A newly developed autoinjector (Astra Tech, Sweden) containing 500 mg HI-6 and 2 mg atropine sulphate was tested in anaesthetized normal pigs. The pharmacokinetics and pharmacodynamics of the drugs after administration by the autoinjector were compared with those after conventional needle and syringe delivery intramuscularly and intravenously. Cardiopulmonary parameters were monitored and serum concentrations of oxime, atropine, and acetylcholinesterase were determined in blood samples taken at intervals over a 6 h period postinjection. After injection in anaesthetized pigs, both HI-6 and atropine were absorbed rapidly and completely from the injection site. Therapeutic serum concentrations of HI-6, arbitrarily taken as 4 micrograms mL-1, were reached within 1 min of intravenous and autoinjector administration, and within 5 min of intramuscular injection. The concentrations remained above this level for 3-4 h. There were no significant changes in acetylcholinesterase activity, mean arterial blood pressure, or respiration frequency after injection of HI-6 and atropine sulphate. The heart rates increased significantly after administration of the two drugs (cardioacceleration defined as > or = 5% increase in heart rate), regardless of the technique employed. Our results show that HI-6 and atropine sulphate can be given intramuscularly by the new autoinjector with the same effectiveness and speed as when given intravenously. Irrespective of the injection technique, no overt signs of toxicity were observed at the drug concentrations used.

The European Union (EU) has mechanisms in place to support countries when an environmental emergency strikes and it deploys experts to assist the local community. These experts may find themselves in a chaotic situation, in which local and national authorities are overwhelmed. Collating the necessary evidence from scattered sources to conduct a robust risk assessment is a major challenge and deployed experts may not have access to the necessary technical expertise.Therefore, the European Multiple Environmental Threats Emergency Network (EMETNET) project is building a simple, efficient and robust methodology to enable the rapid risk assessment (RRA) of environmental emergencies. The RRA, which will be delivered to the European Commission (EC), presents an overview of potential and actual health and environmental impacts of the event. A network of risk assessors is being built to carry out this RRA and provide back-office support to deployed experts, enabling them to have rapid access to information and expertise. EMETNET builds on existing methodologies for the RRA of environmental emergencies, in particular, on a methodology developed for serious cross-border chemical health threats.The EMETNET methodology will support the selection of experts and assets deployed to affected regions and provide a snapshot assessment to experts en route to disaster zones. It will aid defensible decision-making, communication, planning and risk management. Furthermore, it will ensure a harmonised understanding of the associated health, environmental and cross-sectoral impacts of an environmental emergency.

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Catastrophic chemical or radiological events can cause thousands of casualties. Such disasters require triage procedures to identify the development of health consequences requiring medical intervention. Our objective is to analyze recent advancements in biotechnology for triage in mass emergency situations. In addition to identifying persons “at risk” of developing health problems, these technologies can aid in securing the unaffected or “worried well”. We also highlight the need for public/private partnerships to engage in some of the underpinning sciences, such as patho-physiological mechanisms of chemical and radiological hazards, and for the necessary investment in the development of rapid assessment tools through identification of biochemical, molecular, and genetic biomarkers to predict health effects. For chemical agents, biomarkers of neurotoxicity, lung damage, and clinical and epidemiological databases are needed to assess acute and chronic effects of exposures. For radiological exposures, development of rapid, sensitive biomarkers using advanced biotechnologies are needed to sort exposed persons at risk of life-threatening effects from persons with long-term risk or no risk. The final implementation of rapid and portable diagnostics tools suitable for emergency care providers to guide triage and medical countermeasures use will need public support, since commercial incentives are lacking.

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