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Hospital, health, and community burden after oil refinery fires, Richmond, California 2007 and 2012

INTRODUCTION: Emergency Departments experience a significant census burst after disasters. The aim of this study is to describe patient presentations at Emergency Departments in Contra Costa County, California following chemical release incidents at an oil refinery in 2007 and 2012. Specific areas o...

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Autores principales: Remy, Linda L., Clay, Ted, Byers, Vera, Rosenfeld, Paul E.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6524223/
https://www.ncbi.nlm.nih.gov/pubmed/31096983
http://dx.doi.org/10.1186/s12940-019-0484-4
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author Remy, Linda L.
Clay, Ted
Byers, Vera
Rosenfeld, Paul E.
author_facet Remy, Linda L.
Clay, Ted
Byers, Vera
Rosenfeld, Paul E.
author_sort Remy, Linda L.
collection PubMed
description INTRODUCTION: Emergency Departments experience a significant census burst after disasters. The aim of this study is to describe patient presentations at Emergency Departments in Contra Costa County, California following chemical release incidents at an oil refinery in 2007 and 2012. Specific areas of focus include hospital and community burden with an emphasis on disease classes. METHODS: Searching 4 weeks before through 4 weeks after each event, Emergency Department abstracts identified patients living in Contra Costa County and seeking care there or in neighboring Alameda County. City and ZIP-code of residence established proximity to the refinery. This provided the following contrast groups: Event (2007, 2012), time (before, after), location (bayside, rest of county), and within bayside, warned or not warned to shelter in place. Using the Multi-Level Clinical Classification Software, we classified primary health groups recorded 4 weeks before and after the events, then summarized the data, calculated rates, and made tables, graphs, and maps to highlight findings. RESULTS: Number of visits meeting selection criteria totalled 105020 records. Visits increased modestly but statistically significantly after the 2007 incident. After the 2012 incident, two Emergency Departments took the brunt of the surge. Censuses increased from less than 600 a week each to respectively 5719 and 3072 the first week, with the greatest number 2 days post-event. It took 4 weeks for censuses to return to normal. The most common diagnosis groups that spiked were nervous/sensory, respiratory, circulatory, and injury. Bayside communities had statistically significant increases in residents seeking care. Specifically, visits of residents in warned communities nearest the refinery increased by a factor of 3.7 while visits of residents in other nearby un-warned communities increased by a factor of 1.5. CONCLUSIONS: The 2012 Emergency Department census peaked in the first week and did not return to normal for 4 weeks. Diagnoses changed to reflect conditions associated with reactions to chemical exposures. Surrounding communities and nearby hospitals experienced significant emergent burdens. In addition to changes from such events in patient diagnoses and community burden, the discussion highlights the long-term implications of failures to require adequate monitoring and warning systems and failures of health planning. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12940-019-0484-4) contains supplementary material, which is available to authorized users.
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spelling pubmed-65242232019-05-24 Hospital, health, and community burden after oil refinery fires, Richmond, California 2007 and 2012 Remy, Linda L. Clay, Ted Byers, Vera Rosenfeld, Paul E. Environ Health Research INTRODUCTION: Emergency Departments experience a significant census burst after disasters. The aim of this study is to describe patient presentations at Emergency Departments in Contra Costa County, California following chemical release incidents at an oil refinery in 2007 and 2012. Specific areas of focus include hospital and community burden with an emphasis on disease classes. METHODS: Searching 4 weeks before through 4 weeks after each event, Emergency Department abstracts identified patients living in Contra Costa County and seeking care there or in neighboring Alameda County. City and ZIP-code of residence established proximity to the refinery. This provided the following contrast groups: Event (2007, 2012), time (before, after), location (bayside, rest of county), and within bayside, warned or not warned to shelter in place. Using the Multi-Level Clinical Classification Software, we classified primary health groups recorded 4 weeks before and after the events, then summarized the data, calculated rates, and made tables, graphs, and maps to highlight findings. RESULTS: Number of visits meeting selection criteria totalled 105020 records. Visits increased modestly but statistically significantly after the 2007 incident. After the 2012 incident, two Emergency Departments took the brunt of the surge. Censuses increased from less than 600 a week each to respectively 5719 and 3072 the first week, with the greatest number 2 days post-event. It took 4 weeks for censuses to return to normal. The most common diagnosis groups that spiked were nervous/sensory, respiratory, circulatory, and injury. Bayside communities had statistically significant increases in residents seeking care. Specifically, visits of residents in warned communities nearest the refinery increased by a factor of 3.7 while visits of residents in other nearby un-warned communities increased by a factor of 1.5. CONCLUSIONS: The 2012 Emergency Department census peaked in the first week and did not return to normal for 4 weeks. Diagnoses changed to reflect conditions associated with reactions to chemical exposures. Surrounding communities and nearby hospitals experienced significant emergent burdens. In addition to changes from such events in patient diagnoses and community burden, the discussion highlights the long-term implications of failures to require adequate monitoring and warning systems and failures of health planning. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12940-019-0484-4) contains supplementary material, which is available to authorized users. BioMed Central 2019-05-16 /pmc/articles/PMC6524223/ /pubmed/31096983 http://dx.doi.org/10.1186/s12940-019-0484-4 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Remy, Linda L.
Clay, Ted
Byers, Vera
Rosenfeld, Paul E.
Hospital, health, and community burden after oil refinery fires, Richmond, California 2007 and 2012
title Hospital, health, and community burden after oil refinery fires, Richmond, California 2007 and 2012
title_full Hospital, health, and community burden after oil refinery fires, Richmond, California 2007 and 2012
title_fullStr Hospital, health, and community burden after oil refinery fires, Richmond, California 2007 and 2012
title_full_unstemmed Hospital, health, and community burden after oil refinery fires, Richmond, California 2007 and 2012
title_short Hospital, health, and community burden after oil refinery fires, Richmond, California 2007 and 2012
title_sort hospital, health, and community burden after oil refinery fires, richmond, california 2007 and 2012
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6524223/
https://www.ncbi.nlm.nih.gov/pubmed/31096983
http://dx.doi.org/10.1186/s12940-019-0484-4
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