Hazardous Substances Emergency Events Surveillance (HSEES) Report for 1995-2006 Minnesota Department of Health This report is supported by funds from the Comprehensive Environmental Response, Compensation and Liability Act (CERCLA) trust fund and the Office of Terrorism Preparedness and Emergency Response of the Centers for Disease Control and Prevention (CDC), provided to Minnesota Department of Health under a cooperative agreement by the Agency For Toxic Substances and Disease Registry, Public Health Service, U.S. Department of Health and Human Services. Minnesota Department of Health ♦ Division of Environmental Health ♦ P.O. Box 64975, St. Paul, MN 55164 651-201-4899, TTY 651-201-5797 Contents List of Tables List of Figures Executive Summary Introduction Methods Results and Discussion Overview Temporal Trends Geographic Trends Event type Industries Substances released Victims Evacuations Outreach Activities Limitations Conclusion References Appendix Page iii iv 1 1 2 4 4 4 5 6 7 8 12 17 18 20 21 22 ii List of Tables Table 1. Cumulative data by year - Minnesota Hazardous Substances Emergency Events Surveillance, 1995-2006 Table 2. Number of events, by county and type of event - Minnesota Hazardous Substances Emergency Events Surveillance, 1995-2006 Table 3. Frequencies of injuries by type of event - Minnesota Hazardous Substances Emergency Events Surveillance, 1995-2006 Table 4. Industries involved in hazardous substance events, by category Minnesota Hazardous Substances Emergency Events Surveillance, 1995 2006 Table 5. Frequency of substance categories in all events and events with victims Minnesota Hazardous Substances Emergency Events Surveillance, 1995 2006 Table 6. Top two single substances released by year - Minnesota Hazardous Substances Emergency Events Surveillance, 1995-2006 Table 7. Events, victims, and victim/event ratio - Minnesota Hazardous Substances Emergency Events Surveillance, 1995-2006 Table 8. Victims by category - Minnesota Hazardous Substances Emergency Events Surveillance, 1995-2006 iii List of Figures Figure 1. Events by year - Minnesota Hazardous Substances Emergency Events Surveillance, 1995-2006 Figure 2. Victim events by year - Minnesota Hazardous Substances Emergency Events Surveillance, 1995-2006 Figure 3. Events by day of week - Minnesota Hazardous Substances Emergency Events Surveillance, 1995-2006 Figure 4. Events by time of day - Minnesota Hazardous Substances Emergency Events Surveillance, 1995-2006 Figure 5. Events per 100,000 population, by county - Minnesota Hazardous Substances Emergency Events Surveillance, 1995-2006 Figure 6. Number of manufacturing events by county - Minnesota Hazardous Substances Emergency Events Surveillance, 1995-2006 Figure 7. Number of agricultural events by county - Minnesota Hazardous Substances Emergency Events Surveillance, 1995-2006 Figure 8. Event locations and major roadways - Minnesota Hazardous Substances Emergency Events Surveillance, 1995-2006 Figure 9. Event locations and major roadways, Twin Cities Metropolitan Area Minnesota Hazardous Substances Emergency Events Surveillance, 1995 2006 iv Minnesota Hazardous Substances Emergency Events Surveillance, 1995-2006 Executive Summary The Hazardous Substances Emergency Events Surveillance (HSEES) system, maintained by the Agency for Toxic Substances and Disease Registry (ATSDR), collects information to describe the public health consequences of acute releases of hazardous substances in participating states. Minnesota began participation in the HSEES system in 1995. This report summarizes events reported to Minnesota for 12 years of participation, 1995-2006. Information collected about acute events involving hazardous substances includes the substance(s) and quantity released; time, place, and cause of the event; number of victims and injuries sustained; response; and public health protective actions taken. A total of 4,566 events were reported. The most commonly reported categories of substances were inorganic substances (14.6%) and pesticides and fertilizers (13.9%). During 1995-2006, 283 (6.2%) events resulted in 877 victims (eight deaths). The most frequently reported injuries were respiratory irritation, eye irritation, and gastrointestinal system problems. Evacuations were ordered for 447 (9.8%) events. Highlighted prevention outreach activities include contributions toward a mercury thermometer sales ban, meth lab-related legislation, and published papers. Introduction The Hazardous Substance Emergency Events Surveillance (HSEES) system is maintained by the Agency for Toxic Substances and Disease Registry (ATSDR). The purpose of this system is to describe public health effects associated with acute unplanned or illegal hazardous substance releases and to develop strategies to reduce releases and related injuries. Methods The HSEES system maintains data about acute, unplanned or illegal releases of hazardous substances and the associated acute public health effects. A released substance is included if it could cause an adverse health effect, excluding petroleum-only releases. Threatened releases of hazardous substances are included if the threat prompted a public health action, such as an evacuation or a shelter-in-place order. Specific substances have been identified for inclusion at any quantity released, while other substances are included if the release is one gallon or 10 pounds or greater. Any person who sustains at least one documented acute averse health effect within 24 hours of the event or who dies as a result of the event is an event victim. Information collected about victims includes general symptom information, severity of injury (measured by extent of treatment), general demographic information, distance from the release, use of personal protective equipment, and decontamination information. HSEES does not conduct long-term follow-up on victims to assess chronic or latent effects of acute chemical exposure. Health symptoms experienced by victims are classified into 11 categories, including burns, dizziness/central nervous system symptoms, eye irritation, gastrointestinal system 2 problems, headache, heart problems, heat stress, respiratory irritation, shortness of breath, skin irritation, and trauma. An additional category called “Other” is available for symptoms that do not correspond to the pre-defined categories. When possible, burns are placed into subcategories of “thermal” and “chemical.” Likewise, trauma injuries are placed into subcategories of “chemical-related” or “not chemical-related.” ATSDR classifies substances released into 11 categories: acids, anhydrous ammonia, bases, chlorine, mixtures, paints and dyes, pesticides, polychlorinated biphenyls (PCBs), volatile organic compounds (VOCs), other inorganic substances, and “other” substances. The “mixtures” category includes substances from different categories that were combined before the release. The “other inorganic substances” category includes all inorganic substances, except acids, bases, anhydrous ammonia, and chlorine, which have each been assigned a separate category. The category “other” includes substances that cannot be classified into any of the other categories. For a full explanation of categories, see the Appendix. The definition of an HSEES event has been updated periodically to capture relevant events and eliminate some common events with few acute health consequences. For all qualifying events, data collected include, when applicable: substance identity and quantity; industries involved; event start and end time; location and area(s) affected; transportation mode or fixed-facility equipment involved; protective public health actions ordered; response; number of victims; and information about injuries and victim demographics. 3 Sources of preliminary information about events include the Minnesota Duty Officer, the National Response Center, and the U.S. Department of Transportation Hazardous Materials Incident Reporting System. Additional information is collected from company or industry representatives, state and local emergency responders, health and safety personnel and others with knowledge about the release. Results and Discussion Overview From 1995-2006, there were 4,566 HSEES events in Minnesota. Of these, 47 (1.0%) were threatened releases and 36 (0.8%) were part actual and part threatened releases. There were evacuations in 447 events (9.8%) and injuries in 283 events (6.2 %), totaling 877 victims. Temporal Trends Overall, the number of HSEES events have been increasing over time (p < 0.001) (Table 1, Figure 1) while the number of victim events has been fluctuating, with a slight possible increase over time (p = 0.083) (Table 1, Figure 2). The year with the most HSEES events was 2006 (546), while the fewest were in 1995 (229), the first full year Minnesota participated in the system. Notably, the highest number of victims were reported in 1995 (172 victims, 23 events), when two events resulted in several victims. The fewest victims were reported in 1997 (19 victims, 16 events) (Table 1, Figure 2). 4 By day of week, the most events occurred on Wednesdays (807 [17.7%]) and Tuesdays (806 [17.7%]), and the fewest on Sundays (341 [7.5%]). The most victim events occurred on Tuesdays (59 [20.8%]) and the fewest on Sundays (16 [5.7%]) (Figure 3). However, Tuesdays and Saturdays had the highest percentage of events resulting in victims (7.3%), while Wednesdays had the lowest (4.3%). By time of day, most of the 4525 events (99.1%) with known exact time or time category occurred during the daytime hours of 6:00 a.m. – 5:59 p.m. (3183 [70.3%]). Slightly more events occurred in the morning hours of 6:00 a.m. – 11:59 a.m. (1641 [36.3%]) than in the afternoon hours of 12:00 p.m. – 5:59 p.m. (1542 [34.1%]) (Figure 4). There were 281 (99.3%) victim events for which an exact time or time category was available. Most events with injuries (195 [69.4%]) occurred between 6:00 a.m. and 5:59 p.m. (Figure 4). The proportion of events with victims was slightly higher (86 [6.4%]) during the overnight hours of 6:00 p.m. to 5:59 a.m. than the daytime hours of 6:00 a.m. to 5:59 p.m. (195 [6.1%]), though the difference in the proportion was not significant (95% conference interval (-0.012, 0019)). Geographic Trends The seven counties of the Twin Cities metropolitan area (Anoka, Carver, Dakota, Hennepin, Ramsey, Scott and Washington) had about half of the events, with 2280 (49.9%) in the metropolitan area and 2286 (50.1%) in the remaining counties. Of the 5 seven Twin Cities counties, Hennepin County (674 events) and Dakota County (637 events) had the most events (Table 2). By size of county population, Carlton County had the most events (55.3 events/100,000 population per year) (Figure 5). Other geographic trends reflect the economic basis of areas in the state. In agricultural areas of the west and southern half of the state, pesticides and fertilizer releases are common. In the populated areas of the Twin Cities, Mankato, Rochester, Marshall, St. Cloud, International Falls, and Duluth, manufacturing events are more prevalent. In the far northeast, the population is less concentrated and there are few industrial and agricultural sites, with corresponding fewer releases overall (Figures 6 and 7). Many events occur on or near major roadways, as illustrated in the map of the event locations (Figures 8 and 9). While some of the events represent transportation events, many events occur in fixed-facilities that are located along the major roadways. Event type Fixed Facility Fixed facilities are fixed locations such as industrial or commercial sites, schools, health care facilities or residences. For 1995-2006, 3,410 fixed-facility events; 204 events (6.0%) resulted in 765 victims. Evacuations were ordered in 414 (12.1%) events. The most frequently released substance in fixed facilities, including events involving mixing and reactions, was anhydrous ammonia (447 events). Anhydrous ammonia also produced the most fixed-facility victims (45 events, 127 victims). The most frequently reported 6 injury in a fixed facility was respiratory irritation (42.9%) (Table 3). Industries associated with the most fixed-facility events were manufacturing (1,626 events), utilities (372 events), wholesale trade (297 events) and agriculture, forestry, fishing and hunting (261 events). Transportation Transportation events involve chemicals being transported by surface, air, water or pipeline beyond the boundaries of a fixed facility. During 1995-2006, 1,156 (25.3%) were transportation events. Seventy-nine events (6.8%) resulted in 112 victims. The most frequently reported injury in transportation events was trauma, reported for 63 (43.8%) of the 144 transportation-related injuries (Table 3). (A victim could sustain more than one injury type.) Evacuations were ordered in 33 events (2.9%). The most frequently released substance in transportation events was anhydrous ammonia (81 releases). Anhydrous ammonia also produced the most transportation event victims (9 events, 18 victims). Industries The largest proportions of HSEES events were associated with manufacturing (1,690 [37.0%]) and transportation and warehousing (719 [15.7%]) (Table 4). The largest portion of victim events occurred in the manufacturing industry (67 [23.7%]) resulting in 303 (34.5%) victims. Transportation and warehousing had the second-highest number of events with victims (36 [12.7%]), resulting in 86 victims (9.8% of the total), but utilities (11 events with victims, [ 3.9%]) had the second-highest number of victims (91 [10.4%]). 7 The high number of victims in events at utilities was related to one mass casualty event that resulted in several victims with minor injuries. Substances released A total of 5,312 substances were released in the recorded events, with an additional 89 chemicals that were threatened to be released. For all events, the number of substances released ranged from 1 to 197. The majority of events (4,275 [93.6%]) involved release of one substance. The most frequent type of release was spill only, with 3,140 substances (59.1%) released in this way. There were 1,367 substances (25.7%) released by air release only. By category Events were assigned a substance category based on the types of substance(s) released. If more than one substance was released and all were of the same category, the event was assigned that substance category. If the substances were of different categories, the event was assigned to a “multiple substances” category. There were 4,511 events (98.8%) that were assigned a category. The substance categories with the most events include “other inorganic substances” (661 events [14.7%]) and “pesticides and fertilizers” (629 events [13.9%]). The anhydrous ammonia category (which includes ammonium hydroxide) had the highest percentage of events with victims (18.4%) overall, but events assigned the “hetero-organics” category (26.3%) had the highest proportion of victim events within its own category (Table 5). 8 By substance Characteristics of the most commonly released substances are described below: Anhydrous ammonia The substance released most frequently each year was anhydrous ammonia (Table 6), with 521 events (or 528 events including mixtures) (Table 7). Fifty-four anhydrous ammonia events resulted in 145 victims. Anhydrous ammonia was associated with the most victim events for each year except 1995 and 1998, when chlorine resulted in more events with victims. The three primary sources of anhydrous ammonia releases include: agricultural activity (267 events), refrigeration (134 events), and illegal methamphetamine production (51 events). The other 76 events were related to industrial processes (44 events), transportation events (24 events), mixture events (7), and one education/research-related project. Anhydrous ammonia: agricultural events The widespread use of anhydrous ammonia as a fertilizer in agricultural activities creates more occasions for release of this substance. Use of agricultural anhydrous ammonia is most concentrated in the southern and western portions of the state. Anhydrous ammonia releases related to agriculture are most common during the planting season (April, May, June) and in the fall when some fields are prepared for the following spring. Other small releases occur throughout the summer when valves on anhydrous ammonia tanks loosen or when pressure relief valves vent due to temperature changes. Releases also occur from 9 agricultural storage tanks when anhydrous ammonia theft for meth production is attempted (see Anhydrous ammonia: methamphetamine-related events below). Overall, agriculture-related anhydrous ammonia releases make up about half [267, (50.6%)] of all the anhydrous ammonia releases. About 8.2% of these events resulted in victims, with a victim to event ratio of 13 victims/100 events (Table 7). Anhydrous ammonia: refrigeration-related events Refrigerant releases are another major portion (134 events [25.4%]) of all anhydrous ammonia releases. Many of these releases occur at cold storage or food processing companies when refrigeration systems become over-pressurized and anhydrous ammonia is released from pressure relief valves. Releases are also related to other mishaps, such as accidentally punctured pipes or inadequate draining of pipes before maintenance. Anhydrous ammonia theft attempts from these systems occur at times, although they are less common than from agricultural cooperatives and farms. Anhydrous ammonia refrigeration systems have resulted in the most anhydrous ammonia release-related victims, with 16 events (11.9%) resulting in 73 victims and a victim to event ratio of 54 victims/100 events (Table 7). Anhydrous ammonia: methamphetamine-related events Illegal clandestine labs for methamphetamine have been a significant problem in the state in recent years. During the past ten years, the HSEES system recorded 51 releases of anhydrous ammonia (9.7%) that were known to be related to meth activity. There were 10 10 events (19.6%) resulting in 23 victims. The victim to event ratio is 45 victims/100 events (Table 7). Sulfur dioxide The second most frequently released substance was sulfur dioxide (230 events). Unlike anhydrous ammonia, this substance was not consistently among the most frequently released substances by year (Table 6). Often, sulfur dioxide releases were associated with petroleum refining or manufacturing. There were three events that resulted in 48 victims with acute symptoms: all of these events were related to manufacturing. After 2005, unplanned sulfur dioxide releases from emission stacks no longer qualified for HSEES and sulfur dioxide events in the HSEES system decreased substantially. Sulfuric acid Sulfuric acid releases, including battery acid releases, were the third most released substance (196 events). Several of these releases were related to manufacturing or spills from batteries. There were 17 events with victims (8.7%) that resulted in 30 victims, making the victim to event ratio 15 victims/100 events (Table 7). Chlorine Chlorine gas There were 81 releases of chlorine gas from tanks or cylinders during 1995-2006. Fourteen events (17.3%) resulted in 26 victims, with a victim to event ratio of 32 11 victims/100 events (Table 7). These gaseous chlorine releases often resulted from problems with water chlorination systems or manufacturing process equipment. Mercury The number of mercury releases reported to HSEES has risen dramatically in the past few years, possibly because of increased public awareness after extensive news coverage of spills in communities and schools. For 1995-2006, there were 154 releases in the HSEES system. (Data on most mercury spills in 2005 were not collected while the HSEES case definition was reevaluated.) There were two events with victims (1.3%) (one victim each), but injuries were related to trauma or thermal burns and not the mercury release directly. In some instances, people exposed to mercury received follow-up toxicological evaluations, but no injury was reported within 24 hours of the incident. Common sources of mercury releases were thermometers, sphygmomanometers (blood pressure gauges), and barometers. Victims Injuries (Symptoms) Twelve categories of injuries (symptoms) are collected for HSEES, with an additional category called “Other” for injuries that do not correspond to a specific category. When possible, burns are placed into subcategories of “thermal” and “chemical.” Likewise, trauma injuries are placed into subcategories of “chemical related” or “not chemical related.” The most common injury reported for all events was respiratory irritation, reported for 584 (41.2%) of the 877 victims. Eye irritation (176 victims [12.4%]) and 12 gastrointestinal system problems (160 victims [11.3%]) were the second and third most reported injuries (Table 3). Victim categories Of the 877 victims recorded in the MN HSEES system for 1995-2006, most of the victims were employees (517), followed by the general public (244) and students at school (34). (Note: Because the “student” category was not available until 2002, 64 student victims were classified as “general public”.) The victims also included 70 responders: 18 volunteer firefighters, 17 police officers, 10 career firefighters, nine unspecified first responders, seven company first responders, five firefighters (no subcategory specified), and four emergency medical service responders. Category was unavailable for 12 victims. The victims were most often male (60.8%). Male victims comprised the greater part of every category except the student and the “unknown” category (Table 8). By age group, victims were most frequently between 20 and 44 years (46.9% overall), though in the “general public” category, children 19 years and under represented 43.9% of the victims (Table 8). Events involving children Children age 19 and younger were often involved in HSEES events: in 30 events, there were 162 child victims. Excluding events recorded as mixture and reactions, the most frequently released substances resulting in symptoms were pepper gas/pepper spray/tear 13 gas (5 events), anhydrous ammonia (3 events) and chlorine-related events (3 events). Common symptoms sustained by victims include respiratory irritation (126 victims), gastrointestinal problems (76 victims), and headache (67 victims). Children also played a role in initiating some HSEES events. While HSEES does not collect information on individuals responsible for events, some of the record comments note that one or more children were involved in event initiation, either by mishap or purposefully. Examples of chemicals released in child-initiated events include mercury, acids, pepper spray, bleach, and solvents. Some of these events involved injuries to other children. Mass casualty events There were 17 events that involved more than 10 victims, all involving fixed-facility locations. The event with the most victims (64) involved occupants of a school that were affected by methyl mercaptan released from a nearby waste treatment company. Most of the victims experienced respiratory and gastrointestinal symptoms and were evaluated at a hospital, but none required treatment. The chemical most commonly released in events with more than 10 victims was anhydrous ammonia, released in four mass casualty events that resulted in a total of 60 victims. Sources of these releases were refrigeration systems (three events) and illegal methamphetamine production (one event). While nearly all victims were treated on scene or in a hospital and released, three required hospitalization. Common symptoms among 14 victims were respiratory irritation (60 victims) and eye irritation (22 victims), chemical burns (2 victims) and gastrointestinal symptoms (1 victim). Chemicals classified pepper gas, pepper spray not otherwise specified and 2 chloroacetophenone also resulted in four events with 93 total victims. The first event involved pepper gas in a school from an unidentified source. The second involved an adolescent prank in a retail store. The third involved an accidental pepper spray release in a restaurant and the fourth involved an apparent pepper spray release in an airport for an unknown reason. Seventy six of the victims were treated at a hospital and released, 16 had symptoms reported by an official, and one saw a private physician. None of the victims were admitted to a hospital. Reported symptoms were respiratory irritation (61 victims), skin irritation (21) victims), and shortness of breath (20 victims) and eye irritation (17 victims), gastrointestinal symptoms (9 victims), headache (4 victims) and chills (2 victims). Other chemicals released in mass casualty events include antifreeze, a bacterial mixture, chlorine, chlorine dioxide, chloropicrin, ethanol, hydrofluoric acid, mercaptan, and sulfur dioxide. Severity of injuries Fatalities There were no deaths caused directly by chemical releases in the MN HSEES system for 1995-2006. (Note: One death occurred several months after exposure to anhydrous 15 ammonia, but this could not be noted in the HSEES record after the year’s records were closed.) There were six events resulting in eight fatalities that were indirectly related to a chemical release. Six of the deaths were related to trauma and two were related to thermal burns occurring in conjunction with a hazardous substance release. The trauma events involved vehicle crashes (4 events) and a welding explosion. One thermal burn victim was involved in a meth lab event and the other victim was injured in an ethanol tanker rollover that involved a fire. Hospitalizations There were 68 events that resulted in at least one victim requiring hospitalization, with 98 victims hospitalized. Symptoms occurring in at least 15 of those hospitalized included respiratory irritation (45 victims), chemical or thermal burns (27 victims), trauma (26 victims), gastrointestinal symptoms (20 victims), and eye irritation (16 victims). (A victim could have more than one symptom.) The top three substances involved in events requiring at least one victim to be hospitalized were anhydrous ammonia (9 events), sulfuric acid (5 events), and chlorine gas (4 events). A bacterial/endotoxin mixture release resulted in the most victims requiring hospitalization (13 victims) with headache, heart problems, respiratory irritation, eye irritation, and other symptoms. 16 Evacuations There were 447 events (9.8%) involving an evacuation ordered by an official. The number of people evacuated ranged from 1 to approximately 1,500, with about 25,200 evacuated for all events. The most common evacuation length (mode) was about 1 hour, while the median evacuation length was 2 hours. Evacuation lengths ranged from 5 minutes to several weeks. Substances released that required evacuations most frequently included anhydrous ammonia (108 events), chlorine gas (33 events) and mercury (28 events). One hundred twenty-three (27.5%) events with evacuations resulted in victims, totaling 592 victims. The most common industries involved were manufacturing (40 events [32.5%]), and education (13 events [10.6%]). Fourteen events (11.4%) with an evacuation resulted in more than ten victims. There were 159 events without evacuations that resulted in victims, totaling 284 victims. (The evacuation status was unknown for one victim event.) The most common industries of these events were agriculture (29 events [18.2%]) and wholesale trades (including several farm cooperatives) (28 events, [17.6%]). Three events (1.9%) without an evacuation resulted in more than ten victims. The rural nature of many of these events, with the corresponding lower density of populated areas, might have contributed to the decision not to evacuate and to the lower numbers of victims when compared to events with evacuations. 17 Outreach activities In effort to reduce injuries and fatalities related to acute hazardous substances releases, the HSEES system focuses activities on hazards identified through data analysis. Some of the topics targeted include releases associated with anhydrous ammonia, mercury, chlorine, pesticides and meth labs. Other outreach activities provide a general overview of the HSEES program. Some examples of past outreach activities follow. Anhydrous ammonia papers The HSEES program published two papers related to anhydrous ammonia releases. One, called “A description of agricultural releases of anhydrous ammonia in Minnesota” was published in Chemical Health & Safety in Nov/Dec 2000 (1). This paper describes the patterns of unplanned acute anhydrous ammonia releases related to agriculture for 1995 1997 in Minnesota. A second paper, published in March/April 2000 in Minnesota Fire Chief magazine (2), describes anhydrous ammonia hazards and techniques for safe response to an anhydrous ammonia release. Mercury thermometer sales ban When a ban on sale of mercury-containing thermometers was under consideration in the Minnesota Legislature in 2001, MDH and others were asked for data about mercury spills and impacts. The MN HSEES program and other state agencies provided data that demonstrated the problems caused by mercury thermometers. The bill was passed by the legislature, signed by the governor, and went into effect on January 1, 2002 (3). While mercury spills from thermometers continue, it is expected that eventually the ban will 18 decrease the number of mercury-containing thermometers in the state, thereby reducing the number of mercury spills over time. Meth Lab Program and meth response MN HSEES has been involved in a number of projects related to illegal clandestine drug labs (meth labs) in recent years. In the late 1990s, the number of meth labs in the state increased, along with related injuries to general public and responders. As part of the response, the Minnesota Department of Health supported creation of a Meth Lab Program in 2001 to address the public health hazards associated with this illegal activity. Using HSEES and other data, state funds were obtained to implement this program, which focused primarily on providing education and resource connections for responders, local community health workers, and many other groups. One Meth Lab Program activity was a HSEES-supported conference in 2003 that featured panel discussions about safer response to meth labs and protection of responders and the public from chemical hazards. In 2005, HSEES data were used for an event called “Meth Day at the Capitol” that brought attention to proposed meth-related legislation in the Minnesota legislature. The event incorporated posters, presentations, videos, and static displays to educate legislators and the public about meth lab hazards. Meth-related legislation, which restricted access to meth precursors and increased penalties for meth lab-related activity, was passed and became effective July 1, 2005 (4, 5). 19 As part of an effort to evaluate the effectiveness of the meth legislation, the MN HSEES program conducted two surveys of all Minnesota counties to determine the number of newly discovered meth labs before and after the meth legislation implementation, and whether the legislation would have a sustained effect. The results of the surveys showed a sustained decrease of about 66% in newly discovered meth labs after the legislation was implemented (6, 7). In December 2006, the MN HSEES program presented information on illegal meth related activity and anhydrous ammonia releases at a session at the National Environmental Health Center/Agency for Toxic Substances and Disease Registry’s National Environmental Public Health Conference in Atlanta, GA. This session also covered anhydrous ammonia releases related to anhydrous ammonia refrigeration, agricultural anhydrous ammonia, and transportation. Aerial application article An article concerning hazardous substance releases related to aerial application (also called “crop dusting”) was published in the Journal of Environmental Health in November 2005 (8). This article described number of events, substances released, and types of injuries associated with aerial application as well as safety information. Limitations The HSEES system attempts to identify and collect information on all qualifying hazardous substance release events. However, it is not known how many events occur 20 that are not reported to sources available to the HSEES system. Therefore, true trends in hazardous substance releases may slightly differ from what collected data show. The HSEES program continuously monitors recognized hazardous substance release reporting systems, emergency response systems, and media reports, increasing the likelihood that more qualifying reported events will be captured. Another limitation in this report concerns the slight variation in the HSEES case definition over time. The case definition changes can affect the total number of events entered each year, thereby affecting release statistics derived from the system. This report included all reported events for 1995-2006 that met HSEES case definition at the time of entry. Overall, long term trends have not appeared to vary substantially despite the case definition changes. Conclusion The HSEES program serves as a way to monitor the trends in hazardous substances releases within participating states and in multi-state areas. The system is unique in providing information not only about the release event, but also in providing information about victims. This information is useful in identifying and tracking hazards posed to the public from acute hazardous substances releases. The HSEES program strives to protect public health through education and outreach activities when hazards are identified. HSEES continually seeks collaborators to join in preventing unplanned acute hazardous substances releases and the resulting injuries. 21 References 1) Souther, L., Small-Johnson, J., Messing, R. (2000) A description of agricultural releases of anhydrous ammonia in Minnesota. Chemical Health and Safety, 7(6), 16-22. 2) Souther, L. (2000) April Showers Bring May Anhydrous ammonia Releases. Minnesota Fire Chief, 36(4), 14-16. 3) Minn. Stat. 2007 116.92, Subd. 6 4) Minn. Stat. 2007 152.02 Subd. 6 5) Minn. Stat. 2007 152.136 6) Minnesota Department of Health. 2006. Meth Labs Discovered in Minnesota in 2005. Accessed from http://www.health.state.mn.us/divs/eh/meth/ordinance/mnmethlabs2005.pdf May 15, 2008. 7) Minnesota Department of Health. 2006. Meth Labs Discovered in Minnesota in 2005 and January to June, 2006. Accessed from http://www.health.state.mn.us/divs/eh/meth/ordinance/mnmethlabs2006.pdf May 15, 2008. 8) Rice, N., Messing, R., Souther, L., Berkowitz, Z. (2005) Unplanned Releases and Injuries Associated with Aerial Application of Chemicals, 1995-2002. Journal of Environmental Health, 68(4), 14-18. 22 Appendix Table 1. Data by year- Minnesota Hazardous Substances Emergency Events Surveillance, 1995-2006* Events with victims Type of event Year 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 Total Fixed facility 193 224 194 341 287 346 338 228 321 325 271 342 3410 Transportation 36 77 71 36 61 73 76 126 117 143 136 204 1156 Total 229 301 265 377 348 419 414 354 438 468 407 546 4566 No. substances released 386 340 283 440 370 459 472 374 499 740 456 584 5403 No. victims 172 73 19 66 62 83 50 85 83 64 52 68 877 No. deaths 0 0 1 0 0 1 0 1 3 1 0 1 8 No. 23 21 16 22 24 29 19 16 30 26 26 31 283 * Numbers in the table might differ from those reported in previous years because of adjustments in HSEES qualification requirements for events. † Percentage of events with victims. %† 10.0 7.0 6.0 5.8 6.9 6.9 4.6 4.5 6.8 5.6 6.4 5.7 6.2 Table 2. Number of events, by county and type of eventMinnesota Hazardous Substances Emergency Events Surveillance, 1995-2006 Fixed facility Events County Aitkin Anoka Becker Beltrami Benton Big Stone Blue Earth Brown Carlton Carver Cass Chippewa Chisago Clay Clearwater Cook Cottonwood Crow Wing Dakota Dodge Douglas Faribault Fillmore Freeborn Goodhue Grant Hennepin Houston Hubbard Isanti Itasca Jackson Kanabec Kandiyohi Kittson Koochiching Lac Qui Parle Lake Lake of the Woods Transportation Events All Events Events Victim Events Events Victim Events Evacuation Events Events with Victims Total Events 4 104 7 6 14 1 44 17 201 38 5 12 9 23 2 1 13 21 502 22 7 31 16 37 42 5 547 8 9 7 109 6 0 16 16 38 1 12 0 0 0 0 5 1 0 4 1 0 1 0 0 0 1 2 16 0 0 0 2 6 3 0 36 0 1 0 3 0 0 2 0 1 5 58 8 1 6 4 23 13 9 10 0 5 4 9 1 0 2 5 135 6 5 16 8 9 17 7 127 4 2 6 8 7 0 16 3 2 1 4 3 0 0 0 2 0 2 0 0 0 0 0 1 0 0 0 4 0 2 1 0 0 4 1 7 1 0 0 0 1 0 1 1 0 0 18 0 0 0 0 4 5 2 8 1 0 3 3 0 0 1 6 42 1 1 2 1 4 5 1 104 0 2 2 1 0 0 2 0 1 2 16 3 0 0 0 7 1 2 4 1 0 1 0 1 0 1 2 20 0 2 1 2 6 7 1 43 1 1 0 3 1 0 3 1 1 9 162 15 7 20 5 67 30 210 48 5 17 13 32 3 1 15 26 637 28 12 47 24 46 59 12 674 12 11 13 117 13 0 32 19 40 3 0 4 0 0 0 7 5 0 1 1 2 1 6 6 0 0 0 0 0 6 Page 1 of 3 Table 2. Number of events, by county and type of eventMinnesota Hazardous Substances Emergency Events Surveillance, 1995-2006 Fixed facility Events County Le Sueur Lincoln Lyon Mahnomen Marshall Martin McLeod Meeker Mille Lacs Morrison Mower Murray Nicollet Nobles Norman Olmsted Otter Tail Pennington Pine Pipestone Polk Pope Ramsey Red Lake Redwood Renville Rice Rock Roseau St. Louis Scott Sherburne Sibley Stearns Steele Stevens Swift Todd Traverse Wabasha Wadena Transportation Events All Events Events Victim Events Events Victim Events Evacuation Events Events with Victims Total Events 13 2 68 2 4 20 60 14 6 26 16 10 13 12 3 88 27 11 8 10 25 7 264 2 13 31 32 3 22 82 28 60 13 52 44 6 11 9 2 9 3 3 0 3 0 2 1 3 2 2 0 2 1 0 2 0 3 0 4 1 2 3 0 23 0 1 1 2 1 0 5 2 2 0 4 3 2 1 1 0 1 0 11 0 14 1 7 11 14 8 7 4 8 4 7 5 2 28 16 3 1 9 11 5 116 1 9 12 7 5 3 15 13 13 6 24 37 9 9 5 0 2 3 2 0 0 0 0 0 2 0 0 1 0 0 2 1 0 2 2 0 1 3 3 0 3 0 1 0 0 1 1 1 2 1 0 1 3 1 0 1 0 0 1 2 0 9 0 0 3 10 5 1 2 1 1 1 1 0 4 2 2 3 3 4 1 64 0 3 0 6 2 0 14 5 6 3 10 7 0 1 2 0 3 0 5 0 3 0 2 1 5 2 2 1 2 1 2 3 0 5 2 4 2 5 6 0 26 0 2 1 2 2 1 6 4 3 0 5 6 3 1 2 0 1 1 24 2 82 3 11 31 74 22 13 30 24 14 20 17 5 116 43 14 9 19 36 12 380 3 22 43 39 8 25 97 41 73 19 76 81 15 20 14 2 11 6 Page 2 of 3 Table 2. Number of events, by county and type of eventMinnesota Hazardous Substances Emergency Events Surveillance, 1995-2006 Fixed facility Events County Waseca Washington Watonwan Wilkin Winona Wright Yellow Medicine Totals Transportation Events All Events Events Victim Events Events Victim Events Evacuation Events Events with Victims Total Events 11 237 15 1 22 29 1 14 1 0 4 3 7 101 11 3 6 11 1 1 0 1 0 2 1 28 3 0 5 6 2 15 1 1 4 5 18 338 26 4 28 40 10 0 6 1 1 1 16 3410 204 1156 79 447 283 4566 Page 3 of 3 Table 3. Frequencies of injuries by type of event*Minnesota Hazardous Substances Emergency Events Surveillance, 1995-2006 Fixed facility Injury (symptom) Burns (unspecified) No. injuries % Transportation No. injuries All events Total % injuries % of injuries 2 0.2 0 0 2 0.1 Chemical burns 40 3.1 2 1.4 42 3.0 Dizziness/central nervous system symptoms 62 4.9 5 3.5 67 4.7 Eye irritation 152 11.9 24 16.7 176 12.4 Gastrointestinal system problems 155 12.2 5 3.5 160 11.3 Headache 116 9.1 4 2.8 120 8.5 20 1.6 0 0.0 20 1.4 0 0.0 0 0.0 0 0.0 22 1.7 0 0.0 22 1.6 547 42.9 37 25.7 584 41.2 Shortness of breath 48 3.8 2 1.4 50 3.5 Skin irritation 64 5.0 0 0.0 64 4.5 Thermal burns 28 2.2 2 1.4 30 2.1 Trauma 19 1.5 63 43.8 82 5.8 Total‡ 1275 100.1 144 100.2 1419 100.1 Heart problems Heat stress Other Respiratory irritation † * The number of injuries is greater than the number of victims (877) because a victim could have more than one injury. † Of the 82 trauma injuries, one was chemical-related, 38 were not chemical related and 43 were unknown or not specified. ‡ Percentages do not total 100% because of rounding. Table 4.─Industries involved in hazardous substance events, by category Minnesota Hazardous Substances Emergency Events Surveillance, 1995-2006 Industry Category Total events Number Events with victims % Number Percent events with victims % Total number of victims Maximum victims in a single event Accommodation and Food Services 25 0.5 5 1.8 20.0 24 12 Administration and Support and Waste Management and Remediation Services 34 0.7 2 0.7 5.9 2 1 Agriculture, Forestry, Fishing and Hunting 482 10.6 34 12.0 7.1 39 4 Arts, Entertainment, and Recreation 62 1.4 11 3.9 17.7 37 16 Construction 44 1.0 3 1.1 6.8 4 2 Education Services 98 2.1 15 5.3 15.3 67 38 3 0.1 1 0.4 33.3 2 2 45 1.0 3 1.1 6.7 13 11 5 0.1 0 0 0.0 0 0 1690 37.0 67 23.7 4.0 303 46 36 0.8 1 0.4 2.8 1 1 132 2.9 20 7.1 15.2 34 5 Professional services, Scientific and Technical Services 12 0.3 3 1.1 25.0 6 3 Public administration 55 1.2 4 1.4 7.3 12 7 Real Estate, Rental and Leasing 19 0.4 5 1.8 26.3 13 6 Retail trade 89 1.9 8 2.8 9.0 34 21 Transportation and Warehousing 719 15.7 36 12.7 5.0 86 22 Utilities 396 8.7 11 3.9 2.8 91 64 Wholesale trade 465 10.2 35 12.4 7.5 59 11 Not an industry 97 2.1 15 5.3 15.5 25 7 Unknown 58 1.3 4 1.4 6.9 25 21 4566 100.0 283 100.3 6.2 877 64 Finance and Insurance Health Care and Social Assistance Information Manufacturing Mining Other (includes residences) Total Table 5. Frequency of substance categories in all events and events with victimsMinnesota Hazardous Substances Emergency Events Surveillance System, 1995-2006* All events Substance category No. Events with victims % Percent of events Percent of with all releases victims in with substance victims category No. Acids 423 9.4 29 10.2 6.9 Ammonia (includes ammonium hydroxide) 523 11.6 52 18.4 9.9 Bases 214 4.7 9 3.2 4.2 Chlorine 160 3.5 24 8.5 15.0 Formulations 14 0.3 1 0.4 7.1 Hetero-organics 19 0.4 5 1.8 26.3 Hydrocarbons 20 0.4 1 0.4 5.0 Mixture 336 7.4 22 7.8 6.5 Multiple substance category 182 4.0 39 13.8 21.4 Other‡ 181 4.0 8 2.8 4.4 Other inorganic substances 661 14.7 19 6.7 2.9 Oxy-organics 313 6.9 18 6.4 5.8 Paints and dyes 149 3.3 2 0.7 1.3 Pesticides and fertilizers 629 13.9 35 12.4 5.6 Polychlorinated biphenyls 114 2.5 0 0.0 0 80 1.8 3 1.1 3.8 493 10.9 16 5.7 3.2 4511 99.7 283 100.3 N/A † § Polymers Volatile organic compounds Total ¶ * In ATSDR-assigned categories, substances in events that involved multiple substances were counted only once in a substance category when all the substances were associated with the same category. If events involved multiple substances from different substance categories, they were counted only once in the multiple substance category. † Substances from different categories that were mixed or formed from a reaction before the event. ‡ Not classified. § All inorganic substances except for acids, bases, ammonia, and chlorine. ¶ Percentages do not total 100% due to rounding. Of a total of 4566 events, 55 were excluded because they were not assigned a substance category. None of these 55 events had victims. Table 6. Top two single substances released by year*Minnesota Hazardous Substances Emergency Events Surveillance (HSEES), 1995 2006 Year 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 Substance rank (number of events) Most frequently released Second most frequently released substance substance Anhydrous ammonia (20) Sulfur dioxide (16) Anhydrous ammonia (34) Hydrogen sulfide (17) Anhydrous ammonia (42) Polychlorinated biphenyls (15) Anhydrous ammonia (47) Ethylene glycol (13) and Sulfuric acid (13) Anhydrous ammonia (29) Ethylene glycol (17) Anhydrous ammonia (30) Ethanol (26) Anhydrous ammonia (52) Sulfur dioxide (20) Anhydrous ammonia (47) Sulfur dioxide (21) Anhydrous ammonia (52) Sulfur dioxide (36) Anhydrous ammonia (42) Sulfur dioxide (39) Anhydrous ammonia (53) Paint NOS (24) Anhydrous ammonia (73) Paint NOS (51) * Excludes mixtures and reactions Table 7. Events, victims, and victim/event ratio Minnesota Hazardous Substances Emergency Events Surveillance, 1995-2006 Substance Anhydrous Ammonia Sulfur dioxide Sulfuric acid Chlorine Mercury Event type Number events Number with of events victims Agricultural release Refrigerant release Meth labs Ammonia mixtures Other ammonia events All events All events Single substance, excluding mixtures and reactions* Mixures and reactions* All events Gas All events * An "other ammonia event and a "single substance, sulfur dioxide" event overlapped categories 267 134 51 7 69 528 230 171 25 196 81 154 22 16 10 0 6 54 3 11 6 17 14 2 Percent victim events (%) Number of Victims Number of victims/100 events 8.2 11.9 19.6 0.0 8.7 10.2 1.3 6.4 24.0 8.7 17.3 1.3 35 73 23 0 14 145 48 19 11 30 26 2 13 54 45 0 20 27 21 11 44 15 32 1 Table 8. Victims by category - Minnesota Hazardous Substances Emergency Events Surveillance, 1995-2006 Sex Employees General public Students Responders Unknown Total Employees General public Students Responders Unknown Total NA = Not available Total (n) 517 244 34 70 12 877 ≤19 20 107 34 1 0 162 % 59.0% 27.8% 3.9% 8.0% 1.4% 100.0% M 373 90 9 56 5 533 % 72.1% 36.9% 26.5% 80.0% 41.7% 60.8% % 3.9% 43.9% 100.0% 1.4% 0.0% 18.5% 20-44 299 70 0 41 1 411 % 57.8% 28.7% 0.0% 58.6% 8.3% 46.9% F 130 69 25 5 2 231 Age (years) 45-64 94 25 0 8 5 132 % 25.1% 28.3% 73.5% 7.1% 16.7% 26.3% NA 14 85 0 9 5 113 % 18.2% 10.2% 0.0% 11.4% 41.7% 15.1% >64 11 2 0 0 0 13 % 2.7% 34.8% 0.0% 12.9% 41.7% 12.9% % 2.1% 0.8% 0.0% 0.0% 0.0% 1.5% NA 93 40 0 20 6 159 % 18.0% 16.4% 0.0% 28.6% 50.0% 18.1% Figure 1. Events by year- Minnesota Hazardous Substances Emergency Events Surveillance, 1995-2006 600 546 Trendline y = 21.629x + 240.08 (p < 0.001) 500 468 438 Number of Events 419 400 414 407 377 354 348 301 300 265 229 200 100 0 1995 1996 1997 1998 1999 2000 2001 Year 2002 2003 2004 2005 2006 Figure 2. Victim events by yearMinnesota Hazardous Substances Emergency Events Surveillance, 1995-2006 35 Trendline: y = 0.7308x + 18.833 (p = 0.083) 29 Number of Events 30 25 31 30 26 26 2004 2005 24 23 22 21 19 20 16 16 15 10 5 0 1995 1996 1997 1998 1999 2000 Year 2001 2002 2003 2006 Figure 3: Events by Day of Week- Minnesota Hazardous Substances Emergency Events Surveillance, 1995-2006 900 807 806 800 740 732 728 700 Number of Events 600 500 Events Victim Events 412 400 341 300 200 100 46 59 16 35 50 47 30 0 Sun. Mon. Tues. Wed. Day of Week Thurs. Fri. Sat. Figure 4: Events by Time of Day- Minnesota Hazardous Substances Emergency Events Surveillance, 1995-2006 1800 1641 1600 1542 1400 Number of Events 1200 1000 789 800 600 Events Victim Events 553 400 200 101 94 24 62 0 00:00 a.m. - 05:59 a.m. 06:00 a.m. - 11:59 a.m. 12:00 p.m. - 5:59 p.m. Time Range 6:00 p.m.- 11:59 p.m. ��������� ������������������������������������������ ����������������������������������������������������������������������� ������� ������ ���� ����� ������� ����� ���� ���� �������� ��� ����������� ���� ���������� ��� ���� ��� ��� ���� �������� �������� ��� ��� ������ ����� ������ ��� ������� ���� ��� ��� ������ ���� ��� ��� ������ ������ ���� ���� ��� �������� ������� ��������� ���� ��� ��� ���� ����� ���� �������� �������� ����� ���� ��� ��������������� ���� ������� ���� ��� ����� ����� ���� ���� ���� ������ ���� ������ ��� ��� ������ ��������� ��� ��� ��������� ������ ������ ��� ����� ������ ��� ���� ���� ���� ������� ����� �������� ��� �������� ��� 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