Environmental Health Emergencies, Disasters, and Terrorism
STATEMENT OF PROBLEM AND SPECIAL INFORMATION
Environmental health emergencies, disasters, weather-related incidents, and acts of terrorism create situations where normal problems are intensified, existing environmental health problems are magnified, and new problems are created. The level of concern varies with the scope and nature of the situation which has occurred. For instance, a fire in a food warehouse would be an emergency, whereas an uncontrolled wildfire would be a disaster. (See Sub-Problems Including Leading to Impairment, and Best Practices for Environmental Health and Protection Emergencies, Disasters, and Special Issues section below for specific environmental concerns regarding food, water, housing, sewage disposal, solid waste, etc. These specific problems and Best Practices relate to most of the industrial accidents leading to disasters, natural disasters, and acts of terrorism discussed in this chapter and therefore to avoid repetition are being put in one special section.)
Responsibility for reaction to emergencies, disasters, and acts of terrorism may be part of the operational procedures of many different governmental and voluntary agencies. Numerous times, especially around large urban areas, there is a multitude of governmental entities, all with responsibility for the same type of problem. The environmental affects and health effects on people caused by an emergency, disaster, or act of terrorism are not confined to the boundaries set by specific governmental entities. Many times the types of communications systems utilized within communities and between communities are not compatible and therefore one entity cannot communicate effectively with another entity. Emergencies, disasters, and acts of terrorism demand a very rapid response but this may be affected by a lack of communication and coordination of response efforts.
After the immediate problems of the disaster or terrorist act are over, there is typically an overwhelming need for assistance for all individuals, especially the chronically ill and the elderly. People are displaced by the disaster and cannot typically live within their own environment, leading to increased injuries and potential emotional problems. There may be a lack of safe food, water, housing facilities, and bathroom facilities. The individuals may not have their medications available and therefore may deteriorate or die from existing diseases. Older people may tend to have reduced capabilities in their smell, touch, vision, and hearing and in their mobility. Many people, especially the elderly, may have limited financial resources, a reluctance to seek assistance, inability to complete necessary paperwork, and a lack of good transportation. Nutrition may become a serious issue and such things as meals-on-wheels may not be available. Fraud and abuse may be part of the aftermath of the disaster since the individual may be defenseless.
Evacuation centers may be overcrowded and become a means of transmission of acute diseases. The level of noise and overcrowding may profoundly affect the senior adult who is used to be quiet and being involved with very few people. Individuals, especially older ones, may not evacuate from hazardous situations for fear of leaving their pet behind or losing their pet.
In all cases, there is a sudden occurrence which demands an immediate, but thoughtful, coordinated response. An advance plan on how to work together and how to use the resources which are available for the protection of the community is essential. Appropriately staffed, well-prepared, and well-coordinated command-and-control groups working with a multitude of government agencies and citizens’ groups and utilizing good sources of communications, are essential to prevent loss of life and property.
Special attention needs to be given to the environmental conditions within evacuation centers and to the needs of certain people, especially the young, the elderly who typically represent the largest number of people who become ill, injured or die, and the handicapped, pregnant women, and those with existing infectious and/or chronic diseases. Special pet shelters need to be provided. Special care, equipment, and training must be given to all volunteers and first responders.
Industrial accidents leading to disasters may occur in: the defense industry such as explosions at various weapons storage areas, and severe contamination of land, water (especially drinking water), and air from improper storage and disposal of hazardous wastes; the energy industry such as the Chernobyl disaster where the reactor went out of control and there was a nuclear meltdown, the oil spill into the Gulf of Mexico after an explosion on an oil rig, the spilling of coal ash into a river contaminating the water supply, etc.; the food industry with explosions in grain mills and severe outbreaks of foodborne disease; the manufacturing industry with numerous fires killing many people because of improper building construction and maintenance as well as extremely poor working conditions; chemical industry with accidental releases of hazardous chemicals into the air, water, and land during production, transportation, storage, or handling of the hazardous chemicals, and fertilizer plant explosions; the mining industry with improper enforcement of safety standards and improper storage of mine waste which leaks into the water and contaminates the land as well as the air; and the transportation industry with derailments of trains especially those carrying large amounts of crude oil which will catch fire. (See endnote 93 for further information on crude oil transportation by railcar.) This list is but a brief survey of an unusually large potential for disease and injury and severe contamination of the environment. The subject of industrial accidents is extremely complex and therefore needs to be the topic of a separate book. However, many of the Best Practices utilized in other types of disasters will also be utilized to resolve the negative results of industrial accidents. Of great concern is the type of contamination that is released to the air, water, and land, and special engineering controls and other techniques used to control the hazards. Best Practices developed from new knowledge will also be utilized.
Disasters, weather-related incidents, and acts of terrorism may cause contamination of the air, water, land, food, housing, and other facilities. Some of the issues which will be discussed include biological hazards; carbon monoxide; chemical hazards; cleaning and sanitizing of contaminated structures after floods and other events; non-safe housing; electrical hazards; foodborne disease; hand hygiene; heat exposure; heating, ventilation, and air-conditioning (HVAC) systems; mold; respiratory protection; etc. Also, during disasters and weather-related incidents, substantial amounts of solid waste including hazardous waste are produced leading to an increased potential of disease and injury and a sharp increase in insects and rodents. This increases the potential for disease. Collateral damage from disasters includes loss of human and animal habitat, food and water sources, sewage systems, electricity, and communications.
Many of the previously named public health, environmental health, and personal health problems need to be handled efficiently and expeditiously by various health departments at the local, state, and federal level as well as environmental management, environmental protection, and environmental sustainability departments working in a coordinated manner with a large group of medically oriented and public health-oriented partners. These health-oriented people and facilities are tasked to: carry out tests, provide laboratory analysis, and control safety for food, water, air, hazardous chemicals, biological agents, etc.; plan and carry out emergency responses to all types of health problems; study and detect outbreaks of disease; provide emergency medical treatment; etc.
Unfortunately, in recent years there has been a decrease in the funding which is necessary to promote key programs to detect and respond to various emergencies, disasters, and acts of terrorism. Some of the finest career epidemiologists, environmentalists, and others working in preventive medicine are seeking other opportunities because of severe budget cuts at the federal, state, and local level. Also, there is decreased funding for all of the laboratory analysis which needs to be done to make determinations and provide quick responses to serious problems such as the spread of microorganisms.