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

ABSTRACTBackground: 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)

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Combat Casualty Care

Military Medical Ethics in Contemporary Armed Conflict ◽

10.1093/med/9780190694944.003.0006 ◽

2021 ◽

pp. 92-111

Author(s):

Michael L. Gross

Keyword(s):

Medical Personnel ◽

The United States ◽

Medical Attention ◽

Legal Provisions ◽

Combat Casualty ◽

Medical Need ◽

Medical Facilities ◽

Combat Casualty Care ◽

Host Nation ◽

Military Status

To deliver combat casualty care to warfighters, multinational forces deploy medical units to provide immediate front-line treatment, transfer the injured to in-theater combat hospitals, and evacuate the critically wounded to Europe and the United States. With bed space limited, Coalition medical facilities developed medical rules of eligibility to regulate the flow of multinational patients, host-nation allies, detainees, and local civilians. While multinational patients received unreserved medical attention, local nationals were, at best, only eligible for emergency care before transfer to poorly equipped local facilities. Despite legal provisions that stipulate impartial care based solely on urgent medical need, medical personnel attended to patients based on national identity and military status. Military necessity sometimes permits treating moderately injured warfighters before the critically ill to return the former to duty. Appealing to associative duties, however, allows military medical providers to deliver preferential care to compatriots despite urgent medical need elsewhere.

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Hazards of Illicit Methamphetamine Production and Efforts at Reduction: Data from the Hazardous Substances Emergency Events Surveillance System

Public Health Reports ◽

10.1177/00333549111260s115 ◽

2011 ◽

Vol 126 (1_suppl) ◽

pp. 116-123 ◽

Cited By ~ 10

Author(s):

Natalia Melnikova ◽

Wanda Lizak Welles ◽

Rebecca E. Wilburn ◽

Nancy Rice ◽

Jennifer Wu ◽

...

Keyword(s):

Surveillance System ◽

Hazardous Substances ◽

Emergency Events

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Otitis Media

PEDIATRICS ◽

10.1542/peds.74.5.948 ◽

1984 ◽

Vol 74 (5) ◽

pp. 948-949

Author(s):

Charles M. Ginsburg

Keyword(s):

Otitis Media ◽

Viral Infections ◽

Otitis Media With Effusion ◽

Acute Otitis Media ◽

Medical Personnel ◽

Medical Attention ◽

Common Symptom ◽

Upper Respiratory Tract ◽

Primary Responsibility ◽

Printed Materials

Earache, a common symptom in children, causes many parents to seek medical attention. Aside from trauma and the discomfort that often accompanies viral infections of the upper respiratory tract, acute otitis media with effusion is the commonest cause of otalgia in infants and children. Proper management requires a team effort between the physician and the child's parents or caretaker. The physician must transmit to the parents a concise but thorough overview of the problem and a plan for management. This should include information on the pathophysiology of ear disease, its incidence, therapy and the potential adverse effects, and any measures that the parents may take to prevent recurrence. The primary responsibility for transmittal of this information lies with the physician. Ancillary medical personnel and communication aids (videotapes, computers, printed materials) should be utilized, if available, to reinforce the physician's "message.'

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Public health consequences of mercury spills: Hazardous Substances Emergency Events Surveillance system, 1993-1998.

Environmental Health Perspectives ◽

10.1289/ehp.02110129 ◽

2002 ◽

Vol 110 (2) ◽

pp. 129-132 ◽

Cited By ~ 29

Author(s):

Perri Zeitz ◽

Maureen F Orr ◽

Wendy E Kaye

Keyword(s):

Public Health ◽

Surveillance System ◽

Hazardous Substances ◽

Health Consequences ◽

Emergency Events

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Acute Chemical Incidents With Injured First Responders, 2002-2012

Disaster Medicine and Public Health Preparedness ◽

10.1017/dmp.2017.50 ◽

2017 ◽

Vol 12 (2) ◽

pp. 211-221 ◽

Cited By ~ 6

Author(s):

Natalia Melnikova ◽

Jennifer Wu ◽

Alice Yang ◽

Maureen Orr

Keyword(s):

Police Officers ◽

Human Error ◽

Descriptive Analysis ◽

First Responders ◽

Toxic Substances ◽

Limited Information ◽

Hazardous Material ◽

Hazardous Chemical ◽

Chemical Incidents ◽

Awareness Level

AbstractIntroductionFirst responders, including firefighters, police officers, emergency medical services, and company emergency response team members, have dangerous jobs that can bring them in contact with hazardous chemicals among other dangers. Limited information is available on responder injuries that occur during hazardous chemical incidents.MethodsWe analyzed 2002-2012 data on acute chemical incidents with injured responders from 2 Agency for Toxic Substances and Disease Registry chemical incident surveillance programs. To learn more about such injuries, we performed descriptive analysis and looked for trends.ResultsThe percentage of responders among all injured people in chemical incidents has not changed over the years. Firefighters were the most frequently injured group of responders, followed by police officers. Respiratory system problems were the most often reported injury, and the respiratory irritants, ammonia, methamphetamine-related chemicals, and carbon monoxide were the chemicals more often associated with injuries. Most of the incidents with responder injuries were caused by human error or equipment failure. Firefighters wore personal protective equipment (PPE) most frequently and police officers did so rarely. Police officers’ injuries were mostly associated with exposure to ammonia and methamphetamine-related chemicals. Most responders did not receive basic awareness-level hazardous material training.ConclusionAll responders should have at least basic awareness-level hazardous material training to recognize and avoid exposure. Research on improving firefighter PPE should continue. (Disaster Med Public Health Preparedness. 2018;12:211–221)

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Special Reports

PEDIATRICS ◽

10.1542/peds.1.4.528 ◽

1948 ◽

Vol 1 (4) ◽

pp. 528-530

Keyword(s):

School Health ◽

Medical Service ◽

Medical Profession ◽

Medical Personnel ◽

Team Work ◽

Nursing Services ◽

Medical Facilities ◽

Mind And Body ◽

School Health Programs ◽

State And Local

Two of the greatest weaknesses of school health programs are involved in serious controversies that have interfered with obtaining federal legislation for meeting needs where state and local funds are inadequate for satisfactory services. First, there has been a failure in team work between educators and public health personnel, "Doctors are told what they should do by people who do not know what a doctor can do." Medical and nursing services have failed in their educational objectives. Educators and medical personnel have worked independently on the same children as if each child was sharply divided into mind and body. Very little joint planning has been done by the two professions to solve the problems of children and their development. This failure in team work has been the result largely of a continued rivalry over jurisdiction as to who will spend the money, who will have the power, and who will receive the credit. The two great professions of education and medicine have only occasionally, here and there, learned how to use the great resources of the two professions to serve children. Second there has been the frequent failure to get something done for the children in need of medical service. Often the trouble is merely a failure to use the medical facilities that are available in the community. Not infrequently the trouble has had its origin in inadequate education as to how to use those facilities. But the big controversy has been over the question of whether all medical services will be free to all children regardless of ability to pay, or whether a prepayment plan for medical care will be compulsory or voluntary, and whether the federal government will control the funds and pay the physician or whether each community will work out their own plan for making medical service available to all. These problems, of course, can not be divorced from the aims and efforts of the medical profession to improve the knowledge and skill of the physician and the development of laboratory and special diagnostic facilities so that they may be available as needed. Any progress made in extending medical facilities to care for those who might benefit and in the improvement of the quality can come only through agreement rather than through continuing the controversy. Your Committee on School Health has indicated one important way that the work of the physician in the schools can contribute to pediatric health supervision and post graduate medical education.

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Radioanalytical Techniques to Quantitatively Assess the Biological Uptake and In Vivo Behavior of Hazardous Substances

Molecules ◽

10.3390/molecules25173985 ◽

2020 ◽

Vol 25 (17) ◽

pp. 3985

Author(s):

Jae Young Lee ◽

Sajid Mushtaq ◽

Jung Eun Park ◽

Hee Soon Shin ◽

So-Young Lee ◽

...

Keyword(s):

Nuclear Imaging ◽

Hazardous Substances ◽

Environmental Research ◽

Whole Body ◽

Whole Body Imaging ◽

Toxic Substances ◽

Industrial Chemicals ◽

Biological Uptake ◽

Radioanalytical Methods

Concern about environmental exposure to hazardous substances has grown over the past several decades, because these substances have adverse effects on human health. Methods used to monitor the biological uptake of hazardous substances and their spatiotemporal behavior in vivo must be accurate and reliable. Recent advances in radiolabeling chemistry and radioanalytical methodologies have facilitated the quantitative analysis of toxic substances, and whole-body imaging can be achieved using nuclear imaging instruments. Herein, we review recent literature on the radioanalytical methods used to study the biological distribution, changes in the uptake and accumulation of hazardous substances, including industrial chemicals, nanomaterials, and microorganisms. We begin with an overview of the radioisotopes used to prepare radiotracers for in vivo experiments. We then summarize the results of molecular imaging studies involving radiolabeled toxins and their quantitative assessment. We conclude the review with perspectives on the use of radioanalytical methods for future environmental research.

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