Short-term adverse health effects in a community exposed to a large polyvinylchloride plastics fire

Where there's smoke, there's fire: focal points for risk communication

Large fires involving hazardous materials are often characterized by failing crisis communication. In this study, we compared opinions of experts regarding the risks of major fires to lay beliefs using a mental models approach. Amongst lay people this revealed relevant knowledge gaps and beliefs in opposition to those held by experts. While, experts considered the chance of getting cancer from inhaling smoke from a chemical fire extremely small, most lay people thought that even at a great distance, the chance of getting cancer to be large. To improve crisis communication about risk in a case of large chemical fires, and reduce the potential for messages to be misunderstood, distrusted or dismissed, we recommend a clarification of cancer risk in communications about public health emergencies such as chemical fires, for which lay people equate even small exposures to carcinogenic chemicals make one more likely to get cancer later in life.

Airway symptoms and lung function among male workers in an area polluted from an oil tank explosion

OBJECTIVE

To assess whether working in an industrial harbor where an oil tank exploded was associated with more airway symptoms and lower lung function in men 1.5 years later.

METHODS

In a cross-sectional study of 180 men, 18 to 67 years old, airway symptoms and lung function among men who worked in the industrial harbor at the time of the explosion was compared with those of working men with residence more than 20 km away. Regression analyses are adjusted for smoking, occupational exposure, atopy, recent infection, and age.

RESULTS

Exposed men had significantly more upper (ORirritated nose = 2.89 [95% confidence interval = 1.31 to 6.37]) and lower (ORdyspnea uphill = 3.79 [95% confidence interval = 1.69 to 8.46]) airway symptoms, and some indication of more reversible airway obstruction than unexposed workers.

CONCLUSIONS

Men working in an area with an oil tank explosion had more airway symptoms and indication of more airway obstruction 1.5 years after the event.

The 2007 San Diego Wildfire impact on the Emergency Department of the University of California, San Diego Hospital System

INTRODUCTION

In October 2007, San Diego County experienced a severe firestorm resulting in the burning of more than 368,000 acres, the destruction of more than 1,700 homes, and the evacuation of more than 500,000 people.

HYPOTHESIS

The goal of this study was to assess the impact of the 2007 San Diego Wildfires, and the acute change in air quality that followed, on the patient volume and types of complaints in the emergency department.

METHODS

A retrospective review was performed of a database of all patients presenting to the Emergency Departments of University of California, San Diego (UCSD) hospitals for a six-day period both before (14-19 October 2007) and after (21-26 October 2007) the start of the 2007 firestorm. Charts were abstracted for data, including demographics, chief complaints, past medical history, fire-related injuries and disposition status. As a measure of pollution, levels of 2.5 micron Particulate Matter (PM 2.5) also were calculated from data provided by the San Diego Air Pollution Control District.

RESULTS

Emergency department volume decreased by 5.8% for the period following the fire. A rapid rise in PM2.5 levels coincided with the onset of the fires. The admission rate was higher in the period following the fires (19.8% vs. 15.2%) from the baseline period. Additionally, the Left Without Being Seen (LWBS) rate doubled to 4.6% from 2.3%. There was a statistically significant increase in patients presenting with a chief complaint of shortness of breath (6.5% vs. 4.2% p = 0.028) and smoke exposure (1.1% vs. 0% p = 0.001) following the fires. Patients with significant cardiac or pulmonary histories were no more likely to present to the emergency department during the fires.

CONCLUSIONS

Despite the decreased volume, the admission and LWBS rate did increase following the onset of the firestorm. The cause of this increase is unclear. Despite a sudden decline in air quality, patients with significant cardiac and pulmonary morbidity did not vary their emergency department utilization rate. Based on the experience at UCSD, it appears that significant wildfires like that seen in 2007, only may marginally affect emergency department operations, and may not require significant changes to normal staffing levels.

Challenges of exposure assessment for health studies in the aftermath of chemical incidents and disasters

Exposure assessment during and after acute chemical incidents and disasters is essential for health studies that may follow. During chemical incidents, the focus usually lies on risk assessment and afterward attention shifts toward possible (long-term) health effects. This may lead to insufficient available data on exposure to study the association between exposure and health outcome, and collection of additional exposure data is often required. Literature on health studies conducted after several chemical incidents was reviewed to obtain better insight on the needs of health studies. Four different types of scenarios were distinguished based on when exposure data were collected and the exposure data used for health studies. These four scenarios gave insight on exposure data needed for conclusive health studies and when different methods of exposure data collection should be used. Literature indicated that adequate and rapid exposure assessment during chemical incidents is vital for health studies, because data that are not collected during or directly after an incident may be irretrievably lost. Poor exposure assessment is not always the only problem in health studies. Problems in health studies including poor exposure assessment may be prevented when the general design and needs of health studies are taken into account when designing contingency plans. Together with measures that will help facilitate funding, design, and coordination of health studies, disaster management programs should, among others, prepare for methods that lead to a swift identification of released substances, determination of concentrations and dispersion of released substances, designing basic questionnaire outlines, and rapid evaluation of the usefulness and necessity of employing biological sampling.