What to know
In 2021, a fire led to contaminated drinking water in Winnebago County, Illinois. ATSDR conducted an ACE investigation to learn more about the effects of the event.
Background
On July 14, 2021, an industrial fluid and grease manufacturing facility in Winnebago County, Illinois, caught fire. The event released smoke, dust, and debris for 4 days. Local authorities issued a precautionary 1-mile evacuation order and 3-mile masking advisory around the facility during. They reviewed of Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE) data. The data demonstrated increased emergency department visits in 5 zip codes downwind of the fire.
Approach
The Winnebago County Health Department (WCHD), Illinois Department of Public Health, and ATSDR collaborated. They investigated the fire's effect on human health.
The ACE team conducted an Epi-Aid with state and the Winnebago County Health Departments in Illinois. They Combined ATSDR's ACE Toolkit and Epidemiologic Contact Assessment Symptom Exposures (Epi CASE) Toolkit. These were modified into a single, electronic, self-administered survey. The document facilitated rapid, wide distribution.
WCHD used an existing electronic system. The system that had been used for COVID-19 vaccination registration. The survey was distributed by email. Survey links were also emailed to selected zip codes. They went to people registered in this electronic system with valid email addresses.
Results
- 2,030 people completed ACE survey.
- 916 (45.1%) respondents reported one or more new or worsened symptom since the fire. Typically, symptoms related to the ears, nose, and throat (638; 69.7%), nervous system (478; 52.2%); and eyes (383; 41.8%).
Key messages
- This was the first documented use of an electronic, self-administered survey in an ACE investigation
- Survey distribution through the electronic system enrolled about twice as many people as previous participation in ACE investigations.
Follow up
The large number of people reporting symptoms in the initial ACE prompted a follow-up ACE request. The follow-up was completed a year later. This was done by the state and local health department, with the ACE Team's assistance.
The ACE team conducted an Epi-Aid working with State Health Department in Illinois to:
- Complete a follow-up ACE investigation one year after the fire to assess ongoing impact on physical and mental health.
- Interview residents regarding mental health symptoms and community needs, by email, in person, or by phone.
Results
39% of respondents reported new or worsening mental and/or physical health symptoms since the fire. The majority (98%) were still experiencing these symptoms 1 year later.
Results of the follow up investigation: Notes from the Field: Follow-Up Assessment 1 Year After a Chemical Exposure Investigation — Winnebago County, Illinois, July–August 2022
Recommendation
Communities that experience a similar fire or environmental disaster would benefit from easily accessible information, presented in plain language.