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1.
BMC Med Educ ; 22(1): 350, 2022 May 09.
Artigo em Inglês | MEDLINE | ID: mdl-35534890

RESUMO

BACKGROUND: Mass chemical exposure emergencies are infrequent but can cause injury, illness, or loss of life for large numbers of victims. These emergencies can stretch and challenge the available resources of healthcare systems within the community. Political unrest in the Middle East, including chemical terrorist attacks against civilians in Syria and increasing chemical industry accidents, have highlighted the lack of hospital preparedness for chemical incidents in the region. This study aimed to evaluate the effectiveness of a course designed to empower frontline healthcare providers involved in mass casualty incidents with the basic knowledge and essential operational skills for mass chemical exposure incidents in Saudi Arabia. METHODS: A mixed-methods approach was used to develop a blended learning, simulation enhanced, competency-based course for major chemical incidents for front line healthcare providers. The course was designed by experts from different disciplines (disaster medicine, poisoning / toxicology, and Hazard Material Threat - HAZMAT team) in four stages. The course was piloted over five days at the Officers Club of the Ministry of Interior (Riyadh, Saudi Arabia). The 41 participants were from different government health discipline sectors in the country. Pre- and post-tests were used to assess learner knowledge while debriefing sessions after the decontamination triage session and simulation-enhanced exercises were used for team performance assessment. RESULTS: The overall knowledge scores were significantly higher in the post-test (69.47%) than the pre-test (46.3%). All four knowledge domains also had significant differences between pre- and post-test results. There were no differences in the pre and post-test scores for healthcare providers from the different health disciplines. A one-year post-event survey demonstrated that participants were satisfied with their knowledge retention. Interestingly, 38.3% had the opportunity to put this knowledge into practice in relation to mass chemical exposure incidents. CONCLUSION: Delivering a foundation level competency-based blended learning course with enhanced simulation training in major chemical incidents for front line healthcare providers may improve their knowledge and skills in response to such incidents. This in turn can improve the level of national preparedness and staff availability and make a crucial difference in reducing the health impacts among victims.


Assuntos
Vazamento de Resíduos Químicos , Planejamento em Desastres , Incidentes com Feridos em Massa , Emergências , Pessoal de Saúde , Humanos , Projetos Piloto , Arábia Saudita
2.
J Hazard Mater ; 432: 128714, 2022 06 15.
Artigo em Inglês | MEDLINE | ID: mdl-35358764

RESUMO

Chemical accidents have threatened drinking water safety and aquatic systems when hazardous chemicals flow into inland waterbodies through pipelines in industrial complexes. In this study, a forecasting system was developed for the prevention of drinking water resource pollution by considering chemical transport/fate through both pipelines and river channels. To this end, we coupled a pipe network model (Storm Water Management Model) with a calibrated hydrodynamic model (Environmental Fluid Dynamics Code). In addition, we investigated whether chemical transport through pipelines would make a difference in chemical concentration predictions. For both pipelines and river channels, the results showed lower peak concentrations than those without pipelines, whereas the time of peak concentration did not change significantly. When chemicals were transported with both pipelines and river channels, the peak concentrations were 25.81% and 41.91% lower than those of chemicals carried directly into the Han and Geum Rivers without the pipeline transport. Further, our system is automated from scenario generation to analysis and usage is straightforward, with a simple input of accident information. The results of this study can be utilized to establish a safe water supply system and preliminary countermeasures against accidental water pollution in the future.


Assuntos
Vazamento de Resíduos Químicos , Água Potável , Poluentes Químicos da Água , Água Potável/análise , Monitoramento Ambiental , Rios/química , Poluentes Químicos da Água/química
3.
New Solut ; 31(4): 475-483, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-34986059

RESUMO

More than 180 preventable incidents at hazardous chemicals facilities occur each year, resulting in deaths, injuries, evacuations, shelter in place orders, environmental contamination, and facility shutdowns with permanent job loss. As of June 17, 2021, the Chemical Safety Board (CSB) had nineteen open site investigations of incidents that in total killed thirty-two people, injured at least eighty-seven people, led to thousands of residents sheltering in place or evacuating, and resulted in many millions of dollars in property damage. This document outlines twenty-one practical and measurable actions that the CSB can take to rebuild its investigative and recommendations capacity; set clear priorities for agency action; reform its governance policies; and increase public transparency and engagement. The proposed actions address incident investigations, safety studies, safety recommendations, agency governance, and public transparency and engagement.


Assuntos
Vazamento de Resíduos Químicos , Segurança Química , Desastres , Substâncias Perigosas/toxicidade , Humanos , Vigilância da População , Estados Unidos
4.
Environ Sci Pollut Res Int ; 29(18): 26648-26659, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-34854005

RESUMO

We established a hypothetical acrylic acid leak accident scenario, conducted a health risk assessment of local residents, and compared an actual accident case to the hypothetical scenario. The exposed subjects were divided into four age groups, and a noncarcinogenic health risk assessment was conducted for inhalation and soil ingestion. In the hypothetical scenario, 40 tons of acrylic acid was leaked in Ulsan for 1 h from midnight on January 1, 2017. In the actual accident case, 3 L of acrylic acid was leaked in Hwaseong, Gyeonggi Province, for 1 h from 11:00 am on March 5, 2020. The environmental concentration of acrylic acid was calculated using the dynamic multimedia environmental model. Noncarcinogenic assessment of the hypothetical scenario showed the hazard quotient exceeded 1 across all age groups, suggesting that a health risk is likely to occur due to inhalation exposure to acrylic acid resulting from a chemical accident. In addition, Hazardacute exceeded 1 until 2 h after the accident under the hypothetical scenario, indicating the likelihood of a health risk. Thus, we propose a methodology that can assess changing concentrations in a hazardous chemical leak from a chemical accident based on the time, place, the chemical's behaviors in different environmental media, and the health risk posed by the exposure of the chemical to local residents in the area affected by the accident.


Assuntos
Acrilatos , Vazamento de Resíduos Químicos , Ingestão de Alimentos , Humanos , Medição de Risco
5.
Br J Anaesth ; 128(2): e200-e205, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-34794766

RESUMO

On March 4, 2018, two casualties collapsed on a park bench in Salisbury, Wiltshire, UK. They were later discovered to have been the victims of an attempted murder using the Soviet-era Novichok class of nerve agent. The casualties, along with three further critically ill patients, were cared for in Salisbury District Hospital's Intensive Care Unit. Before the COVID-19 pandemic, the Salisbury and Amesbury incidents were the longest-running major incidents in the history of the UK National Health Service. This narrative review seeks to reflect on the lessons learned from these chemical incidents, with a particular focus on hospital and local organisational responses.


Assuntos
Vazamento de Resíduos Químicos/prevenção & controle , Serviços Médicos de Emergência/métodos , Incidentes com Feridos em Massa/prevenção & controle , Agentes Neurotóxicos/envenenamento , Organofosfatos/toxicidade , Equipamento de Proteção Individual , Fatores Biológicos/envenenamento , Humanos , Incidência , Liberação Nociva de Radioativos/prevenção & controle , Saúde Radiológica , Reino Unido/epidemiologia
11.
Artigo em Inglês | MEDLINE | ID: mdl-34769652

RESUMO

The COVID-19 pandemic has seen people and governments utilise an array of chemical and pharmaceutical substances in an attempt to prevent and treat COVID-19 infections. The Centre for Radiation, Chemicals and Environmental Hazards (CRCE) at Public Health England (PHE) routinely undertakes Event-Based Surveillance (EBS) to monitor public health threats and incidents related to chemicals and poisons. From April 2020, EBS functions were expanded to screen international media for potentially hazardous exposures associated with the COVID-19 pandemic. Media sources reported that poisons centres were experiencing increased enquiries associated with the use and misuse of household cleaners and alcohol-based hand sanitiser (HS). There were also media reports of people self-medicating with over-the-counter supplements and traditional or herbal remedies. Public figures who directly or indirectly facilitated misinformation were sometimes reported to be associated with changes in poisoning trends. Border closures were also believed to have been associated with increasingly toxic illicit drug supplies in Canada, and record numbers of opioid-related deaths were reported. In other countries, where the sale of alcohol was banned or limited, home-brewing and methanol-based supplies resulted in a number of fatalities. At least two chemical incidents also occurred at industrial sites in India, after sites were left unattended or were closed and reopened due to lockdown measures. Reports of poisoning identified in the international media were provided to the UK National Poisons Information Service (NPIS) and contributed to the UK COVID-19 public health response.


Assuntos
COVID-19 , Vazamento de Resíduos Químicos , Controle de Doenças Transmissíveis , Humanos , Pandemias , SARS-CoV-2
12.
Artigo em Inglês | MEDLINE | ID: mdl-34769734

RESUMO

The increasing use and distribution of chemicals are causing serious chemical accidents such as fires, explosions, and leaks during manufacturing and handling. In most cases, all risks caused by chemicals are classified as accidents due to defects in process facilities, human errors, and multi-cause accidents. Among chemical accidents caused by human errors, accurate analysis of accidents caused by the complex action of various types of human failures is required. Based on the accident investigation reports that occurred in South Korea from 2010 to 2017, chemical accidents caused by human failure were analyzed, and the fundamental causes were derived by classifying them into human error and violation. Human failure was analyzed according to the classification criteria for human failure of health and safety executive (HSE). As a result of the analysis, several types of human failure acted in combination to be a more significant cause of chemical accidents; incorrect application of process rules and procedures, inappropriate chemical information, lack of education, and defects in the current safety regulation were analyzed as the main causes. In addition, the cause of human errors was presented through case studies of chemical accidents in South Korea.


Assuntos
Vazamento de Resíduos Químicos , Incêndios , Acidentes , Acidentes de Trabalho , Humanos , República da Coreia/epidemiologia
13.
Artigo em Inglês | MEDLINE | ID: mdl-34831738

RESUMO

Chemical accidents can occur anywhere. The need for chemical management in Korea was realized following the 2012 Gumi hydrofluoric acid accident in 2012. The Chemicals Control Act was enacted in 2015. This system evaluates the risks (high, medium, low) and consequent safety management at all plants that handle hazardous chemical substances. However, the system was criticized as excessive when most plants were designated high-risk without considering their size. Thus, laboratories and hospitals handling very small quantities were subject to regulation. Accordingly, in 2021 Korea revised the system to include off-site consequence analyses and a Korean-style risk analysis. Plants handling very small quantities, such as laboratories and hospitals, were exempt from regulation. In this study, changes in risk were examined for four medium-sized plating and paint manufacturing plants. Under the previous system, all four factories were judged as high-risk groups. In particular, the paint manufacturing plant A, which has an underground storage tank, received a medium risk like the plating plant C, although the possibility of a chemical accident was lower than that of other plants. However, in the changed system, all plants were changed to the low-risk group. In the Korean-style risk analysis, it is possible to see at a glance what is lacking in the plants, such as cooperation between local residents and local governments and the construction of safety facilities according to the type of accident scenario. The revised system is a reasonable regulation for medium business plants.


Assuntos
Vazamento de Resíduos Químicos , Prevenção de Acidentes , Substâncias Perigosas , Instalações Industriais e de Manufatura , Pintura , República da Coreia , Medição de Risco
14.
Scand J Trauma Resusc Emerg Med ; 29(1): 99, 2021 Jul 21.
Artigo em Inglês | MEDLINE | ID: mdl-34289881

RESUMO

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.


Assuntos
Vazamento de Resíduos Químicos , Operador de Emergência Médica/estatística & dados numéricos , Serviços Médicos de Emergência/organização & administração , Desastres , Feminino , Grupos Focais , Humanos , Masculino , Polícia , Suécia/epidemiologia
15.
Artigo em Inglês | MEDLINE | ID: mdl-34073178

RESUMO

Risk scenarios are caused by the convergence of a hazard with a potentially affected system in a specific place and time. One urban planning goal is to prevent environmental hazards, such as those generated by chemical accidents, from reaching human settlements, as they can cause public health issues. However, in many developing countries, due to their strategic positioning in global value chains, the quick and easy access to labor pools, and competitive production costs, urban sprawls have engulfed industrial areas, exposing residential conurbations to environmental hazards. This case study analyzes the spatial configuration of accidental chemical risk scenarios in three major Mexican metropolitan areas: Mexico City, Guadalajara, and Monterrey. Spatial analyses use an areal locations of hazardous atmosphere (ALOHA) dispersion model to represent the spatial effects of high-risk industrial activities in conurbations and the potentially affected populations vulnerable to chemical hazards. Complementary geostatistical correlation analyses use population data, marginalization indexes, and industrial clustering sectors to identify trends that can lead to comprehensive environmental justice approaches. In addition, the marginalization degree of inhabitants evaluates social inequalities concerning chemical risk scenarios.


Assuntos
Vazamento de Resíduos Químicos , Meio Ambiente , Cidades , Humanos , México , Fatores Socioeconômicos , População Urbana
16.
Artigo em Inglês | MEDLINE | ID: mdl-33802722

RESUMO

Planning for major incidents involving the release of hazardous chemicals has been informed by a multi-disciplinary research agenda which has sought to inform all aspects of emergency response, but with a focus in recent years on mass casualty decontamination. In vitro and human volunteer studies have established the relative effectiveness of different decontamination protocols for a range of chemical agents. In parallel, a programme of research has focused on communicating with and managing large numbers of contaminated casualties at the scene of an incident. We present an accessible overview of the evidence underpinning current casualty decontamination strategies. We highlight where research outcomes can directly inform response planning, including the critical importance of beginning the decontamination process as soon as possible, the benefits of early removal of contaminated clothing, the evidence under-pinning dry and wet decontamination and how effective communication is essential to any decontamination response. We identify a range of priority areas for future research including establishing the significance of the 'wash-in' effect and developing effective strategies for the decontamination of hair. We also highlight several areas of future methodological development, such as the need for novel chemical simulants. Whilst considerable progress has been made towards incorporating research outcomes into operational policy and practice, we outline how this developing evidence-base might be used to inform future iterations of mass casualty decontamination guidance.


Assuntos
Vazamento de Resíduos Químicos , Planejamento em Desastres , Incidentes com Feridos em Massa , Descontaminação , Emergências , Substâncias Perigosas , Humanos
17.
Acta toxicol. argent ; 29(1): 8-10, abr. 2021. graf
Artigo em Espanhol | LILACS | ID: biblio-1360066

RESUMO

Resumen Se describe un caso de quemadura causada por cloroformiato de etilo en ocasión de la respuesta a un incidente que requirió el trasvase del producto desde contenedores defectuosos a otros seguros. La investigación del evento puso en evidenciala necesidad de mantener un protocolo de registro de materiales que ingresan a la zona caliente, que debe ser tenido en cuentaal momento del retiro de los mismos, procediendo a su correcta descontaminación bajo la fiscalización del oficial de seguridad.


Abstract A burn by Ethyl chloroformate in occasion of response to a chemical emergency which required to transfer products from defective containers to safe containers is described. The investigation of the event highlighted the need to maintain aprotocol for the registration of materials to be entered in the hot zone, which must be considered al the moment of remove andproceeding to the proper decontamination under the supervision of the security officer.


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Queimaduras Químicas/prevenção & controle , Vazamento de Resíduos Químicos , Ésteres do Ácido Fórmico , Acidentes com Materiais Perigosos , Queimaduras Químicas/diagnóstico , Nádegas , Acidentes de Trabalho/prevenção & controle , Descontaminação , Resíduos Corrosivos
18.
J Expo Sci Environ Epidemiol ; 31(5): 867-875, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-33774650

RESUMO

BACKGROUND: Human biomonitoring (HBM) has been repeatedly recommended for and applied to post-incident chemical exposure assessment. The applicability of HBM and the validity of its results, however, closely depend on the existence and quality of preparatory measures such as information and instruction materials, sampling procedures, transport and storage facilities, and on the selection of appropriate biomarkers, sampling time, transport and storage conditions. OBJECTIVE: To establish a standardized HBM program for emergency responders of a large chemical production site, considering the aforementioned aspects. METHODS: An HBM program based on a comprehensive questionnaire, information and training of emergency responders, and availability of sampling material was established. The quantitative determination of metabolites of hazardous substances was carried out based on quality-controlled analytical methods. RESULTS: The use of HBM after emergency operations was significantly increased immediately after the implementation of the program. Only in single cases, however, established HBM assessment values were exceeded. After one major incident, an increased exposure to benzene exceeding the internal action value was observed after firefighting and safeguarding. SIGNIFICANCE: The experience with several minor and one major incident at a chemical production site suggests that the implementation of easily accessible and applicable routines is one paramount prerequisite for the success of HBM programs after chemical incidents.


Assuntos
Monitoramento Biológico , Vazamento de Resíduos Químicos , Benzeno , Monitoramento Ambiental , Substâncias Perigosas/análise , Humanos
19.
BMC Emerg Med ; 21(1): 34, 2021 03 22.
Artigo em Inglês | MEDLINE | ID: mdl-33752618

RESUMO

BACKGROUND: This study analyzed the characteristics of hydrogen fluoride-exposed patients (HFEPs) treated in the emergency department (ED) of a local university hospital, and reviewed the hospital's disaster response according to space, staff, supplies, and systems (4Ss). METHODS: This retrospective observational chart review and descriptive study included 199 HFEPs among 2588 total ED patients who visited a local university emergency medical center for treatment between September 27, 2012 and October 20, 2012, following a hydrofluoric acid leak at the Hube Globe factory in Gumi City, Republic of Korea. Descriptive results concerning the 4Ss were obtained by interviewing ED specialist staff physicians on duty during the study period. In accordance with American Burn Association criteria, patients requiring burn center referral were assigned to the major burn group (MBG) as severe condition. RESULTS: During the acute phase (within 8 h after leak initiation), there were 43 patients in the ED, which was staffed with 3 doctors and 3 nurses, without 4S resources. Of these 43 patients, there were 8 HFEPs (100%) in the MBG and 0 in the non-MBG (NMBG). During the subacute phase (24 h after the acute phase), there were 262 patients in the ED including 167 HFEPs, of whom 45 (26.95%) were in the MBG and 122 (73.05%) were in the NMBG. The ED was then staffed with 6 doctors (3 on day shift and 3 on night shift) and 10 nurses (3 on day shift, 4 on evening shift, and 3 on night shift), and no 4S resources were available. Throughout the study period, no 4Ss were available. First, there was no expansion of ED space or secured disaster reserve beds. Second, there was no increase in manpower with duty time adjustments or duty relocation for ED working personnel. Third, there was no logistics reinforcement (e.g., antidote or personal protective equipment). Fourth, there were no disaster-related measures for the administration department, decontamination zone setup, safety diagnostic testing, or designated disaster triage implementation. CONCLUSIONS: The hospital's disaster response was insufficient for all aspects of the 4Ss. Detailed guidance concerning a hospital disaster management plan is required.


Assuntos
Vazamento de Resíduos Químicos , Planejamento em Desastres , Desastres , Serviço Hospitalar de Emergência/organização & administração , Hospitais , Humanos , Ácido Fluorídrico , República da Coreia , Estudos Retrospectivos
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