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CARIMEC – Chemical & Radiological Inventory for Medical Emergency Countermeasures ASHT III - Alerting, Reporting and Surveillance System for Chemical Health.

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Presentation on theme: "CARIMEC – Chemical & Radiological Inventory for Medical Emergency Countermeasures ASHT III - Alerting, Reporting and Surveillance System for Chemical Health."— Presentation transcript:

1 CARIMEC – Chemical & Radiological Inventory for Medical Emergency Countermeasures ASHT III - Alerting, Reporting and Surveillance System for Chemical Health Threats, Phase III. Dr Rob Orford Public Health England

2 Acknowledgements Alerting System for Chemical Health Threats, Phase III (ASHTIII) Group Rob Orford, Charlotte Hague, Monique Mathieu-Nolf, Laura Settimi, Herbert Desel, Martin Ebbecke, Daniela Pelclova, Sergey Zakharov, Gabija Dragelyte, Robertas Badaras, Erik Andrew Richard Adams, Gillian Jackson, Franca Davanzo, Fabrizio Sesana, Al Bronstein, Raquel Duarte-Davidson

3 CARIMEC Identify and consolidate an inventory of public health measures and medical countermeasures for appropriate response following toxic industrial chemicals or radio nuclear incidents, to include: – Immediate actions after an incident – Decontamination procedures – Monitoring for people/ patient assessment purposes – Public health response State of play for EU coordination and international liaison and alerting Case studies

4 EU co-funded best practise CARIMEC

5

6 CARIMEC monographs for 47 Agents 1.Acetone 2.Acetylene 3.Acrylonitrile 4.Aluminium 5.Aluminium phosphide 6.Ammonia 7.Aniline 8.Arsenic 9.Arsine 10.Asbestos 11.Benzene 12.Bromine 13.Cadmium 14.Carbon disulphide 15.Carbon monoxide 16.Chlorine 17.Chloroform 18.Cyclohexane 19.Diesel 20.Dioxin 21.Ethanol 22.Ethylene glycol 23.Ethylene oxide 24.Formaldehyde 25.Hydrogen chloride 26.Hydrogen cyanide 27.Hydrogen peroxide 28.Hydrogen sulphide 29.Kerosine 30.Lead 31.Mercury 32.Methanol 33.Napthalene 34.Nitric acid 35.Petrol 36.Phenol 37.Phosgene 38.Phosphorous white/ yellow 39.Potassium cyanide 40.Sodium hydroxide 41.Sodium hypochlorite 42.Styrene 43.Sulphuric acid 44.Sulphur mustard 45.Trichlorethylene 46.Xylene 47.VX CARIMEC

7 State of play for EU coordination and international liaison and alerting CARIMEC

8 State of play for EU coordination and international liaison and alerting CARIMEC

9 Development of EU standardized Chemical Emergency Risk Management (CERMs). Evaluation of automated EU Poison Control Centre exposure case data processing for surveillance. Development of a Toxidrome IT tool to enhance RASCHEM functionality. Feasibility study of using RASCHEM for reporting human pesticide exposures (to meet EU Directives 1998/8/EC and 2009/128/EC) Feasibility of establishing a network of toxicological experts to monitor toxicological data reported to RASCHEM & improve global health awareness Objectives

10 1 Acetone 26Chloropicrin51Lambda cyhalthorin76Silicon tetrachloride 2 Acetylene 27Coal tar52 Lead 77Sodium azide 3 Acrylonitrile 28cyanogen chloride53Lewisite78 Sodium hydroxide 4Adamsite29 Cyclohexane 54Malathion79 Sodium hypochlorite 5Agent CS30Deltamethrin55Melamine80Soman 6Alkalis31Dichlorvos56 Mercury 81Strychnine 7 Aluminium 32 Diesel 57Metaldehyde82 Styrene 8 Aluminium phosphide 33Diflubenzuron58Methacrylonitrile83 Sulfur mustard 9Aluminium sulphate34 Dioxin 59 Methanol 84 Sulfuric acid 10Aminotadalafil35Diquot60Methyl Mercaptan85Sulphur 11 Ammonia 36Epichlorohydrin61Methylisocyanate86Sulphur dichloride 12 Aniline 37 Ethanol 62 Napthalene 87Sulphur trioxide 13 Arsenic 38 Ethylene glycol 63 Nitric acid 88Sulphuryl fluoride 14 Arsine 39 Ethylene oxide 64Nitrogen mustard89Tabun 15 Asbestos 40Fentanyl65OP Nerve Agents90Terbufos 16 Benzene 41Fluorine66Paraquat91Thallium 17Botulinum toxin42 Formaldehyde 67Permethrin92Thallium (I) chloride 18 Bromine 43Hydrochloric acid68 Petrol 93Thionyl chloride 19 Cadmium 44 Hydrogen chloride 69 Phenol 94Toluene-2-4-diisocyanate 20Camphor45 Hydrogen cyanide 70 Phosgene 95 Trichlorethylene 21 Carbon disulphide 46Hydrogen fluoride71Phosphorous oxychloride96Triphenyl phosphate 22 Carbon monoxide 47 Hydrogen peroxide 72 Phosphorous white/ yellow 97Vanadium 23 Chlorine 48 Hydrogen sulphide 73 Potassium cyanide 98 VX 24Chloroacetic acid49Iodine74Ricin99 Xylene 25 Chloroform 50 Kerosine 75Sarin Chemical Emergency Risk Management (CERM) sheets

11 Delivery target: 12hrs

12 Rapid Alert System for Chemicals (RASCHEM) RAPEX UK CRCE UK NPIS Webcrawlers Event Based Surveillance

13 Indicator Based Surveillance

14 Severity Route of exposure Chemical Indicator Based Surveillance

15 Rodenticides PT14-Rodenticides (MG 3) PT18-Insecticides (MG 3) Insecticides and Acaricides Mulluscicides PT16-Mulluscides (MG 3) MG 3-Pest control MG 1-Disinfectants MG 2-Preservatives MG 4-Other biocidal products Fungicides and Bactericides Herbicides Plant grouth regulators Other PPPs es/pesticides_database/index_en.htm ides/transition.htm PLANT PROTECTION PRODUCTS Soil sterilants BIOCIDES Indicator Based Surveillance

16 16 Table 1a. Biocidal Rodenticide exposures identified in in Germany, Italy, and the United Kingdom Chemical class Code Chemical class Biocides (code: B14) Active ingredient code (CAS No.) Active ingredient denomination D ^IT UK n.% % % 099Acidic oxides 20,7 00, Carbon dioxide 20,7 00, Coumarins 26899, , , Brodifacum 4717,4 9410,7 281, Bromadiolone 134, , ,6 997* Bromadiolone and other coumarines 00,0 192,2 00, Coumatetralyl 145, ,9 130, Dicoumarol 00,0 10,1 00, Difenacoum 10639,3 637, , Difethialone 3513,0 192,2 20, Flocoumafen 2710,0 80,9 40, Warfarin 269,6 20,2 241,5 070Glucosides 00,0 171,9 281, Chloralose 00,0 171,9 281,8 079Indandiones 20,7 495,6 20, Chlorophacinone 20,7 485,5 20, Diphacinone 00,0 10,1 00,0 185Vitamin D compounds 00,0 10,1 251, Colecalciferol 00,0 10,1 251,6 998Other chemical classes/unclassified 00,0 10,1 362, Corn cob, powdered 00, , Calcium lignumsulfonate 00,0 10,1 00, Strychnine 00,0 0 90,6 999Unknown 00, , ,2 Total Rodenticides , , ,0 *Combined exposure to active ingredients belonging to the same chemical class; **exposures occurred in Indicator Based Surveillance

17 EU PC Data Processing Indicator Based Surveillance

18 ASHT contribution to EU Legal Frameworks Aiding the Commission and MSs in providing ad-hoc surveillance, situational awareness and exchanging best practice both in the preparedness and response to serious cross border chemical incidents in support of the EU Decision for Serious Cross Border Health Threats (Art 4,6) Contributing to work at the European level related to the harmonisation of dangerous chemicals as described in Article 45 of the CLP Directive; Enabling MSs to fulfil their obligations in reporting exposures to biocides and pesticides products as stipulated in Directive 2009/128/EC; Regulation (EC) n. 1107/2009 and Directive 98/8/EC; Regulation (EU) n. 528/2012 in a harmonised manner. Lisbon Treaty – Article A high level of human health protection shall be ensured in the definition and implementation of all Union policies and activities. Union action, which shall complement national policies, shall be directed towards improving public health, preventing physical and mental illness and diseases, and obviating sources of danger to physical and mental health. Such action shall cover the fight against the major health scourges, by promoting research into their causes, their transmission and their prevention, as well as health information and education, and monitoring, early warning of and combating serious cross-border threats to health.

19 There is a need to find a mechanism for: I.Full roll-out and training on RASCHEM. II.Training and support for assessing risks at national level from emerging chemical threats. III.Maintenance of Event & Indicator Based Surveillance and RASCHEM moderation. IV.Development of resources for EU MSs and EC. V.Development and maintenance of codes and terms that are used to record exposures. VI.Development of enhanced cross-sectoral operation and exchange for chemical health threats.


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