Chemical Injuries Surveillance
Friday 12th March 2010
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Chemical Injuries Surveillance
In 2001, ESR was commissioned by the New Zealand Ministry of Health (MoH) to develop a national Chemical Injury Surveillance System (CISS). Since then, several models have been deployed. The present system involves the collection and analysis of hazardous substance injury data that reflects the majority of data sources in the injury pyramid (see Fig. 2 Chemical Injury Surveillance for NZ, 2006). National mortality data are sourced from the Coronial Services Office (CSO) and national inpatient hospitalisation data are received from the New Zealand Health Information Service (NZHIS). In addition, local hospital poisoning notifications (emergency department patients and inpatients) are voluntarily submitted from a number of hospitals representing the following DHBs: Auckland, Capital and Coast, Wairarapa, West Coast and Southland. A range of chemical/poison related notifiable injuries (hazardous substance injuries, chemical poisoning from the environment, decompression sickness, lead absorption and toxic shellfish poisoning) from EpiSurv are also included in the CISS. Summarised National Poison Centre (NPC) calls and PHU spraydrift complaints are also included. The wide range of data sets enables the CISS to provide a comprehensive overview of the burden of injury associated with hazardous substance injuries in New Zealand.The CISS was primarily developed in response to the legislative requirements of Section 143 of the Hazardous Substances and New Organisms (HSNO) Act (1996); all hazardous substance injuries that result in hospitalisation are to be notified to the Medical Officer of Health. In December 2005, an amendment was made to the HSNO Act that requires all diagnosing medical practitioners, in addition to hospitals, to report injuries caused by hazardous substances to the Medical Officer of Health. In September 2007 the Hazardous Substances Injury (HSI) case report form (CRF) was launched in EpiSurv as the mechanism for collecting hazardous substance injury information for the Ministry of Health. The CISS is intended to encompass this legislative requirement, and extend it to achieve the greatest public health utility. For this reason, hazardous substances incorporated in the CISS include substances not covered by the HSNO Act such as medicines in finished dose form and party drugs or alcohol when classified as a food. The purpose of s143 and the CISS is therefore to provide information for public health action and informing health policy formation. These measures in combination can be used to reduce the incidence of hazardous substance injuries in New Zealand and improve public health.
National hazardous substance injury data are currently provided to ESR from the CSO and NZHIS pertaining to deaths and hospital inpatients respectively. However, the NZHIS data does not include emergency department patients, nor detailed substance information for inpatients, thus prohibiting a reliable evaluation of the impact of any poisoning related interventions and effectiveness of regulations. Attainment of emergency data from hospitals for the CISS can be resource intensive for them, and therefore expected to be gradual. Thus, sentinel surveillance comprising hospital data from a number of DHBs including a major metropolitan city, provincial town and rural area is to suffice in the interim.
Further PHUs have been approached and data from other PHUs/hospitals would be readily and appreciatively encompassed into the CISS. ESR would like to hear from any other interested hospitals and PHUs regarding provision of hazardous substance injury data.Please contact survqueries@esr.cri.nz for further information.
Chemical injuries reports are available here.
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