The immediate need with a toxic gas release is to avoid or limit exposure, either by sheltering-in-place or evacuation. However, either choice could result in an exposure. A house may not be airtight, especially over time. Evacuation may likewise cause exposure, and cars usually are not airtight. If the gas hasn’t reached you yet, it’s usually best to evacuate. If the gas has already arrived and is expected to move through quickly, it might be best to shelter in place. But if the gas lingers, or is followed by more releases, evacuation is usually best, even with the risk of outside exposure. Of course, the more deadly the gas, the greater the risk from any exposure.
Following removal from a chlorine gas exposure, the next need is decontamination, including showering, eye rinsing, and removal of clothes and any contact lenses. Otherwise, contamination on skin and clothes continues the exposure. In mass exposures, a designated evacuation shelter or hospital emergency room should provide showers, ideally set up in a controlled environment to prevent secondary exposure to others. Upon your return home later, your house and property may also require decontamination, or you could be re-exposed.
Acute health effects from gas exposure will depend upon the chemical involved and the dose received. The dose will depend on factors such as the concentration of the chemical (parts per million, ppm), the duration of the exposure, your physical activity during the exposure (such as running), and the health and medical history of the person exposed. Generally, the exact dose will be unknown because of the lack of real-time monitoring during the initial exposure. Everyone in a mass exposure can be affected differently, across a spectrum. Emergency medical care may be required.
The site must be controlled to stop any risk of more chemical releases, and residential homes and property must be tested to determine safety for returning. Decontamination and remediation of homes may be necessary before residents return.
In Superfund responses, which involve large quantities of chemicals and usually involve public right-of-way transportation routes and waterways, the EPA or Coast Guard will respond and the responsible party, such as a railroad, will be required to pay for cleanup costs and testing. The railroad will likely pay for housing, food, and immediate medical care during evacuations—they should—but be aware that they may try to deduct those costs later in settling claims. But if the company is responsible for the costs, such aid to victims is not largesse or a loan. Railroads have layers of insurance, so these upfront costs must be paid out to get to the next tier of coverage. This apparent ‘goodwill’ also buys the company good public relations.
Evacuee meetings are crucial for residents, as they provide key information and updates. They should be public meetings sponsored by Incident Command, not the railroad, though the railroad may pay for associated costs. Residents should expect the right to ask questions freely and get honest answers. They should expect interaction with the EPA and other government responding agencies at these meetings. This is a time for residents to speak to officials, as well as environmental, medical and toxicological experts—not claims agents substituting for officials. Residents should expect to be fully informed about efforts to test the site and outlying areas for safety from contamination. Under Right-to-Know laws, residents have the right to know all about the chemicals involved and their potential health effects, acute and chronic.
Residents may want to organize into a spill victims’ group to ensure that all their rights and interests are being addressed. They may seek out expert chemical and medical advice if they feel such issues aren’t being addressed in the response and meetings. They may seek out legal advice, and should not feel stigmatized for it. Such a victims’ group may endure after residents return home.
Ideally, government agencies should provide expert medical help in the form of screenings, referrals, or a clinic, so people are properly diagnosed and a medical baseline is created that can be used to track health into the future. If this help is not provided, residents are usually on their own to get such medical help, though perhaps with the help of lawyers, they will receive certain testing.
If property testing suggests that a home or area is deemed ‘safe,’ it’s important to note that a ‘safe level’ is not the same as 100% contamination free. Residual levels that are ‘safe’ are usually based on OSHA determinations for an 8-hour work day for healthy adult workers, which excludes the young, the old, people with certain illnesses, and people unable to work in a given occupation that involves a given chemical. In other words, these workers are an ideal subset of people. Furthermore, if you have been exposed and are returning to an environment with ‘safe levels,’ you may aggravate any acute illness if you have become acutely sensitized due to your exposure. With chlorine, you may find yourself having health symptoms related to bleach, chlorinated water, and swimming pools, things that previously did not affect you. In sum, returning to an area with ‘safe levels’ of some contaminant, following an acute exposure, may trigger various symptoms, including serious respiratory problems. Acute sensitivity symptoms may include respiratory, skin, and eye problems, fatigue, headache or migraines, and others.
Acute sensitivity may become chronic, or multiple chemical sensitivity, in which you become sensitive to various common chemicals in modern society, such as soaps, pesticides, etc. This means that regardless of residual contamination in your home from the original exposure, you may have symptoms now triggered in your daily life from various new exposures. This sensitivity is difficult to treat. Avoidance is the main approach, and may involve a major change in lifestyle.
Do not be pressured into settling claims quickly. The responsible party, acting through insurance claim agents, is mainly concerned with limiting costs, and will try and settle you for a relatively small sum while requiring you to sign off on any future claims. You should be aware of any potential chronic medical problems before settling a claim. These medical problems could be long-lasting, if not permanent, and therefore costly. Medical problems could also impact your livelihood and financial security. Claims agents may threaten to not settle if you talk to a lawyer, and you may be forced to file a lawsuit. Lawsuits can possibly take years to settle or go to trial. Any lawsuit will be adversarial, so it is important to have good documentation of your health before and after any exposure.
If the CDC/ATSDR proposes health studies, bear in mind any study results could take up to years to be released, so the information will not be quickly available and of use medically or in litigation. Despite any perceived mandates, ATSDR will NOT provide medical care, though they may test and make referrals. If they do propose a study, it’s important that the eligible participants of the exposed community demand to give input for the protocol. ATSDR has been accused of doing inconclusive studies by design, which leaves vague any results and connections to the exposure. In other words, ATSDR has been accused of being a tool of the chemical companies to NOT prove conclusive cause and effect. That said, a well-designed study of a population involved in a toxic exposure could provide valuable data that could help you and future spill victims.
