NEHA March 2023 Journal of Environmental Health

rologic symptoms, 3 reported ophthalmic symptoms, and 5 reported cardiopulmonary symptoms (Table 4). Furthermore, 1 of the 10 symptomatic first responders sought care in an ED, urgent care, or outpatient clinic; 2 first responders self-treated; and the remain- ing 28 did not need healthcare. Discussion Nearly one half of the general health survey respondents reported a new or worsening symptom within the 2 weeks prior to survey completion. Moreover, reported contact with smoke, dust, or debris or report of smelling an odor was strongly associated with being symptomatic. This association suggests that the increase in reported symptoms could be related to reported exposure to the fire and its resulting material. Reported symptoms are consistent with previous reports of exposure to elevated PM 2.5 and PM 10 (An Han et al., 2020; Bazyar et al., 2019). While the long-term health e‹ects of this incident are unknown, other reports have identified adverse health outcomes reported many years after acute exposure to a chemical fire (Degher & Hard- ing, 2004; Granslo et al., 2017; Greven et al., 2009). Given the high level of reported symp- tom burden in this sample, support for the community’s access to appropriate healthcare resources and ongoing monitoring for changes in health, such as via syndromic surveillance, should be prioritized. Findings from this investigation can also inform leaders to prepare for future emer- gency responses. Industrial companies can consider discussions to prevent and miti- gate incidents with chemical exposures by having safety measures and emergency response resources to limit impact on the surrounding population and environment. Robust participation in Local Emergency Planning Committees can contribute to emergency response planning (U.S. EPA, 2022b). Careful attention to first respond- ers’ working conditions and PPE, especially during chemical exposures, is important in protecting the health of this group (Mel- nikova et al., 2018). More attention to gen- der, racial, and ethnic minority groups and residents from areas with higher social vul- nerability—who might be at higher risk for negative e‹ects from disasters—could con- tribute to a better understanding of if and how specific groups are disproportionately

TABLE 4

First Responders Reporting a New or Worsening Symptom Within the 2 Weeks Prior to Survey Completion, Winnebago County, Illinois, July 2021

Symptom

Symptom Category

First Responders Reporting ( N = 31) # (%)

Headache

Neurological Ophthalmic

4 (12.9)

Irritation, pain, or burning in eyes

3 (9.7) 3 (9.7) 2 (6.5) 2 (6.5) 2 (6.5) 2 (6.5) 1 (3.2) 1 (3.2) 1 (3.2) 1 (3.2) 1 (3.2) 1 (3.2) 1 (3.2) 1 (3.2)

Coughing

Cardiopulmonary

Hoarseness

ENT ENT ENT

Stuffy nose or sinus congestion

Increased congestion or phlegm (mucus)

Asthma

Cardiopulmonary

Runny nose

ENT ENT ENT ENT

Burning nose or throat

Odor on breath

Sensation in throat

Dizziness or lightheadedness

Neurological Ophthalmic

Blurred or double vision

Difficulty breathing or feeling out-of-breath

Cardiopulmonary Cardiopulmonary

Wheezing in chest

Note. Data include respondents of the first responders health survey and respondents of the general health survey who self-identified as first responders. Data exclude respondents of the general health survey who did not self-identify as first responders. Respondents were able to report more than one symptom. ENT = ears, nose, and throat.

egories involved was 2 (interquartile range: 1–3). Symptoms reported by ≥100 respon- dents are listed in Table 3. Among symptom- atic respondents, 106 (11.6%) used formal healthcare services and 347 (38.1%) self- treated. Four respondents who used formal healthcare services were hospitalized and the reported indications for admission were asthma ( n = 2), epistaxis ( n = 1), and one unknown indication. First Responders Health Survey Representing 14 di‹erent organizations, 31 first responders completed the surveys (10 from the general health survey and 21 from the first responders health survey). One first responder self-identified as female and the rest self-identified as male. Further, 28 first responders self-identified as White, 1 self- identified as Black or African American, 1 self-identified as Other for race, and 1 first responder was missing race data. Further- more, 2 first responders self-identified as His-

panic or Latino, 1 was missing ethnicity data, and the remaining self-identified as non-His- panic or Latino. Moreover, 19 first responders reported wearing standard fire protection gear (i.e., fire helmet, turnout pants and jacket, leather gloves, and boots); 3 first responders reported wearing a mask; and 7 first responders reported not wearing a mask, gloves, goggles, hazmat suit coveralls, or standard fire protec- tion gear. Further, 7 first responders reported spending ≤4 hr, 17 reported spending 5–23 hr, 5 reported spending ≥24 hr, and 2 were missing data on time spent within 1 mi of the facility. Only 2 first responders reported not contacting any material; 26, 19, 19, and 5 reported contact with smoke, dust, debris, and other material, respectively. And lastly, 26 first responders reported smelling an odor, 4 were unsure whether they smelled an odor, and 1 reported not smelling an odor. Of the 10 symptomatic first responders, 6 reported ENT symptoms, 4 reported neu-

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