Sequelae can occur when widely exposed to high concentrations, including chronic lung disease, blindness, burn scars, and esophageal stricture. Fingertip injuries are troublesome with persistent pain, bone loss, and nail-bed injury. In 1987, in the state of Texas in the United States, a similar leakage of 18 tons of hydrofluoric acid occurred. Acute health effects including respiratory tract and irritation of eyes on local residents were recorded up to 2 yr following the accident (7). Therefore, follow-up surveys need to be done for residents exposed to the leakage.
Local residents are wise in being nervous about the outcome from such an accident (8), but may take some solace in the knowledge that most health effects after exposure appear almost immediately within 3 days, with chronic effects being rare. As a protective measure and for reassurance, the government should act swiftly following an incident, including monitoring the health effects of the residents. Especially, post-traumatic stress disorder and anxiety should be managed. A survey of the countryside for withered plants, affected crops and affected livestock should be done promptly, and continuous monitoring of soils, groundwater, freshwater and seawater should be arranged immediately.
Protocols in the event of a disaster caused by chemicals can and should be prepared in advance, including education of firefighters or public servants in the use of appropriate protective equipment and neutralizers (9). While hopefully not needed, this readiness is a wise course of action.