Introduction:
The Hazardous Substances Emergency Events Surveillance (HSEES) System is an on-going, state-based surveillance program funded by the federal Agency For Toxic Substances and Disease Registry (ATSDR). The system's purpose is to describe the public health consequences associated with the release of hazardous substances and to reduce morbidity and mortality resulting from these releases. Five state health departments participated in the pilot phase of the surveillance system and began data collection on January 1, 1990. Iowa was one of those five states. Since 1990, the number of participating state health departments has increased. As of the year 2001, 16 states participated in the HSEES System program.
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The decision to initiate a surveillance system of this type was based on a 1988 study on the reporting of hazardous substances releases to three national databases. These were the National Response Center Database, the Hazardous Materials Information System (HMIS), and the Acute Hazardous Events Database. A review of these databases indicated that they were limited because many events were missed through incomplete reporting (for example, HMIS did not include events involving intrastate carriers or fixed-facility events). Other missing information included the demographic characteristics of victims, the types of injuries received, and the number of persons evacuated. As a result of this review, ATSDR implemented the HSEES System to describe the public health consequences associated with the release of hazardous substances. The surveillance system has four goals:
A Hazardous Substances Emergency Events Surveillance (HSEES) event is an uncontrolled or illegal acute release of any hazardous substance in any amount for substances listed on the HSEES Mandatory Chemical Reporting List, or if not on the list, in an amount greater than or equal to 10 pounds of one gallon. Events involving exclusively petroleum products, animal waste, or food products such as corn syrup, milk, and chocolate are not included. Threatened releases of qualifying amounts (any amount if on the HSEES Mandatory Chemical Reporting List, or if not on the list, in an amount greater than or equal of 10 pounds or 1 gall) will be included if the threat led to an action (for example, evacuation) to protect the public health.
Fixed-facility events are defined as events occurring inside or outside of buildings or other structures on fixed-facility grounds. Events involving vehicles that are part of the operation of a facility that occur within the facility are coded as fixed-facility events. Examples of these types of event are industrial sites, businesses, farms, schools, private residences, or railroads that are meant to move items within a fixed facility. Transportation-related events are those that involve hazardous materials being transported by ground transportation (for example, trucks, vans, and automobiles), railroad, aircraft, boards, ships, and pipelines outside the boundaries of a fixed facility.
Victims are defined as those persons who reported symptoms or went to a health care facility within 24 hours of the events for symptoms or injuries possibly associated with the event. The exception to the 24-hour stipulation is to count all victims who died as a result of the event. When counting injuries, victims who had more than one injury type were counted more than once. If a person had no symptoms but still sought medical treatment or if a person had symptoms but did not report them or seek medical treatment within 24 hours, they are not included as a victim.
For purposes of analysis, the substances released are grouped in 11 chemical categories. The category "mixtures" consists of mixtures of substances from different categories such as the combination of ammonia and cyanide. The category "other" consists of substances that could not be placed in one of the other 10 categories. The category "inorganic substances" comprises all inorganic substances except for acids, bases, ammonia, and chlorine.
To increase public awareness of the HSEES System, the Iowa Department of Public Health (IDPH) is interested in sharing the HSEES System data via oral presentations at professional and/or governmental meetings and with other interested public or private groups. In order to reach the goal of reducing morbidity and mortality resulting from hazardous substances releases, IDPH seeks to be actively involved in public awareness activities and in sharing information with all interested parties.
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