Recent advances to address European Union Health Security from cross border chemical health threats R. Duarte-Davidson a, ⁎, R. Orford a , S. Wyke a , M. Griffiths a , R. Amlôt b , R. Chilcott c a Centre for Radiation, Chemical and Environmental Hazards, Public Health England, UK b Microbial Risk Assessment & Behavioural Science, Emergency Response Department, Public Health England, UK c Department of Pharmacy, University of Hertfordshire, Hatfield, UK abstract article info Available online 27 March 2014 Keywords: Chemical incident Public health risk assessment and management Cross border health threats CBRN Emergency response Alerting and notification The European Union (EU) Decision (1082/2013/EU) on serious cross border threats to health was adopted by the European Parliament in November 2013, in recognition of the need to strengthen the capacity of Member States to coordinate the public health response to cross border threats, whether from biological, chemical, environmen- tal events or events which have an unknown origin. Although mechanisms have been in place for years for reporting cross border health threats from communicable diseases, this has not been the case for incidents involv- ing chemicals and/or environmental events. A variety of collaborative EU projects have been funded over the past 10 years through the Health Programme to address gaps in knowledge on health security and to improve resil- ience and response to major incidents involving chemicals. This paper looks at the EU Health Programme that un- derpins recent research activities to address gaps in resilience, planning, responding to and recovering from a cross border chemical incident. It also looks at how the outputs from the research programme will contribute to improving public health management of transnational incidents that have the potential to overwhelm national capabilities, putting this into context with the new requirements as the Decision on serious cross border threats to health as well as highlighting areas for future development. Crown Copyright © 2014 Published by Elsevier Ltd. All rights reserved. 1. Introduction Chemical releases can occur from accidental or deliberate releases and from natural disasters. Chemical incidents may be on a small or large scale, and can give rise to a number of primary or secondary chem- ical casualties and fatalities (Baker, 2004). The International Federation of the Red Cross estimated that between 1998 and 2007 there were 3200 incidents involving chemical releases with approximately 100,000 people killed and nearly 1.5 million affected (IFRC, 2010). The number of casualties following a release depends on the location and type of incident and can range from a few casualties to thousands (Baker et al., 2013). In the 1970s and 80s governments focussed their effort on the scien- tific basis for chemical safety to strengthen national capabilities includ- ing safety of production, storage and transport of chemicals. However, high profile chemical incidents such as the Seveso disaster in Italy in 1976 (Bertazzi, 1991), the 1981 toxic oil incident in Spain (Gelpí et al., 2002; WHO, 2004) and the Bhopal Explosion in India in 1984 (Anon, 1984, Shama, 2005; WHO, 2009) led to increased recognition of the public health impact of chemical incidents. More recently deliberate releases as a result of a terrorist action such as the Tokyo sarin attack in 1995 (Okumura et al., 2005), the 9/11 attack in the USA in 2001 (Farley and Weisfuse, 2011) and the terrorist attack in Madrid in March 2004 (Algora-Weber, 2011) have raised further international concern and exposed national weaknesses in dealing with chemical and other threats (Table 1). Large scale incidents are rare, but if they do occur there is a risk that resources may be stretched or overwhelmed in the affected countries. Expert help may be requested from neighbouring nations to deal with the incident effectively. Such large scale incidents could potentially affect several countries. If there are at least some procedures in common between nations, an international response can be carried out more easily and will therefore be more effective and expedite a return to the new normal. Therefore it is important that European wide co- ordination is established and maintained. European networks and research programmes have a key role to play in the development of generic preparedness planning and interoperability, to mitigate the impact of mass emergencies (Baker et al., 2011). It is prudent to plan for the response to a mass emergency involving toxic chemicals, although such events are rare. Nevertheless, such an eventuality may develop at a rate and reach a magnitude sufficient to impose a major crisis on society (Baker et al., 2011). A well developed mechanism exists at the European level where hu- manitarian aid and civil protection assistance can be requested by EU and non-EU countries in response to disasters (EU, 2005). Following Environment International 72 (2014) 3–14 ⁎ Corresponding author at: International Research and Development Group, Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Chilton, OX11 0RQ, UK. Tel.: +44 1235 825275, +44 7770 567851 (Mobile). E-mail address: raquel.duarte-davidson@phe.gov.uk (R. Duarte-Davidson). 0160-4120/$ – see front matter. Crown Copyright © 2014 Published by Elsevier Ltd. All rights reserved. http://dx.doi.org/10.1016/j.envint.2014.01.003 Contents lists available at ScienceDirect Environment International journal homepage: www.elsevier.com/locate/envint