Hostname: page-component-848d4c4894-v5vhk Total loading time: 0 Render date: 2024-06-22T08:01:39.594Z Has data issue: false hasContentIssue false
  • English
  • Français

Secondary Contamination of Medical Personnel, Equipment, and Facilities Resulting From Hazardous Materials Events, 2003–2006

Published online by Cambridge University Press:  08 April 2013

D. Kevin Horton ,
Maureen Orr ,
Theodora Tsongas ,
Richard Leiker  and
Vikas Kapil
Get access Rights & Permissions [Opens in a new window]

Abstract

Background: When not managed properly, a hazardous material event can quickly extend beyond the boundaries of the initial release, creating the potential for secondary contamination of medical personnel, equipment, and facilities. Secondary contamination generally occurs when primary victims are not decontaminated or are inadequately decontaminated before receiving medical attention. This article examines the secondary contamination events reported to the Agency for Toxic Substances and Disease Registry (ATSDR) and offers suggestions for preventing such events.

Methods: Data from the ATSDR Hazardous Substances Emergency Events Surveillance system were used to conduct a retrospective analysis of hazardous material events occurring in 17 states during 2003 through 2006 involving secondary contamination of medical personnel, equipment, and facilities.

Results: Fifteen (0.05%) Hazardous Substances Emergency Events Surveillance events were identified in which secondary contamination occurred. At least 17 medical personnel were injured as a result of secondary contamination while they were treating contaminated victims. Of the medical personnel injured, 12 were emergency medical technicians and 5 were hospital personnel. Respiratory irritation was the most common injury sustained.

Conclusions: Adequate preplanning and drills, proper decontamination procedures, good field-to-hospital communication, appropriate use of personal protective equipment, and effective training can help prevent injuries of medical personnel and contamination of transport vehicles and medical facilities. (Disaster Med Public Health Preparedness. 2008;2:104–113)

Keywords

hazardous materials eventschemically contaminated victimsmedical personnelsecondary contamination
Type
Original Research and Critical Analysis
Information
Disaster Medicine and Public Health Preparedness , Volume 2 , Issue 2 , June 2008 , pp. 104 - 113
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1.Agency for Toxic Substances and Disease Registry. Hazardous Substances Emergency Events Surveillance Annual Report 2004. http://www.atsdr.cdc.gov/HS/HSEES/annual2004.html. Accessed June 28, 2007.Google Scholar
2.Agency for Toxic Substances and Disease Registry. Managing Hazardous Materials Incidents Volume III: Medical Management Guidelines for Acute Chemical Exposures. 1992. http://www.atsdr.cdc.gov/MHMI/mmg.html. Accessed June 28, 2007.Google Scholar
3.Centers for Disease Control and Prevention. Nosocomial poisoning associated with emergency department treatment of organophosphate toxicity–Georgia, 2000. MMWR Morb Mortal Wkly Rep. 2001; 49: 1156–1158.Google Scholar
4.Burgess, JL. Hospital evacuations due to hazardous materials incidents. Am J Disaster Med. 1999; 17: 50–52.Google Scholar
5.Agency for Toxic Substances and Disease Registry. Managing Hazardous Materials Incidents Volume II: Hospital Emergency Departments: A Planning Guide for the Management of Contaminated Patients. 1992. http://www.atsdr.cdc.gov/MHMI/mhmi-v2-p.pdf. Accessed June 28, 2007.Google Scholar
6.Occupational Safety and Health Administration. OSHA Best Practices for Hospital-Based First Receivers of Victims from Mass Casualty Incidents Involving the Release of Hazardous Substances. January 2005. http://www.osha.gov/dts/osta/bestpractices/firstreceivers_hospital.pdf. Accessed June 28, 2007.Google Scholar
7.Horton, DK, Burgess, P, Rossiter, S, et alSecondary contamination of emergency department personnel from o-chlorobenzylidene malononitrile exposure, 2002. Ann Emerg Med. 2005; 45: 655–658.CrossRefGoogle ScholarPubMed
8.Horton, DK, Berkowitz, Z, Kaye, WE. Secondary contamination of emergency department personnel from hazardous materials events, 1995–2001. Am J Disaster Med. 2003; 21: 199–201.Google Scholar
9.SAS Version 9.1 [software]. Cary, NC: SAS Institute.Google Scholar
10.Nozaki, H, Hori, S, Shinozawa, Y, et alSecondary exposure of medical staff to sarin vapor in the emergency room. Intensive Care Med. 1995; 21: 1032–1035.CrossRefGoogle ScholarPubMed
11.Okudera, H. Clinical features on nerve gas terrorism in Matsumoto. J Clin Neurosci. 2002; 9: 17–21.Google Scholar
12.Okumura, S, Okumura, T, Ishimatsu, S, et alTokyo—protecting the health care worker during a chemical mass casualty event: an important issue of continuing relevance. Crit Care. 2005; 9: 397–400.CrossRefGoogle ScholarPubMed
13.Kinoshita, H, Hirose, Y, Tanaka, T, Yamazaki, Y. Oral arsenic trioxide poisoning and secondary hazard from gastric content. Ann Emerg Med. 2004; 44: 625–627.Google Scholar
14.Nakajima T, Sato S, Morita H, Yanagisawa N. Sarin poisoning of a rescue team in the Matsumoto sarin incident in Japan. Occup Environ Med. 1997;54:697–701.CrossRefGoogle Scholar
15.Stacey, R, Morfey, D, Payne, S. Secondary contamination in organophosphate poisoning: analysis of an incident. QJM. 2004; 97: 75–80.CrossRefGoogle ScholarPubMed
16.Occupational Safety and Health Administration. Hospitals and Community Emergency Response—What You Need to Know. 1997. http://www.osha.gov/Publications/OSHA3152/osha3152.html#two. Accessed November 20, 2007.Google Scholar
17.Agency for Toxic Substances and Disease Registry. Managing Hazardous Materials Incidents Volume I: Emergency Medical Services: A Planning Guide for the Management of Contaminated Patients. 1992. http://wonder.cdc.gov/wonder/prevguid/p0000018/p0000018.asp. Accessed June 28, 2007.Google Scholar
18.Occupational Safety and Health Administration. Interpretive letter regarding the acceptability of using computer-based (on-line) training for the HAZWOPER 40-hour classroom training. August 16, 2004. http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=INTERPRETATIONS&p_id=24985. Accessed November 20, 2007.Google Scholar
19.Occupational Safety and Health Administration. Interpretive letter regarding training requirements for emergency medical service personnel. June 14, 1991. http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=INTERPRETATIONS&p_id=20302. Accessed November 20, 2007.Google Scholar
20.Occupational Safety and Health Administration. Interpretive letter regarding training of emergency medical service (EMS) personnel. August 28, 1995. http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=INTERPRETATIONS&p_id=21901. Accessed June 28, 2007.Google Scholar
21.Occupational Safety and Health Administration. Interpretive letter regarding training requirements for hospital personnel involved in an emergency response of a hazardous substance. October 27, 1992. http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=INTERPRETATIONS&p_id=20911. Accessed November 20, 2007.Google Scholar
22.Occupational Safety and Health Administration. 29 Code of Federal Regulations 1910.120 Standard on Hazardous Waste Operations and Emergency Response (HAZWOPER) Appendix E. Training Curriculum. http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_id=9770. Accessed November 20, 2007.Google Scholar