Toxicological aspects of preparedness and aftercare for chemical-incidents

Mobilisation of emergency services for chemical incidents in Sweden - a multi-agency focus group study

BACKGROUND

In chemical incidents, infrequent but potentially disastrous, the World Health Organization calls for inter-organizational coordination of actors involved. Multi-organizational studies of chemical response capacities are scarce. We aimed to describe chemical incident experiences and perceptions of Swedish fire and rescue services, emergency medical services, police services, and emergency dispatch services personnel.

METHODS

Eight emergency service organizations in two distinct and dissimilar regions in Sweden participated in one organization-specific focus group interview each. The total number of respondents was 25 (7 females and 18 males). A qualitative inductive content analysis was performed.

RESULTS

Three types of information processing were derived as emerging during acute-phase chemical incident mobilization: Unspecified (a caller communicating with an emergency medical dispatcher), specified (each emergency service obtaining organization-specific expert information), and aligned (continually updated information from the scene condensed and disseminated back to all parties at the scene). Improvable shortcomings were identified, e.g. randomness (unspecified information processing), inter-organizational reticence (specified information processing), and downprioritizing central information transmission while saving lives (aligned information processing).

CONCLUSIONS

The flow of information may be improved by automation, public education, revised dispatcher education, and use of technical resources in the field. Future studies should independently assess these mechanism's degree of impact on mobilisation of emergency services in chemical incidents.

Optical detection of sulfur mustard contaminated surfaces based on a sprayable fluorescent probe

A water-based sprayable functional polymer was immobilized with the fluorescent probe DPXT and was used as a chemo-sensor for rapid localization of surface contamination by sulfur mustard.

Chemical warfare agents. Classes and targets

Synthetic toxic chemicals (toxicants) and biological poisons (toxins) have been developed as chemical warfare agents in the last century. At the time of their initial consideration as chemical weapon, only restricted knowledge existed about their mechanisms of action. There exist two different types of acute toxic action: nonspecific cytotoxic mechanisms with multiple chemo-biological interactions versus specific mechanisms that tend to have just a single or a few target biomolecules. TRPV1- and TRPA-receptors are often involved as chemosensors that induce neurogenic inflammation. The present work briefly surveys classes and toxicologically relevant features of chemical warfare agents and describes mechanisms of toxic action.

Chemical warfare agents

Among the Weapons of Mass Destruction, chemical warfare (CW) is probably one of the most brutal created by mankind in comparison with biological and nuclear warfare. Chemical weapons are inexpensive and are relatively easy to produce, even by small terrorist groups, to create mass casualties with small quantities. The characteristics of various CW agents, general information relevant to current physical as well as medical protection methods, detection equipment available and decontamination techniques are discussed in this review article. A brief note on Chemical Weapons Convention is also provided.

The influence of the 2010 World Cup on the Tygerberg Poison Information Centre

INTRODUCTION

The soccer World Cup is one of the biggest sporting events in the world, but data on the effect of sporting events of such a magnitude on the service demand on Poison Information Centres (PICs) are limited.

OBJECTIVE

The aim of this study was to determine the influence of the 2010 World Cup on the workload of the Tygerberg Poison Information Centre (TPIC).

METHODS

Data were collected prospectively for three time periods during 2010: (1) 31 days preceding the World Cup (10 May-10 June); (2) 31 days during the World Cup (11 June-11 July); and (3) 31 days after the World Cup (12 July-11 August). The calls received during 2010 were compared to calls received during corresponding time periods in 2008 and 2009. Collected data included date and time, caller's location and medical background, patient's age and gender, intent of exposure, route of exposure and specific toxin class.

RESULTS

During the study, 3888 calls related to human poisoning were received (1162 in 2010, 1412 in 2009 and 996 in 2008). The mean daily call volume between 2010 (12.49; 95% CI 11.57-13.42) and 2009 (13.23; 95% CI 12.30-14.15) did not differ significantly (p = 0.25). The mean daily call volume during the World Cup was 11.13 (95% CI 9.59-12.67; n = 345) compared to 14.26 (95% CI 12.71-15.80; n = 442) for the similar period in 2009 (p = 0.08). The mean daily call volume before and after the World Cup was 12.74 (95% CI 11.20-14.29; n = 395) and 13.61 (95% CI 12.07-15.16; n = 422); p = 1.00 and p = 0.39, respectively, when compared with the World Cup period.

DISCUSSION

An unexpected finding of this study was that the hosting of the 2010 World Cup resulted in fewer calls to the TPIC. This decrease could be attributed to the high visibility of policing, an extended school holiday and the positive attitudes of South Africans towards making the World Cup a success.

CONCLUSION

PICs should be consulted during the planning stages of major sporting events. Contingency plans should still be in place to overcome any unexpected rise in call volume.

Mustard gas or sulfur mustard: an old chemical agent as a new terrorist threat

Sulfur mustard is a member of the vesicant class of chemical warfare agents that causes blistering to the skin and mucous membranes. There is no specific antidote, and treatment consists of systematically alleviating symptoms. Historically, sulfur mustard was used extensively in inter-governmental conflicts within the trenches of Belgium and France during World War I and during the Iran-Iraq conflict. Longitudinal studies of exposed victims show that sulfur mustard causes long-term effects leading to high morbidity. Given that only a small amount of sulfur mustard is necessary to potentially cause an enormous number of casualties, disaster-planning protocol necessitates the education and training of first-line healthcare responders in the recognition, decontamination, triage, and treatment of sulfur mustard-exposed victims in a large-scale scenario.