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Comparative Study Illustrating Difficulties Educating the Public to Respond to Chemical Terrorism

Published online by Cambridge University Press:  28 June 2012

Sarah Hildebrand  and
Anthony Bleetman
Sarah Hildebrand
Affiliation:
Medical Student, University of Birmingham, Birmingham, UK
Anthony Bleetman*
Affiliation:
Consultant in Emergency Medicine, Heart of England NHS Foundation Trust, Birmingham, UK
*
32 Rothwell Drive, Solihull, B91 1HG Birmingham, United Kingdom E-mail: [email protected]
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Abstract

Background:

In recent years, the perceived threat of chemical terrorism has increased. It is hoped that teaching civilians how to behave during a chemical incident will decrease the number of “worried well” patients at hospitals, reduce secondary contamination, and increase compliance with the instructions of emergency services. The governments of the United Kingdom and Israel sent booklets to every household in their respective countries. In Israel, the civilian population was issued chemical personal protective equipment (chemical personal protective equipment).

Methods:

The effectiveness of these public education programs was assessed using a scenario-based questionnaire that was distributed to 100 respondents in Birmingham, UK and Jerusalem, Israel. Respondents were asked how they would behave in three deliberate chemical release scenarios and how they would seek information and help.

Results:

Only 33% of the UK respondents and 22% of the Israeli respondents recalled reading the government booklets. When asked what they would do after being contaminated in a deliberate release, approximately half of the respondents ranked seeking medical care at a hospital as the most appropriate action.

The preferred sources of information in the wake of a chemical strike were (in descending order): radio, television, and the Internet. Approximately half of the respondents would call emergency services for information. Forty-one percent of the UK respondents and 33% of Israeli respondents stated that they either would call or go to the nearest hospital to seek information.

Conclusions:

The public information campaigns in both countries have had a limited impact. Many citizens claimed they would self-present to the nearest hospital following a chemical attack rather than waiting for the emergency services. A similar response was witnessed in the Sarin attacks in Tokyo and the 1991 Scud missile attacks in Israel.

Current UK doctrine mandates that specialist decontamination teams be deployed to the scene of a chemical release. However, this takes >1 hour, and it requires at least 30 minutes to don hospital chemical personal protective equipment. Therefore, it is imperative that hospitals are equipped to cope with unannounced self-presenters after a chemical attack. This requires chemical personal protective equipment and protocols that are easier to use.

Keywords

chemical personal protective equipment (chemical personal protective equipment)chemical weaponsdecontaminationeducationterrorism
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 22 , Issue 1 , February 2007 , pp. 35 - 41
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2007

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References

1.HM Government: Preparing for emergencies: What you need to know. Available at http://www.preparingforemergencies.gov.uk. 25 August 2005.Google Scholar
2.Home Front Command, Israeli Defense Forces: In the genuine event of an emergency: Information on civil defence for the family. Available at http://www.idf.il. Accessed 25 August 2005.Google Scholar
3.Jacobs, L, Burns, K, Gross, R: Terrorism: A public health threat with a trauma system response. J Trauma 2003;55(6):1014–1021.CrossRefGoogle ScholarPubMed
4.Paton, D, Johnston, D: Disasters and communities: Vulnerability, resilience and preparedness.Disaster Prevention and Management 2001;10(4):270–277.CrossRefGoogle Scholar
5.Salcioglu, E, Basoglu, M, Livanou, M: Long-term psychological outcome for non-treatment seeking earthquake survivors in Turkey. J Nerv Ment Dis 2003;191(3):154–160.CrossRefGoogle ScholarPubMed
6.Young, C, Persell, D: Biological, chemical and nuclear terrorism readiness: Major concerns and preparedness of future nurses.Disaster Manag Response 2004;2(4):109–114.CrossRefGoogle ScholarPubMed
7.Boscarino, J, Figley, C, Adams, R: Fear of terrorism in New York after the September 11 terrorist attacks: Implications for emergency mental health and preparedness.Int J Emerg Ment Health 2003;5(4):199–209.Google ScholarPubMed
8.Murray, V, Goodfellow, F: Mass casualty incidents–Towards guidance for public health management.Public Health 2002;116(1):2–14.CrossRefGoogle ScholarPubMed
9.Karsenty, E, Shemer, J, Alshech, I,et al: Medical aspects of the Iraqi missile attacks on Israel.Isr J Med Sci 1991;27(11–12):603–607.Google ScholarPubMed
10.Rotenberg, Z, Noy, S, Gabbay, U: Israeli ED experience during the Gulf War. Am J Emerg Med 1994;12(1):118–119.CrossRefGoogle ScholarPubMed
11.Kark, J, Goldman, S, Epstein, L: Iraqi missile attacks on Israel: The association of mortality with a life-threatening stressor.JAMA 1995;273(15):1208–1210.CrossRefGoogle ScholarPubMed
12.World Health Organization: Public Health Preparedness and Response. In: Public Health Response to Biological and Chemical Weapons 2004: pp 90–96.Google Scholar
13.Tan, G, Fitzgerald, M: Chemical-biological-radiological (CBR) response: A template for hospital emergency departments. Med J Aust 2002;177(4):196–199.CrossRefGoogle ScholarPubMed
14. United States Army Guide to Decontamination. Available at http://www.fas.org/nuke/guide/usa/doctrine/army/mmcch/decontam.htm. Accessed 25 August 2005.Google Scholar
15. West Midlands Ambulance Service and Health Protection Agency report on Operation Horizon. Personal Communication.Google Scholar
16.Al-Damouk, M, Bleetman, A: Impact of the Department of Health initiative to equip and train acute trusts to manage chemically contaminated casualties. Emerg Med J 2005;22(5):347–350.CrossRefGoogle ScholarPubMed