1. Surveillance of Emergency Events U.S. Experience
CIDM Conference, N. Delhi, India
February 12, 2009
Dr. Rubina Imtiaz
Country Representative
US Centers for Disease Control & Prevention

2. Overview Public health consequences of acute HS releases
Chernobyl, Ukraine;
Bhopal, India;
Seveso, Italy;
Graniteville, South Carolina
No cohesive national tracking system in US
Objectives:
Improve emergency response
Improve preparedness planning & prevention-based interventions, to
Reduce # of releases and their PH impact

3. HSEES Hazardous Substances Emergency Events Surveillance
ATSDR initiated in 1993
Earlier databases missed information
Goals:
to define distribution & characteristics of acute releases;
effects on humans; and
prevention strategies.

4. HSEES: Design Active surveillance in 15 states
Type of substance, # & type of injuries, # of victims
Computerized, web-based data
Full participation by states
Info available to industry, responders and public to help prevent future events

5. Results for 1993 - 2005 Total events= 69,991 (95% from FFs)
Substances released = 105,832
# of victims = 25,600; deaths = 452
Commonest victims are employees
Commonest substances: inorganic subs., VOCs, and mixtures
Respiratory irritation, headaches, dizziness and CNS symptoms

6. Data-based Interventions
Increase general awareness
Outreach on high-risk substances (Chlorine, ammonia, cleaning products, NaOH, Hg, CO)
Targeted outreach (first responders, high-risk counties and industrial corridors, and children)

7. Continuing Challenges
Gaps/overlaps between various agencies data
Identify core data present/needed by all
Compatibility and merger of datasets
Rapid interagency communication/sharing
More comprehensive approach
Responsiveness to national security needs
Flexibility to partner with multiple Federal, State and local agencies (needs, shared resources)
NRC= National Response Center, CSHIB= Chemical Safety & Hazard Investigation Board, DOT= Dept.of Transportation, PCCs= Poison Control Centers, CPSC= Consumer Product Safety Commission.

8. National Chemical Incidents Surveillance and Prevention Program
Enhance and unify existing databases into one core data repository (NRC, CSHIB, DOT, PCCs, and CPSC).
Supplement with news media searches, additional data from pilot state HD sites (latter also used for validation)

9. Additional resources
THANK YOU