Management of chemically contaminated bodies

Abstract

In the world today over 23 million chemical compounds are known to man.1 Of these chemicals, about 70 000 are in regular use and some 500 new ones are introduced every month into the market.2 The extensive use of chemicals in industrial processes and their storage, disposal and transport present hazards of chemical accidents (incidents) with the potential to harm humans and the environment. The mass disaster at Bhopal,3 the sarin subway attacks in Tokyo4 and the Lake Nyos incident5 have increased public awareness of the dangers of large acute chemical incidents in modern society. The majority of chemical incidents can do harm if incorrectly managed. The role of public health agencies, emergency response agencies, health providers and related organizations is to prevent, anticipate and respond to chemical incidents so as to reduce the impact on man and his environment.6 All these agencies have a duty to ensure the health and safety of their personnel in such incidents.7 There are well-defined procedures in place for the management of chemical incidents, including advice on incident scene management, decontamination of casualties and use of personal protective equipment for emergency responders.6,8–10 These guidelines are designed to contain the hazards of a chemical incident and minimize the environmental and human impact. However, in certain cases, chemical incidents have resulted in a spread of contamination from the scene to other locations.11,12 This contamination arising from activities subsequent to the actual chemical incident is known as secondary contamination. A hospital emergency room may be contaminated by chemicals from a patient who has primary contamination with material from the scene of the incident. Secondary contamination can occur from a patient even after death and may pose a serious health risk to persons in contact with the body. Recent incidents of secondary chemical contamination from human fatalities have revealed a need for a plan to manage chemically contaminated bodies effectively. Incidents involving chemically contaminated victims have resulted in confusion and adverse health effects in responders.13–15 The absence of guidance on the efficient management of chemically contaminated victims has increased the negative impact of these incidents. This paper aims to promote awareness of the potential impact of secondary contamination from chemically contaminated victims and offers preliminary guidance to those involved.