Contents
Editorial 3
Incident Response 4
Smethwick recycling plant fire - a Met Office perspective 4
Introduction 4
Incident summary 4
Dispersion and the boundary layer 4
Meteorological conditions during the fire 6
Key points 6
References 6
Smethwick recycling plant fire - PHE response 7
Introduction 7
Overview of the incident 7
Potential public health implications 7
Key points 8
References 9
'Le pong' - a public health incident? 10
Introduction 10
Incident 10
Public health risk assessment 10
Multiagency response 11
Discussion 13
Acknowledgements 14
References 14
Sewers, culverts and other underground pipes - an under recognised pathway for chemical exposures in acute incidents: case series 15
Introduction 15
Case study 1. disposal of solvent into a mains sewer 15
Case study 2. solvent groundwater plume ingress into sewer system 16
Case study 3. resin repair to culvert 16
Discussion 17
Acknowledgments 17
References 17
Acute risks from contaminated land 18
Introduction 18
Case study 18
Why is free cyanide a concern? 19
Risk assessment 19
Toxicology of free cyanide 19
Further risk assessment 20
Discussion 20
Acknowledgements 20
References 20
MSC Flaminia - public health assessment and contribution to the places of refuge assessment 21
Background and incident overview 21
Command and control structure 21
Place of refuge (PoR) process 21
Human health implications 21
Worst-case risk assessment 22
Final actions 22
Learning points 22
Conclusion 23
References 23
Emergency Preparedness and Response 24
Collaborative working with local resilience forums to prevent an environmental major incident 24
Background 24
Multiagency response to a waste tyre site 24
Subsequent use of the health risk assessment template - chemical waste processing site 27
Discussion 27
Key learning points 28
References 28
Transition to new health arrangements: Public Health England's exercise assurance programme 29
Exercise Paladin: health system pressures with a chemical incident 29
Lessons identified 29
The Control of Major Accident Hazards (COMAH) Regulations - forthcoming legislative changes and the role of Public Health England 30
Part 1. COMAH and the role of Public Health England 30
IntroductionThe Control of Major 30
Understanding public health 30
Public health roles and responsibilities 31
Future developments - major revision of COMAH Regulations in 2015 31
Contact information 33
References 33
Part 2. Public health information in COMAH off-site emergency plans 34
Introduction 34
Public health risk assessment 34
Findings from a study - top-tier COMAH sites in Wales 35
Guidance for the inclusion of information to support the public health risk assessment within off-site plans 37
Conclusion 37
Contact information 38
References 38
EU Decision for serious cross-border threats to health 39
Introduction 39
Background 39
What are the gaps and how will the Decision address them? 39
Conclusion 41
Glossary 41
References 41
Alerting, Reporting and Surveillance System for Chemical Health Threats, Phase Ⅲ (ASHTⅢ) - update report 42
Introduction 42
Background 42
RASCHEM platform 43
Chemical emergency risk management monographs 43
Ad-hoc monitoring of emerging chemical events: toxicosurveillance 44
Identifying unknown toxic chemicals 44
Network of toxicological risk assessors 44
Examples of use of project outputs 44
What next? 45
Acknowledgements 45
References 45
European Chemical Emergency Network (ECHEMNET) - update report 46
Introduction 46
Background 46
Project objectives and outcomes 46
Reporting guidance and assessment 48
Rapid risk assessment of chemical events that fall outside the remit of other organisations 49
Inter-sectoral preparedness 49
European network of expert public health risk assessors 50
What next? Exercises and engagement 50
Acknowledgements 50
References 50
Developing tools to assist with evaluating a recovery strategy 52
What's next 52
References 52
Practically assessing the GDS framework against CBRN scenarios - can it really do what it says on the tin? 53
Introduction 53
Assessment of environmental sampling capacity and capability 53
Assessment of decontamination capability 54
Conclusions 55
Impact of response actions on recovery - the importance of a consolidated approach to UK resilience 56
Introduction 56
Key considerations during the response and recovery phases 56
Conclusions 58
References 58
A quick tour of social media and emergency preparedness, resilience and response (EPRR) 59
Introduction 59
Information sharing through social media 59
Social media and emergency preparedness, resilience and response (EPRR) 59
Conclusions 60
References 61
Environmental and Toxicological Research 62
Estimating local mortality burdens associated with long-term exposure to particulate air pollution 62
Introduction 62
Background 62
Methods and metrics 62
Results 63
Discussion 63
Application of research to health protection 64
References 64
The Environment and Health Atlas for England and Wales: a printed and online tool 65
The Environment and Health Atlas - what is it? 65
Methods 65
Example maps from the atlas 65
Media and public reception of atlas 67
Asbestos: review of toxicology and epidemiology and an approach for human health risk assessment of low level environmental exposures 68
Introduction 68
Review of toxicology and epidemiology 68
Approach for human health risk assessment of low level environmental exposures 70
Conclusions 72
References 72
Use of fumigants in the transport of goods by sea - health impact 73
Background 73
Methodology 73
Types of fumigants 73
Possible exposure to fumigants 74
Exposure incidents 74
Consumers and long-term exposure 75
Discussion 75
References 76
Role of risk communication in non-infectious disease cluster investigations: a summary of the literature 77
Background 77
Aims 77
Why is effective communication important? 77
Obstacles to risk communication 77
Overcoming obstacles to risk communication 78
Conclusion 79
References 79
Natural Hazards, Extreme Events and Climate Change 80
The oak processionary caterpillar and public health: the Dutch approach 80
Background 80
Inexorable march of the oak processionary caterpillar 80
Lifecycle of the oak processionary moth 81
Oak trees infested with caterpillars 81
Health complaints caused by the urticating hairs 81
Advising and informing the public 82
How to protect against health effects 82
Management of oak processionary caterpillar 82
Conclusion 83
References 83
Improving the response to flooding: changes implemented in Gloucestershire since the summer 2007 floods 84
Background 84
Identifying the problems and solutions 84
Discussion 84
Acknowledgements 85
References 85
Effective flood resilience in health providers: flooding at a major NHS Blood and Transplant facility 88
Background 88
Overview of the incident 88
Potential public health implications 88
Discussion 88
Key learning points 90
Acknowledgements 90
References 90
Conferences and Workshop Updates 92
Atlantic Regions' COastal POLlution (ARCOPOL) Response Plus conference Creating a toolkit for effective maritime incident response - communications, resources and planning 92
Introduction 92
Planning and preparedness to maritime incidents 92
Communication during a maritime incident 93
Response and recovery to a maritime incident 93
ARCOPOL projects - tools and resources 94
Conclusions 95
Acknowledgement 95
About Public Health England 96
Acute risks from contaminated land 20
Table 1. Cyanide content of coloured deposits 20
The Control of Major Accident Hazards (COMAH) Regulations - forthcoming legislative changes and the role of Public Health England 32
Table 1. Health responses in a major incident at a COMAH site 32
Table 2. Items of information to be provided to the public 32
Table 1. Examples of chemical incidents 42
European Chemical Emergency Network (ECHEMNET) - update report 49
Table 1. Health-related reporting and alerting criteria (italicised) 49
Table 2. Rapid risk assessment sections 49
Impact of response actions on recovery - the importance of a consolidated approach to UK resilience 57
Table 1. Key early recovery considerations (within four hours of an incident) 57
Table 1. Airborne levels of asbestos 68
Table 2. Comparison of risk estimates (1 in 100,000 excess lifetime mesothelioma risk) for air concentrations of chrysotile 70
Table 3. Hodgson and Darnton risk estimates - excess lifetime asbestos-related lung cancer and mesothelioma (the two tumour types combined) per 100,000 70
Table 4. Age adjustment factors for mesothelioma risk dependent on the age at which exposure commences 71
Use of fumigants in the transport of goods by sea - health impact 74
Table 1. Commonly used fumigation chemicals and their health effects 74
Table 1. Variations in public and expert perceptions of risk 77
The oak processionary caterpillar and public health: the Dutch approach 82
Table 1. Periods when health complaints can occur 82
Improving the response to flooding: changes implemented in Gloucestershire since the summer 2007 floods 85
Table 1. Key changes made to flood preparedness, resilience and response in Gloucestershire 85
Effective flood resilience in health providers: flooding at a major NHS Blood and Transplant facility 91
Table 1. Summary of lessons learnt and considerations 91
Atlantic Regions' COastal POLlution (ARCOPOL) Response Plus conference Creating a toolkit for effective maritime incident response - communications, resources and planning 94
Table 1. Key workshops from the public health perspective 94
Smethwick recycling plant fire - a Met Office perspective 5
Figure 1. CHEMET area at risk plot issued at 8am on 1 July 2013. Note that this CHEMET assumed that the material was being released at ground level 5
Figure 2. (a) a visible composite satellite image from the NOAA-15 satellite showing the plume from the fire at 07:25 BST on 1 July 2013 - the plume is the dark thin streak heading to the southeast in the area highlighted by the black box, (b) NAME dispersion model prediction of the smoke plume location between 07:00 and 08:00 BST on 1 July 2013 5
Figure 3. Time evolution of boundary layer height, wind direction and temperature during 1 July 2013 at the location of the fire. The meteorological data was extracted from the Met Office's high resolution UK meteorological model 6
Smethwick recycling plant fire - PHE response 8
Figure 1. Location map of sensitive receptors, showing 250 m, 1000 m and 1500 m buffers and AQC monitoring locations 8
Figure 2. Particulate concentrations from 1 July 2013 to 2 July 2013 at monitoring site 1 9
Figure 1. Structure of methyl mercaptan 10
Figure 2. NAME plume modelling 12:00 21/01/13 (coloured for illustration purposes, not representative of atmospheric concentration) 12
Figure 3. NAME plume modelling 00:00 22/01/13 (coloured for illustration purposes, not representative of atmospheric concentration) 12
Figure 4. NAME plume modelling 12:00 22/01/13 (coloured for illustration purposes, not representative of atmospheric concentration) 12
Figure 5. NAME plume modelling 00:00 23/01/13 (coloured for illustration purposes, not representative of atmospheric concentration) 12
Figure 6. NAME plume modelling 12:00 23/01/13 (coloured for illustration purposes, not representative of atmospheric concentration) 12
Figure 7. NAME plume modelling 00:00 24/01/13 (coloured for illustration purposes, not representative of atmospheric concentration) 12
Figure 1. The plateau area of the tipped waste 18
Figure 2. View of coloured deposits (1 m ruler alongside for scale) 18
Figure 3. Signage put in place to warn members of public to avoid high risk exposure activities in the area of the waste tip 20
Collaborative working with local resilience forums to prevent an environmental major incident 28
Figure 1. Hierarchy of incident management options 28
Alerting, Reporting and Surveillance System for Chemical Health Threats, Phase Ⅲ (ASHTⅢ) - update report 43
Figure 1. ASHTⅢ Group at an interim meeting in Vilnius: (left to right) Sergey Zakharov, Herbert Desel, Laura Settimi, Daniela Pelclova, Erik Andrew, Martin Ebbecke, Fabrizio Sesanna, Charlotte Hague, Gabija Dragelyte, Rob Orford, Franca Davanzo, Robertas Badaras, Al Bronstein, Laima Gruzdyte and Monique Mathieu-Nolf 43
European Chemical Emergency Network (ECHEMNET) - update report 47
Figure 1. Project and workstreams in EU projects part funded by the EU Health Programme in the area of chemical health security 47
Figure 2. ECHEMNET group: (left to right) Jim Stewart-Evans, Jesus Ocana Garcia-Donas, Rob Orford, Maria del Carmen Garcia Cazalilla, Kerry Foxall, Mark Griffiths, Elisabeth Wigenstam, Jiri Trnka, Rebecca Gay, Charles Turner, Lisbeth Hall, Barbara Fothergill, Andreas Schaper, Marjolein Groot, Charlotte Hague, Herbert Desel and Raquel Duarte-Davidson 48
Figure 1. GDS framework supplier sampling contaminated area 53
Figure 2. GDS framework supplier undertaking decontamination 54
Figure 3. GDS framework supplier removing waste 55
Figure 1. Illustration of the components involved in response and recovery 56
The Environment and Health Atlas - what is it? 66
Figure 1. (a) smoothed relative risk of breast cancer in England and Wales, 1985-2009 and (b) smoothed relative risk of female COPD mortality in England and Wales, 1985-2009 66
Figure 2. Screenshot of online atlas 66
Figure 3. Average annual particulate matter (PM10) concentration in 2001 in England and Wales 67
Figure 1. Example of the spread of the oak processionary caterpillar in the Netherlands (NVWA3) 80
Figure 2. Oak processionary caterpillars on a branch 'in procession' (Leon van den Heuvel, Foto-effect) 81
Figure 3. Oak processionary caterpillar nest on a tree trunk (Maarten Crezee, Plagen Preventie Dienst) 81
Effective flood resilience in health providers: flooding at a major NHS Blood and Transplant facility 89
Figure 1. Floodwater reaches the entrance to NHSBT Filton 89
Figure 2. Floodwater inside NHSBT Filton was up to 4 inches deep in places 89
Figure 3. Blue paper towels were used to filter out floodwater debris 90
Acute risks from contaminated land 19
Box 1. Consultant approach to deriving assessmentcriteria for free cyanide 19
Collaborative working with local resilience forums to prevent an environmental major incident 25
Box 1. Health risk assessment template produced to support multiagency response to waste tyre site (amended to reflect recent command and control changes in public health) (based on LRF risk assessment template) 25
Box 2. Off-site plan for (xxxx) 26
The Control of Major Accident Hazards (COMAH) Regulations - forthcoming legislative changes and the role of Public Health England 36
Box 1. Information to be included in off-site plan to assist the public health response 36
Box 2. Science and technical advice and Air quality cell 37
Box 3. Public health roles and responsibilities 38
Box 1. Early Warning and Response System (EWRS) alerting criteria (Article 9 of the Decision) 39
Box 2. Principles of subsidiary and proportionality (Article 5 of the Treaty on the European Union) 40
Alerting, Reporting and Surveillance System for Chemical Health Threats, Phase Ⅲ (ASHTⅢ) - update report 44
Box 1. Toxidrome definition 44
Asbestos: review of toxicology and epidemiology and an approach for human health risk assessment of low level environmental exposures 72
Box 1. Hypothetical case study 72