Learning from HSEES: A Vision for National Acute Hazardous Substances Surveillance

摘要

Acute releases of hazardous substances are a significant concern in the U.S. and have been associated with substantial public health impact. Despite numerous attempts by a variety of stakeholders to collect event data, there are gaps in our knowledge of contributing factors, geographic distribution, and resulting health outcomes. Consequently challenges remain in conducting appropriate planning, prevention, and response activities related to such releases. A national acute hazardous substances release surveillance system would lay the basis for addressing these gaps as well as guide the development and evaluation of local, state, and national prevention programs. There are a number of national acute chemical release databases currently in operation: the National Response Center's Incident Reporting Information System (IRIS), managed by the U.S. Coast Guard and the Hazardous Materials Incident Reporting System (HMIRS), administered by the US Department of Transportation. These databases were not originally designed for public health surveillance purposes, therefore their usefulness for public health applications is limited. The Hazardous Substances Emergency Events Surveillance System (HSEES), funded by the Agency for Toxic Substances and Disease Registry (ATSDR), is focused on the public health impacts of hazardous substances release events. However it is not a national system. HSEES gathers data from many sources (including IRIS, HMIS, state and local sources etc.) to complete a standard data collection instrument. The data is analyzed and disseminated to users for planning, preparedness, and prevention activities. HSEES falls short of a national acute hazardous substance surveillance system because the types of releases included are limited by legislative mandate, data is collected in only 14 states, and the data is focused on public health. There are also several databases that house information on some acute hazardous substance exposures. These include the Sentinel Event Notification System for Occupational Risk (SENSOR) of the National Institute of Occupational Safety and Health (NIOSH), the Toxic Exposure Surveillance System (TESS) from the National Poison Control Center, and the Accident Investigation Database from the Occupational Safety and Health Administration (OSHA) among others. Because these are focused primarily on exposure and related health outcomes, event information is generally limited. In addition, threatened releases or events that are not associated with a recognized health outcome are generally not included. ATSDR is currently evaluating the feasibility of a national acute hazardous substance release surveillance program to address the gaps in the current systems. As a part of this process, ATSDR has organized a series of meetings to engage stakeholders in the process of developing a "Roadmap" for this effort. A planning committee is in the process of organizing a two day "roundtable" workshop to refine and finalize a vision document and the Roadmap for this process. In late 2007, a national conference will be held to further engage stakeholders and potential partners and obtain their input.