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Public health consequences from hazardous substances acutely released during rail transit--South Carolina, 2005; selected States, 1999-2004.

On January 6, 2005, two freight trains collided in Graniteville, South Carolina (approximately 10 miles northeast of Augusta, Georgia), releasing an estimated 11,500 gallons of chlorine gas, which caused nine deaths and sent at least 529 persons seeking medical treatment for possible chlorine exposure. The incident prompted the Agency for Toxic Substances and Disease Registry (ATSDR) to review data from its Hazardous Substances Emergency Events Surveillance (HSEES) system and update an analysis of 1993-1998 railroad events. The HSEES system is used to collect and analyze data concerning the public health consequences (e.g., morbidity, mortality, and evacuations) associated with hazardous-substance--release events that occur in facilities or during transportation. This report describes the event in South Carolina, which is not part of the HSEES system, and two others from HSEES, and summarizes all rail events reported to HSEES from 16 state health departments during 1999-2004. Local government agencies, employers, and first responders can help reduce morbidity and mortality from transit-associated hazardous-substance releases by examining historical spill data for planning purposes, developing emergency response plans, undergoing proper hazardous materials (HazMat) training, and reviewing epidemiologic investigation data.

Accidents↗

Chaining nursing diagnosis: the use of etiological sequencing in the development of a plan of care.

There has been an explosion of information on nursing diagnosis. A recent computer search of the literature revealed a total of 595 publications on nursing diagnosis. Only 6 of these manuscripts were released between the years 1971 and 1974 inclusively; 11 between 1975 and 1979, 178 manuscripts appeared between 1979 and 1985, while 400 were published from 1985 and 1989. In addition, a search of the Nursing and Allied Health Data Base revealed 1,068 articles published from 1982 to 1989. These data clearly emphasize the increased interest in this important topic. Consequently, a plethora of information has been made available to the educator, the clinician, the researcher, and the student. However, through over 15 years of experience with nursing diagnosis, this author has found the issue of cause and effect (etiology and problem) to be an ongoing problem.

Humans↗