Chemical Preparedness

Chemical Preparedness Body Image

Large-scale chemical emergencies are low-probability but high-impact events. When one does occur, action needs to be taken immediately to limit the severity of the impact on health. Local health departments (LHDs) play a key role in response.

Results from the 2022 Preparedness Profile, a nationally representative survey to gather key insights and information about preparedness trends and emerging issues at LHDs, found that nearly half (48%) of local health departments did not conduct any preparedness or response activities related to chemical, biological, radiological, and nuclear (CBRN) events in the past year. Additionally:

  • 38% of LHDs conducted planning related to CBRN events; 14% of LHDs conducted drills/exercises; 3% of LHDs responded to actual emergency events.
  • 16% of LHDs activities/functions related to CBRN activities in the past three years increased.
  • 14% of LHDs activities activities/functions related to CBRN activities in the past three years decreased.

To better support local health departments in overcoming these challenges, NACCHO is developing and has identified several evidence-based tools and resources that local health departments may use in planning their response to chemical emergencies.

This toolkit contains background information on chemical emergencies, preparedness and response guidance, trainings, templates and examples for public communications, case studies, and more.

Sign up to receive the Preparedness Brief Digest to stay updated on resources and tools from NACCHO’s Chemical Preparedness portfolio.

Resource Name/Link Description Type of Resource Source
Strategy for Developing a Community Chemical Response Plan Brief overview for developing a chemical response plan Guidance CHEMM
Planning and Decision Framework for Chemical Incident Consequence Management Consequence management planning and decision framework for response and recovery from a large-scale hazardous chemical incident Guidance FEMA
Public Health Preparedness and Response to Chemical and Radiological Incidents: Functions, Practices, and Areas for Future Work Framework for public health preparedness and response roles in chemical and radiological Guidance LaTourrette et al., 2009. RAND Corporation
Hazardous Materials Response: A Guide to Aid Local Health Directors and Staff in Planning For and Responding to Hazardous Materials Releases - Connecticut Department of Public Health Guide for state and local health department staff in Connecticut to respond to hazmat releases Guidance The Connecticut Department of Public Health
EPA’s Response Techniques Information on EPA's emergency response actions Guidance EPA
Hazardous Materials Response Plan An Annex to the Warren County Comprehensive Emergency Management Plan ESF #10 LHD guide for responding to hazardous materials incident Guidance Warren County, NY
The Public Health Response to Biological and Chemical Terrorism Interim Planning Guidance State Public Health Officials Planning guidance to help coordinate efforts for responding to biological or chemical terrorism event Guidance CDC
Key Planning Factors and Considerations for Response to and Recovery from a Chemical Incident Reference for regional, state, local, tribal, and territorial (SLTT) departments that developing response and recovery plans for chemical incidents Guidance FEMA
Primary Response Incident Scene Management (PRISM) Guidance Series of strategic, tactical, and operational guidance on mass patient disrobe and decontamination during a chemical incident Guidance BARDA
Managing Hazardous Materials Incidents (MHMIs) Three sets of planning guides for prehospital and hospital medical management of patients exposed during a hazmat incident Guidance ATSDR
A Guide to Managing Stress for Disaster Responders and First Responders Framework for stress management strategies for first responders Guidance SAMHSA
Engaging Faith-based and Community Organizations: Planning Considerations for Emergency Managers Guide for engaging faith-based and community organizations in emergency preparedness and planning Guidance FEMA
Chemical Quick Reference Guides Quick reference guides (QRGs) for responding to chemical agents in the categories shown below. Intended for Federal On-Scene Coordinators (OSCs). Guidance The U.S. National Response Team
Resource Name/Link Description Type of Resource Source
Crisis and Emergency Risk Communication Course for learning emergency risk communication principles and tools for successful public, partner and stakeholder communication during emergencies. Training Reynolds et al., 2002. CDC
Medical Management of Chem, Bio, Radiological, Nuclear, and Explosive Events CBRNE; medical management Training Texas A&M Engineering Extension Service
Key Planning Factors and Considerations for Response to and Recovery from Chemical Incidents Course for learning how to create a chemical incident-specific plan for response and recovery Training FEMA
IS-5.A: An Introduction to Hazardous Materials HAZMAT; response Training FEMA
HazMat Emergency Preparedness Training and Tools for Responders Training and Tools developed by ATSDR to help communities prepare for hazardous materials emergencies and disasters. Training ATSDR
Resource Name/Link Description Type of Resource Source
Best Practices for Communicating Risk in an Emergency | Key Planning Factors and Considerations for Response to and Recovery from a Chemical Incident Best practices for communicating messages to the public Guidance FEMA
Evacuate In a Chemical Emergency Facts about how and when to evacuate during a chemical emergency Guidance CDC
Get It Off Facts About Personal Cleaning & Disposal of Contaminated Clothing after coming into contacts with dangerous chemicals Guidance CDC
Stay Put and Seal Off Your Space in a Chemical Emergency Facts about sheltering in place during a chemical emergency Guidance CDC
Response Communication Guidelines | Key Planning Factors and Considerations for Response to and Recovery from a Chemical Incident Guidelines for communicating messages to the public Guidance FEMA
Communicating in a Crisis: Risk Communication Guidelines for Public Officials Guidelines for communicating messages to the public Guidance SAMHSA
Crisis and Emergency Risk Communication by Leaders for Leaders Guidelines for communicating messages to the public Guidance Reynolds 2004. CDC
Resource Name/Link Description Type of Resource Source
Prioritizing First-Responder Mental Health with Critical Incident Stress Management Article with three recommended crisis intervention models for managing mental crises among first responders Article Hernandez et al., 2021. ICMA
A Guide to Managing Stress for Disaster Responders and First Responders Framework for stress management strategies for first responders Guidance SAMHSA
Mental Health First Aid for Fire/EMS Training for mental health intervention among first responders Training Mental Health First Aid
Disaster Responder Stress Management Resource for stress management planning Website SAMHSA
Resource Name/Link Type of Resource Source
Public health response and medical management of internal contamination in past radiological or nuclear incidents: A narrative review Journal Article Li et al., 2022. Environment International
Management of acute exposure to toxic gases in the oil & gas industry -a practical approach Journal Article Lizarazo Salcedo et al., 2021. Archives of Environmental & Occupational Health
Anhydrous Ammonia Chemical Release — Lake County, Illinois, April 2019 Report Rispens et al., 2020. Morbidity and Mortality Weekly Report (MMWR)
National Toxic Substances Incidents Program - Nine States, 2010-2014 Report Melnikova et al., 2020. Morbidity and Mortality Weekly Report (MMWR)
Chemical exposures, health and environmental justice in communities living on the fenceline of industry Journal Article Johnston and Cushing 2020. Current Environmental Health Reports
A framework for integrating information resources for chemical emergency management and response Journal Article Seaton et al., 2019. American Journal of Disaster Medicine
Evaluation of US Federal Guidelines (Primary Response Incident Scene Management [PRISM] for Mass Decontamination of Casualties During the Initial Operational Response to a Chemical Incident Journal Article Chilcott et al., 2019. Annals of Emergency Medicine
Nerve Agent Incidents and Public Health Preparedness Journal Article Chang et al., 2019. Annals of Internal Medicine
Extreme Weather, Chemical Facilities, and Vulnerable Communities in the U.S. Gulf Coast: A Disastrous Combination Journal Article Anenberg and Kalman 2019. GeoHealth
Emergency/Disaster Preparedness of Rural Healthcare Providers Dissertation Abrams 2018. ProQuest Dissertations & Theses Global
Multi-plant emergency response for tackling major accidents in chemical industrial areas Journal Article Hosseinnia et al., 2018. Safety Science
Assessment of Impact and Recovery Needs in Communities Affected by the Elk River Chemical Spill, West Virginia, April 2014 Journal Article Burreret al., 2017. Public Health Reports
Acute Health Effects After the Elk River Chemical Spill, West Virginia, January 2014 Journal Article Thomassonet al., 2017. Public Health Reports
Medical Response to a Vinyl Chloride Release From a Train Derailment: New Jersey, 2012 Journal Article Shumateet al., 2017. Disaster Medicine and Public Health Preparedness
Mercury Spill Responses — Five States, 2012–2015 Journal Article Wozniak et al., 2017. Morbidity and Mortality Weekly Report (MMWR)
Hazardous Chemical Releases Occurring in School Settings, 14 States, 2008–2013 Journal Article Anderson et al., 2017. Journal of Environmental Health
Hospital Impact After a Chemical Spill That Compromised the Potable Water Supply — West Virginia, January 2014 Journal Article Hsu et al., 2017. Disaster Medicine and Public Health Preparedness
Off the rails in rural South Carolina: a qualitative study of healthcare provider perspectives on the long-term health impact of the Graniteville train disaster Journal Article Ingram et al., 2016. Rural and Remote Health
Challenges During a Chlorine Gas Emergency Response Journal Article Christensen et al., 2016. Disaster Medicine and Public Health Preparedness
A decision support framework for characterizing and managing dermal exposures to chemicals during Emergency Management and Operations Journal Article Dotson et al., 2015. Journal of Emergency Management
Public Health Response to Acute Chemical Incidents — Hazardous Substances Emergency Events Surveillance, Nine States, 1999–2008 Report Melnikova et al., 2015. Morbidity and Mortality Weekly Report (MMWR)
Engaging a chemical disaster community: lessons from Graniteville Journal Article Abara et al., 2014. International Journal of Environmental research and Public Health
Training of public health personnel in handling CBRN emergencies: A table-top exercise card concept Journal Article Sandström et al., 2014. Environment International
Evidence-Based Patient Decontamination: An Integral Component of Mass Exposure Chemical Incident Planning and Response Journal Article Leary et al., 2014. Disaster Medicine and Public Health Preparedness
Public Health Emergency Planning for Children in Chemical, Biological, Radiological, and Nuclear (CBRN Disasters Journal Article Bartenfeld et al., 2014. Biosecurity and Bioterrorism: Biodefense Strategy, Practice, and Science
Public Health Response Systems In-Action: Learning from Local Health Departments’ Experiences with Acute and Emergency Incidents Journal Article Hunter et al., 2013. PLoS ONE
Local Health Department Capacity for Community Engagement and Its Implications for Disaster Resilience Journal Article Schoch-Spana et al., 2013. Biosecurity and Bioterrorism: Biodefense Strategy, Practice, and Science
Emergency planning and preparedness for the deliberate release of toxic industrial chemicals Journal Article Russell et al., 2010. Clinical Toxicology
Triage, monitoring, and treatment of mass casualty events involving chemical, biological, radiological, or nuclear agents Journal Article Ramesh and Kumar 2010. Journal of Pharmacy & Bioallied Sciences
Chemical Facility Incidents Since April 2020 Website Coalition to Prevent Chemical Disasters
Partners and Collaborators for Emergency Preparedness and Response Website Rural Health Information Hub

For questions or to learn more about chemical preparedness, please email [email protected]

Public Health Preparedness Program

Deise Galan

Lead Program Analyst, Environmental Health & Preparedness

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Public Health Preparedness Program

Sarah Callahan

Program Analyst, Preparedness

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Environmental Health Program

Nikita Kheni

Program Analyst, Environmental Health

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