"The SHARP Joint Action aims to strengthen preparedness in the EU against serious cross-border threats to health and support the implementation of the International Health Regulations (2005) (World Health Organization, 2016). Surveillance is a key activity required under the International Health Regulations (IHR). Tested surveillance systems are required for the detection, verification, and risk assessment of the impact of chemical events of (potential) health concern as part of a multi-hazard surveillance strategy. The aim of this work was to review the global tools, systems, and strategies currently available for the public health surveillance of chemical health threats, including incidents, events, and exposures with the potential to impact health.
The published literature was searched for relevant articles and reports that demonstrated good practice. Using indexing databases, Medline, Web of Science and Embase databases, and grey literature indexing sources, a total of 4066 titles were extracted, of which 175 articles and reports were included in this review. The material identified was divided into nine themes; acute surveillance, event-based surveillance, industrial surveillance, occupational surveillance, oil spills, environmental contamination surveillance, maternal/paediatric surveillance, system approaches and other surveillance and tools (for miscellaneous titles that did not fit into a theme). These were further synthesised into four key themes: acute surveillance, industrial and occupational surveillance, environmental contamination surveillance and system approaches.
In conclusion, different chemical incident surveillance tools are used for identifying and responding to chemical incidents, and for protecting public health and the environment. Various systems and reporting tools are available for chemical health threat surveillance for public health purposes. Through ongoing monitoring and collaboration, these systems can help to prevent and mitigate the impact on health of chemical incidents and promote safe and responsible practices in the use and handling of hazardous materials. In addition to the importance of surveillance, it is critical to take proactive measures to prevent chemical incidents from occurring in the first place. This can include efforts to improve safety regulations, increase awareness of the risks associated with chemicals, and promote the use of safer chemicals and production processes.
Overall, the risk to health of unintentional chemical exposures and chemical incidents underscores the need for ongoing vigilance and coordinated efforts to protect public health and safety. By developing and implementing effective surveillance and prevention strategies, we can help mitigate the risks associated with chemical incidents and reduce their impact on individuals, communities, and the environment."

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