What ails the Bhopal disaster investigations? (And is there a cure?)

A review of the health effects of the 1984 disaster in Bhopal, India, shows continuing morbidity of a multi-systemic nature in the exposed population. Scientific questions about epidemiologic issues are discussed with a view to understanding appropriate methods of investigation into the disaster. Other major chemical incidents were reviewed to note some of the common problems associated with public health investigations of disasters, which have included the lack of accident-related and toxicologic information, expertise, and funds. The complexity of the Bhopal crisis was underscored by the severe mortality and morbidity it entailed as well as its occurrence in a developing nation that had little experience in dealing with chemical disasters. Lessons learned from the disaster are discussed, with recommendations for disaster preparedness, long-term monitoring, rehabilitation, and treatment of the gas victims.