Search

Introduction: Environmental risk assessment in industrial complexes is of significant importance, as the negative impacts of these complexes pose a serious threat to the environment, human life, and international stability. This study aimed to assess the risk of exposure to chemicals and chemical incidents in industrial settings using a hybrid approach based on fuzzy logic. Material and Methods: In this study, a hybrid approach based on fuzzy logic was employed to identify, assess, and prioritize the relevant risks in the Karun oil and gas exploitation industrial zone in Ahvaz city in 1400. This method allows for more accurate and effective risk assessment by considering uncertainties and ambiguities in the data. The study included the assessment of the likelihood of hazard occurrence, the severity of hazard occurrence, the detection probability, hazard effects, risk priority number, and the necessary control measures and proposed actions. Results and Discussion: The results indicated that employees in the evaluated unit are exposed to various chemicals and chemical incidents during their activities. The risk assessment was conducted for 27 types of chemicals and 16 identified chemical incidents. Among the studied substances, exposure and contact with substances butadiene and ethylene oxide are carcinogenic for employees, and mono ethylene glycol with toxic properties causes effects on the heart and kidneys. Butanol can cause respiratory and eye issues due to negligence, leading to fire risks in the facility. The highest risk, with an RPN of 0.715, is associated with gas inhalation from the evaporation of hydrofluoric acid and nitrogen. In contrast, the lowest risks, with RPNs below 0.1, are related to two liquid leakage scenarios at ambient temperature and pressure. The results of the risk assessment calculation show that none of the substances in the company have a very high risk for the employees, but five substances, naphtha, ammonia gas, acetic acid, chlorine gas, and methanol, have a high risk for the employees. The overall risk assessment results for exposure to chemicals and chemical incidents showed that a significant portion of the industry's activities falls within the high-risk range, highlighting the necessity for increased attention and planning to reduce this risk level to prevent serious incidents. Additionally, the results demonstrated that using a systematic fuzzy analysis method provides significant improvements in risk management and can be utilized as an effective tool in this field. Conclusion: Based on the results, risk assessment using a hybrid approach based on fuzzy logic can aid decision-makers in improving environmental performance and creating safer and more sustainable conditions for the industry. By utilizing information related to hazards and the results of measurements and evaluations of chemical factors within the framework of chemical pollutant exposure risk assessment, various jobs can be ranked in terms of exposure to harmful chemical factors. These results can be used to prioritize resource allocation for implementing control measures and reducing exposure risk to an acceptable level.

During the years of war, as a result of aviation and missile attacks, a significant number of health care facilities in various regions of Ukraine were destroyed, and the complexity and intensity of their work increased significantly. If the readiness of hospitals and their employees to treat gunshot and explosive injuries is established, in the case of mass destruction of chemically hazardous enterprises and the threat of the enemy using weapons of mass destruction, including chemical weapons, there is a need for special training of health care facilities to work in the in conditions of chemical threats. The aim of the work was justification of the development and set of measures for the implementation of standard operating procedures in the event of a chemical incident. The legal documents and recommendations of the Ministry of Health of Ukraine, management of the World Health Organization and the Red Cross on the topic of the study were used. The research methods: bibliosemantic, analytical, modeling were applied. It is established that the special management group, which includes representatives of various services, is of decisive impor­tance in the effective management of a health care facility during a chemical incident: administration; communication department; security department; management of nurses and the department of infection control; human resources department; pharmacy; intensive care unit; department of engineering maintenance and repair; laboratory; kitchen; laundry; cleaning service and waste management. The most important measures of response to a chemical incident that ensure the safety of medical personnel and patients are the organization of a triage zone and a decontamination area for chemically affected persons. Based on the above, to prepare a health care facility for work during a chemical incident, it is necessary to develop a response plan, which consists of special administrative and management decisions and provides for regular staff training.

During the years of war, as a result of aviation and missile attacks, a significant number of health care facilities in various regions of Ukraine were destroyed, and the complexity and intensity of their work increased significantly. If the readiness of hospitals and their employees to treat gunshot and explosive injuries is established, in the case of mass destruction of chemically hazardous enterprises and the threat of the enemy using weapons of mass destruction, including chemical weapons, there is a need for special training of health care facilities to work in the in conditions of chemical threats. The aim of the work was justification of the development and set of measures for the implementation of standard operating procedures in the event of a chemical incident. The legal documents and recommendations of the Ministry of Health of Ukraine, management of the World Health Organization and the Red Cross on the topic of the study were used. The research methods: bibliosemantic, analytical, modeling were applied. It is established that the special management group, which includes representatives of various services, is of decisive importance in the effective management of a health care facility during a chemical incident: administration; communication department; security department; management of nurses and the department of infection control; human resources department; pharmacy; intensive care unit; department of engineering maintenance and repair; laboratory; kitchen; laundry; cleaning service and waste management. The most important measures of response to a chemical incident that ensure the safety of medical personnel and patients are the organization of a triage zone and a decontamination area for chemically affected persons. Based on the above, to prepare a health care facility for work during a chemical incident, it is necessary to develop a response plan, which consists of special administrative and management decisions and provides for regular staff training. [ABSTRACT FROM AUTHOR]

An integrated environmental health exposure assessment (IEHA) refers to the integration of human biomonitoring data (HBM) and environmental measurements and aims to optimize the exposure assessment process. Due to lack of data, this approach remains an issue during chemical incidents. This study aims to explore integrated exposure approaches for assessing human health risks during chemical incidents. Based on the Preferred Reporting Items of Systematic reviews and Meta‐Analyses statement, a literature analysis was performed. A level of confidence ranging from 1 to 4 was established to define the quality and strength of data used to undertake an IEHA approach. Twenty‐seven articles (n = 18) and texts (n = 9) from Europe (41%) and the United States (37%) were analyzed. Among the 18 scientific articles, 61% (n = 11) presented a quantitative approach and 17% (n = 3) presented a qualitative approach. Quantitative approaches must be based on accurate data, coupled with predictive models. Of all the scientific papers, 40% (n = 7) responded to a confidence level greater than or equal to 2. Uncertainties detected through the integrated exposure approaches were related to input data, analytical methods, and HBM reference value interpretations. During chemical incidents, direct measurements were the most relevant data. Few scientific studies have developed an integrated approach during emergency situations. However, when this was used, they presented a high level of confidence by defining levels of exposure that support decision‐making processes. Despite the multiple approaches, there was a lack of guidelines allowing an integrated risk assessment to be performed during an emergency chemical exposure. Integr Environ Assess Manag 2024;20:481–497. © 2023 SETAC Key Points: Despite the scientific sources and the multiple specific approaches, there was a lack of good practice guidelines allowing an integrated risk assessment to be carried out during an emergency chemical exposure.There is a need to integrate human biomonitoring data and direct environmental measures to refine exposure assessment and protect the environment and public health.Integrated assessment allows better support for decision‐making during a chemical incident assessment. [ABSTRACT FROM AUTHOR]

The large amounts of opioids and the emergence of increasingly potent illicitly manufactured synthetic opioids circulating in the unregulated drug supply in North America and Europe are fueling not only the ongoing public health crisis of overdose deaths but also raise the risk of another type of disaster: deliberate opioid release with the intention to cause mass harm. Synthetic opioids are highly potent, rapidly acting, can cause fatal ventilatory depression, are widely available, and have the potential to be disseminated for mass exposure, for example, if effectively formulated, via inhalation or ingestion. As in many other chemical incidents, the health consequences of a deliberate release of synthetic opioid would manifest quickly, within minutes. Such an incident is unlikely, but the consequences could be grave. Awareness of the risk of this type of incident and preparedness to respond are required to save lives and reduce illness. Coordinated planning across the entire local community emergency response system is also critical. The ability to rapidly recognize the opioid toxidrome, education on personal protective actions, and training in medical management of individuals experiencing an opioid overdose are key components of preparedness for an opioid mass casualty incident.

Objective: Disaster health literacy is vital for emergency medicine and public health preparedness. Conversely, how health and safety information is communicated has a significant impact on disaster health literacy. A lack of alignment between the disaster response and the public's reaction was apparent during a Dutch chemical incident. This case study aims to provide insights into why that misalignment occurred. Methods: The case study used readily available Twitter data. The tweets represented both the public and the authorities. The tweets were coded, thematically categorised, analysed, and synthesised to generate an explanatory framework describing the obstacles experienced during the emergency. Results: The analysis identified four areas of concern with regards to the lack of alignment between the authorities and the public: the alert of the chemical incident, the inadequate communication, the problematic disaster management, and the insufficient disaster health literacy. Conclusion: The case study showed shortcomings in communication and a lack of alignment in the emergency response of the authorities as well as the public's disaster health literacy. Immediate action points were apparent, and a more profound evaluation is recommended to avoid further escalation of an emergency in the future. Trust needs to be built before the next incident strikes. [ABSTRACT FROM AUTHOR]

Introduction: To date, all human studies of mass-casualty decontamination for chemical incidents have relied on the collection and analysis of external samples, including skin and hair, to determine decontamination efficacy. The removal of a simulant contaminant from the surface of the body with the assumption that this translates to reduced systemic exposure and reduced risk of secondary contamination has been the main outcome measure of these studies. Some studies have investigated systemic exposure through urinary levels of simulant metabolites. The data obtained in these studies were confounded by high background concentrations from dietary sources. The unmetabolized simulants have never been analyzed in urine for the purposes of decontamination efficacy assessment.Study Objective: Urinary simulant analysis could obviate the need to collect skin or hair samples during decontamination trials and provide a better estimate of both decontamination efficacy and systemic exposure. The study objective therefore was to determine whether gross skin contamination as part of a decontamination study would yield urine levels of simulants sufficient to evaluate systemic availability free from dietary confounders.Methods: In this study, a gas chromatography-tandem mass spectrometry method was developed for the analysis of two chemical simulants, methyl salicylate (MeS) and benzyl salicylate (BeS), in urine. An extraction and sample clean-up method was validated, enabling quantitation of these simulants in urine. The method was then applied to urine collected over a 24-hour period following simulant application to the skin of volunteers.Results: Both MeS and BeS were present in all urine samples and were significantly increased in all post-application samples. The MeS levels peaked one hour after skin application. The remaining urinary levels were variable, possibly due to additional MeS exposures such as inhalation. In contrast, the urinary excretion pattern for BeS was more typical for urinary excretion curves, increasing clearly above baseline from four hours post-dose and peaking between 12.5 and 21 hours, a pattern consistent with dermal absorption and rapid excretion.Conclusion: The authors propose BeS is a useful simulant for use in decontamination studies and that its measurement in urine can be used to model systemic exposures following skin application and therefore likely health consequences. [ABSTRACT FROM AUTHOR]

The Northern-Eastern region of Bulgaria is one of the most developed industrial regions of the country. There are numerous chemical plants and industrial installations related to the chemical production. In order to maintain the industry, a lot of warehouses for storage of diverse chemical substances and compounds are also established. Another source for chemical hazard is the biggest Bulgarian port, where thousands of tons of chemicals are continuously loaded or downloaded. The transportation of the chemicals is also a risk factor for chemical incident occurrence. Records are proving that the risk related to the present chemical hazards has not to be neglected, as several chemical major incidents have challenged the regional relief agencies. One of the lessons identified is describing the requirement for faster identification of all those from the population that have been affected by the chemicals in low doses - those into the zones of damaging concentration of the chemical area of damage. All chemical injured casualties that were close to the chemical spill or within the zone of lethal concentration develop rapidly the symptoms of the intoxication and are easily diagnosed and medically attended. The challenge is how to find and direct the casualties with minor symptoms. Majority of these casualties are not considering their complains as serious, therefore are not contacting their general practitioners, but instead are addressing the closest pharmacists for advice and prescription of some drugs for the light symptoms. Based on this records the conclusion of the significant role of pharmacists into chemical incident management has been noted. The objective of this study is to analyze the preparedness and readiness of the pharmacists in Varna region to medically support affected population in case of chemical major incident or disaster. Materials and Methods: a sociological survey of a specific group of healthcare professionals (pharmacists), was conducted, using the direct individual survey method with a standard questionnaire with 38 questions. Method of survey - applied to determine the knowledge of two groups of healthcare professionals – master-degree pharmacists and college degree assistant pharmacists, on the risk of chemical accidents of natural and anthropogenic nature, the properties of some widespread industrial toxic substances, the availability of antidotes and the proper first aid that may be given in case of poisoning with them. The principle of anonymity of the respondents is complied with. A stochastic (or random) selection method was used in which all units of the general aggregation have an equal chance to fall into the sample of the study. The means of the descriptive and comparative method along with the deductive analysis were applied. Results and discussion: 221 people were interviewed, 115 of which were master-degree pharmacists, working with pharmacies (52%) and 106 - students - college degree assistant pharmacists, trained in Disaster Medicine during their education at the Medical University of Varna (48%). The distribution of all respondents by gender is as follows: a total of 40 men (18.1%) and 181 women (81.9%) corresponding to those engaged in the profession. A statistically meaning differences were found into the preparedness of the two main groups of respondents. Overall analysis present relatively low level of readiness of the pharmacist to actively participate into the major chemical incident or chemical disaster medical support to the affected population. Conclusion: The results of the thoroughly performed analyses undoubtedly present the requirement for amelioration of the pharmacists education and training into university and college based undergraduation courses. [ABSTRACT FROM AUTHOR]

Background Contemporary word development is highly dependent on chemical industry. Great variety of chemical elements and compounds are present into the industrial processes - as a sources, medium and final products. Large amount of the chemicals that are into circulation throughout industrial processes or are transported and stored into warehouses or damps are with proven toxicity for humans. Therefore, in certain circumstances, uncontrolled or undesired release into environment, they could create life-threatening area of chemical damage. The risk of chemical exposure of population is increasing with the presence of chemical industrial sites in vicinity of the cities. City of Varna is an example of a city almost under constant siege by several large chemical plants. In case of incidents caused by toxic materials release into environment, always there is high risk level of air pollution and extremely rapid spread of the chemical hazard. The first minutes' activities in such incidents are of utmost importance for life saving and health preserving. Very few of the citizens are keeping at their homes/offices stock of medicines for coping with the possible chemical intoxication. It is expected that in chemical incident threat, alert or incident, the pharmacies will become overcrowded, therefore their operability has to be assessed as a preventive and life-saving asset in case of chemical incidents or disasters. The aim of our study is to analyze the pharmacists' preparedness to safeguard their own life and the lives of their colleagues in case of chemical incidents, thus participating actively into relief and recovery operations for the affected population. Material and Methods A comprehensive survey among the pharmacists, both with master and professional bachelor degrees, was conducted in Varna region. 221 participated into the survey - 115 working pharmacists with master degree and 106 students attending the 3-year pharmacist assistant course in Medical University Varna. A multiply choice questions regarding their self-assessment of knowledge and skills possessed for protecting activities required in case of chemical incidents have been asked. By the means of descriptive and comparative methods the given answers were thoroughly analyzed. Results and discussion Results of the performed analyses undoubtedly highlight the extremely low level of pharmacists in Varna region knowledge, skills and self-confidence related to required activities in case of chemical incidents. Great majority of the respondents are declaring their willingness to increase their capabilities for protection and healthy behavior in case of chemical incident. The most preferable by the participants into the survey are also analyzed and presented. [ABSTRACT FROM AUTHOR]

In a wide range of events, people may be acutely exposured to chemical substances. Particular hospital preparedness plans and vital resources are essential for appropriate health-care measures. The present study aimed to conduct a systematic review to summarize and evaluate the existing evidence on hospital preparedness plans or protocols against chemical incidents and threats. In this aim, through May 15, 2018, 5 electronic databases were searched in MEDLINE (PubMed, Scopus, Web of Science, Cochrane Library, and Google Scholar) for the following key words: hospital preparedness, plan, protocol, chemical incident, and chemical threat. The final review included 11 peer-reviewed papers that met inclusion criteria. The systematic review was performed using the Preferred Reporting Items for the Systematic reviews and Meta-Analysis protocol (PRISMA) (www.prisma-statement.org). Finally, of 16,540 selected papers, 11 papers were included in the final analysis. The thematic analyses revealed 11 major categories of chemical incidents and threats planning, such as planning requirements, planning prerequisites, preparation team member (multidisciplinary team), decontamination, personal protective equipment, education and training, job descriptions and roles, communication, database, staff /volunteer organization, as well as planning barriers and challenges for chemical incidents. Most countries have launched hospital preparedness planning against chemical incidents and threat activities, but the preparedness of hospitals is often less than desirable. Many items, such as databases, hospital preparation team members, communications, etc., are still challenging. [ABSTRACT FROM AUTHOR]

This work deals aims to present a methodology for source identification of chemical incidents in urban areas. We propose an approximation of the problem within the framework of the optimal control theory and we provide an algorithm for its numerical resolution. Finally, we analyze the validity of the algorithm in several academic situations.

Ethylene oxide (EO) is a reactive gas used by numerous industries and medical facilities as a sterilant, a fumigant, and as a chemical intermediate in chemical manufacturing. Due to its common use, EO has been involved in a number of leaks and explosive incidents/accidents requiring HAZMAT response. However, the extent of skin absorption under short-term HAZMAT conditions has not been directly assessed. Such data would assist decision making by first responders regarding skin decontamination in EO HAZMAT incidents. An in vitro test protocol with human skin was used for EO exposures at 800 ppm and 3000 ppm. No evidence of dermal penetration was seen for 800 ppm EO during a 30-min challenge. For 3000 ppm, EO penetration was observed after 20 min and was greater under higher temperature/humidity conditions. Fabric (heavy cotton) on skin enhanced penetration 5-fold compared with naked skin. Off gassing from exposed fabric was rapid. The results show dermal uptake of EO vapour from exposure at 3000 ppm is small but clothing may contribute to further dermal absorption/penetration over time. For exposed, but asymptomatic, persons in EO HAZMAT incidents first responders should remove bulky clothing to prevent potential skin damage and further uptake. [ABSTRACT FROM AUTHOR]

The large amounts of opioids and the emergence of increasingly potent illicitly manufactured synthetic opioids circulating in the unregulated drug supply in North America and Europe are fueling not only the ongoing public health crisis of overdose deaths but also raise the risk of another type of disaster: deliberate opioid release with the intention to cause mass harm. Synthetic opioids are highly potent, rapidly acting, can cause fatal ventilatory depression, are widely available, and have the potential to be disseminated for mass exposure, for example, if effectively formulated, via inhalation or ingestion. As in many other chemical incidents, the health consequences of a deliberate release of synthetic opioid would manifest quickly, within minutes. Such an incident is unlikely, but the consequences could be grave. Awareness of the risk of this type of incident and preparedness to respond are required to save lives and reduce illness. Coordinated planning across the entire local community emergency response system is also critical. The ability to rapidly recognize the opioid toxidrome, education on personal protective actions, and training in medical management of individuals experiencing an opioid overdose are key components of preparedness for an opioid mass casualty incident., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Cibulsky, Wille, Funk, Sokolowski, Gagnon, Lafontaine, Brevett, Jabbour, Cox, Russell, Jett, Thomas and Nelson.)

The application of human physiologically based pharmacokinetic (PBPK) modeling combined with measured biomonitoring data, has a great potential to backtrack external exposure to chemicals during chemical incidents. So far, an important shortcoming of ‘reversed dosimetry' is that uncertainty and variability in the model predictions are often neglected. The aim of this paper is to characterize the variation in predicted environmental air concentrations by means of reversed dosimetry as a result of uncertainty in chemical-specific input data and variability in physiological parameters. Human biomonitoring data ( N -2-cyanoethylvaline in blood) from a chemical incident with acrylonitrile (ACN) combined with the BioNormtox PBPK model are used as a case to reconstruct the air concentration and uncertainty thereof at the time of the incident. The influence of uncertainty in chemical-specific properties and exposure duration, and interindividual variability in physiological parameters on the reconstructed air exposure concentrations were quantified via nested Monte Carlo simulation. The range in the reconstructed air concentrations of ACN during the incident was within a factor of 3. Uncertainty in the exact exposure duration directly after the chemical accident was found to have a dominant influence on the model outcomes. It was also shown that uncertainty can be further reduced by collecting human biomonitoring data as soon as possible after the incident. Finally, the collection of specific information about individual physiological parameters from the victims, such as body weight, may further reduce the variation by 5 to 20% in our case study. Future research should include the comparison of reversed dosimetry model outcomes with measured air and biological concentrations to further increase the confidence in the model approach and its implementation in practice. [ABSTRACT FROM AUTHOR]

A small spill of approximately 3 mL of mercury from a broken barometer in a residential setting resulted in blood values of 32 μg/L in a boy of 9 months and 26 μg/L in a girl of 2.5 years in samples collected within 6 h after the start of the incident. A nanny who attempted to remove the spill had a blood mercury value of 20 μg/L at the same time point. These elevated blood values were attributed to inhalation rather than dermal uptake or ingestion. Exposure was aggravated by the use of a vacuum cleaner in an early attempt to remove the spill and incomplete decontamination of involved persons, leading to a continuation of exposure. Over a period of three months general cleaning was followed by targeted cleaning of hot spots until the indoor air mercury levels reached a median value of 0.090 μg/m 3 with a range of 0.032–0.140 μg/m 3 . Meanwhile the family was staying in a shelter home. Human biological monitoring (HBM) was motivated by the complex exposure situation and the involvement of young children. Initially high blood values triggered alertness for clinical signs of intoxication, that (as it turned out) were not observed in any of the exposed individuals. Despite continued exposure from hair and clothes, within six weeks after the incident, blood levels returned to a background level normally seen in children. HBM contributed to reassurance of the parents of the young children that quick elimination of the mercury did not require medical treatment. [ABSTRACT FROM AUTHOR]

The United Nations response mechanism to environmental emergencies requested a tool to support disaster assessment and coordination actions by United Nations Disaster Assessment and Coordination (UNDAC) teams. The tool should support on-site decision making when substantial chemical emissions affect human health directly or via the environment and should be suitable for prioritizing impact reduction management options under challenging conditions worldwide. To answer this need, the Flash Environmental Assessment Tool (FEAT) was developed and the scientific and practical underpinning and application of this tool are described in this paper. FEAT consists of a printed decision framework and lookup tables, generated by combining the scientific data on chemicals, exposure pathways and vulnerabilities with the pragmatic needs of emergency field teams. Application of the tool yields information that can help prioritize impact reduction measures. The first years of use illustrated the usefulness of the tool as well as suggesting additional uses and improvements. An additional use is application of the back-office tool (Hazard Identification Tool, HIT), the results of which aid decision-making by the authorities of affected countries and the preparation of field teams for on-site deployment. Another extra use is in disaster pro action and prevention. In this case, the application of the tool supports safe land-use planning and improved technical design of chemical facilities. UNDAC teams are trained to use the tool after large-scale sudden onset natural disasters. [ABSTRACT FROM AUTHOR]

In the event of a major chemical incident or accident, appropriate tools and technical guidance need to be available to ensure that a robust approach can be adopted for developing a remediation strategy. Remediation and restoration strategies implemented in the aftermath of a chemical incident are a particular concern for public health. As a result an innovative methodology has been developed to help design an effective recovery strategy in the aftermath of a chemical incident that has been developed; the UK Recovery Handbook for Chemical Incidents (UKRHCI). The handbook consists of a six-step decision framework and the use of decision trees specifically designed for three different environments: food production systems, inhabited areas and water environments. It also provides a compendium of evidence-based recovery options (techniques or methods for remediation) that should be selected in relation to their efficacy for removing contaminants from the environment. Selection of effective recovery options in this decision framework involves evaluating the physicochemical and toxicological properties of the chemical(s) involved. Thus, the chemical handbook includes a series of tables with relevant physicochemical and toxicological properties that should be assessed in function of the environment affected. It is essential that the physicochemical properties of a chemical are evaluated and interpreted correctly during the development of a remedial plan in the aftermath of a chemical incident to ensure an effective remedial response. This paper presents a general overview of the key physicochemical and toxicological properties of chemicals that should be evaluated when developing a recovery strategy. Information on how physicochemical properties have impacted on previous remedial responses reported in the literature is also discussed and a number of challenges for remediation are highlighted to include the need to develop novel approaches to remediate sites contaminated by mixtures of chemicals as well as methods for interpreting chemical reactions in different environmental matrices to include how climate change may affect the speciation and mobility of chemicals in the environment. [ABSTRACT FROM AUTHOR]

Chemicals are an important part of our society. A wide range of chemicals are discharged into the environment every day from residential, commercial and industrial sources. Many of these discharges do not pose a threat to public health or the environment. However, global events have shown that chemical incidents or accidents can have severe consequences on human health, the environment and society. It is important that appropriate tools and technical guidance are available to ensure that a robust and efficient approach to developing a remediation strategy is adopted. The purpose of remediation is to protect human health from future exposure and to return the affected area back to normal as soon as possible. There are a range of recovery options (techniques or methods for remediation) that are applicable to a broad range of chemicals and incidents. Recovery options should be evaluated according to their appropriateness and efficacy for removing contaminants from the environment; however economic drivers and social and political considerations often influence decision makers on which remedial actions are implemented during the recovery phase of a chemical incident. To date, there is limited information in the literature on remediation strategies and recovery options that have been implemented following a chemical incident, or how successful they have been. Additional factors that can affect the approach taken for recovery are not well assessed or understood by decision makers involved in the remediation and restoration of the environment following a chemical incident. The identification of this gap has led to the development of the UK Recovery Handbook for Chemical Incidents to provide a framework for choosing an effective recovery strategy. A compendium of practical evidence-based recovery options (techniques or methods for remediation) for inhabited areas, food production systems and water environments has also been developed and is included in the chemical handbook. This paper presents the key factors that should be considered when developing a recovery strategy with respect to how these may impact on its effectiveness. The paper also highlights the importance of these factors through an evaluation of recovery strategies implemented following real chemical incidents that have been reported in the literature. [ABSTRACT FROM AUTHOR]

The European Union (EU) Decision (1082/2013/EU) on serious cross border threats to health was adopted by the European Parliament in November 2013, in recognition of the need to strengthen the capacity of Member States to coordinate the public health response to cross border threats, whether from biological, chemical, environmental events or events which have an unknown origin. Although mechanisms have been in place for years for reporting cross border health threats from communicable diseases, this has not been the case for incidents involving chemicals and/or environmental events. A variety of collaborative EU projects have been funded over the past 10 years through the Health Programme to address gaps in knowledge on health security and to improve resilience and response to major incidents involving chemicals. This paper looks at the EU Health Programme that underpins recent research activities to address gaps in resilience, planning, responding to and recovering from a cross border chemical incident. It also looks at how the outputs from the research programme will contribute to improving public health management of transnational incidents that have the potential to overwhelm national capabilities, putting this into context with the new requirements as the Decision on serious cross border threats to health as well as highlighting areas for future development. [ABSTRACT FROM AUTHOR]

Good practices in emergency preparedness and response for chemical incidents include practices specific to the different functions of exposure assessment (e.g., within the monitoring function, the use of mobile monitoring equipment; within the modelling function, the use of rapid dispersion models with integrated mapping software) and generic practices to engage incident response stakeholders to maximise exposure assessment capabilities (e.g., sharing protocols and pre-prepared information and multi-agency training and exercising). Such practices can optimise cross-border collaboration. A wide range of practices have been implemented across MSs during chemical incident response, particularly during incidents that have cross-border and trans-boundary impacts. This paper proposes a self-assessment methodology to enable MSs, or organisations within MSs, to examine exposure assessment capabilities and communication pathways between exposure assessors and public health risk assessors. Where gaps exist, this methodology provides links to good practices that could improve response, communication and collaboration across local, regional and national borders. A fragmented approach to emergency preparedness for chemical incidents is a major obstacle to improving cross-border exposure assessment. There is no one existing body or structure responsible for all aspects of chemical incident preparedness and response in the European Union. Due to the range of different organisations and networks involved in chemical incident response, emergency preparedness needs to be drawn together. A number of recommendations are proposed, including the use of networks of experts which link public health risk assessors with experts in exposure assessment, in order to coordinate and improve chemical incident emergency preparedness. The EU's recent Decision on serious cross-border threats to health aims to facilitate MSs' compliance with the International Health Regulations, which require reporting and communication regarding significant chemical incidents. This provides a potential route to build on in order to improve chemical incident preparedness and response across Europe. [ABSTRACT FROM AUTHOR]

First responders to chemical, biological, radiological, or nuclear (CBRN) events face decisions having significant human consequences. Some operational decisions are supported by standard operating procedures, yet these may not suffice for ethical decisions. Responders will be forced to weigh their options, factoring-in contextual peculiarities; they will require guidance on how they can approach novel (indeed unique) ethical problems: they need strategies for 'on the spot' ethical decision making. The primary aim of this paper is to examine how first responders should approach on the spot ethical decision-making amid the stress and uncertainty of a CBRN event. Drawing on the long-term professional CBRN experience of one of the authors, this paper sets out a series of practical ethical dilemmas potentially arising in the context of a large-scale chemical incident. We propose a broadly consequentialist approach to on the spot ethical decision-making, but one which incorporates ethical values and rights as 'side-constraints'. [ABSTRACT FROM AUTHOR]

Abstract: Information on spatial and time dependent concentration patterns of hazardous substances, as well as on the potential effects on population, is necessary to assist in chemical emergency planning and response. To that end, some models predict transport and dispersion of hazardous substances, and others estimate potential effects upon exposed population. Taken together, both groups constitute a powerful tool to estimate vulnerable regions and to evaluate environmental impact upon affected populations. The development of methodologies and models with direct application to the context in which we live allows us to draft a more clear representation of the risk scenario and, hence, to obtain the adequate tools for an optimal response. By means of the recently developed DDC (Damage Differential Coupling) exposure model, it was possible to optimize, from both the qualitative and the quantitative points of view, the estimation of the population affected by a toxic cloud, because the DDC model has a very good capacity to couple with different atmospheric dispersion models able to provide data over time. In this way, DDC analyzes the different concentration profiles (output from the transport model) associating them with some reference concentration to identify risk zones. In this work we present a disaster scenario in Chicago (USA), by coupling DDC with two transport models of different complexity, showing the close relationship between a representative result and the run time of the models. In the same way, it becomes evident that knowing the time evolution of the toxic cloud and of the affected regions significantly improves the probability of taking the correct decisions on planning and response facing the emergency. [Copyright &y& Elsevier]

Management of biological or chemical incidents represents a challenging and demanding issue since it consists of several complex activities and important decisions. In case of accidents in agricultural or industrial mills or plants these decisions have to be made by personnel who are usually not primarily trained for such situations. From the technological perspective, various approaches or principles have been already applied and intended for computer-based support of biological or chemical incidents management. However, few of them incorporate principles of smart solutions which can make decisions even more precise and appropriate. This paper presents model utilizable for the management of biological or chemical incidents created in the multi-agent NetLogo environment and outlines possibilities of its extension by smart solution elements. Furthermore, together with the description of the simulation model, its parameterization is explained, and areas for further research are depicted. [ABSTRACT FROM AUTHOR]

Abstract: Cumene hydroperoxide (CHP) has been used in producing phenol, dicumyl peroxide (DCPO) and as an initiator for synthesizing acrylonitrile–butadiene–styrene (ABS) resin by copolymerization in Taiwan. Four incidents of fire and explosion induced by thermal runaway reactions were occurred in a same plant producing CHP, DCPO and bis-(tert-butylperoxy isopropyl) benzene peroxide (BIBP). The fourth fire and explosion occurred in the CHP reactor that resulted in a catastrophic damage in reaction region and even spread throughout storage area. Descriptions on the occurrences of these incidents were assessed by the features of processes, reaction schemes and unexpected side reactions. Calorimetric data on thermokinetics and pressure were used for explaining the practical consequences or which the worst cases encountered in this kind of plant. Acceptable risk associated with emergency relief system design is vital for a plant producing organic peroxide. These basic data for designing an inherently safer plant can be conducted from adiabatic calorimetry. An encouraging deduction has been drawn here, these incidents may be avoided by the implementation of API RP 520, API RP 521, DIERS technology, OSHA 1910.119 and AIChE''s CCPS recommended PSM elements. [Copyright &y& Elsevier]

Exposure assessment during and after acute chemical incidents and disasters is essential for health studies that may follow. During chemical incidents, the focus usually lies on risk assessment and afterward attention shifts toward possible (long-term) health effects. This may lead to insufficient available data on exposure to study the association between exposure and health outcome, and collection of additional exposure data is often required. Literature on health studies conducted after several chemical incidents was reviewed to obtain better insight on the needs of health studies. Four different types of scenarios were distinguished based on when exposure data were collected and the exposure data used for health studies. These four scenarios gave insight on exposure data needed for conclusive health studies and when different methods of exposure data collection should be used. Literature indicated that adequate and rapid exposure assessment during chemical incidents is vital for health studies, because data that are not collected during or directly after an incident may be irretrievably lost. Poor exposure assessment is not always the only problem in health studies. Problems in health studies including poor exposure assessment may be prevented when the general design and needs of health studies are taken into account when designing contingency plans. Together with measures that will help facilitate funding, design, and coordination of health studies, disaster management programs should, among others, prepare for methods that lead to a swift identification of released substances, determination of concentrations and dispersion of released substances, designing basic questionnaire outlines, and rapid evaluation of the usefulness and necessity of employing biological sampling.Journal of Exposure Science and Environmental Epidemiology (2008) 18, 341–359; doi:10.1038/jes.2008.23; published online 7 May 2008 [ABSTRACT FROM AUTHOR]

Background. The aim of this paper is to describe an incident where elemental mercury led to widespread contamination and the exposure of 225 individuals and confirmed toxicity in 19 individuals. The paper describes the incident and difficulties found in trying to assess the risk to individuals and to identify and decontaminate the residences involved. [ABSTRACT FROM PUBLISHER]

This work deals aims to present a methodology for source identification of chemical incidents in urban areas. We propose an approximation of the problem within the framework of the optimal control theory and we provide an algorithm for its numerical resolution. Finally, we analyze the validity of the algorithm in several academic situations. [ABSTRACT FROM AUTHOR]

Background With the occurrence of a number of major disasters around the world, there is growing interest in chemical disaster medicine. In South Korea, there is a training program for mass casualty incidents (MCI) and backup by legal regulations by the Framework Act on the Management of Disasters and Safety. However, there is no program focusing on chemical disasters. Thus, the authors newly created a program, the Chemical-Mass Casualty Incident Response Education Module (C-MCIREM) in September 2019. This was a pilot study to verify the educational effect of the program. Method A pre/post study was conducted of a chemical MCI training program based on simulation. A total of 25 representative and qualified participants were recruited from fire departments, administrative staff of public health centers, and healthcare workers of hospitals in the Gyeonggi-do province of South Korea. They participated in a one-day training program. A knowledge test and confidence survey were provided to participants just before training, and again immediately following the training online. The authors compared improvements of pre/post-test results. In the tabletop drill exercise, quantified qualitative analyses were used to measure the educational effect on the participants. Results In the knowledge test, the mean (standard deviation) scores for all 25 participants at baseline and after training were 41.72 (15.186) and 77.96 (11.227), respectively ( p  < 0.001). In the confidence survey for chemical MCI response for all 25 participants, all the sub-items concerning personal protective equipment selection, antidote selection, antidote stockpiling and passing on knowledge to colleagues, zone setup and decontamination, and chemical triage were improved compared to the baseline score ( p  < 0.001). The tabletop exercise represented a prehospital setting and had 11 participants. The self-efficacy qualitative survey showed pre- and post-exercise scores of 64/100 and 84/100 respectively. For a hospital setting exercise, it had 14 participants. The survey showed pre/post-exercise scores of 26/100 and 73/100 respectively. Twenty-two (88%) participants responded to the final satisfaction survey, and their overall mean scores regarding willingness to recommend this training program to others, overall satisfaction with theoretical education, overall satisfaction with tabletop drill simulation, and opinion about whether policymakers need this training were all over 8 out of 10 respectively. Conclusion C-MCIREM, the newly created chemical MCI program, provided effective education to the selected 25 participants among Korean chemical MCI responders in terms of both knowledge and practice at a single pilot trial. Participants were highly satisfied with the educational material and their confidence in disaster preparedness was clearly improved. In order to prove the universal educational effect of this C-MCIREM in the future, more education is needed., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2021, Kim et al.)

Introduction: Responder's action during mass environmental chemical incident involves collaboration of multiple agency. They clean the exposure site, control public safety and safe lives. The health of the responder is also as valuable as the public and always been neglected. Hence, this study is to highlights the method used and challenges during the incidents. Methods: A modified Occupational Health Surveillance Programme designed by Baker and Matte (Thirteen Steps in designing and implementing an Occupational Health Surveillance Programme) was implemented. These method full fill the criteria of impossible further reduce exposure to known hazards and uncertain health effect of the offending chemicals. Two core workplace namely the source of chemical contamination locale and victims' evacuation centre were identified. The exposed responder is identified and categorised according to their expected exposure. Offending chemicals identified were known hazardous to health. An electronic survey form was developed and the surveillance were conducted during the event and post-exposures of one, third and sixth months. Laboratory tests were performed as a grab sample randomly and strategically to represent responder exposure. Results: During the event, 1338 responders were surveyed and twenty percent had symptoms of cough, headache, sore throat, nausea and skin irritation. After one-month post-exposure, three percent of responder noted to have continue symptoms. Laboratory tests were performed randomly due to the sheer numbers of responders in action. Only sixty-one samples were collected and sixteen percent had positive metabolites for urine cyanide. Responders with abnormal laboratory result (FBC/LFT/RP/Urine) were interviewed and a repeat sample were performed. Conclusion: The health surveillance of the responder in mass environmental chemical incident is a great challenge when the exposure level is unsure and involve more than one chemicals. Likewise, reliability and validity adopting statistical test for health surveillance instruments is unattainable due to urgency. However, a proper method of occupational surveillance need to be devised and implemented to ensure the protection of worker's health is guaranteed. [ABSTRACT FROM AUTHOR]

Objectives: Chemical-biological-radio-nuclear (CBRN) gas masks are the standard means for protecting the general population from inhalation of toxic industrial compounds (TICs), for example after industrial accidents or terrorist attacks. However, such gas masks would not protect patients on home mechanical ventilation, as ventilator airflow would bypass the CBRN filter. We therefore evaluated in vivo the safety of adding a standard-issue CBRN filter to the air-outflow port of a home ventilator, as a method for providing TIC protection to such patients., Methods: Eight adult patients were included in the study. All had been on stable, chronic ventilation via a tracheostomy for at least 3 months before the study. Each patient was ventilated for a period of 1 hour with a standard-issue CBRN filter canister attached to the air-outflow port of their ventilator. Physiological and airflow measurements were made before, during, and after using the filter, and the patients reported their subjective sensation of ventilation continuously during the trial., Results: For all patients, and throughout the entire study, no deterioration in any of the measured physiological parameters and no changes in measured airflow parameters were detected. All patients felt no subjective difference in the sensation of ventilation with the CBRN filter canister in situ, as compared with ventilation without it. This was true even for those patients who were breathing spontaneously and thus activating the ventilator's trigger/sensitivity function. No technical malfunctions of the ventilators occurred after addition of the CBRN filter canister to the air-outflow ports of the ventilators., Conclusions: A CBRN filter canister can be added to the air-outflow port of chronically ventilated patients, without causing an objective or subjective deterioration in the quality of the patients' mechanical ventilation. (Disaster Med Public Health Preparedness. 2018;12:739-743).

IntroductionFirst responders, including firefighters, police officers, emergency medical services, and company emergency response team members, have dangerous jobs that can bring them in contact with hazardous chemicals among other dangers. Limited information is available on responder injuries that occur during hazardous chemical incidents., Methods: We analyzed 2002-2012 data on acute chemical incidents with injured responders from 2 Agency for Toxic Substances and Disease Registry chemical incident surveillance programs. To learn more about such injuries, we performed descriptive analysis and looked for trends., Results: The percentage of responders among all injured people in chemical incidents has not changed over the years. Firefighters were the most frequently injured group of responders, followed by police officers. Respiratory system problems were the most often reported injury, and the respiratory irritants, ammonia, methamphetamine-related chemicals, and carbon monoxide were the chemicals more often associated with injuries. Most of the incidents with responder injuries were caused by human error or equipment failure. Firefighters wore personal protective equipment (PPE) most frequently and police officers did so rarely. Police officers' injuries were mostly associated with exposure to ammonia and methamphetamine-related chemicals. Most responders did not receive basic awareness-level hazardous material training., Conclusion: All responders should have at least basic awareness-level hazardous material training to recognize and avoid exposure. Research on improving firefighter PPE should continue. (Disaster Med Public Health Preparedness. 2018;12:211-221).