Hostname: page-component-848d4c4894-x5gtn Total loading time: 0 Render date: 2024-05-14T03:09:05.464Z Has data issue: false hasContentIssue false
  • English
  • Français

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 ,
Menno I. Gaakeer ,
Greet Dieltiens ,
Kurt Anseeuw  and
Marc B. Sabbe
Luc J.M. Mortelmans*
Affiliation:
Department of Emergency Medicine, ZNA Camp Stuivenberg, Antwerp, Belgium Center for Research and Education in Emergency Care (CREEC), University Leuven, Belgium
Menno I. Gaakeer
Affiliation:
Department of Emergency Medicine, Admiraal De Ruyter Hospital, The Netherlands
Greet Dieltiens
Affiliation:
Department of Emergency Medicine, ZNA Camp Stuivenberg, Antwerp, Belgium
Kurt Anseeuw
Affiliation:
Department of Emergency Medicine, ZNA Camp Stuivenberg, Antwerp, Belgium
Marc B. Sabbe
Affiliation:
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 luc.mortelmans@zna.be
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction

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.

Hypothesis

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

Methods

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.

Results

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.

Conclusion:

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):483–491.

Keywords

CBRNdisaster preparednesshospitalthe Netherlands
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 32 , Issue 5 , October 2017 , pp. 483 - 491
Copyright
© World Association for Disaster and Emergency Medicine 2017 

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.)

Footnotes

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

References

1. Brandpunt: Figures on transport of dangerous goods. http://brandpunt.kro.nl/ seizoenen/2012/afleveringen/08-07-2012. Accessed September 22, 2015.Google Scholar
2. Manuel Valls évoque le risque d’attaques à l’arme chimique. http://www.lefigaro.fr/ actualite-france/2015/11/19/01016-20151119ARTFIG00070-manuel-valls-evoque-le-risque-d-attaques-a-l-arme-chimique.php. Accessed November 19, 2015.Google Scholar
3. Burda, P, Sein Anand, J, Chodorowski, Z, Groszek, B. Strategic preparedness of selected hospitals to act during massive chemical disasters. Przegl Lek. 2007;64(4-5):212-214.Google Scholar
4. Nathallee, M, Curphey, A, Beeching, N, Carley, S, Crawford, I, Mackway-Jones, K. Emergency departments (EDs) in the United Kingdom (UK) are not prepared for emerging biological threats and bioterrorism. J Infect. 2007;54(1):12-17.CrossRefGoogle Scholar
5. Horby, P, Murray, V, Cummins, A, Mackway-Jones, K, Euripidou, R. The capability of accident and emergency departments to safely decontaminate victims of chemical incidents. J Accid Emerg Med. 2000;17(5):344-347.Google Scholar
6. Williams, J, Walter, D, Challen, K. Preparedness of emergency departments in Northwest England for managing chemical incidents: a structured interview survey. BMC Emerg Med. 2007;7:20-25.Google Scholar
7. Mortelmans, LJM, Van Boxstael, S, De Cauwer, HG, Sabbe, MB. Preparedness of Belgian civil hospitals for chemical, biological, radiation, and nuclear incidents: are we there yet? Eur J Emerg Med. 2014;21(4):296-300.CrossRefGoogle ScholarPubMed
8. Kollek, D, Cwin, AA. Hospital emergency readiness overview study. Prehosp Disaster Med. 2011;26(3):159-165.Google Scholar
9. Li, X, Huang, J, Zhang, H. An analysis of hospital preparedness capacity for public health emergency in four regions of China: Beijing, Shandong, Guangxi and Hainan. BMC Public Health. 2008;8:319-330.Google Scholar
10. Belsky, JB, Klausner, HH, Karson, J, Dunne, RB. Survey of Emergency Department Chemical Hazard Preparedness in Michigan, USA: A Seven Year Comparison. Prehosp Disaster Med. 2016;31(2):224-227.Google Scholar
11. Higgins, W, Wainright, C, Lu, N, Carrico, R. Assessing hospital preparedness using an instrument based on the mass casualty disaster plan checklist: results of a statewide survey. Am J Infect Control. 2004;32(6):327-332.Google Scholar
12. Bennett, RL. Chemical or biological terrorist attacks: an analysis of the preparedness of hospitals for managing victims affected by chemical or biological weapons of mass destruction. Int J Environ Res Public Health. 2006;3(1):67-75.Google Scholar
13. Keim, ME, Pesik, N, Twum-Danso, NA. Lack of hospital preparedness for chemical terrorism in a major US city: 1996-2000. Prehosp Disaster Med. 2003;18(3):193-199.Google Scholar
14. Treat, KN, Williams, JM, Furbee, PM, Manley, WG, Russel, FK, Stamper, CD Jr. Hospital preparedness for weapons of mass destruction incidents: an initial assessment. Ann Emerg Med. 2001;38(5):562-565.Google Scholar
15. Becker, SM, Middleton, SA. Improving hospital preparedness for radiological terrorism: perspectives from emergency department physicians and nurses. Disaster Med Public Health Prep. 2008;2(3):174-184.Google Scholar
16. Tur-Kaspa, I, Lev, EI, Hendler, I, Siebner, R, Shapira, Y, Shemer, J. Preparing hospitals for toxicological mass casualty events. Crit Care Med. 1999;27(5):1004-1008.CrossRefGoogle Scholar
17. Okumura, T, Takasu, N, Ishimatsu, S. Report of 640 victims of the Tokyo subway sarin attack. Ann Emerg Med. 1996;28(2):129-135.Google Scholar
18. Wetter, DC, Daniell, WE, Treser, CD. Hospital preparedness for victims of chemical or biological terrorism. Am J Public Health. 2001;91(5):710-716.Google ScholarPubMed
19. Stewart-Evans, JL, Sharman, A, Isaac, J. A narrative review of secondary hazards in hospitals from cases of chemical self-poisoning and chemical exposure. Eur J Emerg Med. 2013;20(5):304-309.CrossRefGoogle ScholarPubMed
20. Daugherty, EL. Health care worker protection in mass casualty respiratory failure: infection control, decontamination and personal protective equipment. Respir Care. 2008;53(2):201-214.Google ScholarPubMed
21. Larson, TC, Orr, MF, Auf der Heide, E, Wu, J, Mukhopadhyay, S, Horton, DK. Threat of secondary chemical contamination of emergency departments and personnel: an uncommon but recurrent problem. Disaster Med Publ Health Prep. 2016;10(2):199-202.Google Scholar
22. Chan, JTS, Yeung, RSD, Tang, SYH. Hospital preparedness for chemical and biological incidents in Hong Kong. Hong Kong Med J. 2002;8(6):440-446.Google ScholarPubMed
23. Bradley, RN. Health care facility preparation for weapons of mass destruction. Prehosp Emerg Care. 2000;4(3):261-269.CrossRefGoogle ScholarPubMed
24. Hildebrand, S, Bleetman, A. Comparative study illustrating difficulties educating the public to respond to chemical terrorism. Prehosp Disaster Med. 2007;22(1):35-41.CrossRefGoogle ScholarPubMed
25. Baker, D. The problem of secondary contamination following chemical agent release. Crit Care. 2005;9(4):323-324.CrossRefGoogle ScholarPubMed
26. Barelli, A, Biondi, I, Soave, M, Tafani, C, Bononi, F. The comprehensive medical preparedness in chemical emergencies: ‘the chain of chemical survival.’ Eur J Emerg Med. 2008;15(2):110-118.Google Scholar