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Annual Report 2004

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Note: While the original publication dates on some of ATSDR's documents may not appear to be current, the information in the documents is valid and may provide relevant information.

In 1980, Congress created the Agency for Toxic Substances and Disease Registry (ATSDR) to implement health-related sections of laws that protect the public from hazardous wastes and environmental spills of hazardous substances. The Comprehensive Environmental Response, Compensation, and Liability Act of 1980 (CERCLA), commonly known as the "Superfund" Act, designated ATSDR as the lead agency within the Public Health Service to help prevent or reduce further exposure to hazardous substances and the adverse health effects that result from such exposures, and also to expand the knowledge base about such effects.

This publication reports the results and findings of a health study, registry, or other health-related activity supported by ATSDR in accordance with its legislative mandate described above.

Comments regarding this report are welcome. Please send your comments to the following address:

Agency for Toxic Substances and Disease Registry
Attn: Director, Division of Health Studies (E-31)
1600 Clifton Road, N.E.
Atlanta, Georgia 30333

Centers For Disease Control and Prevention
Julie L. Gerberding, MD, MPH, Director

Agency for Toxic Substances and Disease Registry
Howard Frumkin, MD, DrPH, Director

Division of Health Studies
G. David Williamson, PhD, Director
Sharon Campolucci, MSN, Deputy Director
Anne Sowell, PhD, Assistant Director for Science

Surveillance and Registries Branch
Vikas Kapil, D.O., M.P.H., Chief


Hazardous Substances Emergency Events Surveillance Staff
Norys Guerra MD, MPH
Kevin Horton, MSPH
Natalia Melnikova, MD, PhD
Maureen Orr, MS
Perri Zeitz Ruckart, MPH
Casetta R. Simmons
Wendy Wattigney, MStat
Jennifer Wu, Mstat

Contents

• Disclaimer
• List of Tables
• List of Figures
• List of Appendices
• Executive Summary
• Introduction
• Methods
• Results
• Industries
• Substances
• Victims
• Nearby populations
• Evacuations
• Decontamination
• Response
• Reporting Timeliness
• Summary of Results, 1993-2004
• Public Use Dataset
• Prevention Activities
• Uses of HSEES Data
• References

Disclaimer

Use of trade names and commercial sources is for identification only and does not imply endorsement by the Agency for Toxic Substances and Disease Registry or the U.S. Department of Health and Human Services.

List of Tables

Table 1 – Number of events meeting the surveillance definition, by state and type of event— Hazardous Substances Emergency Events Surveillance, 2004

Table 2 – Number of substances involved per event, by type of event—Hazardous Substances Emergency Events Surveillance, 2004

Table 3 – Industries involved in hazardous substance events, by category—Hazardous Substances Emergency Events Surveillance, 2004

Table 4 – Number of substances involved, by substance category and type of event— Hazardous Substances Emergency Events Surveillance, 2004

Table 5 – Number of victims per event, by type of event—Hazardous Substances Emergency Events Surveillance, 2004

Table 6 – Frequency of substance categories in all events and events with victims— Hazardous Substances Emergency Events Surveillance, 2004

Table 7 – Frequencies of injuries/symptoms, by type of event—Hazardous Substances Emergency Events Surveillance, 2004

Table 8 – Distribution of personnel who responded to the event—Hazardous Substances Emergency Events Surveillance, 2004

Table 9 – Cumulative data by year—Hazardous Substances Emergency Events Surveillance, 1993–2004

Table 10 – Time period each state participated in Hazardous Substances Emergency Events Surveillance, 1993-2004

List of Figures

Figure 1 – Areas of fixed facilities involved in events—Hazardous Substances Emergency Events Surveillance, 2004

Figure 2 – Distribution of transportation-related events, by type of transport—Hazardous Substances Emergency Events Surveillance, 2004

Figure 3a – Primary factors reported as contributing to events by type of event—Hazardous Substances Emergency Events Surveillance, 2004

Figure 3b – Secondary factors reported as contributing to events—Hazardous Substances Emergency Events Surveillance, 2004

Figure 4 – Number of victims, by population group and type of event—Hazardous Substances Emergency Events Surveillance, 2004

Figure 5a – Distribution of responders injured in fixed-facility events, by type of responder— Hazardous Substances Emergency Events Surveillance, 2004

Figure 5b – Distribution of responders injured in transportation events— Hazardous Substances Emergency Events Surveillance, 2004

Figure 6 – Injury disposition—Hazardous Substances Emergency Events Surveillance, 2004

Figure 7 – Number of victims, by category and year—Hazardous Substances Emergency Events Surveillance, 1993–2004

List of Appendices

Appendix A – The 96 substances most frequently involved in events-Hazardous Substances Emergency Events Surveillance, 2004

Appendix B – Publications reference list
 

Executive Summary

The Hazardous Substances Emergency Events Surveillance (HSEES) system, maintained by the Agency for Toxic Substances and Disease Registry (ATSDR), actively collects information to describe the public health consequences of acute releases of hazardous substances in 15 states. This report summarizes the characteristics of events reported to ATSDR by all participating state health departments in 2004. Information about acute events involving hazardous substances was collected, including the substance(s) released, number of victims, number and types of injuries, and number of evacuations. The data were computerized using an ATSDR-provided Web-based data entry system.

A total of 7,744 events was reported. In 6,835 (88.3%) events, only one substance was released. The most commonly reported categories of substances were other inorganic substances (excluding chemicals in the categories of acids, bases, ammonia, and chlorine), volatile organic compounds, and mixtures involving substances from different categories that were mixed or formed from a reaction before release. During this reporting period, 620 events (8.0% of all reported events) resulted in a total of 1,838 victims, 41 of whom (2.4%) died. The most frequently reported injuries were respiratory irritation, headaches, and dizziness/central nervous system symptoms. Evacuations were ordered for 499 (6.4%) events.

Findings regarding the percentage of events involving victims and the distribution of types of injuries reported have been consistent in recent years. Topics targeted in 2004 included 1) disaster preparedness, 2) methamphetamine lab awareness activities, 3) outreach to specific groups using ammonia, chlorine, cleaning products, acids, and mercury, 4) outreach to targeted populations including children, responders, the transportation industry, and 5) special interest topics including carbon monoxide poisonings from underground utility fires and exposure to tearing agents from theft deterrent devices.

Introduction

The Centers for Disease Control and Prevention defines surveillance as the

"ongoing, systematic collection, analysis, and interpretation of health data essential to the planning, implementation, and evaluation of public health practice, closely integrated with the timely dissemination of these data to those who need to know. The final link of the surveillance chain is the application of these data to prevention and control. A surveillance system includes a functional capacity for data collection, analysis, and dissemination linked to public health programs" ^[1].

Since 1990, the Agency for Toxic Substances and Disease Registry (ATSDR) has maintained an active, state-based Hazardous Substances Emergency Events Surveillance (HSEES) system to describe the public health consequences of releases of hazardous substances. The decision to initiate a surveillance system of this type was based on a study published in 1989 about the reporting of hazardous substances releases to three national databases: the National Response Center Database, the Hazardous Material Information System (HMIS), and the Acute Hazardous Events Database ^[2].

A review of these databases indicated limitations. Many events were missed because of specific reporting requirements (for example, the HMIS did not record events involving intrastate carriers or fixed-facility events). Other important information was not recorded, such as the demographic characteristics of victims, the types of injuries sustained, and the number of persons evacuated. As a result of this review, ATSDR implemented the HSEES system to more fully describe the public health consequences of releases of hazardous substances.

HSEES has several goals:

To describe the distribution and characteristics of acute hazardous substances releases;

To describe morbidity and mortality among employees, responders, and the general public that resulted from hazardous substances releases; and to

To develop strategies that might reduce future morbidity and mortality resulting from the release of hazardous substances.

For a surveillance system to be useful, it must not only be a repository for data, but the data must also be used to protect public health.

In the last few years, the last goal of the HSEES system has been emphasized; i.e., to develop strategies to reduce subsequent morbidity and mortality by having each participating state analyze its data and develop appropriate prevention outreach activities. These activities are intended to provide industry, responders, and the general public with information that can help prevent chemical releases and reduce morbidity and mortality if a release occurs.

This report provides an overview of HSEES for 2004 in all participating states, summarizes the characteristics of acute releases of hazardous substances and their associated public health consequences, and demonstrates how data from the system are translated into prevention activities to protect public health.

Methods

In 2004, 15 state health departments participated in HSEES: Alabama, Colorado, Iowa, Louisiana, Minnesota, Mississippi, Missouri, North Carolina, New Jersey, New York, Oregon, Texas, Utah, Washington, and Wisconsin. Alabama and Mississippi, however, did not collect a full year of data, so their data are excluded from this report. Information was collected about each event, including substance(s) released, victims, injuries (adverse health effects and symptoms), and evacuations.

Various data sources were used to obtain information about these events. These sources included records and oral reports of state environmental protection agencies, the U.S. Department of Transportation, the National Response Center, police and fire departments, and hospitals. U.S. Census Bureau data were used to estimate the number of residents in the vicinity of the events. All data were computerized using a Web-based data entry system provided by ATSDR.

HSEES defines hazardous substances emergency events as acute uncontrolled or illegal releases or threatened releases of hazardous substances. Events involving releases of only petroleum are excluded. Events are included if (a) the amount of substance released (or that might have been released) needed (or would have needed) to be removed, cleaned up, or neutralized according to federal, state, or local law, or (b) the release of a substance was threatened, but the threat led to an action (for example, evacuation) that could have affected the health of employees, emergency responders, or members of the general public. HSEES defines victims as persons who experience at least one documented adverse health effect within 24 hours after the event or who die as a consequence of the event. Victims who receive more than one type of injury or symptom are counted once for each applicable injury type or symptom. Events are defined as transportation-related if they occur (a) during surface, air, pipeline, or water transport of hazardous substances, or (b) before the substance is unloaded from a vehicle or vessel. All other events are considered fixed-facility events.

For data analyses, the substances released were categorized into 16 groups. The category “mixture” comprises substances from different categories that were mixed or formed from a reaction before the event; the category “other inorganic substances” comprises all inorganic substances except acids, bases, ammonia, and chlorine; and the category “other” comprises substances that could not grouped into one of the existing categories.

Results

For 2004, HSEES received reports of 7,744 acute hazardous substances events; 256 (3.3%) of these events were threatened releases; 48 (0.6%) were events in which substances were both threatened to be released and actually released. The number of events occurring in fixed facilities was 5,687 (73.4%) while 2,057 (26.6%) occurred during transportation. Two states, Texas and New York, reported 43.7% of all releases (Table 1).

Table 1 - Number of events meeting the surveillance definition, by state and type of event

State	Type of event				Total No. events (%)
	Fixed facility		Transportation
	No. events	% *	No. events	% *
Colorado	54	30.2	125	69.8	179	(2.3)
Iowa	244	69.9	105	30.1	349	(4.5)
Louisiana	474	84.0	90	16.0	564	(7.3)
Minnesota	325	69.4	143	30.6	468	(6.0)
Missouri	148	49.3	152	50.7	300	(3.9)
North Carolina	201	52.6	181	47.4	382	(4.9)
New Jersey	444	76.4	137	23.6	581	(7.5)
New York	820	75.5	266	24.5	1086	(14.0)
Oregon	161	70.0	69	30.0	230	(3.0)
Texas	1959	85.2	339	14.8	2298	(29.7)
Utah	397	78.8	107	21.2	504	(6.5)
Washington	261	69.6	114	30.4	375	(4.8)
Wisconsin	199	46.5	229	53.5	428	(5.5)
Total	5687	73.4	2057	26.6	7744	(100.0)
*  Percentage = (number of events by type of event per state/total number of events in that state) x 100

For each fixed-facility event, reporters could select one or two types of area or equipment involved in the fixed facility where the event occurred. Of all 5,687 fixed-facility events, 4,922 (86.5%) reported one type of area and 735 (12.9%) reported a combination of two area types. Type of area was not reported for 30 (0.5%) events. The main areas were classified as follows: 1,825 (32.3%) ancillary processing equipment, 485 (8.6%) indoor, non-industrial, living areas, 470 (8.3%) piping, 460 (8.1%) storage above ground (Figure 1).

Of the 2,057 transportation-related events, 1,791 (87.1%) occurred during ground transport (e.g., truck, van, or tractor) and 160 (7.8%) involved transport by rail (Figure 2). Fewer events involved water, air, and pipeline transportation modes. Most ground transportation events (78.2%) involved trucks. The largest proportions of transportation-related events occurred during unloading of a stationary vehicle or vessel (688 [38.4%]) and from a moving vehicle or vessel (594 [28.9%]). Of the 2057 transportation-related events, 450 (21.9%) involved releases en route that were later discovered at fixed facilities.

Figure 2. Distribution of transportation-related events, by type of transport— Hazardous Substances Emergency Events Surveillance, 2004

Factors consisted of primary (root) and secondary (contributing) causes. Primary factors were reported for 7,673 (99.1%) events (Figure 3a). Primary factors most reported for fixed-facility events, 3,152 (56.0%) involved equipment failure, and most reported for transportation-related events 1,314 (64.4%) involved human error. Secondary factors were reported for 5,198 (67.1%) events (Figure 3b). Of the reported secondary factors, most fixed-facility events 780 (21.3%) involved system/process upset, and most transportation-related events 761 (49.8%) involved improper filling, loading, or packing.

Figure 3a. Primary factors reported as contributing to events, by type of events — Hazardous Substances Emergency Events Surveillance, 2004

Figure 3b. Secondary factors reported as contributing to events — Hazardous Substances Emergency Events Surveillance, 2004

More than 6,835 (88.3%) of all events involved the release of only one substance. Two substances were released in approximately 354 (4.6%) of the events, and more than two substances were released in approximately 555 (7.2%) (Table 2). Fixed-facility events were more likely to have two or more substances released in an event than transportation events (13.8% vs. 6.1%).

Table 2 - Number of substances involved per event, by type of event—Hazardous Substances Emergency Events Surveillance, 2004

No. substances	Type of event						All events
	Fixed facility			Transportation
	No. events	%	Total substances	No. events	%	Total substances	No. events	%	Total substances
1	4904	86.2	4904	1931	93.9	1931	6835	88.3	6835
2	277	4.9	554	77	3.7	154	354	4.6	708
3	110	1.9	330	31	1.5	93	141	1.8	423
4	276	4.9	1104	9	0.4	36	285	3.7	1140
≥ 5	120	2.1	1135	9	0.4	82	129	1.7	1217
Total	5687	100.0	8027	2057	100.0	2296	7744	100.0	10323

The number of events by month ranged from 574 (7.4%) in February to 760 (9.8%) in July, with the summer months having the highest number of events. The proportion of events ranged from 15.3% to 17.0% during weekdays, and from 8.8% to 9.7% during weekend days. Of all 7,580 (97.9%) events for which time of day or time category was reported, 35.5% occurred from 6:00 AM to 11:59 AM, 32.5% from 12:00 PM to 5:59 PM, 17.3% from 6:00 PM to 11:59 PM, and the remainder between midnight and 6:30 AM.

Industries

The largest number of HSEES events were associated with the manufacturing (2,969 [38.3%]) and transportation (1,854 [23.9%]) industries (Table 3). Within manufacturing, chemical and allied products manufacturing (1,506 [50.7%]) and petroleum and coal manufacturing (970 [32.7%]) accounted for most of the events. The largest number of events with victims occurred in the transportation industry (96 [15.5%]). The total number of victims was greatest in professional services (340 [18.5%]), followed by the manufacturing industry (338 [18.4%]) and transportation (319 [17.4%]). The subcategory food and kindred products manufacturing accounted for 26% of all victims in the manufacturing industry. Although the manufacturing industry resulted in a large proportion of events with victims and a large number of victims, only 2.6% of all manufacturing events involved victims. Conversely, 34.0% of all events in private vehicles or property involved victims, however they constituted only a small proportion (5.6%) of events with victims.

Table 3 - Industries involved in hazardous substance events, by category

Industry Category	Total events		Event with victims		Percentage of events with victims	Total no. victims
	No.	%	No.	%		Number (maximum)*
Agriculture	197	2.5	22	3.5	11.2	38	(8)
Mining	180	2.3	5	0.8	2.8	6	(2)
Construction	112	1.4	21	3.4	18.8	48	(7)
Manufacturing	2969	38.3	78	12.6	2.6	338	(36)
Transportation	1854	23.9	96	15.5	5.2	319	(50)
Communications	5	0.1	0	0.0	0.0	0	(0)
Utilities	502	6.5	33	5.3	6.6	65	(9)
Wholesale trade	346	4.5	15	2.4	4.3	54	(40)
Retail trade	149	1.9	31	5.0	20.8	118	(22)
Finance and real estate	53	0.7	14	2.3	26.4	51	(12)
Business and repair services	56	0.7	12	1.9	21.4	17	(3)
Personal services	192	2.5	53	8.5	27.6	102	(28)
Entertainment	39	0.5	10	1.6	25.6	32	(9)
Professional services	210	2.7	55	8.9	26.2	340	(57)
Public administration	71	0.9	16	2.6	22.5	56	(11)
Abandoned facilities	159	2.1	5	0.8	3.1	14	(5)
Private vehicle or property	103	1.3	35	5.6	34.0	42	(4)
Illegal activity (non-illicit drug related)	87	1.1	17	2.7	19.5	41	(7)
Illegal activity (illicit drug related)	414	5.3	90	14.5	21.7	139	(5)
Unspecified and unknown	46	0.6	12	1.9	26.1	18	(4)
Total‡	7744	100.0	620	100.0	8.0	1838	(57)
* Minimum number of victims per event = 1.

*Minimum number of victims per event=1.

^†Includes chemical dumped on highway or other property and currently non-operating former business.

^‡Percentages do not total 100% because of rounding.

Substances

The number of substances were released in all events was 10,323, of which 814 (7.9%) substances were reported as threatened to be released. The substances most frequently released were sulfur dioxide, carbon monoxide, ammonia, and nitrogen oxide (NOX) (Appendix A). Substances were grouped into 16 categories. The substance categories most commonly released in fixed-facility events were other inorganic substances (2,044 [25.5%]), volatile organic compounds (1,544 [19.3%]), and mixtures (1,181 [14.7%]) (Table 4). In transportation-related events, the most common substance categories released were volatile organic compounds (377 [16.5%]), acids (313 [13.7%]), and pesticides (245 [10.7%]).

Two types of releases (e.g., spill and air) could be reported for each substance. Single releases were associated with air releases (4,850 [47.0%]), spills (4,179 [40.5%]), threatened releases (815 [7.9%]), fire (425 [4.1%]), explosion (32 [0.3%]), and radiation (19 [0.2%]). Of events with two types of releases, the following combinations were reported: spill and air releases (389 [72.7%]), spill and fire (61 [11.4%]), air releases and fire (43 [8%]), fire and explosion (19 [3.6%]), spill and explosion (11 [2.1%]), air releases and explosion (11 [2.1%]), and the remaining 1 (0.2%) involved other combinations of release types. The release type was missing for 3 substances.

Table 4 - Number of substances involved, by substance category and type of event

Substance category	Type of Event				All Events
	Fixed facility		Transportation
	No. substances	%	No. substances	%	No. substances	%
Acids	517	6.4	313	13.7	830	8.1
Ammonia	391	4.9	80	3.5	471	4.6
Bases	209	2.6	201	8.8	410	4.0
Chlorine	162	2.0	34	1.5	196	1.9
Formulations	12	0.1	2	0.1	14	0.1
Hetero-organics	98	1.2	28	1.2	126	1.2
Hydrocarbons	102	1.3	64	2.8	166	1.6
Mixture across chemical category*	1181	14.7	80	3.5	1261	12.2
Other †	480	6.0	195	8.5	675	6.5
Other inorganic substances ‡	2044	25.5	201	8.8	2245	21.8
Oxy-organics	734	9.2	190	8.3	924	9.0
Paints & dyes	123	1.5	143	6.2	266	2.6
PCB's	85	1.1	9	0.4	94	0.9
Pesticides	249	3.1	245	10.7	494	4.8
Polymers	85	1.1	130	5.7	215	2.1
Volatile organic compounds	1544	19.3	377	16.4	1921	18.6
Total ¶	8016	100.0	2292	100.0	10308	100.0
* substances from different categories that were mixed or formed from a reaction before the event. † Not belonging to one of the existing categories. ‡ All inorganic substances except for acids, bases, ammonia, and chloring. ¶ Of 10,323 total substances, 15 were excluded because they were not assigned a substance category.

 

Victims

The member of victims involved was 1,838 in 620 events (8.0% of all events) (Table 5). Of the 620 events with victims, 376 (60.7%) involved only one victim, and 87 (14.0%) involved two victims. Of all victims, 1,452 (79.0%) were injured in fixed-facility events. Fixed-facility events were more likely to have three or more victims per event (28.7%) than were transportation-related events (15.3%). An additional 453 persons in 158 events (2.1% of all events) were observed at a hospital or medical facility but did not have symptoms resulting from the event and were not, therefore, counted as victims.

Table 5 - Number of victims per event, by type of event

No. victims	Type of event						All events
	Fixed facility			Transportation
	No. events	%	Total victims	No. events	%	Total victims	No. events	%	Total victims
1	268	57.9	268	108	68.8	108	376	60.6	376
2	62	13.4	124	25	15.9	50	87	14.0	174
3	32	6.9	96	7	4.5	21	39	6.3	117
4	29	6.3	116	8	5.1	32	37	6.0	148
5	15	3.2	75	1	0.6	5	16	2.6	80
≥6	57	12.3	773	8	5.1	170	65	10.5	943
Total	463	100.0	1452	157	100.0	386	620	100.0	1838

To represent the magnitude of the effects of substances involved in injuries, the number of events in a specific substance category was compared with the number of events in the same substance category that involved victims. In events that involved one or more substances from a specific substance category, substances were counted once in that category. In events that involved two or more substances from different categories, substances were counted once in the multiple substance categories. Substances released most often were not necessarily the most likely to involve victims (Table 6). For example, events categorized as other inorganic substances constituted 19.5% of all events; however, only 4.8% of these events resulted in injuries. Conversely, events involving chlorine exclusively accounted for 2.2% and those involving ammonia exclusively 5.2% of all events, but 23.0% of the chlorine events and 12.3% of ammonia events involved injuries.

Employees (837 [45.5%]) constituted the largest proportion of the population groups injured, followed by members of the general public (640 [34.8%]) (Figure 4). In fixed-facility events, 166 emergency response personnel were injured. Of those, 92 (55.4%) were police officers, 46 (27.7%) were career firefighters, and 11 (6.6%) were volunteer firefighters (Figure 5a, 5b). In transportation-related events, 53 responders were injured; most these (37 [69.8%]) were police officers, 8 (15.1%) were career firefighters, and 5 (9.4%) were responders of unknown type. Police officers were injured more frequently in transportation related events (69.8%) than in fixed-facility events (55.4%).

Table 6 - Frequency of substance categories in all events and events with victims*

Substance category	All events		Events with victim
	No.	%	No.	Percentage of all releases with victims	Percentage of events with victims in substance category
Acids	556	7.2	53	8.6	9.5
Ammonia	407	5.3	43	6.9	10.6
Bases	310	4.0	31	5.0	10.0
Chlorine	185	2.4	42	6.8	22.7
Formulations	11	0.1	0	0.0	0.0
Hetero-organics	56	0.7	2	0.3	3.6
Hydrocarbons	101	1.3	4	0.6	4.0
Mixture across chemical category†	596	7.7	57	9.2	9.6
Multi-chemical category	1085	14.0	69	11.1	6.4
Other‡	1237	16.0	61	9.9	4.9
Other inorganic substances§	1227	15.9	43	6.9	3.5
Oxy-organics	603	7.8	86	13.9	14.3
Paints & dyes	233	3.0	6	1.0	2.6
PCB's	91	1.2	0	0.0	0.0
Pesticides	371	4.8	36	5.8	9.7
Polymers	201	2.6	17	2.7	8.5
Volatile organic compounds	466	6.0	69	11.1	14.8
Total ¶	7736	100.0	619	100.0	8.0
* Substances in events that involved multiple substances were counted only once in a substance category when all the substances were associated with the same category. If events involved multiple substances from different substance categories, they were counted only once in the multiple substance category.
† Substances from different categories that were mixed or formed from a reaction before the event.
‡ Not classified.
§ All inorganic substances except for acids, bases, ammonia, and chlorine.
¶ Of 7,744 total events, 8 were excluded because they were not assigned a substance category. These 8 involved one substance each.  One of the excluded events had victims.