Emergency Preparedness And Response Research Articles

Evolution of zoning philosophy for emergency planning around nuclear power plants

Emergency planning zones (EPZs) serve as vital geographic framework within nuclear emergency preparedness and response (EPR) strategies, facilitating the swift implementation of protective measures across varying levels of urgency during nuclear emergencies. Over the years, nations have undergone thorough reassessments of these zones, in the light of evolving evaluation methods, reactor technology, and lessons learned from accidents, leading to the refinement of methodologies for delineating EPZ distances. Adherence to the International Atomic Energy Agency safety guidelines regarding EPZ size has demonstrated effectiveness in protecting both the public and environment surrounding existing nuclear power plants. As the landscape of nuclear energy evolves with the advent of small modular reactors, characterized by reduced power capacity and innovative safety features, there is enough potential for smaller EPZs. However, the determination of EPZ also depends on national policies, public acceptance, and nuanced risk criteria. This paper seeks to synthesize current insights into the evolution of EPZs and explores avenues for resizing them to accommodate emerging reactor technologies. Its findings hold relevance for reactor designers, risk analysts, and experts in nuclear EPR, offering guidance for future planning and implementation efforts.

What are the research priorities for strengthening public health emergency preparedness and response in Africa?

BackgroundResearch evidence is needed to strengthen capacities in emergency preparedness and response (EPR). However, the absence of a clear research agenda limits the optimal use of research evidence. This paper reports on the prioritization of research questions and topics that could contribute to evidence-informed strengthening of EPR capacities in the African region.MethodsThe priority-setting consisted of desk review and stakeholder consultation workshop. Twenty-nine people participated in the workshop, including representatives from WHO regional office and EPR focal points in Africa, representatives of research institutions, and partners from Science for Africa Foundation, United Nations Children's Fund and Africa Center for Disease Control. Modified Delphi technique was used to systematically arrive at specific and cross-cutting research priorities in the three broad areas of the EPR, which are program Implementation, Clinical and Epidemiology. The research questions/topics were ranked on five-point Likert scale (1 = very low to 5 = very high) based on seven agreed-on criteria. Research priority score was calculated for each question as the mean of the criteria scores.ResultsA total of 123 research questions comprising, 29 on Epidemiology, 22 on Clinical, 23 on program Implementation, and 49 on cross-cutting issues were ranked. The top ten research priorities were: knowledge and skills of healthcare workers in detecting and responding effectively to disease outbreaks; quality of data (accuracy, timeliness, completeness) for epidemic prone diseases; determinants of vaccine hesitancy; determinants of infection transmission among health care workers during PHE; effective measures for protecting health workers from highly infectious pathogens in PHE; strategies to improve the effectiveness of contact tracing for epidemic prone diseases; effectiveness of current case definitions as screening tools for epidemic and pandemic prone diseases; measures to strengthen national and sub-national laboratory capacity for timely disease confirmation within the Integrated Diseases Surveillance and Response framework; factors affecting prompt data sharing on epidemic-prone diseases; and effective strategies for appropriate community participation in EPR.ConclusionsThe collaborative multi-stakeholder workshop produced a starting list of priority research questions and topics for strengthening EPR capacities in Africa. Action needs to be taken to continuously update the research agenda and support member States to contextualize the research priorities and commission research for timely generation and uptake of evidence.

Experiences from the ARGOS user group nuclear emergency exercise

The Accident Reporting and Guiding Operational System (ARGOS) is a decision support system used to assist in the Emergency Preparedness and Response (EPR) to nuclear and radiological incidents. The ARGOS user group has been formed that is made up of government agencies across many countries that have a role in EPR to nuclear and radiological incidents. In 2020, a desktop exercise was organised for the members of the ARGOS user group. The exercise involved two hypothetical accidents at different times on the same date, namely a radiological release from a floating nuclear power plant (NPP) off the Norwegian coast and from the Loviisa NPP in Finland. The objectives of the exercise were to train and increase knowledge of the ARGOS system, to perform a comparison of model outputs, and to compare the recommendations of protective actions. In the case of the floating NPP the source term was provided, while in the Loviisa NPP scenario the participants were required to provide their own source term based on a description of the accident. The results on radiological consequences based on dispersion modelling, protective actions, source terms and dispersion modelling settings were collected from participants. A comparison was made between each of these reported aspects. In general, it was found that there was general agreement between the results for the floating nuclear power plant scenario in the sense of plume direction and extent, while in the case of the Loviisa NPP scenario, there was much greater variation, with the difference in source term estimates between the participants being an influencing factor. The participants acknowledged that taking part in an exercise of this nature increased their knowledge and understanding about using decision support tools such as ARGOS in planning and responding to nuclear and radiological emergencies.

Emergency preparedness and response in palm oil mill and investigation of the employees' emergency preparedness knowledge and attitude

AbstractSeveral legislations and standards have listed emergency preparedness and response (EPR) in palm oil mills as one of the requirements. EPR effectiveness depends on the knowledge and attitude of an individual. This study evaluated the EPR in a palm oil mill (POM) company and investigated the employees' emergency preparedness (EP), knowledge, and attitude. The potential emergency occurrences were identified through hazard identification, risk assessment, and risk control (HIRARC). Meanwhile, the current EPR practices were assessed through the Occupational Safety and Health Management System (OSHMS) emergency management checklist and the EP exercises. A social survey provided the data on the EP knowledge and attitude among the employees. There were two high‐risk level work activities: welding and conveyor maintenance, rated at 12 and 16, respectively. The mill did not provide three elements of the 10 minimum requirements listed in the OSHMS guidelines. The EP exercises were successfully conducted. 63.5% of the respondents scored a moderate level of EP knowledge. A positive attitude toward EPR was found. There was no significant relationship between EP knowledge and attitude. The EPR practices in this POM company need improvement and enhancement, including the EP knowledge and attitude among the employees.

Assessing the Emergency Response Role of Community-Based Organizations (CBOs) Serving People with Disabilities and Older Adults in Puerto Rico Post-Hurricane María and during the COVID-19 Pandemic.

In Puerto Rico, a host of factors makes the role of community-based organizations (CBOs) critically important in emergency preparedness and response (EPR) and disability-inclusive disaster risk reduction (DiDRR) addressing the needs of people with disabilities and older adults. The territory has been the site of recurring hurricanes, earthquakes, medical crises, and human-made disasters. Political, social, and economic problems unique to the archipelago have historically limited the preparedness and response capacity of governmental authorities, especially for its most at-risk populations. In a context of severe constraints on government resources, CBOs are positioned to play an outsized role in providing services for disabled and older adults before, during, and after emergencies. This study assesses the emergency preparedness and response capacity of CBOs (n = 22) for addressing the needs of people with disabilities and the elderly. Semi-structured, largely closed-ended interviews were conducted in Spanish with key informants at Puerto Rican CBOs. The interviews included questions about emergency preparedness and response training, as well as organizational capacity during COVID-19 and post-Hurricane María. This study posits that conditions in Puerto Rico place CBOs at the forefront of critical responsibilities including emergency preparedness and response, warranting assessment of their practices and resources to assist them in fulfilling their mission.

On the resilience of health systems: A methodological exploration across countries in the WHO African Region.

The need for resilient health systems is recognized as important for the attainment of health outcomes, given the current shocks to health services. Resilience has been defined as the capacity to “prepare and effectively respond to crises; maintain core functions; and, informed by lessons learnt, reorganize if conditions require it”. There is however a recognized dichotomy between its conceptualization in literature, and its application in practice. We propose two mutually reinforcing categories of resilience, representing resilience targeted at potentially known shocks, and the inherent health system resilience, needed to respond to unpredictable shock events. We determined capacities for each of these categories, and explored this methodological proposition by computing country-specific scores against each capacity, for the 47 Member States of the WHO African Region. We assessed face validity of the computed index, to ensure derived values were representative of the different elements of resilience, and were predictive of health outcomes, and computed bias-corrected non-parametric confidence intervals of the emergency preparedness and response (EPR) and inherent system resilience (ISR) sub-indices, as well as the overall resilience index, using 1000 bootstrap replicates. We also explored the internal consistency and scale reliability of the index, by calculating Cronbach alphas for the various proposed capacities and their corresponding attributes. We computed overall resilience to be 48.4 out of a possible 100 in the 47 assessed countries, with generally lower levels of ISR. For ISR, the capacities were weakest for transformation capacity, followed by mobilization of resources, awareness of own capacities, self-regulation and finally diversity of services respectively. This paper aims to contribute to the growing body of empirical evidence on health systems and service resilience, which is of great importance to the functionality and performance of health systems, particularly in the context of COVID-19. It provides a methodological reflection for monitoring health system resilience, revealing areas of improvement in the provision of essential health services during shock events, and builds a case for the need for mechanisms, at country level, that address both specific and non-specific shocks to the health system, ultimately for the attainment of improved health outcomes.

Emergency Preparedness and Response: Highlights from the Division of Reproductive Health, 2011-2021.

This report provides historical context and rationale for coordinated, systematic, and evidence-based public health emergency preparedness and response (EPR) activities to address the needs of women of reproductive age. Needs of pregnant and postpartum women, and infants-before, during, and after public health emergencies-are highlighted. Four focus areas and related activities are described: (1) public health science; (2) clinical guidance; (3) partnerships, communication, and outreach; and (4) workforce development. Finally, the report summarizes major activities of the Division of Reproductive Health's EPR Team at the Centers for Disease Control and Prevention.

Simulation-based assessments of fire emergency preparedness and response in virtual reality

The current study aimed at evaluating the prospects of a three-dimensional gas power plant (GPP) simulation in an immersive virtual reality (IVR) environment for fire emergency preparedness and response (EPR). To achieve this aim, the study assessed the possibility of safety situational awareness, evacuation drills and hazard mitigation exercises during a fire emergency simulation scenario. The study likewise evaluated the safety and ergonomics of the environment while addressing this aim. We employed the virtual reality accident causation model (VR-ACM) for the assessment with 54 participants individually in IVR. Participants were grouped into two according to whether they had work experience in engineering or not. The obtained results suggested that IVR can be realistic and safe, with the potential for presenting hazardous scenarios necessary for fire EPR. Furthermore, the results indicated that there were no statistically significant differences in the perceptions of both groups regarding the prospects of IVR towards EPR.

Methanol poisoning in South- South Nigeria: Reflections on the outbreak response.

The methanol poisoning outbreak in Rivers State in May 2015, involved 84 persons in five local government areas. An incident management system comprised of an Emergency Preparedness and Response (EPR) committee and the Local Government Area Rapid Response Teams in an Emergency Operations Centre (EOC). The EOC teams conducted case finding activities, line listing, and descriptive analysis, a retrospective cohort study and collection of local gin samples for laboratory investigation. They also coordinated community mobilization and sensitization activities, intervention meetings with local gin sellers, trace back activities and case management. Those affected were male (72; 85.7%) aged between 20 and 79 years. Of the 55 persons whose socio-demographics were obtained, forty-one persons (74.6%) were married, and 23 (41.8%) had primary education. Case fatality rate was 83.3% with an attack rate of 16 per 100,000 persons. Those exposed to ingestion of adulterated gin were six times more likely to develop methanol poisoning than those not exposed RR=6 (1.0-38.5); P=0.0078. It is hoped that this experience has positioned the state for better preparedness towards future outbreaks.

State’s preparedness for coordination of Lassa fever outbreak containment in Nigeria, April 2017

Introduction : lassa fever (LF), an acute viral hemorrhagic fever is endemic in Nigeria with annual recurrent outbreaks in different States and varying levels of mortality and morbidity. In order to prevent such episodes with better preparation for early detection and rapid control of the disease, the Nigeria Center for Disease Control (NCDC) evaluated Nigerian States’ level of preparedness with a view to defining areas with high disease burden and risk of outbreak. The aim of the study is to assess the level of preparedness for co-ordination of LF outbreak response activities across the states for informed decision and effective LF outbreak response, planning and implementing of high impact interventions. Methods : a self-administered LF preparedness questionnaire was filled by 37 State Epidemiologists including the Federal Capital Territory to assess national preparedness. Data was entered, cleaned and analyzed using Epi-Info 7.2. States were stratified into Very High Risk (VHR), High Risk (HR) and Low Risk (LR) based on having ≥10, 1 - 9 or zero confirmed cases respectively in 2016 and 2017. State-specific level of preparedness, based on a three-staged scoring system was categorized into: Inadequate, 0 - 49%; fairly adequate, 50 - 74%; and adequate ≥75% preparedness. Variables of interest were summarized in frequencies and proportions. Results : six (16.0%) states were classified as VHR, 18 (49.0%) were HR, while 13 (35.0%). Twenty-six states (70.3%) had an Emergency Operations Centre (EOC) while 24 (64.9%) can activate their EOCs within 48 hours. Thirty-two (86.5%) have Emergency Preparedness and Response (EPR) Committees. A maximum of 3 (50%) of VHR states had functional EOCs, ability to activate EOCs within 48 hours and EPR Committees, when compared with 13 - 15 HR and 9-12 LR states, respectively. On the state-specific level of preparedness for co-ordination, 16 states (43.2%) were inadequate, 9 (24.4%) fairly inadequate, and 12 (32.4%) adequate. Conclusion : preparedness for co-ordination of Lassa fever outbreak responses should be improved in all the states, especially the VHR and HR states, to reduce morbidity, mortality, economic cost and psychosocial effect associated with LF outbreaks in Nigeria.

Enhancing Disaster Management: Development of a Spatial Database of Day Care Centers in the USA

Children under the age of five constitute around 7% of the total U.S. population, and represent a segment of the population that is totally dependent on others for day-to-day activities. A significant proportion of this population spends time in some form of day care arrangement while their parents are away from home. Accounting for those children during emergencies is of high priority, which requires a broad understanding of the locations of such day care centers. As concentrations of at risk population, the spatial location of day care centers is critical for any type of emergency preparedness and response (EPR). However, until recently, the U.S. emergency preparedness and response community did not have access to a comprehensive spatial database of day care centers at the national scale. This paper describes an approach for the development of the first comprehensive spatial database of day care center locations throughout the U.S. utilizing a variety of data harvesting techniques to integrate information from widely disparate data sources followed by geolocating for spatial precision. In the context of disaster management, such spatially refined demographic databases hold tremendous potential for improving high-resolution population distribution and dynamics models and databases.

International Collaboration for Improved Public Health Emergency Preparedness and Response in India

The International Health Regulations (IHR) 2005, provides a framework that supports efforts to improve global health security and as such, there is an expectation that member states will take necessary steps to develop and strengthen systems and capacity for disease surveillance and detection and response to public health threats. To this end, a collaborative project was set up in 2010 to contribute to training a cadre of future trainers in a manner that sustainably supports ongoing efforts to improve the capability and capacity to undertake disease surveillance and Emergency Preparedness and Response (EPR) activities in India.

Developing a National Inventory of Telehealth Resources for Rapid and Effective Emergency Medical Care: A White Paper Developed by the American Telemedicine Association Emergency Preparedness and Response Special Interest Group

This document is a report from the American Telemedicine Association (ATA) Emergency Preparedness and Response (EPR) Special Interest Group (SIG). It addressed the issues in developing a national response to disaster using telehealth.

Effects of repeated callbacks on response rate and nonresponse bias: Results from a 17-state pharmacy survey

Background Although surveys are the most common method of data collection in research in the social & behavioral pharmaceutical sciences, little evidence exists on pharmacists' and pharmacies' patterns of telephone survey participation and the impact of repeated callbacks on minimizing nonresponse bias. Objectives To (1) describe final disposition of the survey sample, (2) describe the effect of repeated callbacks on response rate, and (3) examine whether hard-to-contact cases differ from those that are relatively easier to contact in terms of general pharmacy characteristics and characteristics specific to survey topics. Methods This study used a cross-sectional descriptive survey design that gathered information from key informants of 2558 community pharmacies in 17 states. Telephone interviews were conducted using a Computer Assisted Telephone Interview system. Final disposition of the sample units and the final response rate were reported. General pharmacy characteristics and characteristics specific to immunization delivery (ID) and emergency preparedness and response (EPR) activities were compared across different ease-of-contact levels. Results A total of 1707 pharmacies (66.7%) completed the interview; 757 (29.6%) were eligible cases that were not interviewed; 8 (0.3%) and 86 (3.4%) were cases of unknown eligibility and ineligibility, respectively. The final response rate was 69.1%. The number of calls to pharmacies was most productive on the first 9 calls and leveled off after the 14th call. When comparing characteristics among different ease-of-contact levels, 2 out of 3 characteristics related to ID activities were different. No differences were found in general pharmacy characteristics and characteristics specific to EPR activities, however. Conclusion The greater number of callbacks resulted in higher response rates due to greater number of completed interviews. The increase in response rate did not rule out nonresponse bias, however. Hard-to-contact cases differed from relatively easier to contact cases in terms of characteristics related to the survey topic, but not general characteristics.