Chapter 7: Reduce Harm from Chemical Emergencies through Prevention, Planning, and Coordination

Additional Recommendations

Recommendation 7.4: The President should issue an Executive Order [41] or Homeland Security Presidential Directive  that articulates an overarching national vision for addressing chemical emergencies; and each federal agency should develop its own supporting strategy to prevent, prepare for, respond to, recover from, and mitigate chemical emergencies, and ensure that preparedness momentum is maintained [42].

Related recommendation:  7.3

Successful implementation of this recommendation, which calls for presidential action similar to that required to secure government-wide commitment to the principles of environmental justice, will represent a significant paradigm shift and require a commitment by all federal agencies. As chemical emergencies can affect multiple governmental departments and programs, it is important that such a commitment encompasses all programs and activities involving chemicals. The outcomes generated from its implementation should more than justify the investment of time and the commitment to government preparedness and response to chemical emergencies across all agencies and levels of government. 

The directive should call on the EPA Administrator and the HHS Secretary, or their designees, to convene an Interagency Working Group on Chemical Emergencies [43] within three months of the date of the order. The Working Group should be responsible for developing a common and shared vision to guide the agencies as they develop their specific strategies. Ideally, the Working Group will collaborate with the federal Office of the Chemical Emergencies Coordinator (Recommendation 7.3) to: 

  • Coordinate with, provide guidance to, and serve as a clearinghouse for each federal agency developing a chemical emergencies strategy to ensure consistency in administration, interpretation, and enforcement of programs, activities, and policies;
  • Help coordinate research by and foster cooperation among EPA, HHS, the Department of Education, and other agencies conducting research and other activities related to chemical emergencies; 
  • Help develop sources of information on safer chemicals and coordinate data collection; 
  • Examine data and studies on chemical emergencies;
  • Develop model projects on chemical emergencies that demonstrate cooperation among federal agencies. 

Recommendation 7.5: ATSDR, HRSA, the HHS Office of the Assistant Secretary for Preparedness and Response, and other federal government agencies should develop an ongoing national program to assess and improve the healthcare response to hazardous chemical releases and to develop an evidence base for chemical emergency planning.

Related recommendations: 4.27.17.27.37.8

One of ATSDR’s missions is to prevent exposure and adverse health effects from unplanned releases of hazardous substances. To achieve this mission, ATSDR educates physicians and other healthcare providers and provides technical support and advice to other federal agencies and tribal, state, and local governments that respond to hazardous chemical releases. The passage of SARA Title III and the Nunn-Lugar Anti-Terrorism Act (Defense Against Weapons of Mass Destruction Act, 1996) reflect increasing concern in recent decades about the country’s preparedness to manage adverse health effects due to hazardous chemical incidents. Unfortunately, there are few empirical studies to inform an evaluation of the country’s current level of preparedness or to guide the development of preparedness programs; limited data suggest that the level of preparedness is not adequate. Since planning is only as good as the assumptions on which it is based, it is important that planning assumptions are correct. 

To address this deficiency, ATSDR, HRSA, and HHS should work with other partners to develop an ongoing national program to assess and improve the healthcare response to hazardous chemical releases and provide the necessary funding to make it sustainable [44].  The program should include the following activities:

  • Establish a regularly updated national collection of published and unpublished documents, reports, and research papers on the responses to chemical emergencies and releases and the lessons learned from them. The collection should be made available to planners, policymakers, practitioners, and the public. 
  • Establish a standing national rapid-response team focused on chemical emergency field research. This team would mobilize quickly to gather data on the operational lessons learned and best practices from responses to chemical emergencies. This activity can occur in conjunction with ATSDR Assessment of Chemical Exposures program teams that collect data on chemical emergency exposures and both short- and long-term outcomes. It is important to collect information from multiple events to identify common trends and patterns and to generate a large enough sampling for analysis. This effort could enhance the work begun by the CDC Disaster Research Project in the Prevention, Response and Medical Support Branch of ATSDR’s Division of Toxicology and Environmental Medicine. In addition, after-action reviews should be held with first responders and receivers, as well as with affected community members, through community post-incident advisory panels.
  • Use data generated to establish evidence-based criteria for effective chemical emergency preparedness. Based on these criteria, conduct periodic national randomized surveys of chemical response organizations and institutions to assess their levels of preparedness. (This might be considered a national “preparedness surveillance system.”)
  • Provide funding to establish additional National Toxic Substance Incidents Program states and promote sharing of chemical emergency incident data. Without an understanding of the chemical emergencies that are occurring and their effects, it is impossible to effectively plan for a chemical emergency. The types of surveillance data collected on chemical emergencies also need to be expanded.
  • Develop recommendations for chemical emergency and disaster preparedness based on information generated from the activities mentioned above. Include the recommendations in training materials for first responders and receivers.

Recommendation 7.6: DHS should support NLM and EPA in developing a single, user-friendly, accessible planning tool for toxicological hazard and hazard vulnerability analysis for use in local response to chemical emergencies.

Related recommendations: 7.2

DHS should support NLM and EPA in developing, integrating, and disseminating modern response tools. The information in NLM’s Wireless Information Systems for Emergency Responders should be expanded to fully inform and educate planners, responders, and receivers on chemical emergency response steps and needs. The database must be accessible to responders in the field by way of laptop, PDA, mobile smart phone, etc., as well as to receivers and members of the public via the internet. A critical component of this expanded body of information would be a functioning toxicological hazard-vulnerability assessment tool that allows planners, responders, and receivers to identify the nature and potential magnitude of a chemical event. This comprehensive tool should bridge the gaps between scientific knowledge, risk management, and best practices in response planning [45]. 

Training should be provided on the use and functions of the program at no cost to the response community. DHS should task NLM and EPA to continuously upgrade and update the program to meet the changing needs of the response community. The program should be implemented within two years, with tracking of program usage, updates, and upgrades to take place within two to three years. 

Recommendation 7.7: Federal agencies with responsibilities for providing funding to tribes, states, and localities to address chemical emergencies should require all relevant funding announcements to include language strongly encouraging the development of partnerships with NGOs, community-based organizations, affected community members, academia, labor unions, and industry.

Related recommendations: 4.14.5

Partnerships are an important tool in preventing, preparing for, and responding to chemical exposures. Ideally, partnerships will lead to information sharing on processes and technologies that can eliminate major chemical hazards. As appropriate, funding agencies should encourage and incentivize proposals that include, as equal partners, representatives from industry, academia, community organizations, NGOs, and members of potentially affected communities, and should give priority to these proposals for acceptance and funding. Proposals that include more than one institution or industry representative as equal partners should receive bonus points during the review process. Partners’ roles and responsibilities should be shared and clearly delineated to avoid enlisting and creating participants in name only. External auditors (one each from the funding source and recipient institutions) should annually review the structure, operating efficiency, and results of any partnerships created as a result of grant-related activities. If recipients are found to be non-compliant with the terms of this recommendation, funding may be reduced or withheld.

Recommendation 7.8:  The federal government should fund and support the ongoing development of trained and experienced Emergency Support Function (ESF) #8 – Health and Medical Service planners [46] and responders to improve emergency operational capabilities and critical decision making and better integrate private- and public-sector responses to public health emergencies during chemical disasters/events.

Related recommendations: 7.17.5

Planners must be trained and prepared for responses that integrate the capabilities and capacities of the many diverse agencies and organizations that might be called on during a chemical emergency. The strategic objectives of such a training program should be to: 

  • Educate medical, public health, and emergency management professionals to serve as ESF #8 planners and response coordinators and to become leaders in this field along the lines of hazardous materials task forces;
  • Provide an experienced and prepared cadre of personnel that can coordinate or assist in ESF #8 planning and augment ESF #8 response activities at the national, tribal, state, and local levels;
  • Enhance effectiveness of ESF #8 regional planning and response partners at the national, tribal, state, and local levels by standardizing theories and methods;
  • Create a highly competent and dynamic faculty/staff to train participants and also help organizations by coordinating or assisting in multijurisdictional planning and response.

Through prior planning and training, leaders at the federal, tribal, county, and local levels will be better prepared to help coordinate response planning involving all stakeholders [47].  Implementation of the training program should occur within one to two years and should be sustained over the long term.

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[41] An executive order is a legally binding order given by the President, acting as the head of the Executive Branch, to the federal administrative agencies. Homeland Security Presidential Directives are issued by the President on matters pertaining to homeland security.

[42] President Obama issued Presidential Policy Directive-8 on March 30, 2011, to develop a national preparedness goal that identifies the core capabilities necessary for preparedness and a national preparedness system to guide activities that will enable the Nation to achieve the goal. For additional information, see  http://www.dhs.gov/xabout/laws/gc_1215444247124.shtm.

[43] The Working Group should include the heads of the following executive agencies and offices, or their designees: DOD; HHS; HUD; Department of Labor; USDA; DOT; DOJ; Department of Interior; Department of Commerce; DOE; EPA; DHS (including FEMA, Coast Guard, Transportation Security Administration, Science and Technology Directorate, Office of Infrastructure Protection, and Office of Health Affairs); Office of Management and Budget; OSTP; Office of the Deputy Assistant to the President for Environmental Policy; and other government officials that the President designates. The Working Group should report to the President through the Deputy Assistant to the President for Environmental Policy.

[44] Note that these elements could also be extrapolated to all-hazards preparedness.

[45] Two future resources are in development. NLM is developing an internet-based web portal to help first responders, first receivers, and emergency planners prepare for and respond to chemical emergencies. The Chemical Emergency Medical Management portal is also being developed and is similar to the popular internet site Radiation Emergency Medical Management. This portal will interact with Wireless Information Systems Emergency Responders. Ideally, these products would be able to interact with tools such as the CAMEO and MARPLOT computer programs that can help both identify and pinpoint hazards and assist with evacuation and containment modeling.

[46] ESF #8 planners develop mechanisms for coordinated federal assistance to supplement tribal, state, and local resources in response to public health and medical disasters, potential or actual incidents requiring a coordinated federal response, and potential health and medical emergencies. See http://www.fema.gov/pdf/emergency/nrf/nrf-esf-08.pdf.

[47] The Yale/Tulane ESF #8 Planning and Response Program is currently in the pilot-testing phase of development and is demonstrating promising results.

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