Death and disease from exposure to chemicals is a significant global public health problem. WHO estimates that 2 million lives and 53 million disability-adjusted life-years were lost in 2019 due to exposures to selected chemicals.
The causes of many chemical incidents are often obvious, such as an explosion, fire or leak resulting in the release of an airborne plume, tainting and polluting water or depositing particles on land. Occasionally, however, a chemical release may not be obvious and the possibility considered only when a number of cases present or are reported. Timely identification of the cause requires detection and verification of clusters and a subsequent outbreak investigation. The investigations may require a detailed study with epidemiological, environmental, clinical and toxicological approaches.
The Manual for investigating suspected outbreaks of illnesses of possible chemical etiology: guidance for investigation and control provides a practical, pragmatic guide for public health and allied professionals for the investigation of clusters and outbreaks in which a noncommunicable cause (in particular a chemical substance) is considered a distinct possibility. The manual was prepared by a group of experts and specialists in investigating chemical-related outbreaks and builds on the experience of past emergency response operations, including WHO missions. The manual identifies the roles and responsibilities of organizations and individuals and covers management and organizational aspects for multidisciplinary investigation, communication and control. The principal target audience is environmental public health practitioners, but environmental scientists, clinicians, toxicologists and epidemiologists (including environmental epidemiologists), as well as policy-makers, will also find this manual of interest.