State programs to reduce uncontrolled ammonia releases and associated injury using the hazardous substances emergency events surveillance system.

OBJECTIVE: To describe how the Hazardous Substances Emergency Events Surveillance (HSEES) program identifies leading causes of uncontrolled ammonia releases and targets activities aimed at reducing the frequency of these incidents. METHODS: Ammonia incidents reported to HSEES nationally were examined. HSEES programs in state health departments conducted and evaluated data-driven prevention outreach. RESULTS: The primary targeted ammonia incidents in the three HSEES states that are presented include food manufacturing, agriculture, and events related to the production of illicit methamphetamine. Key to these prevention activities was using state-specific HSEES data to identify problems and evaluate the prevention activity, and developing partnerships with other stakeholders. CONCLUSION: HSEES data is used to identify determinants of chemical incidents and their outcomes and to help guide strategies to reduce such occurrences. Surveillance of chemical incidents elucidates the causes and consequences of these events and helps identify problems and measure the effectiveness of prevention programs.

Hazardous ammonia releases: public health consequences and risk factors for evacuation and injury, United States, 1993-1998.

Unplanned releases of ammonia lead more often to evacuation and injury than releases of other chemicals, but few studies have systematically investigated ammonia releases. We analyzed Hazardous Substances Emergency Events Surveillance system data for 1993-1998. Evacuation of a total of at least 40,680 persons resulted from 537 ammonia releases, and 248 ammonia releases led to injury of 1434 persons. Equipment failure and operator error were cited as factors contributing to ammonia releases 90% of the time. Eighty-seven percent of releases occurred at fixed facilities. Risk factors for evacuation and injury differed between the food-manufacturing industry and other industries. Indoor release was a consistent risk factor, whereas quantity of ammonia released was not always a risk factor. Preventive maintenance and worker training may be effective tools to reduce the burdens of hazardous ammonia releases.