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The Graniteville Disaster Mark T. Arden Chappell Smith and Arden

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Title: The Graniteville Disaster Mark T. Arden Chappell Smith and Arden


1
The Graniteville DisasterMark T. Arden Chappell
Smith and Arden
  • South Carolina Workers Compensation Educational
    Association
  • 31st Annual Medical Seminar
  • February 28-March 2,2010
  • Francis Marion Hotel Charleston S.C.

2
  • There's a long black train Coming down the
    line Feeding off the souls that are lost and
    crying Tails of sin only evil remains Watch out
    brother for that Long Black Train

3
Facts Concerning the Disaster
  • At approximately 239 a.m. on 1/6/05, NS Train
    192 was heading north on the NS R-line between
    August and Columbia.
  • Train 192 consisted of 2 locomotives, 25 loaded
    cars, and 17 empty cars. Of the 25 loaded cars,
    3 contained chlorine.
  • The ninth car, UTLX 900270 contained
    approximately 90 tons of chlorine.

4
Facts Concerning the Disaster
  • Train 192 rounded a 1-degree curve approaching
    the Avondale Mills Gregg Plant Lead Switch.
  • Train 192 was traveling approximately 49 m.p.h as
    it approached the switch.

5
Facts Concerning the Disaster
  • Unbeknownst to the crew of Train 192, the
    Avondale Mills switch was incorrectly lined for
    the Avondale Mills industry track.
  • Train 192 entered the Avondale Mills industry
    spur with no chance to stop prior to colliding
    with parked Train P22.
  • Car UTLX 900270 was punctured, releasing a poison
    chlorine gas cloud all around the Gregg Plant
    area.

6
  • Damage to the lead locomotives of Train 192
    (left) and Train P22 (right).

7
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8
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9
Chlorine Gas
10
Chlorine Gas
  • Chlorine Gas developed by German chemist Fritz
    Harbor in 1915 for use as a poison gas in WWI.
  • Tear gas first was the first recorded gas attack
    used by the French Army against the German Army
    in August of 1914. Chlorine gas developed shortly
    thereafter.
  • The density of chlorine gas is approximately 2.5
    times greater than air, which will cause it to
    initially remain near the ground in areas with
    little air movement.
  • The strong oxidizing effects of chlorine produce
    corrosive tissue damage. The oxidation of
    chlorine will penetrate cells and react with
    cytoplasmic proteins to destroy cell structure.

11
Chlorine Gas
  • The health effects resulting from most chlorine
    exposures begin within seconds to minutes.
  • There is no antidote for chlorine poisoning.
  • When liquid chlorine is released, it quickly
    turns into a gas that stays close to the ground
    and spreads rapidly.
  • When chlorine gas comes into contact with moist
    tissues such as the eyes, throat, and lungs, an
    acid is produced that can damage these tissues.
  • The gas causes both internal and external
    blisters on the victim within hours of being
    exposed to it.

12
World War One French Soldier/ British Casualties
13
Human Costs
Casualties From Gas- The Numbers
Country Total Casualties Deaths
Austria-Hungary 100,000 3,000
British Empire 188,706 8,109
France 190,000 8,000
Germany 200,000 9,000
Italy 60,000 4,627
Russia 419,340 56,000
USA 72,807 1,462
Others 10,000 1,000

14
The Fallout
  • 9 chlorine related deaths
  • 554 injured who reported to hospital
  • 75 hospital admissions
  • 11 in critical care
  • Over 5,000 people evacuated.

15
Complexities of the Diagnosisfrom the
Graniteville DisasterCase Studies
  • Pulmonary (reactive airways, restrictive lung
    disorder, sleep apnea, cough variant asthma-
    multiple diagnoses of bronchitis) Dyspnea and
    hypoxia with exertion
  • Sinus Issues/Skin Rash Issues- recurrent
    sinusitus-acute bilateral external otitis,
    hypertropy of inferiror turbinates
  • Eye problems ocular injury
  • Psychiatric Disorders- post traumatic stress
    disorder, anxiety, major depression, nightmares,
    flashbacks,

16
Case Study A
  • Case Study A
  • Six days admitted in the hospital , 3 in ICU
  • 64 saturation at the decontamination site,
    spirometry shows primarily a restrictive pattern
    with an FEV1 of 3.18 liters or 73 of predicted
  • Initial complaints difficulty breathing, severe
    dyspnea, severe wheezing, burning sensation,
    dizziness, nausea and vomiting
  • Diagnosis Acute lung injury associated with both
    hypoxemic and hypercapnic respiratory failure
  • Reactive airways disease secondary to chlorine
    exposure, obstructive sleep apnea, moderate
    persistent asthma secondary to chlorine exposure
  • Subsequent right lower lobe pneumonia with
    streptococcus pneumoniae
  • Impairment rating 30 to each lung and sinus
    tract
  • Restrictions no exposure to airborne dust
    particles, gases, fumes, extremes in temperatures
    and molds- No walking distances greater than one
    block-No freguent lifting more than 10 pounds
  • Post Traumatic Stress Disorder- persistent
    symptoms of insomnia
  • Initial GAF 45. Last GAF50.

17
Treatment
  • Pulmonolgist reactive airways disease ongoing
    visits-medicine regimine includes Advair 250/50
    and as needed does of albuterol.
  • Psychiatrist Counseling and Effexor,Trazadone,
    Clonidine, Seroquel and Wellbutrin

18
Case Study A Clothing
19
Case Study B
  • One day ICU- Six Days Hospitalized
  • Initial complaints-Dyspnea with exertion
  • documented hypoxia tachycardia with simple
    activities insomnia, ocular injury reactive
    airways disease with restrictive appearing
    spirometry obstructive sleep apnea recurrent
    sinusitus, cough varient asthma multiple issues
    of bronchitusImpotence
  • Initial FVC 51 of predicted, FEV1 53 of
    predicted.
  • 4 months later- FVC 52 of predicted, FEV1 53
    predicted
  • Low lung volumes- off medication patient
    respiratory function is in the severe range.
  • Pulmonary Function Tests reveal severe airflow
    limitation with noted bronchodialator response,
    severe airway resistance, significantly reduced
    diffusion capacity.
  • Diagnosis- Severe occupational-induced asthma
    with a reactive airways syndrome
    physiologysevere bilateral external otitis,
    chronic sinusitis, hypertrophy of inferior
    turbinates PTSD, Major depression
  • Impairment- 70 to both lungs as well as airway
    sinus tract
  • Restrictions- Limited standing,lifting,bending or
    strenuous activity Avoid exposure to airborne
    dust particles, inicluding gases,fumes,extremes
    of temperature and humidity, - lung capacity
    restricts him to sedentary duties-Modified
    sedentary FCE.

20
Treatment
  • Pulmonologist-It is expected that the patient
    will suffer from recurrent bronchitis,pneumonia
    and other lung infections in the future. Ongoing
    hospitalizations,treatment and medicine regimine.
  • ENT- visits for chronic sinusitus
  • Psychiatrist- ongoing counseling and
    medicine/treatment.
  • Obesity and onset of weight gain due to use of
    oral steroids combined with inactivity.

21
Psychiatric Issues
  • Multitude of DSM IV diagnosis
  • Most prevelant Post Traumatic Stress Disorder
  • Unusual triggering factors- smells/crowds
    hospitals, sirens verses trains
  • Common complaints involve sleep variations,
    anxiety, cautious and on edge demeanor,
    irritability, fearfulness, hypervigilance,
    avoidance/anxiety related to social situations,
    nightmares, flashbacks, and intrusive
    recollections of the traumatic event

22
Conclusion and Lessons Learned
  • Same exposure-varied diagnosis
  • Five different presentations can be from the same
    type of exposure
  • The need for different medical specialist leads
    often to a time lapse prior to acurate diagnosis.
    It does not mean the patient is a poor historian
    or exagerating his symptoms.
  • Minor exposures harder to assess/diagnose and
    even harder to treat.
  • Effects of the exposure are lifelong and there is
    no cure.

23
Emergency Response Issues What Went Wrong in
Graniteville (Stephen Brittle)
  • 1. Emergency responders from the local volunteer
    fire department responded to the train crash and
    subsequent chlorine release without first donning
    personal protective gear. This severely hampered
    and compromised their response. Some wound up
    with blisters on their lungs. This volunteer fire
    department had HAZMAT training and equipment due
    to the proximity if the Savannah River Nuclear
    Site. One would think that the scenario of a
    train derailment involving hazardous materials
    such as chlorine would have been part of their
    training, as well as something the Aiken County
    LEPC would have contemplated and prepared for in
    preparing and updating its EPCRA Section 303
    emergency plan. Neither law enforcement personnel
    nor emergency responders seemed
    trained/drilled/prepared for this scenario.
  • 2. Civilians were mostly on their own when it
    came to evacuating. There were true accounts of
    heroism and good Samaritans. Workers at the
    Avondale Mills plant worked together to make sure
    they got away. Some trying to flee had difficulty
    starting their cars and trucks as the chlorine
    worked with the humidity in the air on ignitions.
    Cell phones also did not always work for the same
    reason.
  • 3.The community had a rare resource, an emergency
    telephone ring-down system, but it was not
    activated for hours after the incident, then told
    people to shelter-in-place at first, when it
    should have told many to evacuate. Later, it was
    used to tell people to evacuate.
  • 4.The railroad did not make the call to the
    National Response Center required by CERCLA 103
    until over an hour and fifteen minutes after the
    release of chlorine. According to the NRC
    report, the incident occurred on 06-JAN-05 at
    0240 local time. Report taken by MST3 CREWS at
    0358 on 06-JAN-05 It is unknown what effect
    this had on the actual response, or if the delay
    exacerbated the emergency response issues, but
    the system set up by federal law was not properly
    utilized. CERCLA requires an immediate phone
    call. Under the EPA penalty policy, penalties
    begin after a 15-minute delay, and the maximum
    penalty is assessed after one hour. The
    notifications from the NRC to the various state
    and federal emergency response agencies came
    after at least a fifteen-minute delay.

24
  • 5. EPA set up a chlorine monitor at the crash
    site that maxed out at 1.5 ppm. Although the
    incident response lasted for several days, a
    better monitor that would show actual levels of
    chlorine in the ambient air was not used. It
    would have served the immediate community of
    Graniteville, as well as the nearby community and
    county seat of Aiken, to have had the information
    and technical data about maximum concentrations
    of chlorine at the site and a variety of off-site
    locations. Again, one wonders why the local
    volunteer fire department did not have this type
    of monitor, as an incident such as a local train
    derailment involving chlorine or other HAZMAT
    would be a foreseeable contingency.
  • 6. The ALOHA modeling program distributed by EPA
    (for use by responders and emergency planners in
    modeling chemical spills) seems to have not
    worked very well in modeling this particular
    chlorine spill. The official account available in
    the press was that only one railcar was breached
    and leaking, but according to an ALOHA model, it
    would have been expected to empty rather quickly,
    certainly within hours. The report later was that
    much of the chlorine in the breached railcar did
    not leak into the atmosphere, and eventually was
    neutralized and off-loaded. There was some
    confusion about how many of the rail cars of
    chlorine were breached. Utilizing this ALOHA
    modeling, responders could have made an educated
    guess about just how far away adverse effects of
    the chlorine might have been felt, as well as the
    infiltration of dwellings.
  • 7. The head of the local volunteer fire
    department and designated incident commander was
    also an employee of the railroad. It is unclear
    whether this had an effect on the release of
    information to the press and the public about the
    incident. I certainly got the impression that the
    Norfolk Southern Railroad was in control of the
    command center and the flow of information. All
    press statements and information seemed to be
    carefully controlled to minimize embarrassment to
    the company. Questioning would be cut off
    whenever the press asked hard questions of the
    rail company, at least when I was present. I was
    able to find out the cause of the incident almost
    immediately upon arrival at Breezy Hill (adjacent
    to Graniteville) on the morning of the 6th of
    January. I learned that the rail crew that parked
    a locomotive and two cars on the side rail by the
    Avondale Mills facility had not switched the
    diversion switch back and had gone home hours
    before the oncoming train with the chlorine
    railcars arrived. The NTSB announced some of the
    information

25
  • 8.As I wandered the incident command center area
    the day after the crash, I noticed a very
    distressed young black woman who seemed to be
    ignored by the various officials and staff
    present at the area. I asked her and found out
    that she was trying to locate information about
    her father, Willie Tyler, and that she had not
    been able to get any kind of answer from
    hospitals or anyone. I convinced a sheriffs
    deputy to assist her, and she was referred to a
    Red Cross center some miles away. Later, Willie
    Tyler was found dead at the Avondale Mills plant.
    He was the ninth victim. It seems wrong that he
    was known to be missing and yet no one or
    official had contacted his family. It also seems
    wrong that she could not find out this vital
    information easily.
  • 9. The area of evacuation was likely not
    sufficient. I spoke with a woman who lived about
    2.5 miles downwind from the rail crash site who
    had not ever been evacuated by emergency
    responders. She had heard the crash but thought
    it was thunder. She awoke the morning of the
    crash feeling weak, and noticed what she
    described as a strange fog outside. She learned
    about the disaster on television. When her
    husband came home later that day, they left their
    home and went further away to some relatives, but
    the chlorine fumes came there also, so they went
    back home. Considering that the potential
    off-site consequence of a catastrophic release of
    chlorine from a rail car can be up to 14 miles
    away, according to EPA, it appears that the
    emergency response and evacuation should have
    looked further into the area outside the IDLH
    (10ppm for Chlorine), and should have conducted
    air monitoring periodically throughout the areas
    downwind. This appears to be a common problem
    going back to the mindset of the emergency
    response community using ALOHA. The area of IDLH
    (Immediate Danger to Life and Health) gets much
    attention, but the levels of chlorine in the
    ambient air outside an IDLH can still be at
    harmful levels, certainly with chronic exposure.
    Even the OSHA standard for workplace exposure is
    0.5 ppm, TWA. People outside the designated IDLH
    should have been warned to avoid exposure and
    what symptoms might indicate an adverse effect.
  • 10. Some of the medical community, despite the
    rail disaster, seems to have ignored the obvious.
    This aforementioned woman did not go to an
    emergency room until Sunday the 9th of January,
    four days after the incident, because she did not
    get any better. There was no notification to her
    and others about potential health effects to
    watch out for. The hospital, unfortunately,
    diagnosed her with pneumonia and merely gave her
    antibiotics, which did not help at all. She saw
    her primary care physician on Tuesday, the 11th
    of January, who realized her chlorine exposure,
    and prescribed something to ease the inflammation
    of her lungs and allow her to breathe easier.

26
  • 11. It is always helpful when the responsible
    party steps up to the plate to assist in
    relieving the problems caused by a chemical
    accident. However, although Norfolk Southern
    Railroad set up a relief center to give people
    checks to cover motel and food expenses, but
    people had to wait hours to process paperwork and
    get these checks. It would have been better if
    this had been expedited with more staffing and
    resources, and it would have also looked better
    for the railroad company if it had not put
    releases for people to sign on these checks. (A
    court action soon ruled that these releases were
    invalid.)
  • 12. It is unbelievable and appalling that the
    Federal Emergency Management Agency rejected Gov.
    Mark Sanford's request for federal disaster
    relief in the wake of the Jan. 6 train accident
    and chlorine gas spill that killed nine and
    temporarily displaced thousands in Graniteville.
    A Feb. 9 letter from FEMA Under Secretary Michael
    Brown told Sanford the agency didn't think the
    Graniteville derailment and chemical spill
    warranted an emergency declaration.
  • 13. The hazardous materials contents of the
    railcars traveling through Graniteville or
    anywhere need not be a mystery. OREIS is a
    software tool that provides emergency responders,
    emergency planners, on-scene fire, police and EMS
    responders with vital information for dealing
    with rescue, response and counter-terrorism
    operations on or around railroads and highways,
    including those involving hazardous materials.
    The software provides responders with real-time
    information about the chemical contents of
    railcars and trucks that have been involved in an
    incident, schematics for passenger railroads and
    a host of other life and timesaving features for
    emergency responders. The concept was born in
    1995 in Houston, Texas and sprang from a Federal
    Railroad Administration (FRA) initiative to
    provide hazardous materials information to
    emergency responders.

27
  • http//www.youtube.com/watch?vecEmm-ZSKU4
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