A public health management model for acute chemical incidents in Wales.
The price of industrial progress is the potential for exposure of an increasingly informed public to
chemical hazards in the environment. Of particular concern are acute exposures to chemical
incidents, where problematic health risk assessments have highlighted the lack of expertise and
resources available to support public health professionals in Wales responsible for protecting the
health of populations.
A systematic literature review of chemical incident databases, public health surveillance systems
and major chemical incidents worldwide was used to guide the development of the first active,
multi-agency community-based public health surveillance system for acute chemical incidents to be
undertaken in Europe. A total of 642 acute chemical incidents were reported in Wales from all
sources over a three year period. Of the 270 incidents reported by the primary source, chemical
spills were the most frequently reported type of incident (28%) and operational industrial sites the
most common location (25%). Of the estimated 238,000 people exposed, 528 reported symptoms
in a total of 57 incidents. A single chemical was implicated in 86% of the incidents.
Shortfalls were identified in the current expertise and resources available to public health
professionals in Wales, leading to the development of a public health management model for acute
chemical incidents. Model development took place in the context of United Kingdom - wide
initiatives and involved the conduct of structured interviews with 41 organisations with interests in
the field. The model selected for Wales was implemented on 1 February 1997 and comprised three
levels of operation: (a) accountability for the protection of public health vested in health authorities
at the local level; (b) a subscription-based front-line advisory and support unit to those authorities;
(c) and a centrally funded national co-ordinating centre to provide the necessary evidence-base
through programmes of surveillance, training, and emergency planning