Hostname: page-component-586b7cd67f-l7hp2 Total loading time: 0 Render date: 2024-11-22T04:53:31.340Z Has data issue: false hasContentIssue false
  • English
  • Français

Acute Chemical Incidents With Injured First Responders, 2002-2012

Published online by Cambridge University Press:  01 August 2017

Natalia Melnikova ,
Jennifer Wu ,
Alice Yang  and
Maureen Orr
Natalia Melnikova*
Affiliation:
Agency for Toxic Substances and Disease Registry, Division of Toxicology and Human Health Sciences, Environmental Health Surveillance Branch; Atlanta, Georgia
Jennifer Wu
Affiliation:
Agency for Toxic Substances and Disease Registry, Division of Toxicology and Human Health Sciences, Environmental Health Surveillance Branch; Atlanta, Georgia
Alice Yang
Affiliation:
Agency for Toxic Substances and Disease Registry, Division of Toxicology and Human Health Sciences, Environmental Health Surveillance Branch; Atlanta, Georgia
Maureen Orr
Affiliation:
Agency for Toxic Substances and Disease Registry, Division of Toxicology and Human Health Sciences, Environmental Health Surveillance Branch; Atlanta, Georgia
*
Correspondence and reprint requests to Natalia Melnikova, MD, PhD, Agency for Toxic Substances and Disease Registry, Division of Toxicology and Human Health Sciences, Environmental Health Surveillance Branch, 4770 Buford HWY, Building 102, room 1408, Atlanta, GA 30341 (e-mail: [email protected]).
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction

First responders, including firefighters, police officers, emergency medical services, and company emergency response team members, have dangerous jobs that can bring them in contact with hazardous chemicals among other dangers. Limited information is available on responder injuries that occur during hazardous chemical incidents.

Methods

We analyzed 2002-2012 data on acute chemical incidents with injured responders from 2 Agency for Toxic Substances and Disease Registry chemical incident surveillance programs. To learn more about such injuries, we performed descriptive analysis and looked for trends.

Results

The percentage of responders among all injured people in chemical incidents has not changed over the years. Firefighters were the most frequently injured group of responders, followed by police officers. Respiratory system problems were the most often reported injury, and the respiratory irritants, ammonia, methamphetamine-related chemicals, and carbon monoxide were the chemicals more often associated with injuries. Most of the incidents with responder injuries were caused by human error or equipment failure. Firefighters wore personal protective equipment (PPE) most frequently and police officers did so rarely. Police officers’ injuries were mostly associated with exposure to ammonia and methamphetamine-related chemicals. Most responders did not receive basic awareness-level hazardous material training.

Conclusion

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)

Keywords

first responderhazardous materials trainingchemical incidentinjuriespersonal protective equipmentsurveillance
Type
Original Research
Information
Disaster Medicine and Public Health Preparedness , Volume 12 , Issue 2 , April 2018 , pp. 211 - 221
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Reichard, AA, Jackson, LL. Occupational injuries among emergency responders. Am J Ind Med. 2010;53(1):1-11.CrossRefGoogle ScholarPubMed
2. Agency for Toxic Substances and Disease Registry (ATSDR). Hazardous substances emergency event surveillance protocol; March 2004. http://www.atsdr.cdc.gov/hs/hsees/protocol030804 html. Accessed July 12, 2017.Google Scholar
3. Agency for Toxic Substances and Disease Registry (ATSDR). National Toxic Substances Incident Program Training Manual. Atlanta, GA: ATSDR; 2014. http://www.atsdr.cdc.gov/NTSIP/Documentation/UserManual.pdf. Accessed July 12, 2017.Google Scholar
4. US Environmental Protection Agency. Summary of the Emergency Planning & Community Right-to-Know Act 42 U.S.C. §11001 et seq. 1986. http://www.epa.gov/laws-regulations/summary-emergency-planning-community-right-know-act. Accessed July 12, 2017.Google Scholar
5. US Chemical Safety and Hazard Investigation Board. Final investigation report, West, TX: West Fertilizer Company fire and explosion; 2016. http://www.csb.gov/assets/1/19/West_Fertilizer_FINAL_Report_for_website_0223161.pdf. Accessed July 12, 2017.Google Scholar
6. Occupational Safety and Health Administration (OSHA). 29 CFR 1910.156 Fire brigades; 2013. https://www.osha.gov/pls/oshaweb/owadisp.show_document?p_id=9810&p_table=STANDARDS. Accessed July 12, 2017.Google Scholar
7. Occupational Safety and Health Administration (OSHA). 29 CFR 1910.134 Respiratory protection; 2012. https://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=standards&p_id=12716. Accessed July 12, 2017.Google Scholar
8. Occupational Safety and Health Administration (OSHA). 29 CFR 1910.120 Hazardous waste operations and emergency response; 2013. https://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=standards&p_id=9765. Accessed July 12, 2017.Google Scholar
9. Occupational Safety and Health Administration (OSHA). OSHA standard interpretation Standard number 1910.120. Dated December 30, 1991 Patricia Clark to Thomas Lowe. https://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=INTERPRETATIONS&p_id=20513. Accessed July 12, 2017.Google Scholar
10. Occupational Safety and Health Administration (OSHA). OSHA technical manual – Section VIII: Chapter 1: Chemical protective clothing; 2016. https://www.osha.gov/dts/osta/otm/otm_viii/otm_viii_1.html#3. Accessed July 12, 2017.Google Scholar
11. Occupational Safety and Health Administration (OSHA). Respiratory protection eTool. https://www.osha.gov/SLTC/etools/respiratory/respirator_selection_advisorgenius.html. Accessed July 12, 2017.Google Scholar
12. US Department of Transportation. The Emergency Responder Guidebook; 2016. http://phmsa.dot.gov/hazmat/outreach-training/erg. Accessed July 12, 2017.Google Scholar
13. Burgess, JL, Nanson, CJ, Bolstad-Johnson, DM, et al. Adverse respiratory effects following overhaul in firefighters. J Occup Environ Med. 2001;43(5):467-473.CrossRefGoogle ScholarPubMed
14. Welles, W, Wilburn, R, Ehrlich, J, et al. New York hazardous substances emergency events surveillance: learning from hazardous substances releases to improve safety. J Hazardous Mat. 2004;115:39-49.CrossRefGoogle ScholarPubMed
15. US Fire Administration. Respiratory diseases and the fire service. International Standard Book Number: 0-942920-51-1; 2010. http://www.iaff.org/hs/Respiratory/RespiratoryDiseases_andtheFireService.pdf. Accessed July 12, 2017.Google Scholar
16. National Fire Protection Association (NFPA). Fire Analysis & Research, Quincy, MA Trends in firefighter injuries 5/15; 2015. http://www.nfpa.org/research/reports-and-statistics/the-fire-service/fatalities-and-injuries/firefighter-injuries-in-the-united-states. Accessed July 12, 2017.Google Scholar
17. White, MK, Vercruyssen, M, Hodous, TK. Work tolerance and subjective responses to wearing protective clothing and respirators during physical work. Ergonomics. 1989;32(9):1111-1123.CrossRefGoogle ScholarPubMed
18. Willis, H, Castle, N, Sloss, E, et al. Protecting Emergency Responders, Personal Protective Equipment Guidelines for Structural Collapse Events, Vol 4. Santa Monica, CA: Rand Corporation; 2006. http://www.rand.org/pubs/monographs/MG425.html.Google Scholar
19. Coca, A, Roberge, RJ, Powell, JB, et al. Cardiovascular responses to five cooling strategies wearing a prototype firefighter ensemble. Med Sci Sports Exerc. 2010;42(5, suppl 1):767-768.CrossRefGoogle Scholar
20. Occupational Safety and Health Administration (OSHA). OSHA Technical Manual (OTM) Section III – Chapter 4: Heat Stress. https://www.osha.gov/dts/osta/otm/otm_iii/otm_iii_4.html#iii:4_1. Accessed July 12, 2017.Google Scholar
21. CDC NIOSH National Personal Protective Technology Laboratory – About NPPTL; 2017. http://www.cdc.gov/niosh/npptl/about.html. Accessed July 12, 2017.Google Scholar
22. Firefighter Life Safety Research Center, Illinois Fire Service Institute, University of Illinois. Firefighter Fatalities and Injuries: The Role of Heat Stress and PPE. Urbana-Champaign: Firefighter Life Safety Research Center, Illinois Fire Service Institute, University of Illinois, 2008. www.fsi.uiuc.edu.Google Scholar
23. Melnikova, N, Orr, M, Wu, J, Christensen, B. Injuries from methamphetamine-related chemical Incidents—five states, 2001–2012. MMWR Morb Mortal Wkly Rep. 64(33):909-912.CrossRefGoogle Scholar
24. Drug Enforcement Administration. Guidelines for Law Enforcement for the Cleanup of Clandestine Drug Laboratories. 2005 edition. Washington, DC: DEA/EPA; 2005.Google Scholar
25. Occupational Safety and Health Administration (OSHA). Best practices for protecting EMS responders during treatment and transport of victims of hazardous substance releases. OSHA 3370-11; 2009. https://www.osha.gov/Publications/OSHA3370-protecting-EMS-respondersSM.pdf. Accessed July 12, 2017.Google Scholar
26. US Department of Transportation. National guidelines for educating EMS instructors; 2002. http://www.nhtsa.gov/people/injury/ems/instructor/instructor_ems/2002_national_guidelines.htm. Accessed July 12, 2017.Google Scholar
27. National Fire Protection Association (NFPA). NFPA 473: Standard for Competencies for EMS Personnel Responding to Hazardous Materials/Weapons of Mass Destruction Incidents. Quincy, MA: NFPA; 2013.Google Scholar
28. Larson, T, Orr, M, Auf der Heide, E, et al. Threat of secondary chemical contamination of emergency departments and personnel: an uncommon but recurrent problem. Disaster Med Public Health Prep. 2015;2(2):104-113.Google Scholar
29. Mathews, R, Leiss, JK, Lyden, JT, et al. Provision and use of personal protective equipment and safety devices in the national study to prevent blood exposure in paramedics. Am J Infect Control. 2008;36(10):743-749.CrossRefGoogle ScholarPubMed
30. LaTourrette, T, Peterson, DJ, Bartis, JT, et al, Protecting Emergency Responders, Vol 2: Community Views of Safety and Health Risks and Personal Protection Needs. Santa Monica, CA: RAND Corporation; 2003. http://www.rand.org/pubs/monograph_reports/MR1646.html.Google Scholar
31. National Institute for Occupational Safety and Health (NIOSH). Emergency Responder Health Monitoring and Surveillance (ERHMS) website. http://www.cdc.gov/niosh/topics/erhms/default.html. Accessed July 12, 2017.Google Scholar