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Safe Management of Mass Fatalities following Chemical, Biological, and Radiological Incidents

Published online by Cambridge University Press:  28 June 2012

David J. Baker ,
Kelly A. Jones ,
Shelly F. Mobbs ,
Ovnair Sepai ,
Dilys Morgan  and
Virginia S.G. Murray
David J. Baker*
Affiliation:
Health Protection Agency, London, UK
Kelly A. Jones
Affiliation:
Health Protection Agency, London, UK
Shelly F. Mobbs
Affiliation:
Health Protection Agency, London, UK
Ovnair Sepai
Affiliation:
Health Protection Agency, London, UK
Dilys Morgan
Affiliation:
Health Protection Agency, London, UK
Virginia S.G. Murray
Affiliation:
Health Protection Agency, London, UK
*
Consultant Medical ToxicologistChemical Hazards and Poisons Division (London)Health Protection Agency7th Floor, Holborn Gate 330, High HolbornLondon WC1V 7PPUnited Kingdom E-mail: david.baker@hpa.org.uk
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Abstract

Contaminated mass fatalities following the release of chemical, biological, or radiological agents pose a potential major health hazard. A United Kingdom government investigation has identified a number of areas of risk. This paper presents an outline of the findings of the study and describes specific pathways for the management of contaminated and non-contaminated fatalities. Factors determining the choice between cremation and burial are discussed. Effective decontamination remains a neglected area of study for both fatalities and casualties.

Keywords

Body Process Pathwayburialchemical, biological, radiologicalcontaminationcremationdecontaminationmanagementmass fatalities

Information

Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 24 , Issue 3 , June 2009 , pp. 180 - 188
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2009

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References

1.Pita, R: Assessing al-Qaeda's chemical threat. International Journal of Intelligence and Counter Intelligence 2007;20(3):480–511.CrossRefGoogle Scholar
2.Borak, J, Callan, M, Abbott, W: Hazardous Materials Exposure: Emergency Response and Patient Care. New Jersey: Prentice Hall Inc., 1991.Google Scholar
3.Home Office: Guidance on dealing with fatalities in emergencies. Available at http://www.ukresilience.info/contingencies/pubs/fatalities.pdf. Accessed 07 October 2008.Google Scholar
4.Health Protection Agency: Deliberate and Accidental Releases. Available at http://www.hpa.org.uk/webw/HPAweb&Page&HPAwebAutoListName/Page/1197637044441. Accessed 09 May 2008.Google Scholar
5.Smith, JM, Ansari, A, Harper, FT: Hospital management of mass radiological casualties: Re-assessing exposures from contaminated victims of an exploded radiological dispersion device. Health Physics 2005;89(5):513–520.CrossRefGoogle Scholar
6.Cooper, JR, Walmsley, A, Charles, D: Individual and collective doses from the release of 89Sr into the environment following medical administration. NRPB M-193. United Kingdom: Chilton NRPB, 1989.Google Scholar
7.Baker, DJ: Chemical and Biological Agents: The Role of the Anaesthesiologist. In Miller, R (ed), Anesthesia (6th edition). St. Louis: Elsevier Inc., 2005.Google Scholar
8.Clarke, SFJ, Chilcott, RP, Wilson, JC: Decontamination of multiple casualties who are chemically contaminated; a challenge for acute hospitals. Prehospital Disast Med 2008;23(2):175–181.CrossRefGoogle ScholarPubMed
9.Edkins, A, Murray, VSG: Management of chemically-contaminated bodies. JR Soc Med 2005;98(4):141–145.CrossRefGoogle ScholarPubMed
10.Bronstein, AC, Currance, PL: Emergency Care for Hazardous Materials Exposure. 2nd ed. St Louis: Mosby Lifeline, 1994.Google Scholar
11.IPEM: Medical and Dental Guidance Notes. A Good Practice Guide on all Aspects of Ionising Radiation Protection in the Clinical Environment. Institute of Physics and Engineering in Medicine, 2002.Google Scholar
12.CDC: Meeting report on the roundtable on guidelines for handling mass fatalities with radioactive contamination. Centers for Disease Control and Prevention, National Center for Environmental Health, Radiation Studies Branch. 2004.Google Scholar
13.SBCCOM: Guidelines for mass fatality during terrorist incidents involving chemical agents.U.S.Army Soldier and Biological Chemical Command.2001.Google Scholar
14.UK Parliament: The Cremation Act. 1902 (c.8).Google Scholar
15.United States Department of Army: The Army Chemical Agent Safety Program 2001, Regulation AR385-61.CrossRefGoogle Scholar
16.UK Department of Environment, Food and Rural Affairs, Scottish Executive and Welsh Assembly Government: Secretary of State's Guidance for Crematoria, Process Guidance Note 5/2 (04), 2004.Google Scholar
17.Cox, M, Kneller, P: Crypt Archaeology: An Approach. IFA paper no 3. Institute of Field Archaeologists, University of Reading, 2001.Google Scholar
18.Trick, JK, Klinck, BA, Coombs, P, Chambers, J, Noy, DJ, West, J, Williams, GM: Groundwater Impact of Danescourt Cemetery, Wolverhampton In Bringing Groundwater Quality Research to the Watershed Scale. (Proceedings of GQ 2004, the 4th International Groundwater Quality Conference held at Waterloo, Canada, July 2004) IAHS Publ 297, 2005.Google Scholar
19.UK Environment Agency: Assessing the Groundwater Pollution Potential of Cemetery Developments. Pamphlet SCHO0404BGLA-E-P. 2004.Google Scholar
20.Santarsiero, A, Minelli, L, Cutilli, D, Capiello, G: Hygienic aspects related to burial Microchemical Journal 2000;67:141–145.Google Scholar
21.Ucisik, AS, Rushbrook, P:The impact of cemeteries on the environment and public health.WHO Regional Office for Europe,1998; Rept EUR/ICP/EHNA 01 04 01 (A):11.Google Scholar
22.Morgan, O: Infectious disease risks from dead bodies following natural disasters. Rev Panam Salud Publica 2004;15(5):307–312.CrossRefGoogle ScholarPubMed
23.Spongberg, AL, Beck, PM: Organic contamination in soils associated with cemeteries. J Soil Contam 2000;9:87–97.CrossRefGoogle Scholar
24.Spongberg, AL, Beck, PM: Inorganic soil contamination from cemetery leachate. Water, Air & Soil Contamination 2000;117:313–327.CrossRefGoogle Scholar
25.Chang, LW: The neurotoxicology and pathology of organomercury, organolead, and organotin. J Toxicol Sci 1990;15(Suppl 4):125–151.CrossRefGoogle ScholarPubMed
26.Cabinet and Home Offices: Guidance on dealing with fatalities in emergencies. Available at http://www.ukresilience.gov.uk/~/media/assets/www.ukresilience.info/fatalitiespdf.ashx. Accessed 07 October 2008Google Scholar