Managing Public Health Risks from Environmental Incidents. Guidance for Use in Wales
Version 3.0
Version 1.0 / March 2014
Version 2.0 / January 2017
Version 3.0 / March 2017
Authors:
Kristian James,
Principal Environmental Public Health Specialist, Public Health Wales
Huw Brunt, Consultant in Environmental Health Protection, Public Health Wales
Andrew Kibble, Operational Manager, Public Health England CRCE-Wales
Kate Cameron,
Natural Resources Wales
Chris Brereton, Chief Environmental Health Officer, Welsh Government
Acknowledgements
The authors would like to thank the following for their comments during the drafting this revised guidance.
Adrian Girvin, Aneurin Bevan University Health Board
Deanne Griffiths, Blaenau Gwent County Borough Council
Oliver Mathews, Carmarthenshire County Council
Sam Naylor, City & County of Swansea
Daniel Rixon, Public Health Wales
Preface
This guidance is intended to support the public health response to environmental incidents prior to formal command and control.
This guidance aims to strengthen and support collaborative structures being implemented to manage public health risks of environmental incidents in Wales by:-
§ defining what constitutes an environmental incident;
§ outlining incident response process, notification and management procedures,
§ clarifying agency roles and responsibilities, and
§ describing available resources to inform action.
It sets out arrangements for the management of incidents that are minor or localised using an Incident Management Team (IMT) approach, through to the early stages of potentially major incidents when existing command and control arrangements may apply.
This guidance is in three parts:-
Part 1: Generic guidance on how environmental incidents in Wales should be managed.
Part 2: Key stages and practical actions (supported by checklists and templates) required to manage an incident.
Part 3: Supporting information for incidents affecting one or more environmental media.
This revised guidance acknowledges the need to apply the Joint Emergency Services Interoperability Programme (JESIP) doctrine of “working together-saving lives-reducing harm” and the Joint Decision Model¹. This is to ensure a consistent approach to incident risk communication, assessment and management and in turn, the fluid escalation of incidents when appropriate.
¹ http://www.jesip.org.uk/joint-decision-model
Preface 4
Abbreviations 6
Part 1: Generic incident management guidance 7
1.1 What is an environmental incident? 8
1.2 Dealing with environmental incidents 8
1.3 Declaring an environmental incident? 9
1.4 Convening an Incident Management Team 9
1.5 Incident Management Team – members, roles and responsibilities 11
1.6 Communication 12
1.7 Major incidents - escalation beyond an IMT 12
1.8 Working together 12
1.9 Evaluation 15
Part 2: Environmental Incident Response: Practical Support & Resources 16
2.1 The incident response process 17
2.2 Logging Actions 18
2.3 Incident notification 19
2.4 Risk assessment 21
2.5 Reviewing risk assessment: medium & long term 24
Part 3: Incident specific information 25
3.1 Incidents affecting air quality 26
3.2 Incidents affecting land quality 28
3.3 Incidents affecting controlled water 29
3.4 Incidents affecting drinking water quality 30
3.5 Resources 31
Appendix 1 32
Abbreviations
AQC Air Quality Cell
CO Carbon monoxide
CRCE Centre for Radiation, Chemicals and other Environmental Hazards
DPH Director of Public Health
DWI Drinking Water Inspectorate
FSA Food Standards Agency
HB Health Board
IMT Incident Management Team
JESIP Joint Emergency Services Interoperability Programme
LA Local Authority
LRF Local Resilience Forum
NRW Natural Resources Wales
PHW Public Health Wales
STAC Scientific and Technical Advice Cell
WAQTA Wales Air Quality Technical Advisor
Part 1: Generic incident management guidance
1.1 What is an environmental incident?
An environmental incident, in public health terms, can be described as
“Any event (usually acute) in which there is, or could be, public exposure(s) to chemical or other hazardous substances which causes, or has the potential to cause adverse health impacts”.
Excluded from this definition and from this guidance, are
· environmental incidents with no associated public health risks,
(it is not always possible to determine that this is the case, especially in the early stages of an incident, and so a dynamic risk assessment is important)
· occupational exposures with no public health risk,
· incidents involving non-ionising radiation and
· incidents involving drugs, other substances of abuse and single case poisonings, with the exception of carbon monoxide (CO) incidents which can pose risks to others.
Environmental incidents can vary in scale. Examples include a small chlorine-mixing accident at a swimming pool affecting few people, or a chemical spill affecting water supplies, or a smouldering waste fire with a plume adversely affecting local communities over a prolonged period.
Incidents may not be immediately obvious but may be identified through ongoing public health surveillance, complaints or community concerns raised.
1.2 Dealing with environmental incidents
The primary aim in the management of an environmental incident is to protect public health. The main objective is to break any source-pathway-receptor linkages to prevent further exposures. Secondary objectives are to improve incident surveillance and to identify learning points and actions to improve future incident management.
Organisations involved in incident management will need to communicate and share information and actions collaboratively as an Incident Management Team (IMT; table 1)
Table 1 Organisations involved in incident response
Core organisations / Likely co-opted partner agencies, including:Local Authorities / Emergency Services
Public Health Wales / Health and Safety Executive
Public Health England (CRCE-Wales) / Food Standards Agency
Health Boards / Drinking Water Inspectorate (DWI) and Water Companies
Natural Resources Wales / Maritime and Coastguard Agency
1.3 Declaring an environmental incident?
Any organisation involved in dealing with a situation that they believe to meet the definition of an environmental incident can convene an IMT. An IMT should be convened immediately if an environmental incident has the following characteristics:-
· immediate and/or continuing health hazard;
· one or more routes of exposure;
· an at-risk population.
If necessary, a joint declaration of an incident will be made and an IMT convened (most likely as a virtual meeting). If an incident is declared, but not unanimously, all core partner organisations must participate in IMT meetings to formally explain their position and engage in the process unless it is clearly outside their remit.
1.4 Convening an Incident Management Team
The responsibility for managing environmental incidents is shared by all members of the IMT. One member should assume the initial lead and coordinating role. The first decisions will be to confirm that an environmental incident is occuring, whether it is a major incident, if existing plans apply or that an IMT is required. Such decisions may need to be kept under review with further risk assessments based upon emerging infomation.
The IMT must:-
· appoint a Chair;
· review membership;
· commence a decision log;
· agree meeting duration, frequency and anticipated life-span;
· discuss and agree purpose, aspirations and outputs (with timescales);
· take minutes to record decisions and actions;
· review evidence and confirm the incident has actual/possible public health impacts;
· identify the population at risk;
· identify the source-pathway-receptor relationships and undertake dynamic public health risk assessment (using epidemiological and environmental health expertise);
· consider if environmental, biological sampling and monitoring data are needed;
· consider action to mitigate risks and protect population health (for example, clean-up, remediation, decontamination, counter measures);
· agree messages and communication methods (e.g. any existing warning & informing strategies.
· consider arrangements for recovery from incident;
· ensure appropriate arrangements are in place for out of hours contact;
· keep relevant local agencies, the general public and the media informed;
· provide support, advice, and guidance to individuals/organisations directly involved;
· regularly review the scale of the incident to determine appropriate level of response and, if necessary, request formal Civil Contingencies structures be established upon escalation;
· evaluate the response provided in a written report (either a formal debrief or multiagency evaluation report).
The Chair will be appointed at the first meeting and is initially likely to be a Public Health representative. As an incident evolves, it may be appropriate for another core organisation member to become Chair. The Chair must ensure the IMT is managed in a professional manner.
A suggested IMT agenda is provided below (Figure 1).
Figure 1 IMT meeting agenda
While core members will have their own incident management responsibilities a commitment should be made by each to co-ordinate action through the IMT. Each core member representative must have sufficient seniority to make and implement decisions and to ensure adequate resources are available to undertake effective actions.
Core members are responsible for ensuring other relevant members are co-opted to the IMT. This includes providing sufficient financial and other resources (within remit and capacity) to bring the incident to a successful conclusion. Others can request to join the IMT if there is a case to do so, but the final decision on membership is with the core members.
Any IMT member, whether core or co-opted, should disclose any available information to inform incident investigation and management.
Where an incident affects people in other UK countries e.g. a chemical incident related plume blows across a national border, it is expected that relevant incident management partners in each area work together to perform the duties of the IMT.
1.5 Incident Management Team – members, roles and responsibilities
Public Health Wales (PHW) is a Category 1 responder (providing a 24/7/365 health protection service) as set out in the Civil Contingencies Act 2004. It provides health protection advice and support to others to interpret, manage and communicate risks associated with such incidents. PHW will draw upon specialist expertise, particularly chemical and radiation and other hazardous substance-related toxicology, from and through Public Health England Centre for Radiation, Chemicals and Environmental Hazards in Wales (CRCE-Wales).
Health Boards (HBs) have a statutory responsibility to protect and improve local population health and wellbeing. In most incidents HBs are supported by Public Health Wales. The main link with HBs will be through the Director of Public health (DPH). Where incidents may impact on wider NHS services e.g. primary and secondary care, other HB staff such as Emergency Planners will be involved.
Local Authority (LA) responsibilities are often met through coordinated activity across a number of different departments. Civil Contingencies units ensure that LAs are adequately prepared for and able to respond to/recover from emergencies in line with the Civil Contingencies Act 2004|. In an incident, LAs will coordinate their responseandresources or support the Emergency Services and others as necessary. As the emphasis switches to recovery, LAs will lead community rehabilitation and the restoration of the environment. Environmental Health professionals have a significant contribution to make to incident response; while they do not have a statutory duty to directly investigate or manage environmental incidents, they often have considerable scientific expertise and capability to act to support incident exposure/risk assessments, management and recovery.
Natural Resources Wales (NRW) has responsibility to prevent or minimise pollution of the environment due to release of substances from prescribed (permitted) processes. It also has powers to prevent any poisonous, noxious or polluting or solid waste matter from entering controlled waters and powers to remove or dispose of the matter, mitigate the impacts and where reasonably practicable restore the waters. NRW is a Category 1 responder as set out in the Civil Contingencies Act 2004.
Non-core IMT members will come from a broad range of other organisations depending on the nature and scale of an incident.
1.6 Communication
Effective communication should be established between IMT members at the outset and maintained throughout. Teleconference facilities will be made available.
The IMT Chair will ensure that minutes are taken at all meetings. The minute taker (as identified by the Chair) is accountable to the Chair for this function.
Communicating messages through partner agencies and the media is important. Each IMT member must support an agreed communications strategy by providing resources, support and advice as necessary. There shall be no communications from IMT members external to the agreed communications strategy, unless agreed by all members.
1.7 Major incidents - escalation beyond an IMT
The IMT should follow the Joint Emergency Services Interoperability Programme (JESIP) doctrine of working together to save saving life and reduce harm (figure 2).
1.8 Working together
A major incident may be declared by one or more emergency responder agencies.
In the event of a significant or ‘major’ incident occurring or where local existing incident plans prevail and the situation escalates beyond an IMT and this guidance, formal Civil Contingencies incident response structures will be implemented as agreed by the Local Resilience Forum (LRF).
A ‘major incident’ has been defined by the Cabinet Office Civil Contingencies Secretariat as
“An event or situation, with a range of serious consequences, which requires special arrangements to be implemented by one or more emergency responder agencies”
Notes:
a) ‘emergency responder agencies’ describes all Category one and two responders as defined in the Civil Contingencies Act (2004) and associated guidance;
b) a major incident is beyond the scope of business-as-usual operations, and is likely to involve serious harm, damage, disruption or risk to human life or welfare, essential services, the environment or national security;
c) a major incident may involve a single-agency response, although it is more likely to require a multi-agency response, which may be in the form of multi-agency support to a lead responder;
d) the severity of consequences associated with a major incident are likely to constrain or complicate the ability of responders to resource and manage the incident, although a major incident is unlikely to affect all responders equally;
e) the decision to declare a major incident will always be a judgement made in a specific local and operational context, and there are no precise and universal thresholds or triggers. Where LRFs and responders have explored these criteria in the local context and ahead of time, decision makers will be better informed and more confident in making that judgement.
Some LRF plans adopt a more flexible interpretation of when they are utilised and in most instances would not meet the major incident criteria as set out in this Cabinet Office definition. In some cases, Tactical Coordinating Group / Strategic Coordinating Group activation does not require the declaration of a major incident. Also, a Tactical Coordinating Group can be established without a Strategic Coordinating group by any LRF member who requires incident management structures above the operational level to be implemented.