Abstract
The medical management of major toxic releases involving the exposure of large numbers of people is often poorly handled, whether the route of exposure is by air, food or water (1). Toxic releases usually arise from industrial activity but natural sources, such as volcanoes, may pose similar problems. A common fault of the emergency response is the delay, for a variety of reasons, in the identification of the agent or agents involved and in evaluating the health risk posed (1). The task of health risk assessment needs to be urgently performed in a major toxic incident, but it requires a multidisciplinary approach that may be difficult to launch in an emergency or disaster. In this chapter I shall describe some of the uses and limitations of the major disciplines that need to be involved, beginning with a classical toxic disaster in the workplace as a starting point for the study of toxic releases in the community.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Baxter, PJ, in press: Review of major chemical incidents and their medical management. Proc. Roy. Soc. Med.
Magos L, 1988: Thoughts on life with untested and adequately tested chemicals. Br. J. Ind. Med., 45: 721–726.
Royal Society of Medicine, 1976: Vinyl chloride. Meeting of the Section of Occupational Medicine. Proceeding of the Royal Society of Medicine, 69: 275–310.
Baxter PJ, Anthony PP, MacSween RNM, Schever PJ, 1977: Angiosarcoma of the liver in Great Britain, 1963–73. Br. Med. J., 2:913–974.
Baxter PJ, Anthony PP, MacSween RNM, Schever PJ, 1980: Angiosarcoma of the liver: incidence and aetiology in Great Britain. Br. J. Ind. Med., 37:213–221.
Fox AJ, Collier PF, 1977: Mortality experience of workers exposed to vinyl chloride monomer in the manufacture of polyvinyl chloride in Great Britain. Br. J. Ind. Med., 34:1–10.
Falk H, Baxter PJ, 1981: Hepatic angiosarcoma registries: implications for rare-tumor studies. Banbury Report 9: Quantification of Occupational Cancer, Coldspring Harbour Laboratory.
Buist AS, Bernstein RS (eds), 1986: Health effects of volcanoes: an approach to evaluating the health effects of an environmental hazard. Am. J. Public Health, 76 (suppl.): 1–90.
Merchant JA, 1986: Preparing for disaster. Am. J. Pub. Health, 76:233–235.
Baxter PJ, Kapila M, Mfonfu D, 1989: Lake Nyos disaster, Cameroon, 1986: the medical effects of large scale emission of carbon dioxide? Br. Med. J., 298: 1437–1441.
World Health Organization, 1984: Toxic Oil Syndrome. Copenhagen: WHO.
Tsubaki T, Irukayama K (eds), 1977: Minamata Disease. Elsevier Scientific Publishing Co, Amsterdam.
Amin-Zaki L, Majeed MA, Clarkson TW, Greenwood MS, 1978: Methyl mercury poisoning in Iraqi children: clinical observations over two years. Br. Med. J., 1:613.616.
Cripps DJ, Peters HA, Gocmen A, Dogramici I, 1984: Porphyria Turcica due to hexachlorobenzene: a 20–30 year follow-up study on 204 patients. Br. J. Dermatol., 111:413–422.
Senanayake N, Jeyaratnam J, 1981: Toxic polyneuropathy due to gingli oil contaminated with tri-cresyl phosphate affecting adolescent girls in Sri Lanka. Lancet, 1:88–89.
Doeglas HMG, Hermans EH, Huisman J, 1961: The Margarine Disease. Arch. Dermatol., 83–837-843.
Kuratsune M, Yoshimura T, Matsuzaka J, Yamaguchi A, 1971: Yusho, a poisoning caused by rice oil contaminated with polychlorinated biphenyls. HSMHA Health Reports, 86:1083–1091.
Hay A, 1982: The chemical scythe. New York: Plenum Press.
Kopelman H, Schever PJ, Williams R, 1966: The liver lesion of the Epping Jaundice. Quart. J. Med., 35: 553–564.
Eisele JW, O’Halloran RL, Reay DT, Lindholm GR, Lewman LV, Brady WJ, 1981: Deaths during the May 18, 1980, eruption of Mount St. Helens. New Eng. J. Med., 305:931–936.
Centers for Disease Control, 1988: Preliminary Report: 2,3,7,8,-tetra- chlorobenzo-p-dioxin. Exposure to humans - Seveso, Italy. MMWR, 37:733–736.
Halbert FL, Jackson TF, 1974: A toxic syndrome associated with the feeding of polybrominated bipheny1-contaminated protein concentrate to dairy cattle. J. Am. Vet. Med. Assoc., 165:437–439.
Brilliant LB, van Amburg G, Isbister J, et al, 1978: Breast milk monitoring to measure Michigan’s contamination with polybrominated biphenyls. Lancet, 2:643–646.
Drotman DP, Baxter PJ, Liddle JA, Brokopp CD, Skinner MD, 1983: Contamination of the food chain by poly-chlorinated biphenyls from a broken transformer. Am. J. Pub. Health, 73:290–292.
Kreiss K, Zack MM, Kimbrough RD, Needham LL, Smrek AL, Jones BT, 1981: Cross-sectional study of a community with exceptional exposure to DDT. J. Am. Med. Assoc., 245:1926–1930.
Anonymous editorial, 1989: Asthma and the bean. Lancet, 2:538–540.
Ashley DL, Needham LL, 1986: Assessments of a scheme for prioritizing inorganic toxicants by using signs-and-symptoms analysis. Clin. Toxicol., 24:375–387.
Varma DR, 1989: Hydrogen cyanide and Bhopal. Lancet, 2:567–568.
Patterson DG, Hoffman RE, Needham LL, et al, 1986: 2,3,7,8-tetra- chlorodibenzo-p-dioxin levels in adipose tissue of exposed and control persons in Missouri. JAMA, 256:2683–2686.
Singh MP, Ghosh S, 1987: Bhopal gas tragedy: model simulation of the dispersion scenario. J. Hazard. Mat., 17:1–22.
Health & Safety Executive, 1983: The fire and explosions at B & R Hauliers, Salford, 25 September 1982. London: HMSO.
Briskman L, 1987: Doctors and witch doctors: which doctors are which? Parts 1 & 2. Br. Med. J., 295:1033–1036; 1108–1110.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1990 Plenum Press, New York
About this chapter
Cite this chapter
Baxter, P.J. (1990). A Multidisciplinary Approach to the Medical Management of Man-Made and Natural Toxic Disasters. In: Duffy, J.C. (eds) Health and Medical Aspects of Disaster Preparedness. NATO, vol 14. Springer, Boston, MA. https://doi.org/10.1007/978-1-4613-0589-7_14
Download citation
DOI: https://doi.org/10.1007/978-1-4613-0589-7_14
Publisher Name: Springer, Boston, MA
Print ISBN: 978-1-4612-7880-1
Online ISBN: 978-1-4613-0589-7
eBook Packages: Springer Book Archive