Engaging a Chemical Disaster Community: Lessons from Graniteville

Abstract

Community engagement remains a primary objective of public health practice. While this approach has been adopted with success in response to many community health issues, it is rarely adopted in chemical disaster response. Empirical research suggests that management of chemical disasters focuses on the emergency response with almost no community engagement for long-term recovery. Graniteville, an unincorporated and medically underserved community in South Carolina was the site of one of the largest chlorine exposures by a general US population. Following the immediate response, we sought community participation and partnered with community stakeholders and representatives in order to address community-identified health and environmental concerns. Subsequently, we engaged the community through regular town hall meetings, harnessing community capacity, forming coalitions with existing local assets like churches, schools, health centers, and businesses, and hosting community-wide events like health picnics and screenings. Information obtained from these events through discussions, interviews, and surveys facilitated focused public health service which eventually transitioned to community-driven public health research. Specific outcomes of the community engagement efforts and steps taken to ensure sustainability of these efforts and outcomes will be discussed.

Persistent effects of chlorine inhalation on respiratory health

“…Following the accident, nine people died immediately, 72 were hospitalized, several hundred people immediately became sick and received medical care, and thousands were exposed . An exposure registry was developed, and community health screenings were provided in 2005–2007 . Using validated plume models, individual chlorine exposures were estimated .…”

“…[28][29][30][31][32] An exposure registry was developed, and community health screenings were provided in 2005-2007. 29,32,33 Using validated plume models, individual chlorine exposures were estimated. 26,34,35 Over the 3 years following the chlorine release, rates of hospitalization and emergency department visits for ambulatory care-sensitive conditions increased significantly in the Graniteville population compared with a nearby population not exposed to chlorine.…”

Hyaluronan and halogen‐induced airway hyperresponsiveness and lung injury

“…They are very reactive gases and pose a significant threat to public health when released into the atmosphere in large quantities during transportation and industrial accidents, as well as acts of terrorism. [5][6][7] Worldwide production of Cl 2 and Br 2 exceeds millions of tons per year; the list of the producing countries is maintained by the World Chlorine Counsel and sustainable development (www. worldchlorine.com).…”

“…The halogens Cl 2 and Br 2 are produced in large quantities throughout the world and used extensively in various manufacturing processes and the sanitation of water. They are very reactive gases and pose a significant threat to public health when released into the atmosphere in large quantities during transportation and industrial accidents, as well as acts of terrorism 5–7 …”

Integrating Health Research into Disaster Response: The New NIH Disaster Research Response Program

“…Public health officials and researchers need to clarify the public’s understanding of the importance of research in assisting emergency responders, medical personnel, and public health departments in their various roles. Abara and colleagues discussed how engaging community members in the recovery process following a chlorine spill assisted with focusing state and local public health priorities and ultimately resulted in community-driven public health research [ 22 ]. This incident demonstrated that including the community in planning for health consequences of disasters enhanced the full spectrum of response and recovery activities [ 23 ].…”