CDC/ATSDR Toxicology Report

Journal of Medical Toxicology

, Volume 7, Issue 1, pp 85-91

Follow-Up Assessment of Health Consequences after a Chlorine Release from a Train Derailment—Graniteville, SC, 2005

  • Mary Anne DuncanAffiliated withEpidemic Intelligence Service, Centers for Disease Control and PreventionDivision of Acute Disease Epidemiology, South Carolina Department of Health and Environmental ControlDivision of Health Studies, Agency for Toxic Substances and Disease Registry Email author 
  • , Daniel DrociukAffiliated withDivision of Acute Disease Epidemiology, South Carolina Department of Health and Environmental Control
  • , Amy Belflower-ThomasAffiliated withDivision of Acute Disease Epidemiology, South Carolina Department of Health and Environmental ControlHealth Education Division, Pitt County Health Department
  • , David Van SickleAffiliated withEpidemic Intelligence Service, Centers for Disease Control and PreventionAir Pollution and Respiratory Health Branch, National Center for Environmental Health, Centers for Disease Control and PreventionReciprocal Labs Corporation
  • , James J. GibsonAffiliated withBureau of Disease Control, South Carolina Department of Health and Environmental Control
  • , Claire YoungbloodAffiliated withDivision of Acute Disease Epidemiology, South Carolina Department of Health and Environmental Control
  • , W. Randolph DaleyAffiliated withEpidemic Intelligence Service Field Assignments Branch, Centers for Disease Control and Prevention

Abstract

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.

Keywords

Chlorine Chemical release Train derailment