The Health Protection Agency Chemical Hazards and Poisons Division: Awareness and Capabilities 22 nd November 2007 Dr Christopher Johnson Senior Environmental Scientist Chemical Hazards and Poisons Division (Cardiff)
Content The Health Protection Agency Structure, roles and responsibilities HPA in the news Chemical Hazards & Poisons Division Roles & Functions Chemical Compendiums Interactions with other agencies Incident classifications Multi-Agency Incident Command Structure STACs
The Health Protection Agency Who are we? Independent organisation dedicated to protecting people s health in the UK. 3000 staff. Provide impartial and authoritative information on health protection issues to the public, to professionals and government. Organisation combines public health and scientific expertise, research and emergency planning. Work at international, national and local levels having links with many other organisations worldwide. Able to respond quickly and effectively to new and existing national and global threats to health!
Role of the Health Protection Agency Established 1 April 2003 The role of HPA is an independent body that protects the health and well-being of the population. Protecting people from infectious diseases also protecting against hazards from chemicals, poisons or radiation occur. Preparing for new and emerging threats such as bio-terrorist attack or virulent new strain of disease.
The Health Protection Agency Act 2004 protect the community against infectious disease and other dangers to health; prevent the spread of infectious disease; assist others who exercise these functions specific radiation protection duties a Category 1 responder Civil Contingencies Act
The HPA Act - summary Statutory function to protect health Few powers to directly intervene, but Strong power to advise Strong power to expect others to co-operate
The Agency in Action Protecting People - Advise on health implications of a range of issues such as proposed landfill sites, effects of chemical incidents, land and water contamination. Preventing Harm - Recently taken over the National Chlamydia Screening Programme on behalf of Dept of Health. - Developing new vaccines and treatments. Preparing for threats - Deliver national emergency exercise programme on behalf of Dept of Health covering deliberate and accidental release and biological outbreaks. - Training packages for exercises and on-line training courses.
HPA in the News: Buncefield HPA part of the Health Gold Information Co-ordinating Centre feeding into Strategic Co-ordinating Group (Gold Command). Provided health advice including - Sheltering during initial stages of incident - Toxicology - Risk assessment - Health advice updates on web site - Surveillance of air monitoring and environmental sampling co-ordinated by HPA - Health surveillance and monitoring. - Health surveillance study published by HPA - Co-authors of initial review of air quality aspects of Buncefield Incident
HPA in the News: London Bombings Four suicide bombers struck in central London on Thursday 7 July 2005. Detonations on 3 underground trains and one bus at approximately 08.50am. 52 fatalities and more than 770 injured. HPA involved at all command and control levels Public health follow up to monitor long term health issues has been organised by the HPA. 158 people completed health questionnaires. Dedicated HPA team looking at this.
HPA in the News: Polonium 210 Incident Public health advice provided by the HPA HPA undertook comprehensive monitoring Po-210 contamination at many sites. Q&As published on HPA web site Large public health follow up investigation conducted by the HPA. - Urine samples of more 700 people taken - Over 700 people identified as not being a health concern - 17 people above 6mSv - increased risk in the long term is likely to be very small. HPA Investigation ongoing - final results to be published later in 2007.
HPA Structure HPA Board Chairman: Sir William Stewart Chief Executive Officer: Professor Pat Troop Centre for Emergency Preparedness & Response (CEPR) Centre for Infections (CfI) Local & Regional Services (LARS) Centre for Radiation, Chemical & Environmental Hazards (CRCEH) Radiological Protection Division (RPD) Chemical Hazards & Poisons Division (CHaPD) Corporate Services National Institute for Biological Standards & Control (2008)
CHaPD Divisional Structure Director Prof. Gary Coleman Deputy Director Deputy Director Dr Elaine Farmery Dr Elaine Farmery Divisional Support Research & Development Chilton (HQ) WHO Collaborating Centre Chemical Hazard & Incident Management Units National Poisons Information Service Belfast Birmingham Cardiff Edinburgh London Newcastle Toxicology Prof. Peter Blain Dr Robin Fielder Epidemiology Dr Mike Joffe Dr Giovanni Leonardi Environmental Health & Risk Management Dr Pat Saunders Transferred DoH Functions: Air Quality Pesticides Dr Robert Maynard Feances Pollitt Birmingham Andrew Kibble Cardiff Dr David Russell Peter Davies London Prof. Virginia Murray Nottingham Naima Bradley
CHaPD Strategic Goal to anticipate and prevent the adverse effects of acute and chronic exposure to hazardous chemicals and other poisons.
Functions of CHaPD CHaPD provides authoritative scientific and medical advice to the NHS and other bodies about the known health effects of chemicals, poisons and other environmental hazards. This advice covers issues such as: personal protective equipment (PPE) decontamination evacuation and shelter toxicological and epidemiological advice on impact on public health clinical advice on antidotes and medical treatment the public health impact of industrial sites health effects from chemicals in the environment
Functions of CHaPD Public health surveillance Advise on acute and chronic health effects Research & Development Management of acute chemical incidents Information and expert advice
Functions of CHaPD Provision of scientific and medical advice: environmental toxicology clinical toxicology environmental science environmental health / public health environmental risk assessment & management 24 hour 365/days a year National Hotline
Chemical Hazards and Poisons Division: Functions - Summary Advice to UK Government Departments and Agencies human health effects from chemicals in air, water, soil and waste. To act as a central source of authoritative scientific and medical advice on acute and chronic effects of chemical releases. To assist PCTs, LHBs on IPPC, air quality, water quality, contaminated land and waste disposal issues. To undertake and commission research needs.
Chemical Hazards and Poisons Division: Chemical Compendiums Aim - to produce an online information resource for the public and all the professionals who may be involved in advising and responding to chemical incidents. The Compendia of Chemical Hazards is split into three sections: The general information section gives a background to the chemical, including a 'frequently asked questions' section. The incident management section focuses on information that may be needed during chemical incidents, such as physicochemical properties, health effects and decontamination. The toxicological overview section provides more in-depth toxicology of the compound. http://www.hpa.org.uk/chemicals/compendium/default.htm
HPA & Other Agencies/Organisations The HPA interacts with a number of different agencies & organisations: UK Government & Devolved administrations First line responders NHS Environment Agency HSE Meteorological Office Local Authorities Environmental Consultants Maritime & Coastguard Agency Food Standards Agency National Chemical & Emergency Centre World Health Organisation Academic Institutes Environmental Health Professionals Other allied public health professionals Members of the public
Incident Notification (CHaPD) Incident Classification First Line Responders Emergency Operations Centre HPU s & Other HPA Centres Media Government & Devolved Administrations Local Authorities Environment Agency Met. Office HSE MCA Allied Public Health Professionals
Incident Classification Type A - Infectious Disease Events B - Chemical Incidents C - Naturally Occurring Emergencies & Accidents D - Radiological & Nuclear Incidents E - Incident in a Devolved Administration F - Overseas Incident with consequences to UK G - Terrorist or Security Incident Localised Meningitis Pandemic Influenza Spills/Discharges to the environment Local/major fires Flooding Heatwave Source found in public domain Nuclear installation accident Any of the above Examples Release of toxic chemicals Chernobyl scale accident Intelligence led identification of threat CBRN attack
HPA Incident Classification Level 5 4 3 2 1 Impact A catastrophic incident that has an overwhelming impact upon HPA. This will require an immediate response with national management. Civil Contingencies Committees (CCC) will sit. Multiple Strategic Coordinating Groups (SCGs) could sit. An incident that has a severe impact and causes major disruption to parts of the HPA. This will require a large number of HPA resources. CCC will sit and one or more SCGs and HATs. An incident that has significant impact on the resources of one or more parts of the agency. An SCG and HAT will sit and media interest is likely to be high. An incident that has a wider local effect but which can be managed within local or regional resources. Unlikely to involve an SCG but will involve significant interagency working. An incident with limited local impact for the HPA, though may require liaison with other responders. Expected Resource Commitment HPA National Command and Control set-up through NECC to manage incident. Response at all levels of the Agency will be required. Likely to be protracted or have a significant recovery component. Divisions without a specific focus in the response will be expected to provide support to other Divisions. HPA National Command and Control set-up through NECC to manage incident. One or more Divisional EOCs will be set-up to provide specialist support within the structure set by the NECC. Incident likely to involve more than one region. Will involve the resources from at least one HPA region with support from Specialist Divisions as needed: Would open EOCs as appropriate. CEO or Duty Director to decide on the need for NECC. EOC likely to open Incident response can be managed within the capacity and resources of two or more HPUs with support from specialist Divisions. Incident response can be managed within the capacity and resources of a single HPU with consultation and support from specialist Divisions.
CHaPD Incident Classification Level 5 4 3 2 1 0000 Example Deliberate or possible deliberate release of chemicals or explosive devices Large explosion/fire/release from a chemical industrial site. Mass casualties or exposure. Mass evacuation/shelter. Mass decontamination issues. Public health implications for many HPUs/LHBs. Incident could have cross border issues. Large fire at an industrial site, actual or potential high numbers of casualties/exposure. Actual or potential evacuation of local population. High profile media interest. Chemical road tanker accident, release to atmosphere and/or local watercourse, some exposure/casualties. Involvement of other agencies (e.g. EA, FSA) Small chemical release, contained locally by emergency services, no casualties, unlikely to be any public health implications Test page or exercise Alerting and Response As Level 4 As Level 3 with: CHaPD EOC opened in line with the HPA command and control through the NECC CEO or nominated representative notified CHaPD may attend HAT or Health gold as requested Other Divisions and Agencies notified As Level 2 with: CHaPD strategic pool would be notified CHaPD Emergency Operations Centre (EOC) would be opened if deemed necessary Strategic pool would notify CEO or nominated representative if necessary Group page issued Notify HPU(s) or NPHSW Notify CHaPD consultant pool CHaPD group page issued if appropriate Notify HPU or NPHSW, others as appropriate. CHaPD consultant pool may be notified if appropriate. Respond as requested by page
Integrated Health Protection Response Reid, Jarvis, Richardson and Stewart SITUATION ANALYSIS National and local considerations RISK MODEL Analysis of: Hazard Exposure Risk: assessment communication STAKEHOLDER POSITION Engagement with communities and partner agencies/sectors INTEGRATED HEALTH PROTECTION RESPONSE
Multi-Agency Major Incident Command Structure GOLD Strategic Coordinating Group (SCG) Multi-Agency Other Agencies Gold Police Gold Fire Service Gold Ambulance Gold Health Gold PCT Lead Major Incident coordination/command Health Protection SILVER On/Off Site Tactical Control SCENE OF INCIDENT Silver control(s) (Tactical) Individual agencies Off Site NHS Tactical e.g. Hospital, PCT Emergency Centre BRONZE OFF SITE Bronze other services ON SITE Bronze (Operational) Individual agencies MMT NHS OFF SITE BRONZE Operational/Clinical Response Hospital / Community / PCT S
FUNCTIONAL ACTIVITIES CHEMICAL HAZARDS AND POISONS DIVISION TOXICOLOGY,PUBLIC HEALTH, RISK ASSESMENT MULTI-AGENCY GOLD ACTIONS HGICC;HEALTH(MULTI-DISCIPLINARY) SILVER INTEGRATED ADVICE,DATA LOGISTICAL SUPPORT,REPORTS HGICC Health Gold Information and Co-ordination Centre
Scientific advice in emergencies 16 April 2007. New guidance from UK Cabinet Office. Co-ordinated scientific and technical advice during major incidents within the multi-agency Strategic Co-ordination Centre (SCC) is now provided through the Science and Technical Advice Cell (STAC). Will include wider scientific advice than the HAT previously did. HPA a permanent member It is envisaged that the STAC will provide advice during the recovery stage. Initial focus of the STAC will be the provision of public health advice to the GOLD commander particularly on wider health and environmental consequences. STAC will be activated either by Gold Commander or on the recommendation of senior public health professional.
Composition of Scientific and Technical Advice Cell Membership likely to include: - Cell Lead (controller) - Secretariat/Staff Officer support - Gold Liaison - HPA - Emergency service technical - EA advisors (eg HAZMAT Officer) - PCT and/or Strategic Health - FSA Authority Director of Public Health - HSE - LA (eg EHO) - GDS - MET Office - DEFRA - Others (eg UU)
Science and Technical Advice Cell The STAC brings together experts under the direction of the Strategic Co-ordinating Group. Role of the Cell is to: - Provide a common source of science and technical advice - To monitor and gather the responding science to deliver on highlevel objectives and immediate priorities - Agree any divergence from agreed arrangements - Pool available information and arrive as far as possible at a common view - Provide a common brief to the technical lead from each agency represented within the Cell, including how the situation may develop - Identify other agencies/individuals with specialist advice who should be invited to join the cell