A framework for integrating information resources for chemical emergency management and response

Integrated environmental health assessment: Proposed approaches to exposure during chemical incidents

An integrated environmental health exposure assessment (IEHA) refers to the integration of human biomonitoring data (HBM) and environmental measurements and aims to optimize the exposure assessment process. Due to lack of data, this approach remains an issue during chemical incidents. This study aims to explore integrated exposure approaches for assessing human health risks during chemical incidents. Based on the Preferred Reporting Items of Systematic reviews and Meta-Analyses statement, a literature analysis was performed. A level of confidence ranging from 1 to 4 was established to define the quality and strength of data used to undertake an IEHA approach. Twenty-seven articles (n = 18) and texts (n = 9) from Europe (41%) and the United States (37%) were analyzed. Among the 18 scientific articles, 61% (n = 11) presented a quantitative approach and 17% (n = 3) presented a qualitative approach. Quantitative approaches must be based on accurate data, coupled with predictive models. Of all the scientific papers, 40% (n = 7) responded to a confidence level greater than or equal to 2. Uncertainties detected through the integrated exposure approaches were related to input data, analytical methods, and HBM reference value interpretations. During chemical incidents, direct measurements were the most relevant data. Few scientific studies have developed an integrated approach during emergency situations. However, when this was used, they presented a high level of confidence by defining levels of exposure that support decision-making processes. Despite the multiple approaches, there was a lack of guidelines allowing an integrated risk assessment to be performed during an emergency chemical exposure. Integr Environ Assess Manag 2024;20:481-497. © 2023 SETAC.

Whether occupational injuries of the industrial workers can be prevented: an analysis from the slums of West Bengal-India?

A lack of research exists concerning the heterogeneity of the occupational injuries of slum dwellers across industries which has a close link with health expenditure and hence livelihood. It necessitates analysing their occupational injuries and associated out-of-pocket health expenditures. Multi-stage random sampling is used to collect the primary data and the logit model is used for data analyses. Permanent non-fatal injuries in the civil-mechanical industries and temporary non-fatal injuries in textile industries are common. The share of health expenditure of the injured workers seeking medical consultations remains 59% of their average monthly income. Average monthly income, parental occupation, types of industry, job security, risk intensity, and salary basis are significant estimates of occupational injuries. The differences in the nature and extent of the occupational injuries of the workers across industries in the light of the socio-demographic and working environment context provide significant insight into the policy implications.

A Scoping Review of the Essential Components of Emergency Medical Response Systems for Mass Casualty Incidents

OBJECTIVE

Emergency medical (EM) response systems require extensive coordination, particularly during mass casualty incidents (MCIs). The recognition of preparedness gaps and contextual priorities to MCI response capacity in low- and middle-income countries (LMICs) can be better understood through the components of EM reponse systems. This study aims to delineate essential components and provide a framework for effective emergency medical response to MCIs.

METHODS

A scoping review was conducted using 4 databases. Title and abstract screening was followed by full-text review. Thematic analysis was conducted to identify themes pertaining to the essential components and integration of EM response systems.

RESULTS

Of 20,456 screened citations, 181 articles were included in the analysis. Seven major and 40 sub-themes emerged from the content analysis as the essential components and supportive elements of MCI medical response. The essential components of MCI response were integrated into a framework demonstrating interrelated connections between essential and supportive elements.

CONCLUSIONS

Definitions of essential components of EM response to MCIs vary considerably. Most literature pertaining to MCI response originates from high income countries with far fewer reports from LMICs. Integration of essential components is needed in different geopolitical and economic contexts to ensure an effective MCI emergency medical response.