Ruckart Perri Zeitz, Orr Maureen F
MMWR Suppl. 2015 Apr 10;64(2):10-7.
PROBLEM/CONDITION: Widespread use of hazardous chemicals in the United States is associated with unintentional acute chemical incidents (i.e., uncontrolled or illegal release or threatened release of hazardous substances lasting <72 hours). Efforts by industries, government agencies, academics, and others aim to reduce chemical incidents and the public health consequences, environmental damage, and economic losses; however, incidents are still prevalent.
1999-2008.
The Hazardous Substances Emergency Events Surveillance (HSEES) system was operated by the Agency for Toxic Substances and Disease Registry (ATSDR) during January 1991-September 2009 to describe the public health consequences of chemical releases and to develop activities aimed at reducing the harm. This report summarizes temporal trends in the numbers of incidents, injured persons, deaths, and evacuations from the nine states (Colorado, Iowa, Minnesota, New York, North Carolina, Oregon, Texas, Washington, and Wisconsin) that participated in HSEES during its last 10 full years of data collection (1999-2008).
A total of 57,975 incidents and 15,506 injured persons, including 354 deaths, were reported. During the surveillance period, several trends were observed: a slight overall decrease occurred in incidents for fixed facilities (R² = 0.6) and an increasing trend in deaths (R² = 0.7) occurred, particularly for the general public (R² = 0.9). The number of incidents increased in the spring during March-June, and a decrease occurred in the remainder of the year (R² = 0.5). A decreasing trend in incidents occurred during Monday-Sunday (R² = 0.7) that was similar to that for the number of injured persons (R² = 0.6). The highest number of incidents occurred earlier in the day (6:00 a.m.-11:59 a.m.) and then decreased as the day went on (R² = 0.9); this trend was similar for the number of injured persons (R² = 1.0).
Chemical incidents continue to affect public health and appear to be a growing problem for the general public. The number of incidents and injuries varied by month, day of week, and time of day and likely was influenced by other factors such as weather and the economy. PUBLIC HEALTH IMPLICATIONS: Public and environmental health and safety practitioners, worker representatives, emergency planners, preparedness coordinators, industries, emergency responders, and others can use the findings in this report to prepare for and prevent chemical incidents and injuries. Specifically, knowing when to expect the most incidents and injuries can guide preparedness and prevention efforts. In addition, new or expanded efforts and outreach to educate consumers who could be exposed to chemicals are needed (e.g., education about the dangers of carbon monoxide poisoning for consumers in areas likely to experience weather-related power outages). Redirection of efforts such as promoting inherently safer technologies should be explored to reduce or eliminate the hazards completely.
问题/状况：在美国，危险化学品的广泛使用与非故意急性化学事故相关（即危险物质的无控制或非法释放或有威胁的释放持续时间<72小时）。行业、政府机构、学术界及其他各方致力于减少化学事故以及公共卫生后果、环境破坏和经济损失；然而，事故仍很普遍。
1999 - 2008年。
1991年1月至2009年9月期间，有毒物质和疾病登记署（ATSDR）运行了有害物质应急事件监测（HSEES）系统，以描述化学物质释放的公共卫生后果并开展旨在减少危害的活动。本报告总结了在HSEES数据收集的最后10个完整年份（1999 - 2008年）参与该系统的9个州（科罗拉多州、爱荷华州、明尼苏达州、纽约州、北卡罗来纳州、俄勒冈州、得克萨斯州、华盛顿州和威斯康星州）的事故数量、受伤人数、死亡人数和疏散人数的时间趋势。
共报告了57,975起事故和15,506名受伤人员，其中包括354人死亡。在监测期间，观察到了几个趋势：固定设施的事故总体略有下降（R² = 0.6），死亡人数呈上升趋势（R² = 0.7），特别是普通公众的死亡人数（R² = 0.9）。3月至6月春季期间事故数量增加，一年中的其余时间则减少（R² = 0.5）。周一至周日事故数量呈下降趋势（R² = 0.7），与受伤人数的趋势相似（R² = 0.6）。事故数量在一天中较早时段（上午6:00 - 11:59）最高，然后随着时间推移而减少（R² = 0.9）；受伤人数的趋势与此相似（R² = 1.0）。
化学事故继续影响公众健康，并且似乎对普通公众而言是一个日益严重的问题。事故和受伤数量因月份、星期几和一天中的时间而异，并且可能受到天气和经济等其他因素的影响。
公共和环境卫生与安全从业者、工人代表、应急规划者、应急准备协调员、行业、应急响应人员及其他各方可利用本报告中的发现为化学事故和伤害做好准备并加以预防。具体而言，了解何时预计会发生最多的事故和伤害可指导应急准备和预防工作。此外，需要开展新的或扩大的工作及宣传活动，以教育可能接触化学品的消费者（例如，对可能经历与天气相关停电地区的消费者进行一氧化碳中毒危险的教育）。应探索调整努力方向，如推广本质更安全的技术，以减少或完全消除危害。
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