title: Exposures and symptoms among workers after an offsite train derailment and vinyl chloride release.
abstract: OBJECTIVE
  In 2012 in New Jersey, a train derailment resulted in the puncture of a tanker car carrying liquid vinyl chloride under pressure, and a resulting airborne vinyl chloride plume drifted onto the grounds of a nearby refinery. This report details the investigation of exposures and symptoms among refinery workers.
  
  
  METHODS
  The investigation team met with refinery workers to discuss their experience after the derailment and provided workers a self-administered survey to document symptoms and worker responses during the incident. Associations among categorical variables and experiencing symptoms were evaluated using Fisher's exact test.
  
  
  METHODS
  Twenty-six of 155 (17 percent) workers present at the refinery or driving on the access road the date the spill occurred completed the survey.
  
  
  METHODS
  Any self-reported symptom following exposure from the vinyl chloride release.
  
  
  RESULTS
  Fifteen workers (58 percent) reported ≥1 symptom, most commonly headache (12, 46 percent). Three (12 percent) reported using respiratory protection. No differences in reporting symptoms were observed by location during the incident or by the building in which workers sheltered. Workers who moved from one shelter to another during the incident (ie, broke shelter) were more likely to report symptoms (Fisher's exact test, p=0.03); however, there are only limited data regarding vinyl chloride concentrations in shelters versus outside.
  
  
  CONCLUSIONS
  Breaking shelter might result in greater exposures, and managers and health and safety officers of vulnerable facilities with limited physical access should consider developing robust shelter-in-place plans and alternate emergency egress plans. Workers should consider using respiratory protection if exiting a shelter is necessary during a chemical incident.
authors: Epidemic Intelligence Service, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia; California Department of Public Health, Richmond, California; CDC's Office of Public Health Preparedness and Response, Atlanta, Georgia.
authors: Jason A
authors: JA
authors: Wilken
authors: Agency for Toxic Substances and Disease Registry, Edison, New Jersey.
authors: Leah
authors: L
authors: Graziano
authors: Agency for Toxic Substances and Disease Registry, Edison, New Jersey.
authors: Elena
authors: E
authors: Vaouli
authors: Agency for Toxic Substances and Disease Registry, Philadelphia, Pennsylvania.
authors: Karl
authors: K
authors: Markiewicz
authors: Agency for Toxic Substances and Disease Registry, Philadelphia, Pennsylvania.
authors: Robert
authors: R
authors: Helverson
authors: Epidemic Intelligence Service, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia; CDC's National Institute for Occupational Safety and Health, Atlanta, Georgia.
authors: Kimberly
authors: K
authors: Brinker
authors: Epidemic Intelligence Service, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia; New Jersey Department of Health, Trenton, New Jersey; CDC's National Institute for Occupational Safety and Health, Spokane, Washington.
authors: Alice M
authors: AM
authors: Shumate
authors: Agency for Toxic Substances and Disease Registry, Atlanta, Georgia.
authors: Mary Anne
authors: MA
authors: Duncan
mesh_terms: D000062:Accidents, Occupational; D055884:Chemical Hazard Release; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D009515:New Jersey; D009784:Occupational Diseases / Q000139:chemically induced*; D016273:Occupational Exposure / Q000009:adverse effects / Q000032:analysis*; D011890:Railroads; D014752:Vinyl Chloride / Q000506:poisoning*
chemical_list: D014752:Vinyl Chloride