Follow-Up Assessment of Health Consequences after a Chlorine Release from a Train Derailment—Graniteville, SC, 2005
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.
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.
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).
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.
- Wenck MA, van Sickle D, Drociuk D, Belflower A, Youngblood C, Whisnant MD et al (2007) Rapid assessment of exposure to chlorine released from a train derailment and resulting health impact. Public Health Rep 122:784–792
- Van Sickle D, Wenck MA, Belflower A, Drociuk D, Ferdinands J (2007) Panel classification of self-reported exposure histories: a useful exposure index after a mass-casualty event. Public Health Rep 122:766–783
- National Center for PTSD. http://www.ptsd.va.gov/professional/pages/assessments/ptsd-checklist.asp, accessed 19 Nov 2010
- Weathers F, Litz B, Herman D, Huska J, Keane T (1993) The PTSD checklist (PCL): reliability, validity, and diagnostic utility. Paper presented at the Annual Convention of the International Society for Traumatic Stress Studies, San Antonio, TX
- SAS Institute, Inc. (2002–2003) SAS®: version 9.1. SAS Institute, Inc., Cary, NC
- Centers for Disease Control and Prevention and World Health Organization (2001) Epi Info 6.04d. CDC/WHO, Atlanta, GA/Geneva, Switzerland
- Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33:159–174 CrossRef
- Follow-Up Assessment of Health Consequences after a Chlorine Release from a Train Derailment—Graniteville, SC, 2005
Journal of Medical Toxicology
Volume 7, Issue 1 , pp 85-91
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- Chemical release
- Train derailment
- Industry Sectors
- Author Affiliations
- 1. Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA
- 2. Division of Acute Disease Epidemiology, South Carolina Department of Health and Environmental Control, Columbia, SC, USA
- 6. Division of Health Studies, Agency for Toxic Substances and Disease Registry, 4770 Buford Highway NE, MS F-57, Chamblee, GA, 30341, USA
- 7. Health Education Division, Pitt County Health Department, Greenville, NC, USA
- 3. Air Pollution and Respiratory Health Branch, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
- 8. Reciprocal Labs Corporation, Madison, WI, USA
- 4. Bureau of Disease Control, South Carolina Department of Health and Environmental Control, Columbia, SC, USA
- 5. Epidemic Intelligence Service Field Assignments Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA