The Beirut explosion reminded us that man-made disasters aren’t just a risk to our environment. They are often a major risk to public health and people's lives. Some examples illustrate both the health risks and the preventative action needed: 

Bhopal Gas Disaster 

In 1984, ~40 tonnes of methyl isocyanate (MIC), a toxic tear gas, was released from the Union Carbide India Limited (UCIL) pesticide plant in Bhopal, India. During the disaster, ~500,000 people were exposed to MIC. This caused the immediate death of ~3,800 people and the death of thousands more over subsequent weeks, as well as adverse health effects including reduced lung function, COPD, chronic conjunctivitis, and impaired motor skills. Following the disaster, UCIL halted operation of the plant but failed to completely clean the industrial site, allowing organochlorine compounds to contaminate surrounding communities.  The Bhopal disaster continued to impact the health of future generations. Children were born with an elevated risk of cancer and congenital defects to parents exposed to MIC and organochlorine compounds.    

Chemical disasters, such as Bhopal, can be mitigated by, for example: 

  • Developing policies to prevent economic growth taking precedence over environmental protection and public health, including ensuring potentially hazardous industrial sites are located well away from centres of population.
  • Enforcing environmental health laws and policies, to ensure the threat industrial organisations pose to public health is minimal.
  • Ensuring a thorough clean-up of affected sites, following industrial accidents, to protect the public from further harmful exposure.{1]

In May 2020, another gas leak occurred in a chemical plant in Visakhapatnam, India, emphasising the continuing need for prevention and mitigation of industrial disasters. 

Chernobyl Nuclear Accident

In 1986, a nuclear reactor safety test triggered a chain reaction at the Chernobyl Nuclear Power Plant in Ukraine, resulting in a steam explosion and open-air fire, causing airborne radioactive contamination for nine days. Contamination was spread across the USSR and parts of Europe. 134 people were hospitalised with acute radiation syndrome and 31 people died. Radioactive fallout included iodine-131, which accumulates in thyroid and mammary glands. In 2006, the WHO estimated there may have been ~9,000 radiation-induced cancer deaths amongst those exposed to high doses of radiation.  

Following the Chernobyl accident, lessons were not only learnt regarding the safety and design of nuclear power plants, but also regarding post-accident logistics, including the need for:

  • Rapid and clear communication nationally and internationally, regardingthe scale of the accident and associated health risks
  • A need for uniform international regulation of the nuclear industry and international emergency preparedness, because radiation releases do not stop at national borders.
  • Considering all routes radiation transmission can take, including taking action to mitigate the entry of radiation into the food chain by monitoring agricultural radioactivity[2]  

Despite follow-up action to contain radiation, surveillance of radioactivity in the exclusion zone will be required for several hundred years. And despite technological advances, negligence in the nuclear industry continues to pose risks to health and the environment, as seen in the 2011 Fukushima accident. 

Flint Water Crisis

In 2014, the City of Flint, Michigan changed its drinking water supply from Lake Huron to the Flint River. However, the water was not treated with corrosion inhibitors, causing lead from aged water pipes to leach into the water supply. In 2015, dangerous lead levels were observed in water from Flint households, causing a significant rise in blood lead levels in children. Lead exposure in early in life can severely impact childhood development, increasing the risk of mental retardation, behavioural disorders and neurological disorders. These impacts are beginning and will continue to emerge among the thousands of children exposed to the lead. A spike in cases of Legionnaires’ disease was also reported between 2014 and 2015, with at least 87 infections and 12 deaths. 

The Flint water crisis highlighted: 

  • The importance of pilot studies and continuous surveillance when making interventions potentially affecting public health.
  • The importance of taking independent environmental health advice.
  • The importance of a safe environmental health infrastructure, e.g. here replacing lead piping.[3]

Efforts have been made to replace lead piping in Flint. However, many US cities still rely on lead pipes for water. In 2016, elevated lead levels were noted in water from schools in Newark, New York, prompting the replacement of lead piping. This suggests there is a need for improved surveillance of water quality and action to replace lead piping across the US.

Beirut Explosion

On 4th August 2020, two explosions sent a blast across the Lebanese capital, Beirut, killing at least 220 people, injuring ~5,000 and leaving an estimated 300,000 people homeless. It is believed the explosion occurred when 2,750 tonnes of ammonium nitrate, which had been unsafely stored for 6 years in a port warehouse, caught alight. Customs officials contacted authorities between 2014 and 2017 multiple times, seeking guidance regarding the ammonium nitrate. 

The explosion highlights the importance of: 

  • Policies, monitoring and enforcement to ensure the safe storage of hazardous chemicals.
  • Communication and cooperation between key stakeholders, in such cases. 

Improper storage of hazardous chemicals has previously caused devastation, including the 2015 Tianjin port explosion which killed 165, injured 798 and caused an economic loss of 6.866 billion CNY.

Man-made disasters in the UK 

The UK also hasn’t been immune from man-made disasters. Examples include: 

  • The 1957 fire at the Windscale nuclear power plant (now known as Sellafield), which caused an estimated 240 cancer cases, including a hundred fatalities. 
  • The 1966 Aberfan disaster, where heavy rain led a colliery spoil tip to slide down into the village, killing 116 children at the local primary school and 28 adults. 
  • The 1974 explosion at the Flixborough chemical plant in North Lincolnshire, which killed 28 people and seriously injured 36 (and could have resulted in many more casualties if the explosion had happened on a normal working day instead of a Saturday). 
  • The 1987 fire at King’s Cross station, which killed 31 people and injured another hundred. 
  • 89 reported outbreaks of waterborne infectious intestinal disease, affecting 4,321 people in England and Wales between 1992 and 2003. 
  • The 28,000 – 36,000 deaths a year attributable to air pollution, according to Public Health England. 

Conclusions 

Man-made environmental disasters are a significant, continuing public health risk. However, risks can be reduced by: 

  • Locating hazardous sites and materials away from centres of population.
  • A safe environmental health structure, to ensure e.g. clean, uncontaminated drinking water.
  • Pilot studies and the taking of independent environmental health advice before making potentially hazardous changes.
  • Agreeing, monitoring and enforcing environmental health policies
  • Rapid, effective remedial action in the event of a disaster, to minimise longer term risks and knock-on effects on health.

Alex Ellicott   August 2020.

 

References

  1.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1142333/
  2.  https://india.mongabay.com/2020/05/years-of-neglect-led-to-vizag-gas-tragedy/
  3.  https://www.sciencedirect.com/topics/earth-and-planetary-sciences/chernobyl-accident
  4.  https://www.epj-conferences.org/articles/epjconf/pdf/2017/22/epjconf_icrs2017_08001.pdf
  5.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6309965/
  6.  https://www.neha.org/sites/default/files/publications/jeh/JEH7-8.19-Feature-Compliance-With-Mandated-Testing.pdf