Evaluating the impact of decontamination interventions performed in sequence for mass casualty chemical incidents

Abstract

The Initial Operational Response (IOR) to chemical incidents is a suite of rapid strategies including evacuation, disrobe and improvised and interim decontamination. IOR and Specialist Operational Response (SOR) decontamination protocols involving mass decontamination units would be conducted in sequence by UK emergency services following a chemical incident, to allow for safe onward transfer of casualties. As part of a series of human volunteer studies, we examined for the first time, the effectiveness of UK IOR and SOR decontamination procedures alone and in sequence. Specifically, we evaluated the additional contribution of SOR, when following improvised and interim decontamination. Two simulants, methyl salicylate (MeS) with vegetable oil and benzyl salicylate (BeS), were applied to participants’ skin. Participants underwent improvised dry, improvised wet, interim wet, specialist decontamination and a no decontamination control. Skin analysis and UV photography indicated significantly lower levels of both simulants remaining following decontamination compared to controls. There were no significant differences in MeS levels recovered between decontamination conditions. Analysis of BeS, a more persistent simulant than MeS, showed that recovery from skin was significantly reduced following combined IOR with SOR than IOR alone. These results show modest additional benefits of decontamination interventions conducted in sequence, particularly for persistent chemicals, supporting current UK operational procedures.

Novel Google Maps and Google Earth application for chemical industry disaster risk assessment during complex emergencies in Eastern Ukraine

“…The Initial Operation Response to chemical incidents and Specialist Operational Response decontamination protocol has proven effective in the United Kingdom 29 and can be adapted to the context of Eastern Ukraine. Treatment facilities such as clinics and hospital emergency rooms should have a decontamination facility.…”

The wash-in effect and its significance for mass casualty decontamination

“…While this fundamental change to operational guidance in the UK was made on a precautionary basis, further evidence demonstrated that this reduction in showering time did not have a significant deleterious impact on the efficacy of decontamination based upon chemical remaining on skin. Further work is required to determine whether this is also true for systemic exposure, though initial work conducted under the Protocols for Hair and the Optimization of Existing and Novel decontamination Interventions through eXperimentation (PHOENIX) project was unable to demonstrate a significant reduction in urinary levels of either methyl salicylate or benzyl salicylate in a series of human volunteer decontamination studies following skin and hair application despite significant reductions to levels remaining on hair and skin (Collins et al 2020 , 2021b ; Southworth et al 2020 ).…”