Challenges of exposure assessment for health studies in the aftermath of chemical incidents and disasters

Abstract

Exposure assessment during and after acute chemical incidents and disasters is essential for health studies that may follow. During chemical incidents, the focus usually lies on risk assessment and afterward attention shifts toward possible (long-term) health effects. This may lead to insufficient available data on exposure to study the association between exposure and health outcome, and collection of additional exposure data is often required. Literature on health studies conducted after several chemical incidents was reviewed to obtain better insight on the needs of health studies. Four different types of scenarios were distinguished based on when exposure data were collected and the exposure data used for health studies. These four scenarios gave insight on exposure data needed for conclusive health studies and when different methods of exposure data collection should be used. Literature indicated that adequate and rapid exposure assessment during chemical incidents is vital for health studies, because data that are not collected during or directly after an incident may be irretrievably lost. Poor exposure assessment is not always the only problem in health studies. Problems in health studies including poor exposure assessment may be prevented when the general design and needs of health studies are taken into account when designing contingency plans. Together with measures that will help facilitate funding, design, and coordination of health studies, disaster management programs should, among others, prepare for methods that lead to a swift identification of released substances, determination of concentrations and dispersion of released substances, designing basic questionnaire outlines, and rapid evaluation of the usefulness and necessity of employing biological sampling.

Disasters and Perinatal Health: A Systematic Review

“…For example, stress is likely to be widespread after almost any disaster (29; 30). Environmental exposures, however, might be specific to the disaster, and are likely to be limited to a smaller proportion of the population (31). Access to health care and other resources (such as nutritious food) will be problematic for some women but not others (23; 32; 33).…”

A GIS-based generic real-time risk assessment framework and decision tools for chemical spills in the river basin

“…Neither such study on spill EDSS has been documented with consideration on the risk analysis of vulnerable receptors' short-term exposure hazard to pollutants during incidents, nor generic risk assessment procedure was comprehensively or specially reported so far [15]. Real-time risk assessment during incidents is essential to guide emergency disposal of accidental surface water pollution on response stage, generally persisting several days [16].…”

Epidemiologic Methods Lessons Learned from Environmental Public Health Disasters: Chernobyl, the World Trade Center, Bhopal, and Graniteville, South Carolina

“…However, appropriate exposure assessment during both the early and late phases of an environmental disaster is vital. During the early phase, identification and quantification of released material and characterization of dispersion patterns helps define the at-risk population, determine potential health risks, and enable exposure estimation [81]. At the WTC and Bhopal, recall of exposure location alone successfully facilitated exposure estimation.…”