Decontamination and management of human remains following incidents of hazardous chemical release.

OBJECTIVE: To provide specific guidance and resources for systematic and orderly decontamination of human remains resulting from a chemical terrorist attack or accidental chemical release. DESIGN: A detailed review and health-based decision criteria protocol is summarized. Protocol basis and logic are derived from analyses of compound-specific toxicological data and chemical/physical characteristics. SETTING: Guidance is suitable for civilian or military settings where human remains potentially contaminated with hazardous chemicals may be present, such as sites of transportation accidents, terrorist operations, or medical examiner processing points. PATIENTS AND PARTICIPANTS: Guidance is developed from data-characterizing controlled experiments with laboratory animals, fabrics, and materiel. MAIN OUTCOME MEASURE(S): Logic and specific procedures for decontamination and management of remains, protection of mortuary affairs personnel, and decision criteria to determine when remains are sufficiently decontaminated are presented. RESULTS: Established procedures as well as existing materiel and available equipment for decontamination and verification provide reasonable means to mitigate chemical hazards from chemically exposed remains. Unique scenarios such as those involving supralethal concentrations of certain liquid chemical warfare agents may prove difficult to decontaminate but can be resolved in a timely manner by application of the characterized systematic approaches. Decision criteria and protocols to "clear" decontaminated remains for transport and processing are also provided. CONCLUSIONS: Once appropriate decontamination and verification have been accomplished, normal procedures for management of remains and release can be followed.