title: The public health response during and after the Lac-Mégantic train derailment tragedy: a case study.
abstract: On July 6th2013, a train derailment occurred in the small town of Lac-Mégantic, Quebec, Canada, causing a major human and environmental disaster. In this case study, we comprehensively describe and analyze actions taken by the Public Health Department of the Eastern Townships, in close collaboration with community-based organizations, during both the impact phase emergency response and the post-impact recovery operations that continued for months. Due to the complexity of the event, public health actions needed to be broadly diversified. Preventive measures targeted chemical, physical, biological, and psychosocial hazards in the short-, medium- and long-term. Our analyses yielded valuable lessons that will improve and inform our response to future events while serving as a basis for developing a conceptual framework for public health emergency preparedness.
authors.affiliation: Public Health Department; Eastern Townships Integrated University Centre for Health & Social Services - Sherbrooke Hospital University Centre; Sherbrooke, Québec, Canada; University Institute for Primary Health Care & Social Services; Eastern Townships Integrated University Centre for Health & Social Services - Sherbrooke Hospital University Centre; Sherbrooke, Québec, Canada; Department of Community Health Sciences; Faculty of Medicine and Health Sciences; Université de Sherbrooke; Sherbrooke, Québec, Canada.
authors.forename: Mélissa
authors.initials: M
authors.lastname: Généreux
authors.affiliation: Public Health Department; Eastern Townships Integrated University Centre for Health & Social Services - Sherbrooke Hospital University Centre; Sherbrooke, Québec, Canada; Department of Community Health Sciences; Faculty of Medicine and Health Sciences; Université de Sherbrooke; Sherbrooke, Québec, Canada.
authors.forename: Geneviève
authors.initials: G
authors.lastname: Petit
authors.affiliation: University Institute for Primary Health Care & Social Services; Eastern Townships Integrated University Centre for Health & Social Services - Sherbrooke Hospital University Centre; Sherbrooke, Québec, Canada; Department of Human and Social Sciences; Education Unit in Social Work; Université du Québec à Chicoutimi; Chicoutimi, Quebec, Canada.
authors.forename: Danielle
authors.initials: D
authors.lastname: Maltais
authors.affiliation: University Institute for Primary Health Care & Social Services; Eastern Townships Integrated University Centre for Health & Social Services - Sherbrooke Hospital University Centre; Sherbrooke, Québec, Canada; Department of Family Medicine and Emergency Medicine; Faculty of Medicine and Health Sciences; Université de Sherbrooke; Sherbrooke, Québec, Canada.
authors.forename: Mathieu
authors.initials: M
authors.lastname: Roy
authors.affiliation: Public Health Department; Eastern Townships Integrated University Centre for Health & Social Services - Sherbrooke Hospital University Centre ; Sherbrooke, Québec, Canada.
authors.forename: Robert
authors.initials: R
authors.lastname: Simard
authors.affiliation: Public Health Department; Eastern Townships Integrated University Centre for Health & Social Services - Sherbrooke Hospital University Centre ; Sherbrooke, Québec, Canada.
authors.forename: Sonia
authors.initials: S
authors.lastname: Boivin
authors.affiliation: Center for Disaster & Extreme Event Preparedness (DEEP Center); University of Miami Miller School of Medicine ; Miami, FL USA.
authors.forename: James M
authors.initials: JM
authors.lastname: Shultz
authors.affiliation: Public Health Department; Eastern Townships Integrated University Centre for Health & Social Services - Sherbrooke Hospital University Centre; Sherbrooke, Québec, Canada; University Institute for Primary Health Care & Social Services; Eastern Townships Integrated University Centre for Health & Social Services - Sherbrooke Hospital University Centre; Sherbrooke, Québec, Canada; Department of Community Health Sciences; Faculty of Medicine and Health Sciences; Université de Sherbrooke; Sherbrooke, Québec, Canada.
authors.forename: Linda
authors.initials: L
authors.lastname: Pinsonneault
keywords: anthropogenic disaster; disaster cascade; human-generated disaster; rail disaster; risk landscape; technological disaster; transportation disaster