Challenges to health care facilities
A study published in the January, 2009 issue of the American Journal of Emergency Medicine illuminates the challenges a large-scale chlorine gas release poses to hospitals and other health care facilities. The study was conducted by a team from the Centers for Disease Control and Prevention (CDC) and the South Carolina Department of Health and Environmental Control (DHEC), led by David Van Sickle, Ph.D. According to Van Sickle, hospitals need to be able to quickly recognize the signs of chlorine exposure, and to develop a plan to provide a sufficient number of mechanical ventilators in the event of another massive chlorine disaster.

At 2 a.m. on January 6, 2005, a freight train carrying three tanker cars loaded with chlorine collided with a parked locomotive in the center of Graniteville, S.C., population 7,000. The crash ruptured one of the tankers, releasing between 42 and 60 tons of chlorine gas that infiltrated the nearby Avondale Mills textile plant, where 180 people were working the overnight shift.

Chlorine is one of the most widely-used chemicals, effective in water treatment and industrial manufacturing. A toxic gas, it is an irritating, fast-acting and potentially deadly inhalant. Much of the 13 million to 14 million tons produced in the United States each year is transported by rail, often through densely populated areas.

Opportunity to learn from disaster The South Carolina disaster was one of the largest community exposures to chlorine ever, providing CDC and South Carolina health officials with the opportunity to learn as much as possible about the health effects from this widespread chlorine gas exposure, and to better prepare for the next emergency. "We also wanted to understand how physicians treated the patients, how quickly they recovered, and what resources hospitals would need to respond effectively in the future," Van Sickle said.

Eight people died at the scene that night, and at least 525 people were treated in emergency rooms. According to the report, many hospitalized patients showed evidence of severe lung damage. More than a third were admitted to intensive care, and 10 percent required mechanical ventilation. Despite the severity of their injuries, most people recovered quickly and were discharged within a week. However, the Bureau of Disease Control at the South Carolina DHEC continue to monitor the long-term health effects.

Chemical of Concern
The U.S. Department of Homeland Security has declared chlorine to be a Chemical of Concern. According to their estimates, as many as 100,000 people would be hospitalized and 10,000 would die if terrorists deliberately attacked a chlorine storage tank in an urban area.