Medical planning for toxic releases into the community: the example of chlorine gas.

Abstract

Emergency planning for a major accidental release of chlorine gas from industrial installations into the community is outlined for emergency services and hospitals. Realistic planning has been made possible with the advent of computer models for gas dispersion which may be used to estimate the numbers of deaths and casualties, according to their severity. For most purposes sufficient accuracy may be obtained by using a small number of computer analyses for the most serious reasonably foreseeable events under typical day and night weather conditions, and allowing for the emergency response to be scaled up or down according to the size ofan actual release. In highly populated areas triage should be preplanned to deal with a large number of victims; field stations will be needed for the treatment and observation of minor casualties. The management and treatment of casualties is summarised. The best protection against a gas cloud is afforded by buildings whose windows, doors, and ventilation systems have been closed. Hospitals in the vicinity of an installation should draw up plans to protect patients and staff. Coordination in a disaster will require toxicological and epidemiological expertise and hospital plans should allow for this.In Britain emergency planning for industrial disasters involving fires, explosions, or toxic releases has been given an impetus by the introduction of the Control of Major Accident Hazards (CIMAH) Regulations, 1984.' A key innovation of these regulations is the obligation placed on local authorities, at county level, to prepare emergency plans for communities around the so called top-tier sites; currently there are over 200 large inventory, top-tier sites involved. Hospital disaster plans are likely to require modification to deal with the potentially large number of casualties caused by a major chemical release into the community, and county emergency planners are legally obliged to consult health authorities when drawing up their offsite plans for these special installations. Chlorine is the commonest toxic gas for which planning has to be undertaken and the problems it presents to medical planners are typical of irritant gases in general-for instance, ammonia and sulphur dioxide. We provide *This paper represents the view of the authors and should not be regarded as a statement of HSE policy.

Brain But Not Lung Functions Impaired after a Chlorine Incident

“…These new observations and others show that the transport and handling of concentrated chlorine is dangerous 33) . Concentrations injurious to the human CNS may be found around indoor swimming pools, sewage treatment plants and from cleaning of floors and sterillization of dishes and utensils, especially indoors 35,36) .…”

“…Chlorine boils upon release from storage. Its vapor pressure is 33.8 at 0°C so doses reach equilibrium indoors at 20°C in seconds 30,33) . What mechanism is responsible for the CNS effects of chlorine?…”

“…Concentrations injurious to the human CNS may be found around indoor swimming pools, sewage treatment plants and from cleaning of floors and sterillization of dishes and utensils, especially indoors 35,36) . Transport of compressed chlorine in cylinders or spheres on highways and railways risks accidents and human exposures 10,33) .…”

Inhaled budesonide in experimental chlorine gas lung injury: influence of time interval between injury and treatment

“…Chlorine is used or generated during many industrial processes, including the pulp and paper industry, the manufacture of bleaching powder and water purification [1]. Exposure typically occurs as a result of industrial accidents, transportation mishaps and in the home from mixing household cleaners [2,3].…”