Key aspects of a Flemish system to safeguard public health interests in case of chemical release incidents.

Abstract Although well-established protocols are available for emergency services and first-responders in case of chemical release incidents, a well-developed system to monitor and safeguard public health was, until recently, lacking in Flanders. We therefore developed a decision support system (DSS) to aid public health officials in identifying the appropriate actions in case of incidents. Although the DSS includes human biomonitoring as one of its key instruments, it also goes well beyond this instrument alone. Also other, complementary, approaches that focus more on effect assessment using in vitro toxicity testing, indirect exposures through the food chain, and parallel means of data collection (e.g. through ecosurveillance or public consultation), are integrated in the Flemish approach. Even though the DSS is set up to provide a flexible and structured decision tree, the value of expert opinion is deemed essential to account for the many uncertainties associated with the early phases of technological incidents. When the DSS and the associated instruments will be fully operational, it will provide a valuable addition to the already available protocols, and will specifically safeguard public health interests.