Assessment of chemical exposures: epidemiologic investigations after large-scale chemical releases.

W hen a large-scale chemical incident occurs and large numbers of people are seeking care for chemical exposure at local hospitals, personnel at local or state health departments can be overwhelmed and unsure of how to best proceed. The Assessment of Chemical Exposures (ACE) program at the Agency for Toxic Substances and Disease Registry (ATSDR) is available to help public health agencies responding to acute chemical releases. For over 20 years, ATSDR has partnered with state health departments to perform surveillance for acute chemical releases. From 1990 to 2009, this program was known as the Hazardous Substance Emergency Events Surveillance. Participating state health departments collected detailed data on acute chemical releases and entered them into the surveillance database. Data were used by the state partners for alerting local health departments and other interested parties, situational awareness , supporting policy, and targeting prevention outreach activities. In 2010, the Hazardous Substance Emergency Events Surveillance program was expanded to be a more comprehensive approach to acute chemical release surveillance and became the National Toxic Substance Incidents Program (NTSIP; Agency for Toxic Substances and Disease Registry [ATSDR], 2014a). The state-based surveillance continued with the addition of national surveillance and large incident investigations. The national surveillance component uses the Department of Transportation (DOT) Hazmat Intelligence Portal to combine chemical release data, including data from the DOT Hazardous Materials Information System, National Response E d i t o r 's N o t e : As part of our continuing effort to highlight innovative approaches to improving the health and environment of communities, the Journal is pleased to publish a bimonthly column from the Agency for Toxic Substances and Disease Registry (ATSDR). ATSDR, based in Atlanta, Georgia, is a federal public health agency of the U.S. Department of Health and Human Services and shares a common offi ce of the Director with the National Center for Environmental Health at the Centers for Disease Control and Prevention (CDC). ATSDR serves the public by using the best science, taking responsive public health actions, and providing trusted health information to prevent harmful exposures and diseases related to toxic substances. The purpose of this column is to inform readers of ATSDR's activities and initiatives to better understand the relationship between exposure to hazardous substances in the environment and their impact on human health and how to protect public health. We believe that the column will provide a valuable resource to …