BACKGROUND: Background: The North Carolina Division of Public Health has been participating in the National Toxic Substance Incidents Program (NTSIP) surveillance system since 2010. This program is managed by the Agency for Toxic Substances and Disease Registry. The purpose of the surveillance system is to monitor acute toxic substance releases and their public health consequences and find ways to reduce potential harm. This paper examines the types of injuries caused by toxic substance releases and their contributing factors in North Carolina from 2010 to 2014.
METHODS: We used Event, Victim, and Chemical data collected from 2010—2014 to investigate type of injuries, severity of injuries, chemicals, and factors associated with these incidents. NTSIP defines an injured person as anyone who experiences at “least one documented adverse health effect within 24 hours after an incident” or “who dies as a consequence of an incident”. Up to seven injuries may be recorded for each victim. The data are collected from multiple sources including the U.S. Department of Transportation, Carolinas Poison Center, National Response Center, N.C. Emergency Management, and media reports. In 2014, syndromic surveillance data were also obtained from NC DETECT.
RESULTS: In the 172 events during the 5-year timeframe, 558 injured persons were identified with 786 injuries. Respiratory system problems accounted for 27% (n=209) of the injuries, headaches 14% (n=114), gastrointestinal problems 13% (n=104), dizziness and other central nervous system symptoms 13% (n=104), trauma 8% (n=60), and burns 7% (n=59). Half or 50% of the trauma injuries and burns were chemically related. Equipment failure contributed to 41% (n=70) of the chemical incidents that resulted in injuries, followed by illegal activities 22% (n=38) and human error 15% (n=26). The most common chemicals that resulted in injuries were methamphetamine chemicals and carbon monoxide. In 2014, there were more injuries than previous years; 40% (n=191) of injuries during the 5 year period occurred this year.
CONCLUSIONS: Equipment failure contributed to many of the injuries, which suggests that industries may need to be educated on the importance of repair and maintenance to avoid chemical incidents. Also, human error resulted in many incidents, which may indicate there may be a lack of education in handling these chemicals. The increase of injuries in 2014 may be attributed to the use of syndromic surveillance to supplement other data sources. Therefore, we conclude that improving ways to collect data may not only improve surveillance but help capture a more accurate estimate of incidence.