Surveillance of Surveillance of Emergency EventsEmergency Events

U.S. ExperienceU.S. ExperienceCIDM Conference, N. Delhi, IndiaCIDM Conference, N. Delhi, India

February 12, 2009February 12, 2009

Dr. Rubina Imtiaz Dr. Rubina Imtiaz Country RepresentativeCountry Representative

US Centers for Disease Control & US Centers for Disease Control & PreventionPrevention

OverviewOverview Public health consequences of acute HS Public health consequences of acute HS

releasesreleases Chernobyl, Ukraine;Chernobyl, Ukraine; Bhopal, India;Bhopal, India; Seveso, Italy;Seveso, Italy; Graniteville, South CarolinaGraniteville, South Carolina

No cohesive national tracking system in USNo cohesive national tracking system in US Objectives:Objectives:

Improve emergency responseImprove emergency response Improve preparedness planning & prevention-Improve preparedness planning & prevention-

based interventions, tobased interventions, to Reduce # of releases and their PH impactReduce # of releases and their PH impact

HSEESHSEESHazardous Substances Hazardous Substances

Emergency Events Emergency Events SurveillanceSurveillance

ATSDR initiated in 1993 ATSDR initiated in 1993 Earlier databases missed Earlier databases missed

informationinformation Goals: Goals:

to define distribution & characteristics to define distribution & characteristics of acute releases; of acute releases;

effects on humans; and effects on humans; and prevention strategies.prevention strategies.

HSEES: DesignHSEES: Design

Active surveillance in 15 statesActive surveillance in 15 states Type of substance, # & type of Type of substance, # & type of

injuries, # of victimsinjuries, # of victims Computerized, web-based dataComputerized, web-based data Full participation by statesFull participation by states Info available to industry, Info available to industry,

responders and public to help responders and public to help prevent future eventsprevent future events

Results for 1993 - 2005Results for 1993 - 2005 Total events= 69,991 (95% from FFs)Total events= 69,991 (95% from FFs) Substances released = 105,832Substances released = 105,832 # of victims = 25,600; deaths = 452# of victims = 25,600; deaths = 452 Commonest victims are employeesCommonest victims are employees Commonest substances: inorganic Commonest substances: inorganic

subs., VOCs, and mixtures subs., VOCs, and mixtures Respiratory irritation, headaches, Respiratory irritation, headaches,

dizziness and CNS symptomsdizziness and CNS symptoms

Data-based InterventionsData-based Interventions

1.1. Increase general awarenessIncrease general awareness

2.2. Outreach on high-risk Outreach on high-risk substances (Chlorine, ammonia, substances (Chlorine, ammonia, cleaning products, NaOH, Hg, cleaning products, NaOH, Hg, CO)CO)

3.3. Targeted outreach (first Targeted outreach (first responders, high-risk counties responders, high-risk counties and industrial corridors, and and industrial corridors, and children)children)

Continuing ChallengesContinuing Challenges Gaps/overlaps between various agencies dataGaps/overlaps between various agencies data Identify core data present/needed by allIdentify core data present/needed by all Compatibility and merger of datasetsCompatibility and merger of datasets Rapid interagency communication/sharingRapid interagency communication/sharing More comprehensive approach More comprehensive approach Responsiveness to national security needsResponsiveness to national security needs Flexibility to partner with multiple Federal, Flexibility to partner with multiple Federal,

State and local agencies (needs, shared State and local agencies (needs, shared resources)resources)

National Chemical National Chemical Incidents Surveillance and Incidents Surveillance and

Prevention ProgramPrevention Program

Enhance and unify existing Enhance and unify existing databases into one core data databases into one core data repository (NRC, CSHIB, DOT, repository (NRC, CSHIB, DOT, PCCs, and CPSC).PCCs, and CPSC).

Supplement with news media Supplement with news media searches, additional data from searches, additional data from pilot state HD sites (latter also pilot state HD sites (latter also used for validation)used for validation)

Additional resources

http://www.atsdr.cdc.gov/HS/HSEES

THANK YOU