Dr. Sapp & Class,
In thinking of mass casualty situations due to chemicals, I think about chlorine exposures, especially in summer due to chlorine use with swimming pools and water park areas. According to the CDC, chlorine can be in a poisonous gas or a liquid form that can cause respiratory and skin issues when exposed to dangerous exposures (2018).
On July 1, 2021, in Spring, Texas, there was an airborne chemical exposure at a Six Flags water park that involved approximately 60 individuals. According to the NBC news broadcast, the Harris County Public Health and Harris County Fire Marshal’s office under the Texas Health and Safety Chapter 341 gives public health the authority to issue a closure order for the investigation (2021). According to ABC News, investigators found 35% sulfuric acid and 10-13% bleach concentrations were found in the water, as a statement from the water park authorities theorize that “there was a vapor released in a small outdoor section of the park that quickly dissipated” (2021). In this type of mass chemical exposure, victims need to be decontaminated and sent to local hospitals as part of chemical exposure planning. Hospitals must plan and prepare to provide appropriate decontamination and care of victims of these types of exposures.
Within the San Antonio, Texas area, we have University Hospital, the local area Level 1 trauma center for adults and children. University Hospital participates yearly with the South Texas Regional Advisory Council, providing hospital training and scenario-based training for mass casualty and incidents. They practice hazardous material and chemical decontamination with their staff and have specific teams that are deployed. Because San Antonio also has another level 1 trauma center in the San Antonio Military Medical Center provides our city with additional support in mass casualty and incidents with chemical, biological, radiological, or nuclear (CBRN) type events through the military. Assessments of exposure typically are gauged with the chemical dose, the chemical concentration, the duration of time, the environment you are in with the exposure type. The exposure type can be exposure of skin, mucus membranes, ingestion as examples. The Agency for Toxic Substances and Disease Registry (ATSDR) provides exposure dose calculations to assist public health assessments (2005). The importance of appropriate evaluation, testing, calculating exposures and providing decontamination assists victims and hospital systems with treatment.
References:
Centers for Disease Control and Prevention: Public Health Assessment Guidance Manual. (2005, November 30). Appendix G: Calculating Exposure Doses. Centers for Disease Control and Prevention. https://www.atsdr.cdc.gov/hac/phamanual/appg.html.
Centers for Disease Control and Prevention. (2018, April 4). Emergency Preparedness and Response: Facts About Chlorine. Centers for Disease Control and Prevention. Retrieved from https://emergency.cdc.gov/agent/chlorine/basics/facts.asp#:~:text=Howpeoplecanbeexposedtochlorine,touchingordrinkingwaterthatcontains…More.
Romero, D., & Varela, J. (2021, July 18). Over 60 people decontaminated after a chemical leak at a Texas water park. NBCNews.com. https://www.nbcnews.com/news/us-news/34-people-exposed-chemical-leak-six-flags-water-park-texas-n1274285.