Injuries Caused by Hazardous Materials Accidents,☆☆,,★★

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Abstract

Study objective: To describe exposures that prehospital and ED personnel may encounter as a result of hazardous material incidents. Methods: Retrospective analysis of hazardous material incident reports from six district hazardous material teams in Massachusetts from their inception through May 1996. Results: The chemicals most frequently involved were various hydrocarbons and corrosive materials. Chlorine derivatives were involved in 18% of all incidents and 23% of all incidents resulting in victims. Victims were produced by 47 of 162 (29%) incidents. Respiratory exposures were the most frequent type of exposure and resulted in the largest number of victims transported to a hospital. Overall 24 of 26 (92%) incidents with chemical exposures resulted in symptomatic victims and 33 of 35 (94%) incidents produced victims requiring hospital transport. Respiratory symptoms were the most frequent, both in the number of incidents where they were observed and the total number of victims with symptoms. Conclusion: Multiple victim transport to EDs from a single hazardous material incident is most likely to result from an inhalation exposure to a respiratory irritant. Information from descriptive studies should allow improved preparation for potential hazardous material victims. [Kales SN, Polyhronopoulos GN, Castro MJ, Goldman RH, Christiani DC. Injuries caused by hazardous materials accidents. Ann Emerg Med November 1997;30:598-603.]

Section snippets

INTRODUCTION

Hazardous materials are defined as substances that are potentially toxic to living systems.1 Human health effects associated with hazardous material releases are well known from such examples as Bhopal, India; Seveso, Italy; and Chernobyl in the former Soviet Union,2 as well as the recent Tokyo subway sarin attack.3 Many reviews have emphasized the need for emergency community and medical preparedness to minimize the adverse consequences of such incidents.1, 4, 5, 6, 7, 8, 9 Recent articles in

MATERIALS AND METHODS

The Metrofire Haz-Mat Team (formed June 1990) is made up of selected firefighters from 24 fire departments in the greater Boston suburban area and responds to hazardous material incidents within an area of 43 communities. Likewise, district teams are made up of firefighters from various local departments in the five other regions: Natick (May 1991), Lowell (November 1990), Bourne (November 1990), Chicopee (May 1991), and Pittsfield (September 1991).

A “hazardous material incident” included any

RESULTS

The teams responded to a total of 165 incidents: 88 incidents from 1990 through February 1994 and 77 incidents from March 1994 to May 1996. For 3 of the 165 incidents (2%), information on substances was unavailable. In terms of absolute numbers, chlorine derivatives were the most frequently observed hazardous material in incidents with victims (11 incidents, 23% of 47 incidents with victims), followed by metals and metalloids (6 incidents, only 2 with chemical exposure victims) (Table 1).

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DISCUSSION

Chlorine derivatives, hydrocarbons, metals, petroleum-derived fuels, and various corrosives (acids and bases) were frequently involved in Massachusetts hazardous material incidents. Comparison with our original Massachusetts series17 (inception through February 1994, 88 incidents) demonstrates similar relative frequencies of involvement of various hazardous substances and proportion of incidents with victims, suggesting some temporal stability in the types of Massachusetts hazardous material

Acknowledgements

We thank the members of Massachusetts District Hazardous Materials Response Teams: The Commonwealth of Massachusetts Hazardous Materials Response Program; Ms. Dianne Plantamura, and Drs. Karl Kelsey, Howard Hu, Thomas Gassert, Charles Sweet, and David Artzeronian for their continuing support of this research.

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  • Cited by (0)

    From The Cambridge Hospital, Cambridge, MA;* Harvard Medical School, and Harvard School of Public Health, Department of Environmental Health (Occupational Health Program), Boston; Newton Fire Department and Metrofire Haz-Mat Team, Newton, MA;§ and Pulmonary/Critical Care Unit, Massachusetts General Hospital/ Harvard Medical School, Boston; and the Center for Occupational and Environmental Medicine, Massachusetts Respiratory Hospital, Braintree, MA.

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    Supported by National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention grant No. K01 0H00156-01 (Dr Kales), and National Institutes of Health grants No. 1K07ES00266-01 (Dr Goldman), and Nos. ES00002 and ES05947 (Dr Christiani).

    Reprint no. 47/1/85326

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    Address for reprints: Stephen N Kales, MD, MPH, Occupational Medicine, Department of Medicine, The Cambridge Hospital, 1493 Cambridge Street, Cambridge, MA 02139, 617-498-1580, 617-498-1671

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