identified for major incident response monitoring

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The July 2005 London bombings: environmental monitoring, health risk assessment and lessons identified for major incident response James Wilson, Virginia Murray and J Nick Kettle Occup. Environ. Med. 2009;66;642-643 doi:10.1136/oem.2008.039933

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The July 2005 London bombings: environmental monitoring, health risk assessment and lessons identified for major incident response James Wilson,1 Virginia Murray,1 J Nick Kettle2 The July 2005 London bombings rapidly resulted in ‘major incidents’ being declared by the emergency services, thereby triggering the three-tier major incident command and control framework used in the UK.1 This framework includes Bronze (operational), Silver (tactical) and Gold (strategic) levels2 with a Strategic Co-Ordinating Group (SCG) which, at the time of the London bombings, was supported by a Health Advice Team (HAT).2 The organisations involved in responding to the London bombings included: Transport for London, London Underground, the emergency services, the NHS, central government and other agencies/organisations including the Health Protection Agency (HPA). Environmental sampling and analysis play a vital role in informing public and occupational health risk assessments and in influencing the development of incident management strategies. Important lessons related to environmental monitoring and risk assessment were identified during the response to the London bombings, which are discussed here with reference to updated guidance recently issued by the UK Government on major incident management. In the aftermath of the explosions, hazard profiling was undertaken by the emergency services on the London Underground network, which included visual/photographic inspections of train carriages and airborne asbestos fibre monitoring at Kings Cross, Russell Square, 1

Chemical Hazards and Poisons Division (London), Health Protection Agency, London, UK; 2 Safety and Health Risk Management Team, Metropolitan Police Service, London, UK Correspondence to: Professor Virginia Murray, Chemical Hazards and Poisons Division (London), Health Protection Agency, 7th Floor, Holborn Gate, 330 High Holborn, London WC1V 7PP, UK; Virginia.Murray@ hpa.org.uk 642

Aldgate, Edgware Road and Covent Garden underground stations (table 1). After the initial response to the incident, an Environment Group was set up outside of the Strategic Co-ordinating Group in order to share information from environmental and occupational hygiene sampling and to evaluate the response to the incident.4 This group consisted of personnel from organisations such as London Underground/Transport for London, the Chemical Hazards and Poisons Division of the Health Protection Agency, and health and safety personnel from the Metropolitan Police Service. At the first meeting of this group (19 July 2005) strategies for reassurance sampling during the recovery phase of the incident were discussed prior to reopening the underground network to the public.

The information shared between organisations during the initial response and Environment Group meetings concluded that some London Underground rolling stock had hazardous materials including: chrysotile (white) and amosite (brown) asbestos (in heating panels and resistance grids, and between steel plates on the underside of carriages), mercury (in 2 ml glass tubes housed in plastic in trip switches for doors), a corrosive liquid sodium-potassium alloy (in thermal switches in fibreglass covers, surrounded by oil) and banks of lead batteries. These materials represent no risk to the workers or members of the public using the London Underground under normal circumstances, as they are contained. Scene hazard profiling and where necessary visual inspections and photographic examinations indicated that the train carriage components of concern were intact after the blasts. In the case of asbestos, this was confirmed by environmental monitoring. Therefore, the risk associated with the potential release of hazardous materials from train carriages was assessed to be negligible. With respect to the health of the emergency responders present on scene during the forensic investigation, the health risks related to airborne fibres was negated by the adoption of good working practices (including the use of appropriate personal protective equipment, such as P3 respiratory protection). The use of personal

Table 1 Summary of measured airborne fibre concentrations Station (dates of sampling) Kings Cross (7–25 July 2005) Tunnels (proximal and distal) Platforms and other publicly accessible areas Personnel in vicinity of damaged carriages Covent Garden (8–10 July 2005) Platforms Russell Square (7–25 July 2005) Tunnels (near and distal to damaged carriages) Platforms and other publicly accessible areas Personnel in vicinity of damaged carriages Aldgate (7–8 July 2005) Platforms Ramp (25 m from end of damaged carriage) Edgware Road (7 July 2005) Platform (50 m to rear carriage of damaged train) Open carriage opposite blast damaged carriage

Airborne fibre concentrations (f/ml)

Test type

Method

,0.01 to ,0.02 ,0.01 to ,0.04

Static reassurance Static reassurance

MDHS39/43 MDHS39/4

,0.02 to ,0.08

Personal 4 h control limit

MDHS39/4

,0.01

Static reassurance

MDHS39/4

,0.01 to ,0.02

Static reassurance

MDHS39/4

,0.01 to ,0.02

Static reassurance

MDHS39/4

,0.04 to ,0.16

Personal 4 h control limit

MDHS39/4

,0.01 ,0.01

Static reassurance Static reassurance

MDHS39/4 MDHS39/4

,0.01

Static reassurance

MDHS39/4

,0.01

Static reassurance

MDHS39/4

Occup Environ Med October 2009 Vol 66 No 10


Leader protective equipment by those present after the stations were evacuated and casualties rescued, reflected a precautionary approach in the event that hazard profiles changed at the scenes. Tunnel dust (consisting largely of iron oxide produced by wear of train wheels, tracks and brakes) was also identified as a material to which responders and members of the public may have been exposed. Although there are a lack of environmental monitoring data with which to assess exposure to respirable dust in the aftermath of the bombs, ill-health attributable to iron particle inhalation in chronically exposed occupational groups does not appear to be common5–7 and the potential exposure duration in the aftermath of the bombings was one comparatively short event. One aspect of major incident response that cannot be easily resolved, is the time required to deploy personnel to the scenes to initiate occupational hygiene or environmental monitoring. This may result in a gap in the data available for assessing health risks. While there appears to be little that can be done to prevent this (apart from ensuring the preparedness of response teams), the Metropolitan Police Service Safety and Health Risk Management Team have prepared contingency plans to support a timely and balanced response to support scene hazard profiling and the implementation of occupational hygiene monitoring strategies. In the event of similar incidents occurring in the future, the most appropriate response may include airborne particulate monitoring being undertaken by the emergency services who can access scenes more readily.

Occup Environ Med October 2009 Vol 66 No 10

The concept of a multi-agency group of key medical, health and safety, engineering and scientific stakeholders to advise on health risks, appropriate monitoring strategies, regimes, risk assessments and safe systems of work proved to be extremely valuable. Key output included the collation, dissemination and assessment of environmental and occupational hygiene sampling data by the stakeholders involved in response.4 It is essential that in the event of any similar incident in the future, relevant occupational hygiene monitoring can be deployed in a timely manner. The UK major incident command and control structure guidance has been updated to include a Science and Technical Advice Cell (STAC), which for health protection purposes, functions in a similar way to the former HAT arrangements, but includes the capacity for wider scientific and technical advice and the ability to continue to operate after the initial emergency response into the recovery phase of an incident.8 The July 2005 London bombings highlighted the fact that the initiation of environmental and occupational hygiene monitoring strategies is essential to support both public and occupational health risk assessments in the aftermath of major incidents. These monitoring strategies should be underpinned and supported by a multi-agency approach involving key health, safety, engineering and scientific stakeholders. The recently updated UK guidance should encourage such an approach. Acknowledgements: The authors would like to thank London Underground infrastructure companies (Metronet, 4-Rail) and Casella for their assistance. The

authors would also like to thank the members of the Environment Group set up during the London bombings for their co-operation. Competing interests: None. Provenance and peer review: Commissioned; not externally peer reviewed. Accepted 29 April 2008 Occup Environ Med 2009;66:642–643. doi:10.1136/oem.2008.039933

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