Michigan's Environmental Disaster Epidemiology Plans

BACKGROUND: After the awarding of initial funding from CDC for emergency preparedness in 2002, the Michigan Department of Community Health (MDCH) designated as a priority the development of a chemical emergencies response plan that included a detailed plan for chemical emergency epidemiologic response.  Subsequent experiences with environmental emergencies and changes in program priorities furthered the development MDCH’s environmental emergency epidemiology plans. This presentation describes the format of the disaster epidemiology plans, experiences in implementing the plans (and subsequent plan modifications), and areas for additional testing and refinement of the plans. 

METHODS:  Following reviews of numerous resources on emergency planning, the MDCH Emergency Operations Plan was developed with designated annexes for chemical emergencies, natural disasters, and radiologic emergencies. The natural disasters and radiologic emergencies annexes were based on the chemical annex. Each annex has a designated appendix for surveillance and epidemiology response that follows a format and includes implementing instructions as attachments. 

RESULTS: The environmental emergencies surveillance/epidemiologic annexes describe in detail actions steps for response to chemical, natural and radiologic disasters.  These steps include: initial assessment of the impact of the environmental emergency event on human health; development of the surveillance plan (case definition, surveillance strategies, geographic/temporal scope; available data collection and management tools; data sources); plan implementation; data analysis and dissemination; and closing the investigation. Tools for implementation include: check lists, templates for case-based data collection, instructions for adapting the MDCH communicable disease electronic disease reporting and syndromic surveillance systems for an environmental emergency event, federal tools (e.g. ATSDR Rapid Response Registry Survey form), and copies of relevant laws/rules with public health authorities for non-infectious disease surveillance.  Several events provided valuable input into the effectiveness of these plans, including a large oil spill, a summer heat wave, and the first Michigan Community Assessment for Public Health Emergency Response (CASPER).  

CONCLUSIONS: Having written surveillance plans and implementing tools was helpful for MDCH’s response to a variety of relatively small environmental emergencies, and critical for the response to the 2010 oil spill.  The process of developing the plans necessitated building new collaborations between the MDCH environmental program and the communicable disease program, local health departments, and CDC programs. However, these plans have not been exercised as much as other parts of the MDCH All Hazards Response Plan.  In addition to more exercises, collaboration with other states in reviewing and exercising epidemiology plans for environmental emergencies would be helpful.