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Are Dutch Hospitals Prepared for Chemical, Biological, or Radionuclear Incidents? A Survey Study

Published online by Cambridge University Press:  08 May 2017

Luc J.M. Mortelmans*
Department of Emergency Medicine, ZNA Camp Stuivenberg, Antwerp, Belgium Center for Research and Education in Emergency Care (CREEC), University Leuven, Belgium
Menno I. Gaakeer
Department of Emergency Medicine, Admiraal De Ruyter Hospital, The Netherlands
Greet Dieltiens
Department of Emergency Medicine, ZNA Camp Stuivenberg, Antwerp, Belgium
Kurt Anseeuw
Department of Emergency Medicine, ZNA Camp Stuivenberg, Antwerp, Belgium
Marc B. Sabbe
Center for Research and Education in Emergency Care (CREEC), University Leuven, Belgium Department of Emergency Medicine, University Hospital Gasthuisberg, Leuven, Belgium
Correspondence: LJM Mortelmans, MD, FESEM, FRBSS Department of Emergency Medicine, ZNA Camp Stuivenberg Lange Beeldekensstraat 267 B2060 Antwerp, Belgium E-mail



Being one of Europe’s most densely populated countries, and having multiple nuclear installations, a heavy petrochemical industry, and terrorist targets, the Netherlands is at-risk for chemical, biological, or radionuclear (CBRN) incidents. Recent world and continental events show that this threat is real and that authorities may be underprepared.


The hypothesis of this study is that Dutch hospitals are underprepared to deal with these incidents.


A descriptive, cross-sectional study was performed. All 93 Dutch hospitals with an emergency department (ED) were sent a link to an online survey on different aspects of CBRN preparedness. Besides specific hospital information, information was obtained on the hospital’s disaster planning; risk perception; and availability of decontamination units, personal protective equipment (PPE), antidotes, radiation detection, infectiologists, isolation measures, and staff training.


Response rate was 67%. Sixty-two percent of participating hospitals were estimated to be at-risk for CBRN incidents. Only 40% had decontamination facilities and 32% had appropriate PPE available for triage and decontamination teams. Atropine was available in high doses in all hospitals, but specific antidotes that could be used for treating victims of CBRN incidents, such as hydroxycobolamine, thiosulphate, Prussian blue, Diethylenetriaminepentaacetic acid (DTPA), or pralidoxime, were less frequently available (74%, 65%, 18%, 14%, and 42%, respectively). Six percent of hospitals had radioactive detection equipment with an alarm function and 22.5% had a nuclear specialist available 24/7 in case of disasters. Infectiologists were continuously available in 60% of the hospitals. Collective isolation facilities were present in 15% of the hospitals.


There is a serious lack of hospital preparedness for CBRN incidents in The Netherlands.

MortelmansLJM, GaakeerMI, DieltiensG, AnseeuwK, SabbeMB. Are Dutch Hospitals Prepared for Chemical, Biological, or Radionuclear Incidents? A Survey Study. Prehosp Disaster Med. 2017;32(5):483491.

Original Research
© World Association for Disaster and Emergency Medicine 2017 

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Conflicts of interest: The authors declare that they have no competing interests.


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