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Hospital Preparedness for Chemical Accidents: The Effect of Environmental Legislation on Health Care Services

Published online by Cambridge University Press:  28 June 2012

Linda Y. Landesman ,
Steven B. Markowitz  and
Stephen N. Rosenberg
Linda Y. Landesman*
Affiliation:
Albert Einstein College of Medicine, Department of Pediatrics
Steven B. Markowitz
Affiliation:
Mt. Sinai School of Medicine, Division of Environmental and Occupational Medicine
Stephen N. Rosenberg
Affiliation:
Columbia University School of Public Health, Division of Health Policy and Management
*
Albert Einstein College of Medicine, Nurses' Residence 6S 21, Pelham Parkway and Eastchester Road, Bronx, NY 10461USA
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Abstract

Background:

Chemical accidents occur often across the United States, endangering the health and safety of many people. The Super fund Amendments and Reauthorization Act of 1986 (SARA) requires that communities increase their planning for medical response to these accidents. So far, little evidence has come forth that supports the notion that environmental legislation, such as SARA, improves preparedness for such accidents.

Methods:

A one-group pretest/post-test longitudinal design was used to survey the medical directors of emergency departments in all acute care hospitals in the State of New York. Data were collected by mail survey and telephone follow-up in 1986 before the passage of SARA (Timel), and in 1989 after its implementation (Time2).

Results:

Ninety-four percent of the directors responded at Timel and 72% at Time2. In New York State, hospital preparedness for chemical accidents improved significantly during the study interval. The longer a hospital had a plan for response to chemical accidents, the more elements of preparedness were in place. Further, as a group, the hospitals that were the least prepared were located in the areas at highest risk.

Conclusion:

Environmental legislation can influence the manner by which health care organizations prepare for environmental emergencies.

Keywords

administrative preparednesschemical accidentsemergency departmentemergency preparednessenvironmental emergenciesenvironmental legislationhealth carehazardous materialshospital preparednesslocal emergency planning committeesmedical directorsrisk assessmentstructural preparednessSuperfund Amendments and Reauthorization Act of 1986
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 9 , Issue 3 , September 1994 , pp. 154 - 158
Copyright
Copyright © World Association for Disaster and Emergency Medicine 1994

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References

1. Skinner, PN: It can't happen here, recent significant toxic chemical incidents: A discussion and compendium (Draft Report). Environmental Protection Bureau. Albany, New York: Office of Attorney General R. Abrams, 1991.Google Scholar
2. Report of joint public hearings on toxic chemical accidents in New York state. (Sponsored by Hon. Abrams, R., Hon. Axelrod, David, Hon. Williams, Henry G., Hon. Farley, Hugh, and Hon. Hinchey, Maurice.) Environmental Protection Bureau. Albany, New York: Office of Attorney General R. Abrams. 18 June 1986.Google Scholar
3. Acute hazardous events data base (Final Draft). Environmental Protection Agency. Cambridge: Prepared by Industrial Economics, Inc., 1988.Google Scholar
4. Toxic chemical accidents in New York state: The risk of another Bhopal. Environmental Protection Bureau. Albany, New York: Office of the Attorney General R. Abrams, 14 January 1986.Google Scholar
5. Bhopal working group: The public health implications of the Bhopal disaster: Report to the program development board of the American Public Health Association. AJPH 1987;77:230–236.CrossRefGoogle Scholar
6. American Public Health Association Policy #9116: Health professionals and disaster preparedness and prevention, adopted at 1991 annual meeting, American Public Health Association.Google Scholar
7. Landesman, LY: Improving medical preparedness for chemical accidents: An inter-organizational resource review. International Journal Of Mass Emergencies and Disasters 1989;7:152–166.CrossRefGoogle Scholar
8. Landesman, LY, Leonard, RB: SARA three years later: Emergency physicians' knowledge, beliefs, and actions. Prehospital and Disaster Medicine 1993;8:39–44.CrossRefGoogle ScholarPubMed
9. PL 99–499: The Superfund Amendments and Reauthorization Act of 1986. Title III. Subtitle A, Sees. 303–304. Sub-title B, Secs. 311–313, 1986.Google Scholar
10. Leonard, RD, Calabro, JJ, Noji, EK, Leviton, RH: SARA (Superfund Amendments and Reauthorization Act), title III: Implications for emergency physicians. Ann Emerg Med 1989;18:1212–1216.CrossRefGoogle ScholarPubMed
11. Saving victims of toxic chemicals: The need for better medical preparedness. Environmental Protection Bureau. Albany, New York: Office of Attorney General R. Abrams. 1987; 1–16.Google Scholar
12. Landesman, LY: Hospital preparedness for chemical accidents: The effects of SARA (Doctoral Dissertation). New York: Columbia University, School of Public Health, 1990.Google Scholar
13. Fleiss, JL: Statistical Methods for Rates and Proportions. 2d ed. New York: Wiley and Sons, 1981.Google Scholar
14. Caldwell, LK: Environmental policy as a catalyst for institutional change. American Behavioral Scientist. 1974 17:711–730.CrossRefGoogle Scholar