NEHA May 2014 Journal of Environmental Health - page 11

May 2014
• Journal of Environmental Health
11
as incidents in any location involving any
chemical intended for pool use. HSEES data
differ from NEISS data, which focus on ED
patients, and from SENSOR data, which are
occupational. HSEES data are comprehen-
sive and include chemical incidents with and
without injuries and from all sectors includ-
ing transportation.
Methods
Our study included data from the HSEES sys-
tem from2001 to 2009. During various periods
within this time frame, 17 states participated
in HSEES (Colorado, Florida, Iowa, Louisiana,
Michigan, Minnesota, Mississippi, Missouri,
New Jersey, New York, North Carolina, Ore-
gon, Rhode Island, Texas, Utah, Washington,
and Wisconsin). HSEES served as an active
state-based surveillance system of hazardous
substance incidents collected from multiple
sources, including state and local environ-
mental protection agencies, police and fire
departments, poison control centers, hospi-
tals, local media, and various federal databases
(e.g., U.S. Department of Transportation Haz-
ardous Material Incident Reporting Systems
and the U.S. Coast Guard’s National Response
Center). States entered their data directly into
a secure web-based application. A hazardous
substance release was included in the HSEES
system if it was an uncontrolled or illegal
release of any hazardous substance, exclusive
of petroleum-only incidents. Releases were
included if they had to be cleaned up accord-
ing to federal, state, or local law.
Pool chemical incidents involved at least
one chemical intended to be used to maintain
water quality or equipment at an aquatic venue
(e.g., hot tub, water park, or pool). To identify
potential pool chemical incidents, we queried
the HSEES database for the following terms:
“swim,” “pool,” “Jacuzzi,” “spa,” and “hot tub.”
We also queried pool chemicals mentioned in
De Haan and Johanningsmeier’s (1997) pool
operator training manual: “algaecide,” “bro-
mide,” “chlorinated isocyanurate,” “cyanuric
acid,” “lithium hypochlorite,” “hypobromous
acid,” “dichlor,” “trichlor,” “muriatic acid,”
“chlorine,” “calcium hypochlorite,” “hypochlo-
rous solution,” “hydrogen peroxide,” “hydro-
chloric acid,” “sodium hypochlorite,” “potas-
sium monopersulfate,” “biguanide,” “soda
ash,” “sodium bisulfate,” and “copper sulfate.”
We manually reviewed the incident records
to confirm that pool chemicals were actually
involved. We performed descriptive analysis
of HSEES data by using SAS version 9.2. We
used the North American Industry Classifica-
tion System (NAICS) industry codes to iden-
tify sectors where pool chemical incidents
occurred. Hereafter, NAICS industry codes
will be referred to as sectors.
Results
Summary of Incidents
A total of 71,747 HSEES incidents occurred
during 2001–2009. Pool chemical incidents
were a small percentage of all HSEES incidents
(400, 0.6%) but were a six-fold higher percent-
age (240, 3.6%) of the 6,642 HSEES incidents
with injured persons. Pool chemical incidents
had a higher percentage of evacuations than
all HSEES incidents (21.0% vs. 6.7%, respec-
tively) (Table 1). Pool chemical incidents also
had a higher percentage of incidents with
injuries than all HSEES incidents (60.0% vs.
9.3%, respectively). Of the 428 pool chemicals
released in the 400 incidents, 61% were chlo-
rine or chlorine-based disinfectants (calcium,
sodium, or lithium hypochlorite; dichloro- or
trichloroisocyanuric acid) (Figure 1).
Most pool chemical incidents occurred
during the warmer months, May–September
(70%), with the most in July (
n
= 93). Pool
chemical incidents most frequently occurred
at private residences (38.8%) (Table 2). Inci-
dents occurring, however, in the public arts,
entertainment, and recreation sectors injured
the most persons (34.3%), followed by the
accommodations sector (hotels) (23.6%). Both
sectors are places that typically have a public
pool or other aquatic venue. Other sectors
where chemical incidents occurred and aquatic
venues were likely to be were educational ser-
vices (schools); real estate, rental, and leasing
(apartment complexes); and health care and
social assistance (i.e., retirement homes and
hospitals). Sectors
least likely to have aquatic
venues included waste management and reme-
diation services (disposal); utilities; construc-
tion; wholesale trade; transportation and ware-
housing; and administration of housing, urban
planning, and community development.
The most commonly reported contributing
factors to acute pool chemical incidents were
human error (71.9%) and equipment failure
(22.8%). The remaining primary contribut-
ing factors were intentional or illegal action
(4.7%) and bad weather (0.5%). A more
detailed secondary contributing factor was
reported for 221 (55.3%) incidents. The most
frequent secondary contributing factors were
improper mixing (39.8%); improper filling,
loading, or packing (12.2%); fire (10%); ille-
gal or improper dumping (6.8%); and over-
spray or misapplication (5.9%). Secondary
factors for the remaining 25.3% of incidents
included equipment failure; improperly per-
forming maintenance; system process upset;
improper system start-up or shutdown;
power failure or electrical problems; illegal
or intentional acts; vehicle or vessel collision;
vehicle or vessel derailment/rollover/capsiz-
ing, explosion, load shift; or other.
Injured Persons
During 2001–2009, 732 persons were injured
in pool chemical incidents. The one reported
Summary of Pool Chemical Incidents Compared With All Hazardous
Substances Emergency Events Surveillance Incidents, 2001–2009
Category
Pool Chemical Incidents
All Incidents
Events
400
71,747
Evacuations ordered
84 (21.0%)
4,796 (6.7%)
Total people evacuated
a
4,867
378,966
Events with injured persons
240 (60.0%)
6,642 (9.3%)
Injured persons
732
18,468
Events with shelter in place order
10 (2.5%)
680 (0.9%)
a
Number indicates the number of known evacuees. When large areas were evacuated, not all the evacuees could be
counted, so the number for evacuees is an underestimate.
TABLE
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