Emergency response to environmental toxic incidents: the role of the occupational physician.

Abstract

A survey of accidental environmental releases of hazardous chemicals conducted by the Agency for Toxic Substances and Disease Registry indicates that fixed facility events accounted for 77% of the episodes whereas 23% of the releases were related to transportation activities, such as loading or unloading materials. In nearly all the events (88%) only one chemical was released. Volatile organic compounds, chlorine, herbicides, acids and ammonia were the most common substances involved. In nearly one out of six reported events, an injury occurred. To prepare for emergencies associated with the accidental release of hazardous materials, the federal government, industry and professional organizations including the medical community have all been involved. In the United States, the Superfund Amendment Reauthorization Act (SARA) Title III passed in 1986 addresses the need to establish local emergency planning committees, to report and collect data, and a number of other matters. Professional societies, including the Joint Commission for the Accreditation of Health Care Organizations, the American College of Occupational and Environmental Medicine (ACOEM), and the American Industrial Hygiene Association, have all attempted to ensure proper education and training of those professionals called to assist in such emergencies. The occupational physician can assume numerous roles in the challenge related to emergency response, by becoming familiar with computerized information available to promptly determine the type of hazard released and its appropriate antidote, advising on the proper personal protective equipment, awareness of secondary contamination and participation on local emergency planning committees among many others. Emergency release of hazardous materials continues to occur with a frequency in the United States that deserves active vigilance and planning.