Hostname: page-component-cd9895bd7-q99xh Total loading time: 0 Render date: 2024-12-18T22:08:34.306Z Has data issue: false hasContentIssue false
  • English
  • Français

SARA Three Years Later: Emergency Physician's Knowledge, Beliefs, and Actions

Published online by Cambridge University Press:  28 June 2012

Linda Y. Landesman  and
Ralph B. Leonard
Linda Y. Landesman*
Affiliation:
Albert Einstein College of Medicine, Department of Pediatrics, Nurses's Residence, Pelham Parkway and Eastchester Road, Bronx, N.Y.
Ralph B. Leonard
Affiliation:
The Bowman Gray School of Medicine, Department of Emergency Medicine, Wake ForestUniversity Medical Center, Winston-Salem, N.C.
*
Albert Einstein College of Medicine, Department of Pediatrics, Nurse's Residence, Pelham Parkway and Eastchester Road, Bronx, NY 10461USA
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

Investigate Emergency Physicians' knowledge about the Superfund Amendments and Reauthorization Act (SARA) Title III legislation, passed by the United States Congress in 1986, and to determine the factors contributing to their level of preparedness in dealing with patients exposed to toxic chemicals.

Methods:

A 115-item questionnaire was mailed to the medical directors of all emergency departments (EDs) in the State of New York. The results of the cross-sectional survey were analyzed using standard statistical methods.

Results:

One hundred and eighty-seven (72%) of the directors of EDs in New York State responded to the survey. Three years after SARA was enacted, only 33% of the directors had heard about this legislation. Only 18% had been invited to attend the meetings of the Local Emergency Planning Committees (LEPC). Sixty percent of the directors knew whether or not the LEPC had devised plans that defined a role for their EDs in responding to environmental emergencies. This knowledge about community planning mainly had an effect on preparedness of the EDs. Preparedness also was predicted by how recently the EDs had treated patients exposed to toxic chemicals, the perception that emergency physicians had a legitimate role in planning for and responding to chemical emergencies, and how often emergency physicians had attended continuing education courses about hazardous materials.

Conclusion:

Despite the finding that some emergency physicians are involved in community preparations, two main problems persist in planning a medical response to environmental emergencies. First, the ED directors generally are unaware of the legislation that mandates these preparations and are not interacting with community planners. Second, there is not full involvement by the local EDs in the LEPC planning efforts.

Recommendations:

A procedure is needed to disseminate information about legislation which affects emergency physicians, such as SARA, and about regional planning for environmental emergencies. Dissemination should include education about the professions' role in planning for and providing care for patients exposed to toxic chemicals.

Keywords

ACTchemical emergenciesemergency departmentsemergency physiciansenvironmental emergencieshazardous materialsmedical directorsplanningpreparednessSARASuperfund Amendments and Reauthorization Acttoxic chemicals
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 8 , Issue 1 , March 1993 , pp. 39 - 44
Copyright
Copyright © World Association for Disaster and Emergency Medicine 1993

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

1. Environmental Protection Agency: Acute Hazardous Events Data Base, Final Draft. Prepared by Industrial Economics, Incorporated. Cambridge: EPA, 1988.Google Scholar
2. The New York Times: 17 U.S. Accidents Resemble Bhopal's. Sunday, 30 April 1989.Google Scholar
3. PL 99–499: The Superfund Amendments and Reauthorization Act of 1986. Title III. Subtitle A Secs. 303, 304. Subtitle B Secs. 311, 312, 313.Google Scholar
4. Landesman, LY: Hospital Preparedness for Chemical Accidents: The Effects of SARA. Doctoral Dissertation, Columbia University, 1990.Google Scholar
5. Landesman, LY: Hospital Preparedness for Chemical Accidents. The 199 Plant, Technology, and Safety Management Series, Emergency Preparedness: When The Disaster Strikes. The Joint Commission, 1990 Number 2, pp 33–38.Google Scholar
6. Leonard, RD, Calabro, JJ, Noji, EK, Leviton, RH: SARA: (Superfund Amendments and Reauthorization Act), Title III: Implications for Emergency Physicians. Ann of Emerg Med 1989:18:1212–1216.CrossRefGoogle ScholarPubMed
7. Landesman, LY: Improving medical preparedness for chemical accidents: An inter-organizational resource review. International Journal of Mass Emergencies and Disasters 1989;7:152–166.CrossRefGoogle Scholar
8. Leonard, RB: Community planning for hazardous materials disasters. Topics in Emergency Medicine 1986;7:55–64.Google ScholarPubMed
9. Leonard, RB: Role of pediatricians in disasters and mass casualty incidents. Pediatric Emergency Care 1988;4:41–44.CrossRefGoogle ScholarPubMed
10. Leonard, RB, Ricks, R: Emergency department radiation accident protocols. Ann Emerg Med 1980;9:462–470.CrossRefGoogle Scholar
11. Doyle, CJ, Little, NE, Ulin, LS: Acute Exposure to Hazardous Materials. In Haddad, LM, Winchester, JF (eds.), Clinical Management of Poisoning and Drug Overdose. Philadelphia: W. B. Saunders Co., 1983;250–263.Google Scholar
12. Linneman, RE: Medical experience and preparedness for handling radiation injuries. Journal of MAG 1989:78:95–100.Google Scholar
13. Ryals, PA: Hazardous Chemicals in Industry and Environment. In Noji, EK, Klelan, GD, Goessel, TK (eds.), Manual of Toxicological Emergencies. Chicago: Yearbook Medical Publishers, Inc., 1989, pp 703–709.Google Scholar
14. Landesman, LY: Preparedness for Chemical Accident Inventory. White Plains, New York, 1989.Google Scholar
15. Environmental Protection Bureau, Office of the Attorney General Robert Abrams. Toxic Chemical Accidents in New York State: The Risk of Another Bhopal. New York: Office of the Attorney General, 14 January 1986.Google Scholar
16. Environmental Protection Bureau, Office of Attorney General Robert Abrams: Saving Victims of Toxic Chemicals: The Need for Better Medical Preparedness. New York: Office of the Attorney General, 1987, pp 1–16.Google Scholar
17. American Medical Association: Socioeconomic Database. Chicago: AMA, 1989.Google Scholar
18. Rogers, EM: Diffusion of Innovation (3rd ed). New York: Macmillan, 1983.Google Scholar