• M R Hoek, S Bracebridge, and I Oliver.
• EPIET, European Programme for Intervention Epidemiology Training, The Wheelhouse, Bond's Mill, Stonehouse GLOS GL10 3RF, UK. maarten.hoek@hpa.org.uk
• J Public Health (Oxf). 2007 Sep 1; 29 (3): 298-302.

BackgroundOn Sunday 11th of December 2005, an explosion occurred at the Buncefield oil depot, Hertfordshire, resulting in a large fire that blazed for several days. Two Accident and Emergency (A&E) departments were placed on stand-by to receive casualties. A simple surveillance system was put in place during the acute phase of the incident, but this was not adequate to fully examine the health impact of the fire.MethodsRetrospective study of A&E records at Hemel Hempstead and Watford A&E departments for the period that the fire burnt.ResultsTwo hundred and forty-four people attended A&E as a result of the fire: 187 were members of the emergency services; 17 were oil depot workers; and 40 were members of the public. The most common presenting complaints were respiratory symptoms (n = 66) and injuries (n = 38). Twenty-five (21%) individuals were referred for medical follow-up. There were no fatalities.ConclusionThere was a significant impact on local health services, with many emergency service personnel attending A&E asymptomatically. Alternative health service provision for these individuals, possibly near to the scene of the incident, should be considered. This incident has also highlighted an urgent need to develop surveillance systems that enable real-time monitoring of the acute public health impact of major incidents.

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