This week’s MMWR includes a report on the experience of volunteer firefighters, police and other personnel who responded to a November 2012 train derailment in Paulsboro, NJ. The Contrail train twisted off a movable bridge and three tank cars containing vinyl chloride landed in Mantua Creek. About 20,000 gallons of vinyl chloride were released, resulting in a noxious vapor cloud.

Among those responding to the early morning incident were individuals with the Paulsboro Fire Department, and HAZMAT teams from the PBF Energy’s Paulsboro Refinery, Gloucester County, and Conrail. It wasn’t long before residents and responders complained of respiratory problems, headaches and other problems. Ultimately, more than 250 individuals visited local emergency rooms because of symptoms following the incident.

The MMWR article provides the results of a survey, conducted by the New Jersey Department of Health, the CDC’s National Institute for Occupational Safety and Health (NIOSH) and the Agency for Toxic Substances and Disease Registry, of 93 emergency responders to the Paulsboro incident. One topic of particular interest was identifying symptoms of acute exposure to vinyl chloride, which is already known as a human carcinogen. Their survey findings include:

• 48% of respondents reported spending >12 hours at the site, and only 22% reported using respiratory protection during their response activities
• 26% reported experiencing headaches, 26% reported experiencing upper respiratory symptoms, and 22% reported experiencing lower respiratory symptoms

Among the 72 respondents who reported they did not wear respiratory protection on initial arrival at the scene:

• 49% said they didn’t’ think it was required for their work
• 24% said none was available
• 17% said they were not advised to wear respiratory protection
• 17% said they did not think they needed it

What the MMWR piece doesn’t describe are the circumstances that might illuminate why better safety precautions were not taken. As Debra Coyle McFadden, assistant director of the New Jersey Work Environment Council told me:

“It is imperative that every step is taken to protect and train emergency responders. When the exposure levels are unknown, the leadership onsite should proceed to instruct emergency responders to protect themselves as if the level is above established occupational exposure limits until it is proven otherwise.”

In the Paulsboro incident, that didn’t happen. The National Transportation Safety Board’s (NTSB) investigation describes the troubling nature of the emergency response. For example:

• There was confusion about the contents of some of the railcars. About 25 minutes after the derailment, the fire chief radioed: “We are getting some information that a couple of these tanks have bad stuff, we just can’t get the placards.”

• The trainmaster reviewed the shipping manifest [a.k.a., train consist] with the deputy fire chief, but then the trainmaster departed with the document. It was the only available copy. “The trainmaster retained possession of the consist for almost 3.5 hours, leaving emergency responders with no means of referencing the document for response planning.”

• “The incident commander and other first responders remained within about 50 yards of an active vinyl chloride release. …About 6 hours into the incident, the fire chief had yet to relocate the ICP [incident command post] to a safe location and failed to establish PPE requirements for the accident scene.”

NTS Board Member Robert Sumwalt noted:

“This new location was only about 1/4 mile from the ruptured tank car—a distance that still posed unacceptable risk because the responders were not wearing protective clothing and equipment.”

The NTSB’s report goes on and on like this. (It makes me wonder what the situation would be like for emergency responders in my town should one of the dozens of trains motoring through it derailed.)

The NTS Board Members raise critical issues concerning our country’s hefty reliance on volunteer fire fighters. They are an integral part of local emergency response, but the NTSB asks some serious questions about the ability of volunteers to respond safely to event such as the Paulsboro incident. NTSB acting chairman Christopher Hart asked:

“How can volunteer firefighters obtain the training they need to do their jobs adequately without being required to have so much training that people who have full-time jobs will choose not to be a volunteer firefighter because the training requirements are more than they can reasonably handle?”

There was harsh criticism directed at individuals in charge of the emergency response. NTS Board Member Sumwalt said:

“…when disasters occur, the very men and women putting their lives on the line as first responders count on prudent, informed decision-making by their incident commanders. While the decision to not evacuate nearby Paulsboro residents can be somewhat explained by logistical concerns and uncertainty, what is indefensible are the decisions, actions, and inactions that placed first responders directly in harm’s way.”

Erring on the side of caution, as Debra Coyle McFadden suggests, would be a good first step toward protecting the health of our community’s emergency responders. The MMWR article’s authors recommend ongoing health monitoring of the emergency responders involved in the Paulsboro, NJ incident. The trouble is they note, there’s not a complete roster of individuals who participated in the emergency response.