NEHA March 2023 Journal of Environmental Health

ADVANCEMENT OF THE SCIENCE

Assessment of Chemical Exposures Investigation After Fire at an Industrial Chemical Facility in Winnebago County, Illinois

Jasmine Y. Nakayama, PhD Krishna Surasi, MD

found for other analytes monitored, includ- ing volatile organic compounds, carbon monoxide, oxygen, and hydrogen sulfide (Illinois Environmental Protection Agency, 2022; U.S. EPA, n.d.). Because additional chemical exposures, such as exposures to heavy metals, were unknown, public health authorities considered how to determine the health ešects of the chemicals released from the fire in nearby communities and among first responders, who could have had dišerent exposure experiences than the general population. After a chemical exposure incident, ATSDR evaluates the need to conduct an Assessment of Chemical Exposures (ACE) investigation, which is an epidemiological assessment that can provide information to assess the health ešects of the incident on individuals and communities, direct the public health response, focus outreach to prevent similar incidents, assess the need for modification of emergency response pro- cedures, and identify groups of people who might need long-term follow-up (Agency Epidemic Intelligence Service, Centers for Disease Control and Prevention Lance R. Owen, PhD Office of Innovation and Analytics, Agency for Toxic Substances and Disease Registry Mark Johnson, PhD Office of Community Health Hazard Assessment, Agency for Toxic Substances and Disease Registry Sandra Martell, DNP Abigail Kittler Peter Lopatin, MBA Winnebago County Health Department Sarah Patrick, PhD Illinois Department of Public Health Caitlin Mertzlufft, PhD Office of Community Health Hazard Assessment, Agency for Toxic Substances and Disease Registry D. Kevin Horton, DrPH Maureen Orr, MS Office of Innovation and Analytics, Agency for Toxic Substances and Disease Registry

b:;r(*; After a chemical fire, an investigation assessed health e ects by using syndromic surveillance to monitor emergency department (ED) visits, a general health survey to assess the general public, and a first responders health survey to assess first responders. A total of four separate multivariable logistic regression models were developed to examine associations between reported exposure to smoke, dust, debris, or odor with any reported symptom in the general public. Syndromic surveillance identified areas with increased ED visits. Among general health survey respondents, 45.1% (911 out of 2,020) reported at least one symptom. Respondents reporting exposure to smoke, dust, debris, or odor had 4.5 (95% confidence interval (CI) [3.7, 5.5]), 4.6 (95% CI [3.6, 5.8]), 2.0 (95% CI [1.7, 2.5]), or 5.8 (95% CI [4.7, 7.3]) times the odds of reporting any symptom compared with respondents not reporting exposure to smoke, dust, debris, or odor, respectively. First responders commonly reported contact with material and being within 1 mi of the fire ≥5 hr; 10 out of 31 of first responders reported at least one symptom. There was high symptom burden reported after the fire. Results from our investigation might assist the directing of public health resources to e ectively address immediate community needs and prepare for future incidents.

Introduction On the morning of June 14, 2021, a fire ignited and spread rapidly through an industrial chemical facility owned by the largest industrial grease manufacturer in the U.S. and located on the Beloit Corporation Superfund site (U.S. Environmental Pro- tection Agency [U.S. EPA], 2022a) in Win- nebago County, Illinois (2020 population: 285,350; U.S. Census Bureau, n.d.). The fire created a dark plume of smoke visible by sat- ellite imagery; required specialized firefight- ing services; and released smoke, dust, and debris for 4 days. Local authorities issued a 1-mi evacuation order and a 3-mi masking

advisory during this time to assist mitigation of potential negative health outcomes in the nearby communities. The available air sampling data from the U.S. Environmental Protection Agency demonstrated several 2.5 micron (PM 2.5 ) and 10 micron (PM 10 ) measurements above the World Health Organization pub- lic health screening levels (World Health Organization and Environmental Health Team, 2006); the Illinois Department of Public Health and the Agency for Toxic Substances and Disease Registry (ATSDR) determined that no measurements above the public health screening levels were

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