NSSP Supports Ohio Train Derailment Response


  • Assessing potential chemical exposures and health impacts was vital after a train derailed in the village of East Palestine in Columbiana County, Ohio.
  • CDC supported the response by monitoring overall emergency department (ED) trends—in partnership with state and local health departments—through the National Syndromic Surveillance Program (NSSP).
  • Officials used syndromic data to assess health threats, inform public service announcements, and alert medical facilities of the need to prepare for an influx of patients.
Train derailed and in flames in East Palestine, Ohio

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On Feb. 3, 2023, a cargo train carrying hazardous substances derailed in the village of East Palestine in Columbiana County, Ohio, near the Pennsylvania border, resulting in fire and release of rail car contents into the surrounding environment. Response efforts at the local and state levels included assessments of potential chemical exposures and health impacts associated with the incident and the use of improved situational awareness to communicate instructions and essential information to those affected by the derailment.

Monitoring and understanding the impact

Steps taken to monitor and better understand the impact of the incident on the local population included:

  • Air monitoring of homes
  • Sampling of private water wells
  • Community air monitoring
  • Sampling of public water systems potentially affected in the area

Ohio and Pennsylvania authorities requested assistance from CDC and the Agency for Toxic Substances and Disease Registry (ATSDR) to provide additional technical assistance in the areas of epidemiology, toxicology, and syndromic surveillance to support response goals.

Through partnerships with state and local health departments and CDC programs, NSSP supported this response. NSSP ED data were used to detect, monitor, and guide mitigation efforts. The ED visit data provided information drawn from chief complaints and codes reported during admission, discharge, and final billing. NSSP supported this response in various ways, including:

  • Monitoring overall ED trends—NSSP gathered data from electronic health records, allowing public health officials to identify mentions of East Palestine, train derailment, and symptoms related to chemical exposures such as cough, headache, sore throat, and shortness of breath. NSSP, working with partners in state and local health departments, analyzed ED visits that referenced the incident either as a chief complaint or admit reason.
  • Monitoring Columbiana County—Working with health officials in Columbiana County, NSSP monitored trends in ED patient visits by identifying and tracking the changes in the use of diagnosis codes within the county after the derailment, even if the visits did not necessarily mention the incident or chemical exposure.

Informing next steps

Monitoring trends is one way that decision-makers used syndromic surveillance to assess the complexities of threats to the public's health. Automated analyses (text mining) and reports gave visibility into common symptoms or complaints and terms that stood out as interesting or different. These reports provided health department leadership with the necessary awareness to inform next steps.

Data from anyone seeking care in an ED in the surrounding area were used to detect potential exposures and identify the ways in which health was being adversely affected. Officials also used syndromic data to inform public service announcements, assess how broadly areas were affected by potential exposures, and alert medical facilities of the need to prepare for an influx of patients.

NSSP's collaboration with our nation's public health jurisdictions ensures that syndromic surveillance remains an essential source of data to support public health decision-making.