Major chemical incidents: bridging the occupational-public health gap

Increasing awareness and concern about possible long-term health effects of exposure to chemicals after major chemical incidents has opened up a new a rea of public health activity. However, progress is hampered by a lack of l ow level exposures in potentially highly susceptible subgroups of the popul ations, and by a lack of expertise in public health. The challenge is to ex tend the toxicological and epidemiological experience developed in the occu pational setting to the community level. To better define the problem popul ation surveillance of acute chemical hazards, first set up in Wales, has be en extended throughout the UK, and is also being piloted internationally. F urther work is needed to address specific problems of the epidemiological f ollow-up of populations exposed, the assessment of the psychological conseq uences at the community level, and risk perception and communication. Organ isational arrangements for the public health management of incidents and th eir sequelae must move beyond short-term funding and market competition and must incorporate the expertise of the occupational disciplines.