Recent advances to address European Union Health Security from cross border chemical health threats

Environment International

Volumn 72, Issue , 2014, Pages 3-14

  Duarte Davidson, R ^a   Orford, R ^a   Wyke, S ^a   Griffiths, M ^a   AmlOt R ^a   Chilcott, R ^b  

^a PUBLIC HEALTH ENGLAND   (United Kingdom)

^b UNIVERSITY OF HERTFORDSHIRE   (United Kingdom)

Author keywords

Alerting and notification; CBRN; Chemical incident; Cross border health threats; Emergency response; Public health risk assessment and management

Indexed keywords

PUBLIC HEALTH; RESEARCH AND DEVELOPMENT MANAGEMENT; RISK ASSESSMENT;

ALERTING AND NOTIFICATION; CBRN; CHEMICAL INCIDENTS; CROSS-BORDER; EMERGENCY RESPONSE;

HEALTH RISKS;

BORDER REGION; EUROPEAN UNION; HEALTH IMPACT; HEALTH POLICY; HEALTH RISK; HEALTH STATUS; POLICY APPROACH; POLICY IMPLEMENTATION; PUBLIC HEALTH;

ARTICLE; CHEMICAL ACCIDENT; ECOSYSTEM RESILIENCE; EMERGENCY HEALTH SERVICE; EMERGENCY PLANNING; EMERGENCY PREPAREDNESS; EMERGENCY RESPONSE; ENVIRONMENTAL PLANNING; EUROPEAN UNION; GOVERNMENT REGULATION; HEALTH CARE PLANNING; HEALTH HAZARD; HEALTH PROGRAM; HEALTH SECURITY; HEALTH SERVICE; HUMAN; NONHUMAN; PUBLIC HEALTH SERVICE; RISK ASSESSMENT; RISK MANAGEMENT; ALERTING AND NOTIFICATION; BIOLOGICAL ACCIDENT; CBRN; CHEMICAL INCIDENT; CROSS BORDER HEALTH THREATS; LEGAL ASPECT; NUCLEAR ACCIDENT; POLLUTION; PUBLIC HEALTH; PUBLIC HEALTH RISK ASSESSMENT AND MANAGEMENT; SAFETY; STANDARD;

EUROPE;

ALERTING AND NOTIFICATION; CBRN; CHEMICAL INCIDENT; CROSS BORDER HEALTH THREATS; EMERGENCY RESPONSE; PUBLIC HEALTH RISK ASSESSMENT AND MANAGEMENT;

BIOHAZARD RELEASE; CHEMICAL HAZARD RELEASE; ENVIRONMENTAL POLLUTION; EUROPEAN UNION; HEALTH PLANNING; HUMANS; PUBLIC HEALTH; RADIOACTIVE HAZARD RELEASE; RISK ASSESSMENT; SAFETY MANAGEMENT;

EID: 84907624203     PISSN: 01604120     EISSN: 18736750     Source Type: Journal    
DOI: 10.1016/j.envint.2014.01.003     Document Type: Article

References (73)

1. Algora-Weber M. Madrid train bombings: what we have learnt from that sad event. ISBT Science Series 2011, 6:216-218. International Society of Blood Transfusion.
2. Amlôt R., Edkins V., Jones D.R., Larner J., Chilcott R.P. The ORCHIDS project: evaluation, optimisation, trialling and modelling of procedures for mass casualty decontamination. ASA Newsl 2010, 10-4(139):16-17.
3. Amlôt R., Larner J., Mater H., Jones D.R., Carter H., Turner E.A., et al. Comparative analysis of showering protocols for mass-casualty decontamination. Prehosp Disaster Med 2010, 25(5):435-439.
4. Anon Calamity at Bhopal. Lancet 1984, 2:1378-1379.
5. Baker D.J. Civilian exposure to toxic agents: the emergency medical response. Prehosp Disast Med 2004, 19(2):157-161.
6. Baker M.G., Fidler D.P. Global Public Health Surveillance under New International Health Regulations. Emerg Infect Dis 2006 July, 12(7):1058-1065.
7. Baker D., Watson S., Holmes S., Mobbs S., Murray V. Mass casualties and health care following the release of toxic chemicals or radioactive material. WP9 - final report. Foresight into needs, possibilities and information requirements for the future. MASH EU Project 2007/209 2011, Health Protection Agency, Chilton.
8. Baker D.J., Murray V.S.G., Pierre A., Carli M.D. A pan-European study of capabilities to manage mass casualties from the release of chemical agents: the MASH project. Am J Disaster Med 2013, 8(1):13-23.
9. Bertazzi P.A. Long-term effects of chemical disasters. Lessons and results from Seveso. Sci Total Environ 1991, 106(1-2):5-20.
10. Bongers S., et al. Challenges of exposure assessment for health studies in the aftermath of chemical incidents and disaster. J Expo Sci Environ Epidemiol 2008, 18(4):341-359.
11. Cabinet Office Strategic National Guidance. The decontamination of buildings, infrastructure and open environment exposed to chemical, biological, radiological or nuclear materials Available:. http://www.cabinetoffice.gov.uk/resource-library/strategic-national-guidance-decontamination-buildings-infrastructure-and-open-envir.
12. Carlsen H.K., Gislason T., Benediktsdottir B., Kolbeinsson T.B., Hauksdottir A., Thorsteinsson T., et al. A survey of early health effects of the Eyjafjallajökull 2010 eruption in Iceland: a population-based study. BMJ Open 2012, 2:e000343. 10.1136/bmjopen-2011-000343
13. Carter H., Amlôt R., Riley P. Guidelines for conducting exercises involving major chemical incidents: a workbook. CIE toolkit WP9 report 2010, Health Protection Agency, UK.
14. Chilcott R.P. An overview of the Health Protection Agency's research and development programme on decontamination. Chemical Hazards and Poisons Report 2009, 15:26-28.
15. Chilcott R.P. Managing mass casualties and decontamination. Environ Int 2014, (in this edition).
16. Clements B.W. Disasters and public health. Planning and response 2009, Elsevier Inc., Oxford.
17. Croft J., Bailey M., Maguire H., Tattersall P., Morrey M., McColl N., et al. Management of response to the polonium-210 incident in London 2010, Westminster City Council, [Available http://www.irpa12.org.ar/fullpapers/FP0841.pdf].
18. Desel H., Duarte-Davidson R., Edwards N.J., Kupferschmidt H., Schaper A., O'Connell S., et al. Are poisons centres recognised by EU legislation?. Clin Toxicol 2008, 46(5):399.
19. Desel H., Wyke S., Orford R., Duarte-Davidson R., Edwards N., Kennedy K., et al. Language independent description of poisoning symptoms in RAS-CHEM using MedDRA terminology. Clin Toxicol 2011, 49:197-269. (abstract #111, page 223).
20. Duarte-Davidson R., Etherington G., Chilcot R., Orford R., et al. Final report. The chemical and radiological inventory for chemical emergency countermeasures (CARIMEC) 2012, EU Service Contract No. 2010 61 22. Health Protection Agency, UK.
21. EC (European Commission) Progress report on the implementation of the EU CBRN action plan 2012, May 2012, European Commission, [Available online: http://ec.europa.eu/dgs/home-affairs/what-we-do/policies/crisis-and-terrorism/securing-dangerous-material/docs/eu_cbrn_action_plan_progress_report_en.pdf (accessed on 17/12/2013)].
22. Egan J.R., Amlôt R. Modelling mass casualty decontamination systems informed by field exercise data. Int J Environ Res Public Health 2012, 9:3685-3710.
23. Elliot A.J., Singh N., Loveridge P., Harcourt S., Smith S., Pnaiser R., et al. Syndromic surveillance to assess the potential public health impact of the Icelandic volcanic ash plume across the United Kingdom in April 2010. Eurosurveillance 2010, 15(23). [Available online: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19583 (accessed on 15/12/2013)].
24. EU Technical guidance on generic preparedness planning for public health emergencies 2005, Available on line: http://ec.europa.eu/health/ph_threats/Bioterrorisme/keydo_bio_01_en.pdf (accessed on 31/01/2014).
25. EU Council Decision of 8 November 2007 establishing a Community Civil Protection Mechanism. The Council of the European Union 2007/779/EC 2007, Official Journal L 314, 01/12/2007: 0009-0019.
26. EU (European Union) White paper - together for health: a strategic approach for the EU 2008-2013 Available at, [accessed Dec 2013]. http://ec.europa.eu/health-eu/doc/whitepaper_en.pdf.
27. EU Decision No 108 2/2013/EU of the European Parliament and of the Council on serious cross border threats to health and repealing Decision no 2119/98/EC. OJ L293/1, 5.11.2013: 1-15 Available online:, [accessed 17/12/2013]. http://ec.europa.eu/health/preparedness_response/docs/decision_serious_crossborder_threats_22102013_en.pdf.
28. EU CBRN Action Plan Available online:, [accessed on 16/12/2013]. http://europa.eu/legislation_summaries/justice:freedom_security/fight_against_terrorism/jl0030_en.htm.
29. EU Health Growth Programme for 2014-2020 Available online:, [accessed on 16/12/2013]. http://ec.europa.eu/health/programme/docs/prop_prog2014_en.pdf.
30. EU Health Programme Available online:, [Accessed on 16/12/2013]. http://ec.europa.eu/health/programme/policy/2008-2013/index_en.htm.
31. Euripidou E., Murray V. Public health impacts of floods and chemical contamination. J Public health 2004, 26(4):376-383.
32. Farley T.A., Weisfuse I. Redefining of public health preparedness after 9/11. Lancet 2011, 378(9794):957-959.
33. Gelpí E., Posada de la Paz M., Terracini B., Abaitua I., Gómez de la Cámara A., Kilbourne E.M., et al. Centro de Investigación para el Síndrome del Aceite Tóxico, The Spanish toxic oil syndrome 20years after its onset: a multidisciplinary review of scientific knowledge. Environ Health Perspect 2002, 110(5):457-464.
34. Griffiths M.R., Amlôt R., Carter H., Riley P., Szosland D., Merecz D., et al. Emergency planning and preparedness. Public health response to chemical incident emergencies. Chemical Hazards and Poisons Report 2012, 21:24-26.
35. Gouweloos J., Dückers M., Brake H., Kleber R., Drogendijk A. Psychosocial care to affected citizens and communities in case of CBRN incidents: A systematic review 2014, Environ, Inter, (in this edition).
36. Guglielmetti P., Kusters B., Orford R., Wyke S., Griffiths M., Duarte-Davidson R., et al. Notification and reporting health threats caused by chemical events through RAS CHEM: policy and mechanism for coordinating public health measures at EU Level. Clin Toxicol 2011, 49:197-269. [abstract #109, page 223].
37. Hemsley T. Initial operation response (IOR) to a CBRN incident. Chemical Hazards and Poisons Report, Issue 2013, 23:17-18.
38. HPA Exercise Iridium. Report on three EU regional chemical exercises 2011, Health Protection Agency, UK.
39. IFRC (International Federation of Red Cross and Red Crescent Societies) World disasters report 2010 Available on line from:, [accessed on 20/12/2013]. http://www.ifrc.org/Global/Publications/disasters/WDR/WDR2010-full.pdf.
40. IMPEL Lessons learnt from industrial accidents 2011, IMPEL.
41. Kamoie B. The national response plan: a new framework for homeland security, public health and bioterrorism response. J Health law 2005, 38(2):287-318.
42. Krausmann E., Cozzani V., Salzano E., Renni E. Natural Hazards and Earth System Sciences Industrial accidents triggered by natural hazards: an emerging risk issue. Nat Hazards Earth Syst Sci 2011, 11:921-929.
43. Kar-Purkayastha I., Horwell C., Murray V. Review of evidence on the potential health impacts of volcanic ash on the population of the UK and ROI 2012, Health Protection Agency, [Available at http://www.hpa.org.uk/webc/HPAwebFile/HPAweb_C/1317136779478].
44. Kerger B.D., Gerthoux P.M., Mocarelli P. Trichlorophenol reactor explosion at Seveso, Italy. Encycl Environ Health 2011, 125-136.
45. Kowalczyk G., Griffiths M., Brown J., Duarte-Davidson R. Protocols and guidelines for health threat and risk assessment of chemical events and appropriate sharing of information between member states. Consolidated report: chemical incidents 2011, Chemical and Radiation Risk Assessment Network (CARRA-NET), [EAHC Contract (2010 61 21). Implementing Framework Contract 2009 61 05].
46. Kowalczyk G., Griffiths G., Brown J., Duarte-Davidson R. Chemical and radiation risk assessment network (CARRA-Net): coordinating the international response to European transboundary incidents. Chemical Hazards and Poisons Report 2012, 21:27-31.
47. Lindstrom G. Protecting the European Homeland. The CBR dimension. Chaillot paper no 69 2004, Institute for Security Studies, European Union, Paris, [Available from www.iss-eu.org].
48. Matar H., Price S.C., Chilcott R.P. Protective and temporal effects of clothing on the in vitro absorption of chemical warfare agents and simulants. Royal Society of Chemistry, "Issues in Toxicology" Series 2013, D. Anderson, T.C. Marrs, M.D. Waters, M. Wilks (Eds.).
49. Misik J., Pavlikova R., Josse D., Cabal J., Kuca K. In vitro skin permeation and decontamination of the organophosphorus pesticide paraoxon under various physical conditions-evidence for a wash-in effect. Toxicol Mech Methods 2012, 22:520-525.
50. Moody R.P., Maibach H.I. Skin decontamination: importance of the wash-in effect. Food Chem Toxicol 2006, 44:1783-1788.
51. Moody R.P., Nadeau B. In vitro dermal absorption of two commercial formulations of 2,4-dichlorophenoxyacetic acid dimethylamine (2,4-D amine) in rat, guinea pig and human skin. Toxicol In Vitro 1997, 11:251-262.
52. Nisbet A., Brown J., Jones A., Rochford H., Hammond D., Cabianca T. HPA-RPD-064 - the UK recovery handbooks for radiation incidents v3 2009, Available [March 2012] at: http://www.hpa.org.uk/web/HPAweb&HPAwebStandard/HP_C/1259152442006.
53. Okumura T., Hisaoka T., Naito T., Isonuma H., Okumura S., Miura K., et al. Acute and chronic effects of sarin exposure from the Tokyo subway incident. Environ Toxicol Pharmacol 2005, 19(3):447-450.
54. Orford R., Wyke S., Desel H., Edwards N., Dragelyte G., Badaras R., et al. Alerting system for chemical health threats phase II. Final implementation report 2007210 2010.
55. Orford R., Wyke S., Desel H., Schaper A., Pelclova D., Edwards N., et al. The alerting system for chemical alerting system for chemical threats, phase II - update report. Chemical Hazards and Poisons Report 2011, 19:42-44.
56. Orford R., Crabbe H., Schaper A., Duarte-Davidson R. EU alerting and reporting systems for potential chemical public health threats and hazards. Environ Int 2014, (in this edition).
57. Parry J. China's tainted infant formula sickens nearly 13,000 babies. BMJ 2008, 337.
58. Pearce J.M., Rubin G.J., Amlôt R., Wessely S., Rogers M.B. Communicating public health advice after a chemical spill: results from national surveys in the United Kingdom and Poland. Disaster Med Public Health Prep 2012, 7(1):65-74.
59. Pelclova D., Edwards N., Tizzard Z., McParland M., Kennedy K., Sutton N., et al. Clinical effect profiles for chemical agents of concern - role of syndromic surveillance and rare symptoms. Clin Toxicol 2011, 49:197-269. (abstract #110, page 223).
60. Powles H., Battrick E. Bhopal chemical disaster. Chemical Incident Report 2001 2001, 22:5-8.
61. Rasko D.A., Worsham P.L., Abshire T.G., Stanley S.T., Bannan J.D., Wilson M.R., et al. Bacillus anthracis comparative genome analysis in support of the Amerithrax investigation. Proc Natl Acad Sci U S A 2011, 108(12):5027-5032.
62. Riley A. Report on the management of an anthrax incident in the Scottish borders; July 2006 to May 2007 2007, National Health Service Borders, Melrose, [Available from: http://www.nhsborders.org.uk/__data/assets/pdf_file/0019/6580/anthrax_report_131207.pdf].
63. Roorda J., Van Stiphout W.A.H., Huijsman-Rubingh Post-disaster health effects: strategies for investigation and data collection. Experiences from the Enschede firework disaster. J Epidemiol Community Health 2004, 58:982-987.
64. Schaper A., Desel H., Wyke S., Orford O., Griffiths M.R., Edwards N., et al. Countering health threats by chemicals with a potential terrorist background - creating a rapid alert system for Europe. Eur J Intern Med 2012, e63-e66.
65. Shama D.C. Bhopal: 20 years on. Lancet 2005, 365(9454):111-112.
66. UNECE Convention of United Nations Economic Commission for Europe (UNECE) on the transboundary effects of industrial accidents Available at. http://www.unece.org/env/.
67. WHO Public health and chemical incidents. Guidance for national regional policy makers in the public/environmental health roles 1999, International Programme on Chemical Safety, World Health Organization, Geneva.
68. WHO Environmental health in emergencies and disasters: a practical guide 2002, [Available at; http://www.who.int/water_sanitation_health/emergencies/emergencies2002/en/]. B. Wisner, J. Adams (Eds.).
69. WHO Toxic oil syndrome. Ten years of progress 2004, World Health Organization, [http://www.euro.who.int/__data/assets/pdf_file/0005/98447/E84423.pdf (accessed on 15/12/2013)].
70. WHO International health regulations 2005, World Health Organization, [Available at http://www.who.int/ihr/en/ (accessed 15/12/2013)].
71. WHO Manual for the public health management of chemical incidents 2009, World Health Organization, Geneva.
72. Wyke S., Orford R., Desel H., Schaper A., Pelclova D., Edwards N., et al. The Alerting System for Chemical Threats, Phase II - Update. Chemical Hazards and Poisons Report 2011, 19:42-44. Available http://www.hpa.org.uk/webc/HPAwebFile/HPAweb_C/1296685843305.
73. Wyke-Sanders S., Brooke N., Dobney A., Baker D., Murray V. The UK recovery handbook for chemical incidents Version 1. Available:. https://www.gov.uk/government/publications/uk-recovery-handbook-for-chemical-incidents-and-associated-publications.