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Hazardous substances disease and injury notifications

An electronic notification system has been designed for general practices to report cases of disease and injury related to exposure to hazardous substances, including lead absorption. It was developed by bestpractice Decision Support (BPAC Inc) and the Centre for Public Health Research, Massey University and is funded by the Ministry of Health.

The notification system was introduced progressively throughout New Zealand in 2013. There were 244 notifications in 2013 and 229 in 2014. Of these, 180 and 130 were for lead absorption in 2013 and 2014 respectively.

What is defined as a hazardous substance injury or disease?

A hazardous substance is anything that can explode, catch fire, oxidise, corrode or be toxic to humans, as defined in the Hazardous Substances and New Organisms Act 1996. The Act requires medical practitioners to notify cases of injury or disease caused by exposure to a hazardous substance to the Medical Officer of Health.

There are a multitude of possibilities of exposure to hazardous substances, such as: ingestion of cleaning products or cosmetics by children, overdose with agrichemicals, illness caused by exposure to solvents or chlorine, contact dermatitis due to chemicals, a fireworks burn or eye injury and “huffing’ (inhaling) of butane.

How should a case be notified?

Look for the “Hazardous Substances and Lead notifications” module on the bestpractice Decision Support dashboard (see Figure 1 for an example). Submitting the form will send it to your local Medical Officer of Health via a secure system.

If your practice does not currently have access to this electronic form, contact your local Public Health Unit to notify them of a case.

Lead notifications

Cases of lead exposure including occupational and non-occupational, in which a patient has a blood lead level of ≥0.48 µmol/L, are required to be notified. The electronic form can be used for these notifications.

Poisoning from chemical contamination of the environment

Cases of poisoning arising from chemical contamination of the environment (e.g. from carbon monoxide, agrichemical spraydrift) are also required to be notified under the Health Act 1956, and this can be done via the electronic form.

Why notify?

The Medical Officer of Health and Public Health Unit staff will assess the information about the exposure and determine if further follow-up with the patient is required.

Primary care notifications allow identification of substances which are causing harm, and can lead to controls being put in place to prevent disease or injury. For example, exposure to lead from deteriorating lead-based paint can be reduced through a range of remedial actions. Some controls may be regulatory; for example, the sale of highly alkaline dishwashing powders was prohibited in 2007 following increased reports of oesophageal and upper airway injuries in children who ingested this powder.

For further information about reporting exposures to hazardous substances, contact your local Public Health Unit, or for more information about the e-notification tool, contact:

Fei Xu
0800 588 265

Helene Marsters
04 979 3382

Figure 1: (click to enlarge)
Example of the Exposure Event tab of the notification form – ingestion of dishwashing powder