Alerting System for Chemical Health Threats phase 2

Transcription

1 Alerting System for Chemical Health Threats phase 2 RASCHEM Rapid Alert System for Chemicals Prof Raquel Duarte-Davidson Head, International R&D Centre for Radiation, Chemicals & Environmental Hazards

2 Burden of disease: chemical incidents Although rare, the burden to human health from large chemical incidents worldwide ( ) was approximately 13,000 deaths,100,000 injuries and 3 million evacuees. Long term health impacts (i.e. congenital anomalies & cancer) are not included, neither is social disruption i.e. from loss of homes, agricultural land etc.

3 Poisoning from toy beads containing 1,4- butanediol which metabolised to Gamma hydroxybutyrate (GHB) following ingestion (Bindeez ; Australia) Magic Nano (Germany) and waterproofing sprays (EAPCCT) caused health impairment following inhalation

4 Suddenly I realised my nose and eyes were running, and I was feeling so strange - that was when I decided to go to hospital Wataru Kitamura All Agencies reported 12 fatalities; minor and severe injuries were approximately 5, passengers, 196 station workers approximately 10% of responders with secondary effects. Clinical effects (n=627 in one hospital): miosis (90.5%), headache (50.4%), visual darkness (37.4%), eye pain (37.5)%, dyspnea (29.2)%, nausea (26.8%), cough (18.8%), throat pain 18.3)%, and blurred vision (17.7%) Source BBC.co.uk/news

5 Lessons learned Poor reporting and slow Signs and symptoms not spotted No decontamination (dry decontaminations would have helped) Mis-identification of agent at scene

6 ASHT Phase I Growing public and government concern about the deliberate release of chemicals by terrorists led to the EU commission funding, phase I of the ASHT project. The aim of the project was to: Design and test an IT platform to allow rapid communication of information regarding chemical events, particularly terrorist, between European Poisons Centres and National Public Health Officials.

7 ASHT Phase II Aim: To develop a two tiered communication system to share information and alerts to potential transboundary chemical public health threats from Poisons Centres to National Public Health Officials and the EU. RAS-CHEM: Risk Assessment Tier To facilitate communications between EU Poisons Centres and Public Health Authorities RAS-CHEM: Risk Management Tier To allow National Public Health Authorities to alert EU member states To activate RAS-BICHAT if warning criteria are fulfilled

8 Overview of how RAS-CHEM works Member states now have a common platform to share information and act together regarding chemical incidents that could cross borders and affect citizens throughout the European Union.

9 Problems to overcome: There are many ways to describe toxic exposures and chemical poisoning (& 23 MS languages) as well as the circumstances of the exposure and the toxic agent itself Each MS has a different mechanisms to communicate potential transboundary chemical health threats - from the risk assessment level and risk management level

10 Data Harmonisation Aim: To extend the number of chemicals agents covered by the systems; to include terrorist, major accidents and those of interest to poisons centres. 113 chemicals were described in terms of there clinical effect upon toxic exposure 1,039 clinical effects for toxic exposures to chemicals were matched to a harmonised multilingual hierarchical terminology system - The Medical Dictionary for Regulatory Activities (MedDRA)

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12 What next? CARRA-NET (Chemical & Radiation Risk Assessment Network): Network of expert risk assessors for chemical threats &risks Development of protocols, guidelines & SOPs Criteria for when to escalate alert from the risk assessment to risk management tier of RAS-CHEM CARIMEC (Chemical & radiation inventory of public health measures & medical countermeasures): Immediate actions, monitoring & triage, decontamination Managing public health response ASHT III Take forward gaps identified in ASHTII (e.g. development of toxidrome matrix to enable RAS-CHEM system users to identify unknown chemicals from presented clinical features

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