Follow-up assessment of health consequences after a chlorine release from a train derailment--Graniteville, SC, 2005.

Publisher: Springer Country of Publication: United States NLM ID: 101284598 Publication Model: Print Cited Medium: Internet ISSN: 1937-6995 (Electronic) Linking ISSN: 15569039 NLM ISO Abbreviation: J Med Toxicol Subsets: MEDLINE

Publication: 2010- : New York : Springer
Original Publication: Philadelphia, Pa. : University of Pennsylvania Press, c2005-

Chemical Hazard Release* ; Railroads*; Air Pollutants/*toxicity ; Chlorine/*toxicity ; Inhalation Exposure/*adverse effects ; Poisoning/*physiopathology; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Female ; Follow-Up Studies ; Health Status ; Humans ; Male ; Middle Aged ; Needs Assessment ; Poisoning/therapy ; South Carolina ; Stress Disorders, Post-Traumatic/diagnosis ; Stress Disorders, Post-Traumatic/epidemiology ; Stress Disorders, Post-Traumatic/etiology ; Surveys and Questionnaires ; Time Factors ; Young Adult

Introduction: After a train derailment released chlorine gas in Graniteville, South Carolina, in 2005, a multiagency team performed an epidemiologic assessment of chlorine exposure and resulting health effects. Five months later, participants were resurveyed to determine their health status and needs and to assist in planning additional interventions in the community.
Methods: Questionnaires were mailed to 279 patients interviewed in the initial assessment; follow-up telephone calls were made to nonresponders. The questionnaire included questions regarding duration of symptoms experienced after exposure and a posttraumatic stress disorder (PTSD) assessment tool.
Results: Ninety-four questionnaires were returned. Seventy-six persons reported chronic symptoms related to the chlorine exposure, 47 were still under a doctor's care, and 49 were still taking medication for chlorine-related problems. Agreement was poor between the first and second questionnaires regarding symptoms experienced after exposure to the chlorine (κ=0.30). Forty-four respondents screened positive for PTSD. PTSD was associated with post-exposure hospitalization for three or more nights [relative risk (RR) = 1.7; 95% confidence interval (CI)=1.1-2.6] and chronic symptoms (RR=9.1; 95% CI=1.3-61.2), but not with a moderate-to-extreme level of chlorine exposure (RR=1.2; 95% CI=0.8-1.8).
Conclusions: Some victims of this chlorine exposure event continued to experience physical symptoms and continued to require medical care 5 months later. Chronic mental health symptoms were prevalent, especially among persons experiencing the most severe or persistent physical health effects. Patients should be interviewed as soon as possible after an incident because recall of acute symptoms experienced can diminish within months.
(© American College of Medical Toxicology 2011)

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0 (Air Pollutants)
4R7X1O2820 (Chlorine)

Date Created: 20110203 Date Completed: 20110719 Latest Revision: 20211020

20231215

PMC3614108

10.1007/s13181-010-0130-6

21287309