http://www.shipsan.eu/Home/EuropeanManual.aspx [24th October2018]

 

 

 

Chemical threats

Recovery of a chemical incident

Tom Gaulton, Charlotte Hague, Emma-Jane Goode, Eirian Thomas and Raquel Duarte-Davidson

Chemical incidents can occur rapidly and pose serious health hazards for members of the public. Once the immediate danger to the public is over, chemical incidents can continue to affect the local community and pose a risk to health as, in some cases, contamination can persist for years after the incident has taken place.

Immediately following a chemical incident, the next step in the response process is recovery of the affected area. Recovery is defined as the process of rebuilding, restoring and rehabilitating the community following an emergency.¹ The recovery phase should begin at the earliest opportunity following an emergency, often running in tandem with the emergency response. The recovery phase continues until the disruption has been rectified, demands on services have returned to normal and the needs of those affected (directly and indirectly) have been met.² It can be a quick, or time-consuming process depending on the nature of the chemical involved. For example, a release of a chemical gas would be resolved very quickly as the gas dissipates into the atmosphere, or could be a lengthy and complex process in the event of a release of persistent toxic chemicals to livestock or arable farmland.

PHE, in collaboration with other UK organisations, has produced a suite of guidance to remediate the environment in the event of a Biological, Chemical or Radiological incident. In addition, tools have been produced to complement this guidance such as interactive learning recovery tools and digital support learning aids. These manuals and tools are currently being reviewed in the UK, but are available for download from the following address: https://www.gov.uk/government/publications/uk-recovery-handbook-for-chemical-incidents-and-associated-publications

The response to a major chemical incident in the UK would involve numerous government departments and agencies, public services and other bodies. Each of these will have their own emergency plans, which cover the detail of their specific areas of responsibility. Expert advice on the chemical(s) will be needed from the outset. The response is likely to be complex, and decision making on recovery and remediation will need to take account of a variety of factors. The UK Recovery Handbook for Chemical Incidents (UKRHCI) is designed to aid the development of a recovery and remediation strategy for the environment in the post-incident (post-acute) phase, and to facilitate the selection of clean-up methods following a chemical incident. A recovery strategy is required to ensure adequate clean-up of the incident, that no further exposures to the chemical(s) are possible, and to prevent the chemical(s) from entering human exposure pathways (air, soil, food chain, drinking water etc.)

Due to the high number of individual, diverse chemicals in production (>100,000,000)³, developing a recovery strategy to each one would be extremely complex and time consuming, assuming it is possible. The UKRHCI uses the physical and chemical properties of a chemical (which can be shared by many different individual chemicals) to predict how it might behave in the environment, and design an appropriate remediation strategy based on this behaviour, and other influencing factors (e.g. cost, time etc.). This handbook provides guidance on how to manage the many facets of the impact of a chemical incident on the environment, and should therefore augment existing detailed emergency plans held by individual organisations. Sources of contamination considered in the handbook include industrial accidents and deliberate chemical dispersion devices.

Under the International Health Regulations, countries are required to keep international trade and disruption to a minimum, it is therefore imperative that after a chemical incident at a Point of Entry, a recovery strategy is in place to facilitate a return to normal as quickly as possible.

 

References

1. Strategic National Guidance: decontamination of CBRN substances. Available from: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/622617/SNG_5thEdition_Final_March_2017__1_.pdf (last accessed 17/04/19)

2. UK Recovery Handbook for Chemical Incidents (UKRHCI). Available from: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/201024/UKRHCI_publication_31st_May_2012_web2.pdf (last accessed 17/04/19)

3. Chemical Abstract Service (CAS): CAS Registry of chemical substances. Available from: https://www.cas.org/support/documentation/chemical-substances (last accessed 17/04/19)

 

 

Events

Past Events of the joint action

Webinar Series on Preparedness at Points of Entry

Three webinars were broadcasted live as part of the series during April-May 2019.Inspection Grading System for the shipping industry, 11^th April 2019Inspection Grading System for the shipping industry, 11^th April 2019

• Inspection Grading System for the shipping industry, 11th April 2019

The webinar aimed to give an overview of the inspection programme (EU SHIPSAN/HEALTHY GATEWAYS) and the inspection grading system methodology and presented at the same time the results of the pilot-testing. Moreover, it explained the publication of inspection grades process and provided detailed information about the grading methodology. Presenters of the webinar were Dr Barbara Mouchtouri, Leader of Work Package 7 “Maritime transport”, EU HEALTHY GATEWAYS Joint Action, from the Department of Hygiene and Epidemiology, Medical Faculty, University of Thessaly, Greece and Mr Jaret Ames, Senior Technical Expert, EU HEALTHY GATEWAYS Joint Action.Inspection Grading System for the Port Health Officers, 19^th April 2019

• Inspection Grading System for the Port Health Officers, 19th April 2019

The webinar aimed to give an overview of the inspection programme (EU SHIPSAN/HEALTHY GATEWAYS), to familiarise participants with the inspection scoring methodology and the grading system design, to explain the scoring and grading worksheets and how to better determine when to deduct points and to establish grades after completing inspections.  A total of 58 participants from 15 EU Members States registered to watch the live or recorded webinars out of which 32 watched the live. Presenters of the webinar were Dr Barbara Mouchtouri, Leader of Work Package 7 “Maritime transport”, EU HEALTHY GATEWAYS Joint Action, from the Department of Hygiene and Epidemiology, Medical Faculty, University of Thessaly, Greece and Mr Jaret Ames, Senior Technical Expert, EU HEALTHY GATEWAYS Joint Action.Preparing and responding to chemical events at Points of Entry: ports, 28^th May 2019

• Preparing and responding to chemical events at Points of Entry: ports, 28th May 2019

The webinar aimed to explain the requirements of International frameworks (IHR, EU Dec 2013/1082) relating to chemicals, to understand what is involved in the public health response to chemical events, the different sources of chemicals at port/on ships, the role of Competent Authorities in the identification, risk assessment and management of chemical incidents at port, and to help to be familiar with key stakeholders that may be involved in the investigation of a chemical incident at port. It covered following topics: IHR core capacities – Chemicals; Management of public health events at ports due to chemicals; Public health response; Risk assessment process; Modelling and mapping; and Case studies – Chemical incidents at ports. Presenters of the webinar were Dr Tom Gaulton, a Health Protection Scientist in the Chemical and Environmental Effects Department (CEED) at Pubic Health England (PHE), UK; Dr Charlotte Hague, Health Protection Scientist in the Chemical and Environmental Effects Department (CEED) at Pubic Health England (PHE), UK; Mr Matej Ivartnik, an expert associate at National Institute of Public Health Slovenia, and Dr Boris Kopilovic, head of Working Group for Infectious Diseases in Unit Koper, Centre for Communicable Diseases National Institute of Public Health, Slovenia.

A webinar was broadcasted live on 28^th of May 2019 as part of the EU HEALTHY GATEWAYS joint action webinar series on Preparedness at Points of Entry. A total of 86 participants from 15 EUMS and from 6 non-EU countries registered to watch the live or recorded webinar out of which 35 watched the live webinar. Participants were from international organisations (WHO), European agencies (DG SANTE), Ministries of Health, Port Health Authorities and the cruise industry.

The webinar was recorded and is available for play back viewing. Contact us if you are interested to receive access to the recorded webinar.

 

1^st General Assembly meeting

When: 13-14 June 2019  Where: Hamburg, Germany

The first General Assembly meeting took place from the 13th – 14th of June 2019 in Hamburg, Germany. It was held in parallel to the 15th International Symposium on Maritime Health (ISMH15).  A total of 73 participants attended the meeting, including: 34 participants from partners representing 14 European countries; 11 participants from collaborating stakeholders representing 10 European countries; 2 participants from Taiwan; 9 participants representing the transport industry (Cruise Lines International Association (CLIA) and cruise lines, the International Union of Railways (UIC) and Lufthansa German Airlines); 17 participants representing DG SANTE, CHAFEA, ECDC, EASA, EMSA, FRONTEX, WHO HQ, WHO EURO, ICAO/CAPSCA, US CDC and other joint actions, institutes and professional associations). Nearly all partners and most collaborating stakeholders were represented in the General Assembly meeting (participation rate: 82% and 71%, respectively). The General Assembly is the decision-making body of the Joint Action. The General Assembly consists of associated partners, collaborating stakeholders and work package leaders, as well as industry representatives who will be invited ad hoc to attend as observers at the specific sessions in the meeting, without voting rights.

 The objectives of the 1st General Assembly meeting were:

• to plan (long-term) and monitor the Joint Action activities
• to discuss sustainability issues of the Joint Action
• to decide about dissemination of the Joint Action deliverables
• to make strategic decisions for the long-term planning and sustainability issues of the Joint Action

Simulation exercise (SE). Haemorrhagic fever on board a cargo ship (Algeciras, Spain, May 7^th. 2019)

The Spanish Directorate of Public Health – Deputy Directorate of Foreign Health organized a Full-scale simulation exercise on May 7^th in the port of Algeciras related to a public health risk at maritime borders. Two HEALTHY GATEWAYS representatives participated as observers.

The aim of the exercise was to assess the capacity to respond to a public health emergency at Spanish points of entry in the framework of the IHR-2005. The main objective was to evaluate coordination between all the Organisms involved in the response, taking into account that all of them have their own protocols which must be properly integrated.

A great number of Organisms and Entities took part in the exercise. All of them played their own role and applied their own procedures:

1. Ministry of Health (Directorate General of Public Health, Deputy Directorate of Foreign Health, Health Alerts and Emergencies Coordinating Centre)
2. Spanish Navy
3. Algeciras Port Health Authority (Algeciras Foreign Health Unit)
4. Regional Health Authorities (Regional Public Health Authority, Medical assistance, Directorate General of Emergencies-112)
5. Algeciras Port Authority
6. Algeciras Maritime Administration – Rescue Control Tower
7. Radio-Medical Centre (located in Madrid)
8. Administration of Justice – Judge on duty – Institute of Legal Medicine – Coroners 
9. Police
10. Spanish Red Cross
11. Funeral company
12. DDD company
13. Waste management company
14. Ship agent at the port of Algeciras

The scenario proposed described the presence of one suspected case of Hemorrhagic Fever and a cadaver on a cargo ship. The exercise included communications between the ship and the authorities through the Radio Medical Centre, as well as between the different competent authorities. It also included all the actions taken by all the Organisms upon arrival. The SHIPSAN INFORMATION SYSTEM (SIS) was used to communicate the event to the rest of the European ports.

The simulation exercise tested communication flows between the players, coordination among competent authorities, risk assessment procedures, response of each authority in their own field and applying their own protocols, control measures applied, PPE placement and removal and risk communication.

All objectives were achieved. It provided the opportunity to test the cross-sectoral cooperation among the different competent authorities, the contingency plans and protocols and the risk assessment process.

 

Forthcoming events of the joint action

Training of the trainers’ face-to-face course:” Preparedness and Response to public health events at airports”, 18-20 September 2019, Belgrade, Serbia

When: 18-20 September 2019   Where: Belgrade, Serbia

The training of the trainers’ course on Preparedness and Response to public health events at airports will be held in September 2019 in Serbia.

The training is co-organised by the Institute of Occupational and Maritime Medicine, University Medical Center Hamburg-Eppendorf (UKE)-Germany, the Public Health Agency of Sweden, the University of Thessaly-Greece, RIVM-Netherlands and the Institute of Public Health of Republic of Serbia "Dr Milan Jovanović Batut".

The purpose of the course is to increase competence and capacity for managing public health events at airports. After completing the course, participants will act as trainers in face-to-face national training courses to be organised in their country. Training will comprise a blended format with both e-learning and face-to face components.

 

Workshop for chemical threats at Points of Entry

When: 20 September 2019   Where: Belgrade, Serbia

The training of the trainers’ course on Preparedness and Response to public health events at airports will be held from 18^th until 20^th of September 2019 in Serbia. The training is co-organised by the Institute of Occupational and Maritime Medicine, University Medical Center Hamburg-Eppendorf (UKE)-Germany, the Public Health Agency of Sweden, the University of Thessaly-Greece, RIVM-Netherlands and the Institute of Public Health of Republic of Serbia "Dr Milan Jovanović Batut".  The purpose of the course is to increase competence and capacity for managing public health events at airports. After completing the course, participants will act as trainers in face-to-face national training courses to be organised in their country. Training will comprise a blended format with both e-learning and face-to face components. Methods for the face-to-face training will include presentations and learning activities. Partners and collaborating stakeholders have been asked to nominate participants to this event.

A half-day 1st workshop for chemicals threats at Points of Entry will be held back-to-back with the training of the trainers’ course on the 20th September 2019.  The purpose of the workshop is to identify gaps, opportunities and raise awareness of best practice for chemicals at all points of entry and improve understanding of existing arrangements in Member States. It will address, at a national level, the plans for preparedness and action for dealing with a chemical incident at all Points of Entry.  Information obtained from the workshop will be used as the basis for developing training materials to be used in EU Member States to train staff on chemical safety and preparedness to chemical incidents at Points of Entry.

 

Other Past Events

ECDC National Focal Points meeting for Preparedness, Response and Threat Detection

When: 23 - 24 May 2019   Where: Radisson Blu Royal Park Hotel, Stockholm

This was the annual joint meeting of the ECDC National Focal Points (NFP) for Preparedness and Response and the NFP for Threat Detection, Early Warning and Response Systems (EWRS) and International Health Regulations (IHR).

The following topics were covered:

• Anticipation stage of a public health crisis.
• EU public health program joint actions in the area of preparedness, IHR core capacities and points of entry.
• Early detection enhancement.
• Response phase of a health emergency, including discussion on emergency operation centres, progress of the epidemic intelligence tools and discussion on how to measure preparedness.
• Recovery phase, including experiences on recovering from seasonal influenza and a panel discussion on After Action review practices.
• A keynote speech on a historical perspective of infectious diseases.

Ms Lemonia Anagnostopoulou representing the coordinator of the EU HEALTHY GATEWAYS joint action (Technical Officer, University of Thessaly, Greece) participated and presented the overview of the EU HEALTHY GATEWAYS joint action activities.

 

People from the Consortium

Note from the Coordinator, Prof. Christos Hadjichristodoulou

 It has been a great pleasure for us working with Dr Dominique Wanger over so many years and through several projects. Your tremendous support, collaboration and contributions on these projects has been invaluable and added greatly to their success. Through your dedication, enthusiasm and work of the highest quality, you have left an immense mark on the field of public health in the EU, and your support and input will be missed.

Dominique Wagner

Dominique Wagner is a Chief medical officer, head of service Saniport, Federal Public Service of Public Health, Food Chain Safety and Environment in Belgium.

She was born in Belgian Congo and her first vaccination booklet has a stamp form 1956 issued by Saniport which was also the department for which she worked for before retirement. She left Africa in 1967 and after a few year in Iran, she graduated from the Medical School of the Université Libre de Bruxelles  in 1982, and from the Institute of Tropical Medicine in Antwerp in 1983.

She soon left for Sudan, working for Médecins Sans Frontières in South Darfur (Ed Dain) until they expelled MSF after the Islamic coup. But she went back a few months later, to supervise a dispensary for refugees in Omdurman, outside of Khartoum (project financed by the GTZ German cooperation).

She left Sudan a year after with her husband, and after giving birth to her first boy (she has two of them), she followed him to Cairo and, a year later, to Istanbul.

She returned to Belgium in 2000, to attend a special degree in Environmental Sciences Management at the Université Catholique de Louvain from which she graduated in 2002.

After working for the European project ARPAC for 3 years, she joined the Belgian Federal Public Health in 2007, in crisis management first, then for Saniport, implementing IHR in PoE.

 

QUIZ

By National Institute of Public Health, Slovenia

Answer to the previous Quiz What links to: Femme Fatale, Paul Erlich, Franz Schubert and The Great Pretender?

The Answer:........................................................
Why? ..................................................................

 

Please send your answers to info@healthygateways.eu

 

Points of Entry in Focus

Port in focus - Valletta Cruise Port in Malta

Written by:  Martin Anthony Williams

Valletta is a UNESCO heritage city and the European city of culture 2018. Valletta is the capital city of Malta, a small island state located in the middle of the Mediterranean Sea

The Valletta Grand Harbour (Port of Valletta) is situated at the lower sea fronts of Valletta, and the Three Cities of Cospicua, Vittoriosa and Senglea. The Harbour mouth faces North East, protected on the north by St. Elmo’s Point breakwater and Ricasoli Breakwater arm on the south. Its North West shore is formed by the Sciberras peninsula (over which Valletta, and its suburb Floriana, were built). This peninsula also divides the Grand Harbour from a second parallel natural harbour, Marsamxett Harbour.

 

The Port of Valletta is a natural deep-water harbour and extends for about 3.6 kilometres inland. Its two-arm breakwater renders it a safe, all-weather port throughout the year, and operational on a 24 /7 basis, although movement may be restricted during strong easterly winds. The Port of Valletta is a multi-purpose port equipped to offer a wide range of maritime services. These include: 

• Valletta Cruise Port,
• ferry terminals,
• cargo berths, specialised grain and cement silos,
• petroleum installations, bunkering facilities,
• ship repair, building yards and chandelling,
• other ship related services and yacht marina,
• warehousing and open storage facilities available throughout the port area. 

The Valletta Cruise Port (VCP) is the gateway port to Valletta for cruise liner and their passengers, and forms part of the Valletta Grand Harbour. The VCP offers state of the art sea passenger terminal facilities with an exciting waterfront promenade well beloved by passengers, tourists and locals alike for its shops, cafes and restaurants.

In 2017, the VCP welcomed a total of 342 cruise ship visits, with a monthly average of 42 calls. The number of passengers embarking and disembarking the port in the same year was 778,596, with 5 cruise liner tours operating Malta to Malta cruises in 2017/18. During this period a total of 11 events of public health threats were reported the Port Health Authorities, whilst in 2018 so far 15 events have been recorded. These mainly included sporadic cases of Varicella rash, Influenza like illness and acute gastroenteritis (AGE) outbreaks. In furtherance of implementation of the International Health Regulation 2005, from January 2018 to date, Health Inspection have carried out inspection and issued 46 Ship Sanitation Control Certificate, 227 Ship Sanitation Control Exemption Certificate and 28 Extension of Ship Sanitation Certificate on various categories of vessels. Of the above inspection was performed on 6 cruise ships of which 2 Ship Sanitation Control Certification and 4 Ship Sanitation Control Exemption certificates were issued.

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