Purpose
ATSDR conducts Assessments of Chemical Exposure (ACE) investigations. The results provide insight about the health effects on the community. ACE evaluations can improve future emergency responses.
Chlorine release at a metal recycling facility
Chlorine gas was released when a 1-ton, low-pressure tank was cut at metal recycling facility. Most workers and customers followed the planned evacuation route, exiting the facility through the main gate and meeting in an open field that was downwind from the tank.
The ACE team, working with the state and local health department:
- Interviewed responders and facility owners.
- Surveyed exposed persons.
- Had hospital charts abstracted by state partners.
The team also prepared a chemical release alert to send to metal recycling facilities throughout the state. Key messages included:
- Only accept containers that are cut open, dry, and without a valve or plug.
- Treat closed containers as potentially hazardous waste.
- Develop and practice an evacuation plan.
- Train workers to stay upwind when evacuating for a chemical release.
The state health department conducted follow-up interviews and medical record review of the affected workers 6 months after the incident. They determined that some workers had ongoing respiratory and psychological symptoms. As a result of their findings, they provided technical assistance to the treating providers.
Published results of the investigation: Chlorine Gas Exposure at a Metal Recycling Facility
Ammonia release at a refrigeration facility
A pipe ruptured on the roof of a refrigeration facility, releasing anhydrous ammonia. A cloud of ammonia drifted over a canal behind the facility, exposing personnel on ships docked at the refrigeration facility. It also exposed a large facility across the canal where work was taking place outdoors.
The ACE team, in conjunction with the local health department and the state's CDC Career Epidemiology Field Officer:
- Interviewed personnel at the refrigeration facility, responders, and employees of a large facility that was downwind.
- Surveyed exposed persons at the downwind facility and reviewed hospital charts.
- County partners surveyed hospitals where patients were treated.
- County partners surveyed hospitals where patients were treated.
- Participated in a Hotwash (after action review) of the response to the incident and reported that there was a lack of notification of the people in the area of the release.
- The county later obtained a reverse 9-1-1 system to be able to call telephones belonging to residents and businesses in a defined geographic area and deliver recorded emergency notifications.
- The county later obtained a reverse 9-1-1 system to be able to call telephones belonging to residents and businesses in a defined geographic area and deliver recorded emergency notifications.
Chlorine release at a poultry processing facility
A worker accidently mixed sodium hypochlorite with an acid-containing disinfectant, releasing approximately 40 lbs of chlorine gas within the facility. Due to the air flow within the building, workers were exposed both at their work stations and in a major hallway used as an evacuation route. The ACE team, assisting the state and local health department:
- Partnered with NIOSH on the investigation. The NIOSH team performed a Health Hazard Evaluation at the facility and surveyed workers to learn their health effects.
- Interviewed responders, surveyed staff at hospitals where patients were treated,
- Reviewed hospital charts of patients treated for chlorine exposure.
- Determined that the existing emergency response protocols had an excessively high threshold for notification of the health department about chemical incidents.
After the ACE investigation identified the issue, the notification protocol was modified to include notifying the health department of any incident involving a biological, chemical, radiological, or nuclear substance.
Published results of the investigation: Challenges During a Chlorine Gas Emergency Response
Vinyl chloride release from a train derailment
A train derailment punctured a tanker releasing approximately 24, 000 gallons of vinyl chloride on the edge of a small town. A shelter-in-place order was established for surrounding areas, then was lifted and reestablished repeatedly over four days, as vinyl chloride levels in the air fluctuated due to weather conditions. The ACE team, in partnership with the state and local health department:
- Surveyed community members who were potentially exposed.
- Surveyed staff from hospitals where patients were treated for vinyl chloride exposure.
- Surveyed staff from a facility whose only access road was blocked by the derailed train.
- Performed hospital chart abstractions. State partners mailed a survey to all households in the community.
- Partnered with a NIOSH team which interviewed representatives from responder groups and created a written survey for responders. A report of the NOISH investigation has been published.
- Answered responders' questions during their meetings and collected information needed to address community concerns.
Reports
Paulsboro Air Quality Health Consultation Following Vinyl Chloride Gas Release: September 2014
Q & A on Health Effects of Vinyl Chloride: December 2012
Q & A on Community and First Responder Health Surveys: December 2012
Published results
Exposures and symptoms among workers after an offsite train derailment and vinyl chloride release
Medical Response to a Vinyl Chloride Release From a Train Derailment New Jersey 2012
Contamination of a public water supply
A tank containing chemicals used in coal processing leaked into a river just upstream from the intake of the municipal water supply for approximately 300,000 people. A "Do not use" water order was issued for a nine-county area. The ACE team, working with the state health department:
- Performed hospital chart abstractions for patients treated for exposure to the contaminated water.
- Surveyed area hospitals to learn of their experiences with the "Do Not Use" water order. A review of disaster epidemiology capacity within the inviting agency was also performed.
- Used results from the hospital chart reviews for local outreach and education efforts in an effort to alleviate the public's concerns about spill-related health effects.
Findings of the hospital survey were used to provide information to hospitals planning for emergencies where their water supply is compromised. The disaster epidemiology capacity report was used to aid in planning for health department responses to future disasters.
Published results
Acute Health Effects After the Elk River Chemical Spill, West Virginia, January 2014
Methyl bromide exposure at a condominium resort
Methyl bromide, an outdoor pesticide, was inappropriately used as a fumigant at a condominium resort in the U.S. Virgin Islands. A family of four were exposed and developed life threatening illness. Thirty-seven others were potentially exposed. The ACE team, in partnership with the local health department:
- Worked with the EPA and condominium management to identify additional persons who were potentially exposed to methyl bromide.
- Interviewed exposed persons using a standardized questionnaire about possible exposure related health effects.
Published results of the investigation: Severe Illness from Methyl Bromide Exposure at a Condominium Resort — U.S. Virgin Islands, March 2015.