Introduction to the Health Protection Agency and its Role in Chemical Incident Response

1
Introduction to the Health Protection Agency and
its Role in Chemical Incident Response
Andy McParland Centre for Radiation, Chemical
and Environmental Hazards 8th November 2012
2
Introduction

• Part 1. Overview of the HPA and CRCE
• Background and Structure of HPA CRCE
• Functions of CRCE
• Part 2. Chemical Incident Response
• Acute Incidents
• Chronic Environmental Public Health Concerns
• HPA Resources

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Part 1. Overview of HPA CRCE
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Health Protection Agency

• Independent non-departmental government body,
  created from existing organisations on 1st April
  2003
• HPA Act 2004
• Protect the community (or any part of the
  community) against infectious diseases and other
  dangers to health
• Civil Contingencies Act 2004
• Category One responder
• Provide expert support and advice
• Infectious disease, radiation, chemicals,
  poisons, emergency response
• 24 hour service

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Structure of the Health Protection Agency
HPA Board
Executive Group
CRCE/Radiation, Chemical and Environment
(Chilton and Regional)
Microbiology Services (Porton, Colindale and
Regional)
NIBSC/Biological Standards and Controls
(Potters Bar)
Health Protection Services (Colindale and
Regional)
Corporate Services
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Health Protection Services

• Nine English regions
• Gateway to HPA at a local level
• Health Protection Units
• 1 HPU/ 2 million head of population
• CsCDC/ Consultants in HP/ HP Specialists
• Link to Director of Public Health at PCT (now in
  LA)
• Supported by national centres

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Centre for Radiation, Chemical and Environmental
Hazards

• Centre HQ at Chilton, Oxon
• Formerly two divisions (merged in 2009)
• Radiation Protection Division
• Chemical Hazards Poisons Division
• Specialist units/ teams
• Nationally-based across
• England
• Wales
• Scotland

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CRCE Chemical Units

• CRCE Chemical Units (England)
• 4 areas covering several Government areas but
  acting as a national department
• Close links with CRCE Wales as similar functions
• Link to Health Protection Scotland for chemical
  issues (via CRCE Nottingham)
• CRCE Wales
• Sole HPA unit in Wales
• Extreme Events Health Protection Section

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CRCE Chemical Units

• Offices
• Birmingham Manchester
• Chilton Bristol
• London
• Nottingham Newcastle
• Cardiff

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CRCE Chemical Units main functions (1)

• Emergency response
• Local
• National
• Emergency preparedness
• Planning
• Exercising
• Chronic cases
• E.g. Contaminated land, cluster investigation,
  private water supplies

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CRCE Chemical Units main functions (2)

• Consultations
• Environmental Permitting (EP)
• Planning applications
• National consultations (IPC, NSIP)
• Applied research and development
• Improving the evidence base
• European projects
• Advice
• Position statements
• Chemical Research Reports

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The Future

• Public Health White Paper
• Public Health England
• Transition 1st April 2013

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Part 2. Chemical Incident Response
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Chemical Incidents

• Any event leading to exposure of two or more
  individuals to any substance resulting in illness
  or potentially toxic threat to health.
• Hill and OSullivan (1992)
• Examples
• Fire
• Explosion
• Release / Spillage
• Water pollution
• Food contamination
• Transport-related

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HPA Role in Chemical Incidents

• Undertake assessment of public health risk
• Provision of advice and support to first line
  responders
• PCTs and Directors of Public Health
• other agencies (e.g. local authorities, NHS,
  emergency responders etc)
• the public
• Clinical Treatment Advice via National Poisons
  Information Service (NPIS) through TOXBASE
  website and 24hour phone number
• http//www.hpa.org.uk/ProductsServices/ChemicalsPo
  isons/PoisonsInformationService/NationalPoisonsInf
  ormationService/

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Incidents Reported to CRCE in 2010
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Chemical Incidents Who Responds?

• Blue light services deal with the initial
  incident.
• AEs deal with casualties.
• Public health aspects are dealt with by the HPA
  PCT. The HPA is a Category 1 Responder under
  the Civil Contingencies Act 2004.
• NHS Direct, GPs, PCTs deal with queries regarding
  individuals health.
• Other stakeholders likely to be involved Local
  Authority, Environment Agency, Food Standards
  Agency, Health and Safety Executive, Met. Office,
  Media.

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Fires
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Chemical Fatalities
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Air Quality Cell (AQC)

• A virtual multi-agency advisory group which can
  be convened during a major incident to
  co-ordinate air monitoring and modelling.
• Partners include EA, HPA, Met Office, HSL, FSA
  others.
• It aims to provide timely (interpreted) air
  quality and air modelling information to the
  Science and Technical Advice Cell (if formed), or
  to a multi-agency group.

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Chronic Environmental Public Health Concerns

• Advice and support is also given with respect to
  chronic incidents.
• Example areas of support to local authorities
• Contamination of private drinking water supplies
• Health concerns from industrial emissions
• Contaminated school play areas/allotments
• Health implications of nuisance dust
• Fuel spillages affecting residential properties
• Alleged cancer clusters near industrial premises

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The Avenue Coking Works

• Former Avenue Coking Works, Chesterfield.

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Resources

• Compendium of Chemical Hazards
• General Information
• Provides background information on the compound,
  including its uses and 'frequently asked
  questions.
• Incident Management
• Focuses on information that may be needed during
  chemical incidents, such as physicochemical
  properties, health effects and decontamination.
• Toxicological Overview
• Provides more in-depth toxicology.
• http//www.hpa.org.uk/Topics/ChemicalsAndPoisons/C
  ompendiumOfChemicalHazards/

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Compendium of Chemical Hazards
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Land Contamination Publications

• http//www.hpa.org.uk/Publications/ChemicalsPoison
  s/LandContamination/

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Checklists for Chemical Incident Management

• Acute incidents, e.g. chemical spills
• Non domestic fires
• Water incidents
• Sheltering or evacuation decisions
• Land contamination
• Flooding incidents
• http//www.hpa.org.uk/HPA/ProductsServices/Chemica
  lsPoisons/ChemicalRiskAssessment/1158313435104/

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Factsheets for the Public

• Carbon Monoxide
• Mercury
• Lead Incidents
• Chemicals in toys
• Petroleum products incidents
• Odour
• http//www.hpa.org.uk/HPA/ProductsServices/Chemica
  lsPoisons/ChemicalRiskAssessment/1158313435037/

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Internal Action Cards Guidance

• Bioaerosols from composting sites
• http//hpanet/webc/HPAnetFile/HPAnet_C/13099700435
  16
• Carbon monoxide action card
• http//hpanet/webc/HPAnetFile/HPAnet_C/12572604800
  33
• Elevated concentrations of nitrate and nitrite in
  drinking water
• http//hpanet/webc/HPAnetFile/HPAnet_C/12495429933
  40
• Lead action card
• http//www.hpa.org.uk/web/HPAwebFile/HPAweb_C/1274
  092896741
• Asbestos Toolkit Responding to fires involving
  asbestos
• http//hpanet/webc/HPAnetFile/HPAnet_C/12076390822
  32

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CHaP Reports http//www.hpa.org.uk/Publication
s/ChemicalsPoisons/ChemicalHazardsandPoisonsReport
s/

• Incident response lessons learned guidance
• Emergency planning and preparedness
• Training

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HPA Chemical Research Reports

• HPA CHaPD 001 Review of Environmental Chemicals
  and Neurotoxicity Focus on Neurological
  Diseases
• HPA CHaPD 002 Review of Chemical Toxicity to the
  Reproductive System, with Particular Reference to
  Developmental Toxicity
• HPA CHaPD 003 The Public Health Significance of
  Asbestos Exposures from Large Scale Fires
• HPA CHaPD 004 A Toxicological Review of the
  Products of Combustion
• http//www.hpa.org.uk/Publications/ChemicalsPoison
  s/ChemicalResearchReports/

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Position Documents

• Health Impacts of Operating Landfill Sites
• http//www.hpa.org.uk/NewsCentre/NationalPressRele
  ases/2011PressReleases/110728Landfillnorisk/
• Intensive Farming
• http//www.hpa.org.uk/web/HPAwebFile/HPAweb_C/1194
  947378905
• Health Impacts of emissions to air from municipal
  waste incinerators 
• http//www.hpa.org.uk/web/HPAwebFile/HPAweb_C/1266
  228112244

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Any Questions?
Andy McParland CRCE (Nottingham) Email
Andy.McParland_at_hpa.org.uk
T 0844 225 4524 E