IV. ACTION RECOMMENDATIONS 776
777
RECOMMENDATION #1: The federal government should establish an office or program whose 778
goal would be to serve as a coordinating agency, unifying and integrating the efforts of federal, 779
state, local, and tribal government agencies with responsibilities related to preventing, preparing 780
for, responding to, recovering from, and mitigating chemical emergencies, and serving as a central 781
program charged with creating consistency and avoiding redundancy of information on chemical 782
emergencies on the national, state, local, and tribal levels. 783
784
Establishing an Office of the Chemical Emergencies Coordinator could accomplish a variety of goals. 785
First, this office would exist to integrate the often disparate data developed by federal agencies before, 786
during, and after a chemical emergency, and proactively disseminate it to planners, responders, and where 787
appropriate, the general public via a National Clearinghouse for Chemical Emergencies. Secondly, the 788
work group envisions this office as having a role in community outreach and volunteer training on 789
personal and community responsibilities and roles in chemical emergency prevention, preparedness and 790
response. 791
792
Ideally, this office would establish a National Clearinghouse for Chemical Emergencies. In part, the 793
Office should collect, develop and disseminate toxicological informational tools. The Office would be 794
charged with receiving reports of chemical emergencies and guiding timely response through referrals to 795
agencies of jurisdiction (for instance through public health, first response, first receiver and poison center 796
channels). In addition, this office would be responsible for ensuring that responders at all levels have 797
access to real-time information on regional resources and response capabilities. 798
799
The recommended Clearinghouse could emulate the national Poison Control System, already partially 800
funded by the Health Resources and Services Administration (HRSA). Advantages of using the existing 801
hotline structure for access include: 802
803
• Immediate access to medical toxicologists 804
• Availability of specialists in poison information trained to collect exposure data 805
• Real-time response and staff trained in risk communications with professionals/public 806
• Alignment with academic resources 807
• Public and professional familiarity with the existing phone number and service 808
• Economies of scale 809
• Robust regional knowledge of response partners and public health agencies 810
811
A structure utilizing one or more regional poison control centers might form the backbone of the 812
emergency reporting and response system under this Office. The availability of clinical toxicologists and 813
other specialists may yield high quality interpretation of exposure data (often incomplete in the literature, 814
or requiring collection from several esoteric sources), provide real-time treatment recommendations for 815
first responders and first receivers, and direct access to the system for the public and other professionals. 816
Poison control center personnel routinely capture, record and report emergency events, exercises and 817
drills, and engage in related public health notifications and risk communications for the public. 818
Mechanisms for raising awareness of services already exist, and modest enhancement in function and 819
dedicated funding of one or more poison control centers to adopt this important function would shorten 820
turn-around time for the creation of this Office and to endow it with functionality. Re-branding of poison 821
control centers should be advertised to the public, chemical industry and professionals. Moreover, contact 822
data for the Office and for the Poison Control system (1-800-222-1222) should be included on all MSDS 823
sheets and similar chemical datasheets. In addition, web searches of terms such as "chemical emergency," 824
should yield this site among the first listed. The website should be easy to navigate to find the needed 825
information and, if additional assistance is needed, there should be the option to chat with a live operator. 826
827
Because there are many potential actors involved with preventing, preparing for, responding to, 828
recovering from, and mitigating chemical emergencies, with varying skills, education and training, it will 829
be difficult to develop such a clearinghouse without a unifying body. Thus this recommendation focuses 830
first on the establishment of an Office of the Chemical Emergencies Coordinator whose goal would be to 831
coordinate and integrate the efforts of all relevant federal government agencies. 832
833
In addition, there are multiple local, state, tribal, and federal agencies and NGOs at all levels, who have 834
the resources and expertise to assist communities and industries during a chemical release. Another goal 835
of this Office would be to establish outreach and volunteer training programs to promote and support 836
individual and community preparedness (e.g., public education, training sessions, demonstrations), 837
including preparedness of those with functional needs. This would allow agencies and NGOs at all levels 838
to have a centralized location to report efforts so that duplication is avoided and stakeholders can follow 839
the process. A comprehensive, easily accessible website should also be established for this service, with 840
an eye toward providing ongoing education with regard to chemical release and its prevention. 841
842
The Department of Health and Human Services, in coordination with the Department of Homeland 843
Security, the National Response Center, and other appropriate agencies should be considered as key 844
resources during the establishment of this office. The Office may draw upon other resources such as 845
medical toxicologists, clinical toxicologists, or basic science toxicologists (available through 846
organizations such as the American College of Medical Toxicologists, American Academy of Clinical 847
Toxicology, American Association of Poison Control Centers, the Society of Toxicology and other 848
organizations), the chemical industry, industrial hygienists, academia, ATSDR, OSHA, NIOSH, EPA and 849
others. 850
851
Although establishment of the Office of the Chemical Emergencies Coordinator could be led by DHHS, it 852
might be more effective if it is established as an independent entity, and not under the ownership or 853
control of any one agency. In addition, the Office of the Chemical Emergencies Coordinator should work 854
free from political persuasion, with major funding coming from a pool of contributions by all relevant 855
federal agencies or funding triggered by a federal emergency declaration. 856
