for periods of 3 to 4 hours. These three events resulted in 494 injured persons, 407 of whom were students at a neighboring high school. These figures illustrate the potential public health threat and financial costs associated with releases of hazardous substances in the manufacturing of chemicals and allied products industry.

    USE OF HSEES DATA

    During 1999-2000, ATSDR continued to respond to requests for HSEES information from local, state, and federal agencies and organizations. In addition, ATSDR continued to receive requests from researchers for copies of the HSEES protocol, data collection form, data, and publications. HSEES data have been used to produce the publications listed in Appendix D.

    The HSEES Internet Web site page is available at http://www.atsdr.cdc.gov/HS/HSEES/. At this site, HSEES annual reports and other information can be downloaded to a user's personal computer. Internet linkages to other relevant Web sites will be available on the HSEES Web site in the future.

    Current activities include collaboration with the Federal Emergency Management Agency and other agencies and organizations involved with response to chemical terrorism, emergency response, hazardous substances releases, and public health. Eight years of HSEES data are now available for trend analysis, and several publications are under way. Participating states have developed their own cumulative data reports and prevention plans.

    In December 1999, a new Internet-based data-entry system became available for use by participating states. This system has improved data management and synchronization and has resulted in more rapid reporting, which could lead to broader uses of the data.

    SUMMARY OF RESULTS, 1993-2000

    The number of events, substances released, events with victims, and deaths for the years 1993 through 2000 are shown in Table 8. During this period, most events involved a single substance at fixed facilities. However, the number of transportation events is increasing, partially the result of using the U.S. Department of Transportation's Hazardous Materials Information System as a primary notification source for transportation events. The total number of events and the number of substances released during 1999-2000 continued the upward trend. This is partially explained by the addition of two new states in 2000; however, the number of events in states that have been in the system since 1993 grows every year.

    Respiratory symptoms have consistently been most frequently reported. The number of deaths associated with events continues to suggest the need to evaluate not only the danger posed by exposure to hazardous substances, but also the circumstances surrounding the occurrence of events. Employees continue to be the most commonly reported victims of emergency events (Figure 8). Cumulative data on the number of events, substances, victims, and events involving victims are displayed in Figure 9.

    HSEES data regarding risk factors related to the occurrence of emergency events and the associated morbidity and mortality have multiple uses. The states and ATSDR use the results of data analysis for prevention activities aimed at several different target groups, including school personnel, industry and labor groups, first responders, hospital personnel, and producers or users of potentially dangerous substances.

    Table 8-Cumulative data for all states, Hazardous Substances Emergency Events Surveillance, 1993-2000.*
     

    Year

    No. of states

    Type of event

    No. of substances released

    No. of deaths

    No. of victims

    Events with victims

    No. -- (%)†

     

    Fixed facility

    Transportation

    Total

    1993

    11

    3,199

    634

    3,833

    4,361

    16

    2,230

    464

    (12)

     

    1994

    12

    3,321

    912

    4,233

    5,073

    21

    2,181

    414

    (10)

     

    1995

    14

    4,273

    1,037

    5,310

    6,027

    14

    1,688

    402

    (8)

     

    1996

    14

    4,327

    1,159

    5,486

    5,862

    33

    1,622

    390

    (7)

     

    1997

    13

    4,385

    1,128

    5,513

    6,089

    28

    1,896

    372

    (7)

     

    1998

    13

    4,729

    1,252

    5,981

    6,486

    36

    1,533

    405

    (7)

     

    1999

    13

    4,634

    1,626

    6,260

    6,974

    30

    1,912

    504

    (8)

     

    2000

    15

    5,499

    2,049

    7,548

    8,384

    44

    2,513

    752

    (10)

     

    Total

     

    34,367

    9,797

    44,164

    49,256

    222

    15,575

    3,703

    (8)

     


    *Numbers in the table may differ from those reported in previous years because of adjustments in HSEES qualification requirements for events. †Percentage of events with victims.


    Figure 8-Distribution of victims, Hazardous Substances Emergency Events Surveillance, 1993-2000†

    *The student category was not available before 1995.
    †The numbers of unknown victims were as follows: 14 for 1993, six for 1994, three for 1996, 14 for 1997, eight for 1998, one for 1999, and 17 for 2000.


    Figure 9-Cumulative data for all participating states, Hazardous Substance Emergency Events Surveillance, 1993-2000.

    REFERENCE

    1. Binder S. Death, injuries, and evacuations from acute hazardous materials releases. Am J Public Health 1989;79:1042-4.

    APPENDICES

    Appendix A-The 100 Most Frequently Released Substances, Hazardous Substances Emergency Events Surveillance, 1999-2000
     

     

    Number

    Standardized Substance Name

    Frequency

    1.

    Ammonia

    801

    2.

    Sulfur Dioxide

    560

    3.

    Sulfuric Acid

    422

    4.

    Hydrochloric Acid

    330

    5.

    Paint or Coating NOS*

    323

    6.

    Sodium Hydroxide

    302

    7.

    Mercury

    267

    8.

    Carbon Monoxide

    259

    9.

    Nitric Oxide

    253

    10.

    Ethylene Glycol

    244

    11.

    Chlorodifluoromethane

    192

    12.

    Butadiene

    187

    13.

    Benzene

    187

    14.

    Chlorine

    183

    15.

    Oxides of Nitrogen NOS

    179

    16.

    Polychlorinated Biphenyls

    174

    17.

    Corrosive NOS

    153

    18.

    Nitrogen Dioxide

    127

    19.

    Solvent NOS

    124

    20.

    Phosphoric Acid

    123

    21.

    Hydrogen Sulfide

    121

    22.

    Mix: Hydrogen Sulfide/Sulfur Dioxide

    120

    23.

    Potassium Hydroxide

    114

    24.

    Adhesive NOS

    110

    25.

    Sodium Hypochlorite

    110

    26.

    Mix: Nitric Oxide/Nitrogen Dioxide

    105

    27.

    Acid NOS

    96

    28.

    Resin Solution

    92

    29.

    Ethanol

    86

    30.

    Ethylene

    82

    31.

    Pesticide NOS

    82

    32.

    Xylene

    82

    33.

    Toluene

    79

    34.

    Methanol

    77

    35.

    Flammable Liquid NOS

    76

    36.

    Acetone

    75

    37.

    Methylene Chloride

    72

    38.

    Isopropanol

    69

    39.

    Hydrogen Peroxide

    68

    40.

    Nitric Acid

    67

    41.

    Mix: Benzene/Butadiene

    65

    42.

    Ink NOS

    59

    43.

    Propylene

    57

    44.

    Acetic Acid

    56

    45.

    Ethyl Ether

    54

    46.

    Formaldehyde

    50

    47.

    Freon NOS

    50

    48.

    Diesel Fuel

    49

    49.

    Nitrogen Fertilizer

    47

    50.

    Methyl Ethyl Ketone

    46

    51.

    Tetrachloroethylene

    46

    52.

    Brake or Hydraulic Fluid NOS

    44

    53.

    Hypochlorite NOS

    40

    54.

    Asbestos

    39

    55.

    Resin NOS

    38

    56.

    Base NOS

    37

    57.

    Ethylene Oxide

    37

    58.

    Hydraulic Oil

    36

    59.

    Urea Ammonium Nitrate

    36

    60.

    EPA F039: Multi-code Treatment, Storage, or Disposal Leachate

    35

    61.

    Hydrofluoric Acid

    35

    62.

    Malathion

    35

    63.

    Sulfur

    35

    64.

    Battery Acid NOS

    33

    65.

    Fertilizer NOS

    32

    66.

    Mix: Dimethyl Disulfide/Dimethyl Sulfide/Hydrogen Sulfide/Methyl Mercaptan

    32

    67.

    Pendimethalin

    31

    68.

    Vinyl Chloride

    31

    69.

    Acrolein

    30

    70.

    Ammonium Nitrate

    30

    71.

    Calcium Hypochlorite

    30

    72.

    Isopropylamine Glyphosate

    30

    73.

    Mix: Nitric Oxide/Sulfur Dioxide

    30

    74.

    Trifluralin

    29

    75.

    VOCs NOS

    29

    76.

    Ephedrine

    28

    77.

    Methamphetamine Chemical NOS

    28

    78.

    O-Chlorobenzylidene Malononitrile

    28

    79.

    Styrene

    28

    80.

    Chlorpyrifos

    27

    81.

    Mix: Nitric Oxide/Nitrogen Dioxide/Sulfur Dioxide

    27

    82.

    Phosphorus

    27

    83.

    Ether NOS

    25

    84.

    Iodine

    25

    85.

    Methyl Mercaptan

    25

    86.

    Urea

    25

    87.

    Naphtha

    24

    88.

    Carbon Dioxide

    23

    89.

    Alcohol NOS

    23

    90.

    Chloroform

    23

    91.

    Transformer Oil NOS

    23

    92.

    Xylene NOS

    22

    93.

    Black Liquor†

    22

    94.

    Nitrous Oxide

    22

    95.

    Phenol

    22

    96.

    Propylene Glycol

    22

    97.

    Ammonium Hydroxide

    21

    98.

    Calcium Oxide

    21

    99.

    Carbon Black

    21

    100.

    Diazinon

    21

    Total

     

    9,169

    VOCs--Volatile organic compounds.
    NOS--Not otherwise specified.
    *Unable to assign a standardized name for 128 substance.
    †This is a substance used in pulp processing; it is not for consumption.

    Appendix B-- Profiles of Events With Fatalities in Fixed Facilities, Hazardous Substances Emergency Events Surveillance, 1999-2000.
     

    Industry/
    Location

    Type of release

    Chemicals (quantities)

    Factors

    Victim Category

    Sex*

    Injury

    PPE*

    Specialty plastic

    Explosion

    Tetrafluoroethylene

    Human error

    Employee

    2 F
    1 M

    Thermal burns

    Unknown

    Industrial
    chemical mfg.*

    Fire

    Sulfur dioxide (1,000 lb)

    Other

    Employee

    M

    Respiratory irritation

    Eye protection, hard had, steel-toed shoe

    Private
    residence

    Spill + Air emission

    Oxidizer (liter)
    Vinegar (liter)
    Sodium hydroxide 
    Sodium hypochlorite
    Sodium silicate (liter)

    Improper mixing

    Employee

    F

    Respiratory irritation

    None

    Tire mfg.

    Spill + Fire

    Drain cleaner (liter)

    Unknown

    Employee

    M

    Trauma

    None

    Illegal drug lab

    Fire + Explosion

    Carbon black
    Ethanol
    Hexane

    Illegal activity

    General public

    M

    Respiratory irritation

    None

    Fireworks

    Fire + Explosion

    Black powder

    Unknown

    Employee

    F

    Trauma, thermal burns

    None

    Private
    residence/
    Business Fireworks

    Explosion

    Black powder
    Pyrotechnic chemicals

    Unknown

    General public

    M

    Trauma, thermal burns

    Unknown

    Fireworks

    Spill + Air emission

    Black powder
    Pyrotechnic chemicals

    Human error

    Employee

    F

    Trauma

    None

    Special
    chemical mfg.

    Spill + Air emission

    Sodium hydrosulfide

    Human error

    Employee

    M

    Asphyxia

    Eye protection,
    hard hat

    Powder and magnesium mfg.

    Explosion

    Magnesium
    Teflon
    Viton

    Other

    Employee

    M

    Trauma,
    chemical and
    thermal burns

    None

    Dairy farm/Agriculture

    Air emission

    Ammonia
    Carbon dioxide
    Hydrogen sulfide
    Methane

    Human error

    Employee

    M
    M

    Other, respiratory irritation

    None

    Fireworks
    disposal

    Explosion

    Black powder
    Sodium chlorate
    Potassium perchlorate (100lb)

    Human error

    Employee

    M

    Thermal burns

    None

    Restaurant

    Air emission

    Ammonium
    Calcium hypochlorite

    Equipment failure

    Employee

    M

    Respiratory irritation,
    other

    None

    Private
    residence

    Fire

    Acid
    Base
    Solvent
    Cyanide

    Unknown

    Employee

    M

    Trauma

    None

    Hospital

    Air emission

    Nitrogen

    Equipment failure

    Employee

    M

    Asphyxia

    Unknown

    Private
    residence

    Air emission

    Hydrochloric acid (2kg)

    Human error

    General public

    M

    Respiratory
    and eye
    irritation,
    chemical
    burns

    Unknown

    Organic
    chemicals mfg.

    Fire

    Di-tert-butyl peroxide (138 gal)

    Human error

    Employee

    M

    Thermal burns

    Gloves
    hard hat, eye protection

    Polyethylene mfg.

    Explosion + Spill +
    Air emission + Fire

    12 different chemicals
    (22.5)

    Improper mixing

    Employee

    M

    Trauma,
    chemical and 
    thermal burns

    Eye
    protection,
    hard hat,
    steel toed shoe.

    Private property/
    Illegal drug

    Fire

    Acetone

    Human error

    General public

    M
    F

    Thermal burns

    None

    Single family residence

    Air emission

    Carbon monoxide

    Unknown

    General public

    1 M
    2 F

    Suffocation

    None

    Mfg. thermal controls

    Spill

    Mixture

    Unknown

    Employee

    M

    Chemical
    and thermal
    burns

    Unknown

    Boy Scout camp

    Air emission

    Carbon monoxide

    Unknown

    Employee

    M

    Suffocation

    None

    *Personal protective equipment.

    Appendix C-- Profiles of Events With Fatalities in Transportation Events, Hazardous Substances Emergency Events Surveillance, 1999-2000.

    Industry/
    Location

    Type of release

    Chemicals
    (quantities)

    Victim Category

    Sex*

    Injury

    PPE*

    Truck transportation

    Spill

    Sulfur (900 gal)

    Employee

    M

    Trauma

    None

    Transportations

    Spill

    Acrylic acid polymer

    Employee

    2 M

    Trauma

    Unknown

    Aerial pesticide
    applicators

    Spill + Air
    emission

    Imazapyr
    Triclopyr(13 lb)

    Employee

    2 M

    Trauma

    Unknown

    Motor freight
    transportation

    Spill + fire

    2-(2-Aminoethyoxyl)-
    ethanol (8 ton)
    Diesel fuel
    Chlorimuron-ethyl
    Metribuzine (10 tons)

    Employee

    M

    Trauma

    None

    Grain elevator

    Spill

    Imazethapyr

    Employee

    M

    Trauma

    None

    Motor freight
    transportation

    Spill

    Sulfur (3,200 gal)

    General public

    M

    Trauma

    None

    Motor freight
    transportation

    Spill + Fire

    Fire fighting foam
    (28 tons)
    Household cleaners
    (28 tons) 
    Diesel fuel

    Employee

    2 M

    Trauma

    None

    Motor freight
    transportation

    Air emission

    Nitrogen (50 lb)

    Employee

    M

    Trauma

    None

    Truck transportation

    Spill

    Potassium chloride
    Diesel fuel

    Employee

    M

    Trauma

    None

    Illegal meth drug lab

    Explosion

    Ammonia (20 lb)

    General public

    M

    Trauma,
    chemical burns,
    respiratory

    None

    Truck transportation

    Spill

    Sodium hydroxide
    (6 gal)

    Employee

    M

    Trauma

    None

    Multi-vehicle
    accident

    Spill + Fire

    Hydrochloric acid
    (8 gal)
    Gasoline

    General public

    2 F
    8 M

    Trauma,
    asphyxia,
    respiratory,
    thermal
    burns

    None

    Truck

    Spill + Fire

    Dichlobenil (20 tons)

    General public

    F

    Trauma

    None

    Truck

    Spill

    Hydramethylnon
    (360 lb)

    Employee

    M

    Trauma

    None

    Private vehicles

    Spill

    Sulfuric acid (gal)
    Methanol
    Formaldehyde

    General
    public

    M

    Trauma,
    heart
    problems

    None

    Environmental
    transport

    Spill

    Diesel fule
    Sodium hypochlorite
    (35 gal)

    Employee

    M

    Trauma

    Unknown

    Truck

    Spill

    Diesel fuel (200 gal)
    Vitamins

    Employee

    M

    Trauma

    None

    Aerial spraying

    Spill + Fire

    Diesel fuel
    Sulfur oil

    Employee

    M

    Trauma

    Unknown

    Truck

    Spill

    Calcium carbonate
    (200 lb)

    General public

    Unk

    Trauma

    Unknown

    Private
    contractor

    Spill +
    Threat

    Diesel fuel (150 gal)
    Ethyl lactate
    (4,370 gal)

    Employee

    M

    Trauma

    None

    Truck

    Spill

    Diesel fuel (75 gal)
    Hydrochloric acid
    (10 gal)

    General 
    public

    M

    Trauma

    None

    Motor freight
    carrier

    Spill

    Sodium hypochlorite
    (2,000 gal)

    Employee

    M

    Trauma

    None

    Pool chemical
    supply

    Spill

    Hydrochloric acid
    (150 gal)

    General public

    M

    Trauma

    None

    Crop duster

    Spill

    Atrazine
    2,4-D
    Metasulfuron-methyl
    (20 gal)

    Employee

    M

    Trauma

    Eye
    protection,
    hard hat

    Crop duster

    Spill + Air 
    emission

    Malathion (100 gal)

    Employee

    M

    Trauma

    Hard hat

    Motor freight 
    carrier

    Spill

    Sodium hypochlorite
    (150 gal)

    Employee

    M

    Trauma

    None

    Motor freight
    carrier

    Threat

    Helium (9,600 gal)

    Employee

    F
    M

    Trauma

    None

    Truck

    Spill

    Phosphoric acid

    Employee

    M

    Trauma

    None

    Private citizen

    Fire

    Radioactive material
    Plutonium

    General public

    F

    Heart problems

    None

    Chemical transport

    Air
    emission

    Carbon dioxide
    (1 ton)

    Employee

    M

    Trauma

    None

    Truck

    Threat

    Black liquor
    (6,500 lb)

    General public

    M

    Trauma

    None

    Manufacturing
    adhesive and
    resins

    Spill

    Phenon (ton)

    Employee

    M

    Respiratory
    irritation

    None

    *PPE = Personal protective equipment; mfg. = manufacturing; M = male; F = female.

    Appendix D-Hazardous Substances Emergency Events Surveillance-Related Publications

    Agency for Toxic Substances and Disease Registry. Hazardous Substances Emergency Events Surveillance annual report, 1993. Atlanta: US Department of Health and Human Services; 1994.

    Agency for Toxic Substances and Disease Registry. ATSDR update: Hazardous Substances Emergency Events Surveillance (HSEES) system: 1993 data. Health and Environment Digest 1995;8:83-4.

    Agency for Toxic Substances and Disease Registry. Hazardous Substances Emergency Events Surveillance annual report, 1994. Atlanta: US Department of Health and Human Services; 1995.

    Agency for Toxic Substances and Disease Registry. Hazardous Substances Emergency Events Surveillance System: information for local emergency planning committees and first responders. Atlanta: US Department of Health and Human Services; 1995.

    Agency for Toxic Substances and Disease Registry. Hazardous Substances Emergency Events Surveillance annual report, 1995. Atlanta: US Department of Health and Human Services; 1996.

    Agency for Toxic Substances and Disease Registry. Hazardous Substances Emergency Events Surveillance annual report, 1996. Atlanta: US Department of Health and Human Services; 1997.

    Agency for Toxic Substances and Disease Registry. Hazardous Substances Emergency Events Surveillance annual report, 1997. Atlanta: US Department of Health and Human Services; 1998.

    Agency for Toxic Substances and Disease Registry. Hazardous Substances Emergency Events Surveillance annual report, 1998. Atlanta: US Department of Health and Human Services; 1999.

    Agency for Toxic Substances and Disease Registry. Hazardous Substances Emergency Events Surveillance five-year cumulative report 1993-1997. Atlanta: US Department of Health and Human Services; 2001.

    Burgess JL, Kovalchick DF, Harter L, Kyes KB, Thompson JN. Hazardous materials events: an industrial comparison. J Occup Environ Med 2000;42:546-53.

    Burgess JL, Kovalchick DF, Harter L, Kyes KB, Lymp JF, Brodkin CA. Hazardous materials events: evaluation of transport to health care facility and evacuation decisions. Am J Emerg Med 2001;19:99-105.

    Hall HI, Dhara VR, Price-Green PA, Kaye WE. Surveillance for emergency events involving hazardous substances-United States, 1990-1992. MMWR 1994;43(No. SS-2):1-6.

    Hall HI, Dhara VR, Kaye WE, Price-Green PA. Surveillance of hazardous substance releases and related health effects. Arch Environ Health 1994;49:45-8.

    Hall HI, Price-Green PA, Dhara VR, Kaye WE. Health effects related to releases of hazardous substances on the Superfund priority list. Chemosphere 1995;31:2455-61.

    Hall HI, Dhara VR, Kaye WE, Price-Green PA. Public health consequences of hazardous substance releases. Toxicol Ind Health 1996;12:289-93.

    Hall HI, Haugh GS, Price-Green PA, Dhara VR, Kaye WE. Risk factors for hazardous substance releases that result in injuries and evacuations: data from 9 states. Am J Public Health 1996;86:855-7.

    Orr MF, Kaye WE, Zeitz P, Powers ME, Rosenthal L. Public health risks of railroad hazardous substance emergency events. J Occup Environ Med 2001;43:94-100.

    Orr MF, Kaye WE, Zeitz P, Powers ME, Rosenthal L. Letter to editor: Public health risks of railroad hazardous substance emergency events. J Occup Environ Med 2001;43:738-40.

    Orr MF, Haugh GS, Kaye WE. Hazardous Substances Emergency Events Surveillance, 1993 to 1997. Chemical Health and Safety. Jan/Feb 2001:35-41.

    Souther L, Small-Johnson J, Messing RB. A description of agricultural releases of anhydrous ammonia in Minnesota. Chemical Health and Safety. Nov/Dec 2000: 16-22.

    Centers for Disease Control and Prevention. Public health consequences among first responders to emergency events associated with illicit methamphetamine laboratories- selected states, 1996-1999. MMWR 2000;49:1021-4.

    Weisskopf MG, Drew JM, Hanrahan LP, Anderson HA. Hazardous ammonia releases in Wisconsin: trends and risk factors for evacuation and injury. Wisconsin Medical Journal. November 2000:30-46.

    Welles WL, Wilburn RE. Hazardous Substances Emergency Events Surveillance (HSEES) in New York State, 1993 to 1997. Chemical Health and Safety. January/February 2001:42-52.

    Wendt RD, Hall HI, Price-Green PA, Dhara VR, Kaye WE. Evaluating the sensitivity of hazardous substances emergency events surveillance: a comparison of three surveillance systems. J Environ Health 1996;58:13-7.

    Zeitz P, Berkowitz Z, Orr MF, Haugh GS, Kaye WE. Frequency and type of injuries in responders of hazardous substances emergency events, 1996 to 1998. J Occup Environ Med 2000;42:1115-20.

    Zeitz P, Orr MF, Kaye WE. Public health consequences of mercury spills: Hazardous Substances Emergency Events Surveillance System: 1993-1998. Environ Health Perspect 2002;110:129-32.

    Other HSEES documents available:

    1995 Annual Report [HTML] []
    1996 Annual Report [HTML] []
    1997 Annual Report [HTML] []
    1998 Annual Report [HTML] []
    1999-2000 Biennial Report []
    2001 Annual Report [HTML] []
    2002 Annual Report [HTML] []
    2003 Annual Report [HTML] []
    1993 through 1997 Annual Report [HTML] []
    1998 through 2001 Annual Report [HTML] []