No abstract

We analyzed data from states that participated in the Hazardous Substances Emergency Events Surveillance (HSEES) system maintained by the Agency for Toxic Substances and Disease Registry to describe the public health consequences of mercury releases. From 1993 through 1998, HSEES captured 406 events in which mercury was the only substance released. Schools and universities, private residences, and health care facilities were the most frequent locations involved in mercury events, and human error was the contributing factor for most of the releases. Fourteen persons experienced adverse health effects as a result of the releases. An additional 31 persons had documented elevated levels of mercury in the blood. No fatalities resulted. Evacuations were ordered in 90 (22%) of the events, and the length of evacuation ranged from 1 hr to 46 days. Mercury spills have a significant public health impact and economic burden. Some actions that could potentially lessen the consequences of mercury spills are to switch to mercury-free alternatives, train people in the safe handling and disposal of mercury, and keep mercury securely stored when it is necessary to have it on hand.

All responders should have at least basic awareness-level hazardous material training to recognize and avoid exposure. Research on improving firefighter PPE should continue. (Disaster Med Public Health Preparedness. 2018;12:211-221).

Objective To analyze hazardous substance release surveillance data for events involving secondary contamination of hospital emergency departments (EDs). Secondary contamination of EDs may occur when a patient, exposed to a hazardous chemical, is not decontaminated before arrival at the ED and when ED staff is not wearing appropriate personal protective equipment. This can result in adverse health outcomes among department personnel, other patients, and visitors. Even events without actual secondary contamination risk can be real in their consequences and require the decontamination of the ED and/or its occupants, evacuation, or temporary ED shut-down. Methods Events involving secondary contamination were identified using the Hazardous Substances Emergency Events Surveillance system and the National Toxic Substances Incidence Program during 2007–2013. Results Five incidents involving involved the threat of secondary contamination (0.02% of all events reported to the surveillance systems [n=33,001]) were detected and are described. Four incidents involved suspected secondary contamination in which the facility was evacuated or shut down. Conclusions These results suggest that while rare, incidents involving secondary contamination continue to present a hazard for emergency departments. Suggested best practices to avoid secondary contamination have been described. Hospitals should be made aware of the risks associated with secondary contamination and the need to proactively train and equip staff to perform decontamination.

Adequate preplanning and drills, proper decontamination procedures, good field-to-hospital communication, appropriate use of personal protective equipment, and effective training can help prevent injuries of medical personnel and contamination of transport vehicles and medical facilities.