7 Industrial / Chemical Disasters : Medical Care , Public Health and Epidemiology in the Acute Phase

The twentieth century has witnessed the appearance of a whole new series of man-made or technological disasters, resulting from enormously increased industrial growth and chemical utilization. Vast amounts of chemical or potential energy are now focused in highly concentrated areas; unanticipated events can lead to uncontrollable releases with devastating effects (Parrish et at., 1987). Unintended disasters, and other resultant injuries and health effects, are not simply isolated accidents. Their causes can be studied; the pathways leading to injury, illness, and death can be analysed; the performance of emergency units and medical care systems under extraordinary circumstances can be evaluated. In short, if we are to prevent, control, and manage disasters to the best of our ability, then we must plan and prepare assuming that disasters will occur, and we must scientifically evaluate each disaster to be more knowledgeable and better prepared for the next one. While the provision of medical care to disaster victims is obviously paramount in the acute phase, from a public health standpoint the following activities must simultaneously be considered (Armenian, 1986):