Every year, thousands of toxic substance incidents in the United States harm workers, first responders and the public — and some could be catastrophic. From 2010 to 2014, the Agency for Toxic Substances and Disease Registry (ATSDR) ran the National Toxic Substance Incidents Program (NTSIP), the successor to its 1991–2009 HSEES system, with nine state health departments: California, Louisiana, Missouri, New York, North Carolina, Oregon, Tennessee, Utah and Wisconsin.
What counted
An uncontrolled or illegal release of a toxic substance — chemical, biological, radiological or medical — lasting under 72 hours. Petroleum releases counted only if they led to an injury or a public health action such as an evacuation; threatened releases were excluded, as were small releases of some common substances. States gathered reports from federal, state and local sources, aiming to log 80% of incidents within 48 hours.
Five years in numbers
| Incidents reported | 22,342 — 13,529 met the definition |
| Injured people | 5,134, with 6,635 injuries |
| Deaths | 190 |
| Fixed facilities vs transportation | 8,711 vs 4,818 incidents — and about 10 times as many injured people at fixed sites (4,650 vs 484) |
In the three states that took part throughout — North Carolina, Tennessee and Wisconsin — incidents with injuries declined over the five years.
Incidents with injuries in the three states that participated throughout. Image from CDC's report
When and how
- More incidents in summer (4,087) and spring, fewer in fall and winter; most on weekdays and during the workday (6 a.m.–6 p.m.).
- Fixed sites: the main cause was equipment failure (48.5%); common specific causes included illegal drug production, improper filling or loading, fire, overspray and ruptured pipelines.
- Transportation: the main cause was human error (67.5%) — improper loading, forklift punctures, loose closures, derailments and rollovers. Most happened unloading a stopped vehicle, but most transport injuries came from moving shipments — often crash trauma rather than chemical exposure.
- Release type: vapor (volatilization) led in fixed-site incidents and in injuries (53.9%); spills dominated transport (85.2%).
Which substances
| Fixed facilities | Transportation |
|---|---|
| Natural gas 14.1% | Sodium or potassium hydroxide 10.2% |
| Carbon monoxide 8.4% | Sulfuric acid 5.5% |
| Illegal methamphetamine-lab chemicals 6.9% | Hydrochloric acid 4.8% |
| Ammonia 6.7% | Natural gas 3.4% |
Seven substances — carbon monoxide, natural gas, meth-lab chemicals, chlorine, sulfuric acid, propane and ammonia — caused 46.8% of injuries.
Mass-casualty incidents. Twelve incidents injured 30 or more people each, seven of them from carbon monoxide, in crowded places where no one expected a release. At one elementary school, a disconnected water heater exhaust pipe vented gas into classrooms; with about 280 students present, 30 people were treated on site and 44 students and teachers were hospitalized. At a detention center, a faulty gas water heater sickened 47 inmates.
Who was hurt
- Members of the public and students made up the largest group of injured, then employees (37.6%) and first responders (9.3%). A large share of people were hurt at home or in a vehicle (22.2%) or at schools (11.8%).
- Of injured people with a known sex, men outnumbered women more than two to one; among first responders, 297 men to 23 women. 790 of those with a known age were under 18.
- Among responders, career firefighters and police were hurt most. Firefighters usually wore turnout gear; police and other responders mostly wore no protective equipment.
- Most common health effects: respiratory problems, dizziness or other nervous-system effects (18.5%), burns (10.2%) and headache (9.4%).
- Most injured people (49.4%) were treated at a hospital without admission; most (81.3%) weren't decontaminated.
By industry, transportation and warehousing had the most incidents (4,476) but relatively few injuries; manufacturing (668), educational services (606) and real estate and rental (425) had the most injured people.
Response
18.9% of incidents led to an evacuation — 26.0% at fixed sites, 6.3% in transport — and 1.8% to shelter-in-place orders. Evacuations were far more common for a vapor (36.2%), fire (35.5%) or explosion (36.6%) than a spill (8.4%).
Why it matters
Chemical safety reform tends to come after disasters: the U.S. Chemical Safety Board was created after the 1984 Bhopal disaster; a catastrophic incident in West Texas on April 17, 2013, prompted an Executive Order to modernize chemical safety; yet on June 21, 2019, a Philadelphia refinery released process fluid containing hydrofluoric acid, starting a fire and three explosions. The Board says industry must do more — including safer alternatives to extremely hazardous substances.
But industrial sites are only part of the problem. Natural gas, carbon monoxide, meth-lab chemicals and ammonia reach people where they live, work, study and play. Public health should focus prevention on schools, daycares, nursing homes, recreation areas, jails, prisons and hospitals, and on first responders, who are often injured without protective gear. NTSIP ended when funding ran out in 2014, though some states continued; its public-use data remain online, and ATSDR's Assessment of Chemical Exposures (ACE) program still helps states investigate incidents. See atsdr.cdc.gov/ntsip.
Limits: states used different sources and methods; not every incident was captured; and some transport injuries came from crashes rather than chemicals.
Sources
Based on Natalia Melnikova, Jennifer Wu, Patricia Ruiz and Maureen F. Orr, "National Toxic Substances Incidents Program — Nine States, 2010–2014," MMWR Surveillance Summaries, volume 69, Centers for Disease Control and Prevention; a work of the United States government in the public domain. The report gives the public's share of injured people as both 43.6% and 51.2%, and respiratory problems as both 23.9% and 25.8%, so those figures are not given here.
Licence: CC0 1.0 (public domain) · Adapted from www.cdc.gov
1
0
0
0
Comments
