Radiological Disaster Research Articles

Evaluating Saudi Arabian nurses' willingness to respond to nuclear and radiological disasters.

We evaluated Saudi Arabian nurses' willingness to engage in nuclear and radiological disaster response. In the face of rising nuclear and radiological threats, it is essential that nurses are fully prepared to handle the health consequences of such emergencies. As frontline responders, nurses play a critical role in managing high-stakes situations, making their readiness a key factor in ensuring public safety during these crises. A cross-sectional survey was conducted among 612 registered nurses in Saudi Arabia. The survey used a structured questionnaire based on the theory of planned behavior, identifying behavioral intentions as the primary outcome and attitudes toward these behaviors, subjective norms, and perceived behavioral control as influencing factors. The data were analyzed using descriptive and inferential statistics. Most respondents lacked specialized training and reported strong behavioral intentions. Attitude and perceived behavioral control were key drivers of these behavioral intentions, with less impact from subjective norms. Behavioral intentions were also shaped by education, the perceived likelihood of nuclear and radiological emergencies in their region, peer influence, perceived self-efficacy, and family concerns. Younger and married nurses showed significantly stronger behavioral intentions. Although most nurses lacked specialized training, their strong engagement intentions and positive responses to active learning and training indicate a desire to close this gap through further education. However, inadequate institutional support, trouble communicating with family, and concerns about personal radiation exposure emerged as potential barriers. Targeted educational initiatives and support systems are needed to enhance nurses' confidence, competence, and willingness to engage in radiological and nuclear emergency scenarios. Policymakers should prioritize the development of specialized training programs and support mechanisms for nurses, ensuring they are adequately prepared to respond effectively to increasing radiological and nuclear threats.

Preparing for Nuclear Disaster: A Structured Equation Model by Health Professionals

Abstract The potential for a radiological disaster from natural environmental causes, human error, aging nuclear power plants, buried radioactive waste, regular ground transport of radioactive materials, a shared international border, and the threat of radiological terrorism make the Western New York region vulnerable for a radiation emergency. A global threat from Russia and intentional uses of nuclear weapons by non-state approved users, such as North Korea, raise public awareness. Limited importance has been given to educating medical providers and emergency planners with radiological knowledge and preparation. Objective The goal of this study was to understand the relationships of the peerception of risk, emergency self-efficacy and willingness to respond to a radiation emergency among health professionals. Method Two hundred sixty-nine (269) medical and health practitioners were selected for a purposive, convenience sample in an eight-county region of Western New York. Participants identified the need for improved knowledge and preparation for the management of a radiation emergency. Results Statistical findings using the author created Structural Equation Model (SEM) revealed a goodness of fit for perception of risk as a strong predictor of willingness to respond to a radiation emergency. Conclusion The SEM study names the variables that influence training for global nuclear realities.

A study on the establishment of database for local government disaster response and decision support system in the nuclear accidents

ABSTRACT Radiological disasters have been recognized as a prominent societal catastrophe worldwide since the Fukushima nuclear accident in 2011. In order to cope with such disasters, efforts have been made to improve disaster response plans and systems based on the lessons learned from the Fukushima accident. Particularly, as demonstrated by the Fukushima case, radiological disasters require the assumption of large-scale evacuation of residents. Thus, it is essential for prompt and accurate decision-making to take place at the local government’s Emergency Management Center (EMC), enabling smooth execution of the missions assigned to personnel at the field. This is crucial for protecting the lives of residents and ensuring their safety. However, the existing systems for effective response to radiological disasters are relatively inadequate compared to other types of disasters. To overcome these limitations, this study aims to develop Standard Operating Procedures (SOPs) that are optimized for radiological disaster response by standardizing the Field Measure Motion Manual at nuclear safety for local governments. Based on these SOPs, The Resident Protection Measures Support System (RPMS) will be proposed, which enables the timely dissemination of specific missions and information to personnel, while providing real-time information on the situation at the field to the EMC, supporting decision-making and facilitating effective situation management.

A human lung alveolus-on-a-chip model of acute radiation-induced lung injury

Acute exposure to high-dose gamma radiation due to radiological disasters or cancer radiotherapy can result in radiation-induced lung injury (RILI), characterized by acute pneumonitis and subsequent lung fibrosis. A microfluidic organ-on-a-chip lined by human lung alveolar epithelium interfaced with pulmonary endothelium (Lung Alveolus Chip) is used to model acute RILI in vitro. Both lung epithelium and endothelium exhibit DNA damage, cellular hypertrophy, upregulation of inflammatory cytokines, and loss of barrier function within 6 h of radiation exposure, although greater damage is observed in the endothelium. The radiation dose sensitivity observed on-chip is more like the human lung than animal preclinical models. The Alveolus Chip is also used to evaluate the potential ability of two drugs - lovastatin and prednisolone - to suppress the effects of acute RILI. These data demonstrate that the Lung Alveolus Chip provides a human relevant alternative for studying the molecular basis of acute RILI and may be useful for evaluation of new radiation countermeasure therapeutics.

The Goiânia incident, the semiotics of danger, and the next 10,000 years

The Goiânia Incident In September 1987, two men in Goiânia, Brazil, discovered an abandoned international standard capsule containing less than 100 g of cesium-137 chloride. The material was unguarded, and the warning systems were inadequate and inscrutable. The men took the capsule and sold it for scrap, and within days the city would be contaminated with highly radioactive material. Within weeks, 112,000 individuals would be screened for radioactive contamination, 249 would be exposed to radioactive materials, 46 would receive medical treatment for radioactive contamination, and four would die from acute radiation sickness. The citywide radioactive contamination occurred, in part, due to arbitrary and unfamiliar written warning systems. The individuals who discovered the cesium-137 capsule were illiterate and unfamiliar with the radiation trefoil logo, which was first used in 1946 in California, United States of America. As a result, written language and visual symbols were useless warnings against the dangerous contents of the capsule. Management of cesium-137 exposure in 2023 Cesium-137 enters the body through ingestion or inhalation. This isotope emits beta and gamma radiation, both forms of ionizing radiation which damage living tissues. The radiation dose lethal to 50% of an exposed population within 60 days (LD50/60) is approximately 3.5 to 4 Gray (Gy) without medical intervention. However, this dose increases to around 6-7 Gy when medical support is provided, which typically includes antibiotics, blood transfusions, granulocyte-macrophage colony-stimulating factor, and Prussian blue. Prussian blue binds to cesium, thereby facilitating its elimination from the body. Lessons learned regarding radioactive waste disposal and the next 10,000 years The radiological disaster in Goiânia was due in large part to the failures of various agencies to warn of danger and minimize access to radioactive material. Barriers to risk communication included a lack of a universal semiotic language regarding radioactive hazards, which was compounded by the illiteracy of the scrappers and their inability to recognize the radioactivity warning trefoil. There is no society in which every member understands written language or recognizes every symbol. Given that the teletherapy unit was abandoned in an urban environment, there were no administrative or engineering controls in place to prevent human beings from becoming exposed to radioactive material. Conclusions As little as 100 g of highly radioactive material, such as cesium-137, may lead to massive environmental contamination, fatalities and permanent disability due to acute radiation sickness, wreak havoc, and disrupt society on a scale that is challenging for public health officials to manage. Thousands of tons of radioactive materials from the waste products of nuclear weapons and power plant manufacture will have to be stored for at least 100,000 years to prevent danger to human life and society. Public health officials and governments must build systems to keep humans safe and physically isolated from these radioactive materials for as long as possible.

Russian strikes on Ukrainian nuclear plants stir talk but little action in Western nations

Even as shelling of Ukrainian facilities threatens a radiological disaster, Russia’s sales of enriched uranium to the US and the EU continue.

Cognitive bias and selected atmospheric parameters may severely influence the threat perception in a radiological disaster

The increasing application of nuclear technology worldwide raises the associated risks of such technology being used for harm. This study shows how an urban area affected by a radiological threat can experience the influence of the coupling of cognitive biases and apparently independent environmental variables. The simulated scenario considers the deliberate release of radioactive material over an inhabited urban area through a radiological dispersion device (RDD). The simulation was performed using the computer code HotSpot Health Physics version 3.1.2. A conservative assessment of the situation in its initial phase is developed to better support early decision-making. The influence of human factors through cognitive bias were considered based on the Dunning-Kruger (DK) effect. The results suggest that local atmospheric stability factors and the DK specific coefficients coupling effects should be emphatically considered in the decision process at this early stage. It was also found that there is a coupling between environmental variables and human factors in the perception of radiological risk. The conservative perspective adopted leads to courses of action that can make better use of available resources. Conducting frequent studies, building exercises based on simulated scenarios and testing decision-makers’ capabilities are measures of fundamental importance to improve the effectiveness of response plans.

Chemical, Biological, Radiological, or Nuclear Response in Queensland Emergency Services: A Multisite Study.

A disaster overwhelms the normal operating capacity of a health service. Minimal research exists regarding Australian hospitals' capacity to respond to chemical, biological, radiological, or nuclear (CBRN) disasters. This article, and the research supporting it, begins to fill that research gap. We conducted a descriptive quantitative study with 5 tertiary hospitals and 1 rural hospital in Queensland, Australia. The study population was the hospitals' clinical leaders for disaster preparedness. The 25-item survey consisted of questions relating to each hospital's current response capacity, physical surge capacity, and human surge capacity in response to a CBRN disaster. Data were analyzed using descriptive statistics. The survey data indicated that over the previous 12 months, each site reached operational capacity on average 66 times and that capacity to respond and create additional emergency, intensive care, or surgical beds varied greatly across the sites. In the previous 12 months, only 2 sites reported undertaking specific hospital-wide training to manage a CBRN disaster, and 3 sites reported having suitable personal protective equipment required for hazardous materials. There was a noted shortfall in all the hospitals' capacity to respond to a radiological disaster in particular. Queensland hospitals are crucial to CBRN disaster response, and they have areas for improvement in their response and capacity to surge when compared with international preparedness benchmarks. CBRN-focused education and training must be prioritized using evidence-based training approaches to better prepare hospitals to respond following a disaster event.

Automatic reagent handling and assay processing of human biospecimens inside a transportation container for a medical disaster response against radiation.

Biological materials can be shipped off-site for diagnostic, therapeutic and research purposes. They usually are kept in certain environments for their final application during transportation. However, active reagent handling during transportation from a collection site to a laboratory or biorepository has not been reported yet. In this paper, we show the application of a micro-controlled centrifugal microfluidic system inside a shipping container that can add reagent to an actively cultured human blood sample during transportation to ensure a rapid biodosimetry of cytokinesis-block micronucleus (CBMN) assay. The newly demonstrated concept could have a significant impact on rapid biodosimetry triage for medical countermeasure in a radiological disaster. It also opens a new capability in accelerated sample processing during transportation for biomedical and healthcare applications.

CytoRADx: A High-Throughput, Standardized Biodosimetry Diagnostic System Based on the Cytokinesis-Block Micronucleus Assay.

In a large-scale catastrophe, such as a nuclear detonation in a major city, it will be crucial to accurately diagnose large numbers of people to direct scarce medical resources to those in greatest need. Currently no FDA-cleared tests are available to diagnose radiation exposures, which can lead to complex, life-threatening injuries. To address this gap, we have achieved substantial advancements in radiation biodosimetry through refinement and adaptation of the cytokinesis-block micronucleus (CBMN) assay as a high throughput, quantitative diagnostic test. The classical CBMN approach, which quantifies micronuclei (MN) resulting from DNA damage, suffers from considerable time and expert labor requirements, in addition to a lack of universal methodology across laboratories. We have developed the CytoRADx™ System to address these drawbacks by implementing a standardized reagent kit, optimized assay protocol, fully automated microscopy and image analysis, and integrated dose prediction. These enhancements allow the CytoRADx System to obtain high-throughput, standardized results without specialized labor or laboratory-specific calibration curves. The CytoRADx System has been optimized for use with both humans and non-human primates (NHP) to quantify radiation dose-dependent formation of micronuclei in lymphocytes, observed using whole blood samples. Cell nuclei and resulting MN are fluorescently stained and preserved on durable microscope slides using materials provided in the kit. Up to 1,000 slides per day are subsequently scanned using the commercially based RADxScan™ Imager with customized software, which automatically quantifies the cellular features and calculates the radiation dose. Using less than 1 mL of blood, irradiated ex vivo, our system has demonstrated accurate and precise measurement of exposures from 0 to 8 Gy (90% of results within 1 Gy of delivered dose). These results were obtained from 636 human samples (24 distinct donors) and 445 NHP samples (30 distinct subjects). The system demonstrated comparable results during in vivo studies, including an investigation of 43 NHPs receiving single-dose total-body irradiation. System performance is repeatable across laboratories, operators, and instruments. Results are also statistically similar across diverse populations, considering various demographics, common medications, medical conditions, and acute injuries associated with radiological disasters. Dose calculations are stable over time as well, providing reproducible results for at least 28 days postirradiation, and for blood specimens collected and stored at room temperature for at least 72 h. The CytoRADx System provides significant advancements in the field of biodosimetry that will enable accurate diagnoses across diverse populations in large-scale emergency scenarios. In addition, our technological enhancements to the well-established CBMN assay provide a pathway for future diagnostic applications, such as toxicology and oncology.

Evaluation on Medical Application of Survey meters in Convergence Perspective for the Efficient Disaster Responses in the Massive Radiological Disasters : A Simulation Study of Externally Contaminated Patients Using Two Representative type of Survey-Meters

The purpose of the study is to evaluate the effect on medical application and convergence for the efficient disaster responses in the massive radiological events by comparison of two types of survey-meters(hand held survey-meter and transportable portal monitor). In the simulated radiation disaster drill, twelve participants randomly wore a personal protective equipments (PPE) with twelve check source. We measured participants to detect five real radioactive sources of the twelve check sources, using two types of survey meters. The primary outcome was the measuring time. The secondary outcome was the sensitivity and specificity of the detection of the real radioactive source. The average time by the hand held survey meter was 231.9 ± 116.6 seconds, and the time by transportable portal monitor was statistically shorter 8.690 ± 1.667 seconds. There was no difference in the sensitivity and specificity between two survey meters. The transportable portal monitor survey meter was considered to have medical application and play an important role in radiological disasters.

Rapid analysis of 237Np and Pu isotopes in small volume urine by SF-ICP-MS and ICP-MS/MS

Internal contamination with alpha-particle emitting actinides, such as 237Np, 239Pu, 240Pu, is likely to bring a large amount of dose to the tissues of persons even if the intake amount is small. To provide timely information for prompt decision-making in radiation emergency therapy, we developed a simple and rapid method for urinary bioassay to determine ultra-trace 237Np and Pu isotopes using SF-ICP-MS and ICP-MS/MS. To avoid polyatomic interferences and tailing effects from U, 237Np and Pu isotopes were collected after removing U effectively using a simple single chromatographic column packed with 2 mL AG MP-1M anion exchange resin, exhibiting a high decontamination factor of 108 for 238U. The overall chemical fractionation between 237Np and 242Pu for the whole analytical procedure was 0.974 ± 0.064 (k = 2), allowing us to measure 237Np and Pu isotopes using 242Pu as a yield tracer with yields of 76 ± 5%. Using ICP-MS/MS with low background provided the method detection limits for 237Np, 239Pu, 240Pu, and 241Pu of 0.025, 0.025, 0.015, and 0.020 fg mL−1, respectively, for 20 mL of urine sample. Those were comparable to detection limits of SF-ICP-MS with high sensitivity. Subsequently, three urine reference materials with Pu spike, provided by the Association for the PROmotion of Quality COntrol in RADiotoxicological Analysis (PROCORAD), France, were analyzed by the developed method and the conventional alpha spectrometry technique for validation. Finally, the developed method was successfully employed to measure the contamination level of 237Np, 239Pu, 240Pu, and 241Pu in urine samples collected during decorporation therapy using DTPA, after a Pu inhalation exposure accident in Japan. The high throughput (9 h for 12 samples), simplicity, low cost, and high sensitivity of the method will allow greater numbers of related laboratories to be involved in screening activities for unexpected actinide exposure, such as in the case of a large scale radiological disaster.

Orotracheal tube versus supraglottic devices in biological, chemical and radiological disasters: meta-analysis in manikin-based studies.

To compare the mean time of orotracheal intubation and insertion of supraglottic airway devices, considering healthcare providers wearing waterproof overall, gloves, boots, eye protection and mask at the Chemical, Biological, Radiological and Nuclear context in simulation setting. Six databases were searched. The selected studies were put in a pool of results using a random-effects meta-analysis, with standardized mean differences and calculation of 95% confidence intervals. Nine observational studies were included. Regarding reducing time to provide ventilatory support, subgroup analyses were made. The emergency setting subgroup: -12.97 [-16.11; -9.83]; I2 = 64%. The surgery setting subgroup: -14.96 [-18.65; -11.27]; I2 = 75%. Another analysis was made by reproductive methodology subgroups. Ophir's subgroup: -15.70 [-17.04; -14.37]; I2 = 0%. All meta-analyses had orotracheal tube as comparator. Moderate level of evidence was in favor of insertion of supraglottic devices because of fast application.

Nuclear Disaster Preparedness Level of Medical Responders in Pakistan.

Pakistan is a country with nuclear capability in a region sharing borders with 2 other nuclear powers-that is, India to the east and China to the northeast. This geographic positioning makes the area a nuclear flash point. It is therefore imperative to have commensurate health-care facilities to meet any eventualities. Although Pakistan is trying to improve medical facilities for the people, health-care facilities are already overwhelmed with patients because of the large population of the country. The current study was conducted to evaluate the level of awareness and preparedness of medical responders for nuclear and radiological disasters in public hospitals in the major cities of Pakistan. Methods: A detailed questionnaire covering all aspects of the study was designed and discussed with the people most concerned, including health-care workers in the field of medicine, nuclear sciences, and disaster management in Pakistan. It was adopted on the basis of early studies on the subject, with necessary modifications to fulfill the requirements at Pakistan's level. Semistructured interviews were also conducted with key personnel of different response agencies in Pakistan. Results: Of 880 surveys, 554 were completed and collected from medical providers in different hospitals across the country. The respondents included doctors, nurses, and medical assistants from emergency and nonemergency departments. They are aware of the catastrophic consequences of nuclear disaster and are willing to respond to these kinds of disasters voluntarily, but they are not satisfied with their level of preparedness and awareness regarding nuclear and radiological disasters. Conclusion: Although medical responders have good educational backgrounds and knowledge in their specific fields and are quite active and energetic in their response to conventional injuries and natural disasters, they feel a dire need to enhance their level of knowledge about and preparedness for unconventional disasters and injuries such as those caused by nuclear or radiological events.

Bone marrow stromal cell therapy improves survival after radiation injury but does not restore endogenous hematopoiesis

The only available option to treat radiation-induced hematopoietic syndrome is allogeneic hematopoietic cell transplantation, a therapy unavailable to many patients undergoing treatment for malignancy, which would also be infeasible in a radiological disaster. Stromal cells serve as critical components of the hematopoietic stem cell niche and are thought to protect hematopoietic cells under stress. Prior studies that have transplanted mesenchymal stromal cells (MSCs) without co-administration of a hematopoietic graft have shown underwhelming rescue of endogenous hematopoiesis and have delivered the cells within 24 h of radiation exposure. Herein, we examine the efficacy of a human bone marrow-derived MSC therapy delivered at 3 h or 30 h in ameliorating radiation-induced hematopoietic syndrome and show that pancytopenia persists despite MSC therapy. Animals exposed to radiation had poorer survival and experienced loss of leukocytes, platelets, and red blood cells. Importantly, mice that received a therapeutic dose of MSCs were significantly less likely to die but experienced equivalent collapse of the hematopoietic system. The cause of the improved survival was unclear, as complete blood counts, splenic and marrow cellularity, numbers and function of hematopoietic stem and progenitor cells, and frequency of niche cells were not significantly improved by MSC therapy. Moreover, human MSCs were not detected in the bone marrow. MSC therapy reduced crypt dropout in the small intestine and promoted elevated expression of growth factors with established roles in gut development and regeneration, including PDGF-A, IGFBP-3, IGFBP-2, and IGF-1. We conclude that MSC therapy improves survival not through overt hematopoietic rescue but by positive impact on other radiosensitive tissues, such as the intestinal mucosa. Collectively, these data reveal that MSCs could be an effective countermeasure in cancer patients and victims of nuclear accidents but that MSCs alone do not significantly accelerate or contribute to recovery of the blood system.

Antihumanist modernism in biopolitical junkyards of controlled remediation and risk

ABSTRACT This essay proposes a new reading of modernism as a mode for separating the signal from the noise in conceptions of the human after humanism. It expands on a theory of second modernism which I have outlined in previous works, and by which the scene of modernist value is one of perilous event horizon, dictated by systematic ambivalences in modernity that have conventionally been obscured in Modernist studies. The following work tracks a succession of such risky horizons – moving between analyses of a significant but largely unremembered radiological disaster at Goiânia, Brazil in the late 1980s, J.G. Ballard’s 1960s story ‘The Terminal Beach’, Shumon Basar, Douglas Coupland, and Hans Ulrich Obrist Ballard-inspired piece The Age of Earthquakes, and the theories of Czech-Brazilian media theorist Vilém Flusser. Through these materials, modernity and modernism are identified as chimerical non-spaces – characterised by the accumulation of data without shape or purpose, of connectivity without content, and the expectation of redemptive catastrophe, consigned to the past prior even to the point of conception.

Willingness to Respond to Radiological Disasters Among First Responders in St. Louis, Missouri.

During radiological disasters, firefighters and emergency medical services personnel are expected to report to work and engage in response activities; however, prior research exploring willingness to respond to radiological disasters among first responders has considered only radiological terrorism scenarios and not nonterrorism radiological scenarios. The goal of this study was to compare willingness to respond to terrorism and nonterrorism radiological disaster scenarios among first responders in St. Louis, Missouri, and to explore determinants of willingness to respond. Firefighters and emergency medical services personnel were surveyed about their willingness to respond to a dirty bomb detonation (terrorism) and a radioactive landfill fire (nonterrorism). McNemar's tests were used to assess differences in individual willingness to respond between the 2 scenarios and differences if requested versus required to respond. Chi-square tests were used to identify significant individual predictors of willingness to respond. Multivariate logistic regressions were used to determine final models of willingness to respond for both scenarios. Willingness to respond was lower for the dirty bomb scenario than the landfill scenario if requested (68.4% vs 73.0%; P < .05). For both scenarios, willingness to respond was lower if requested versus required to respond (dirty bomb: 68.4% vs 85.2%, P < .001; landfill: 73.0% vs 87.3%, P < .001). Normative beliefs, perceived susceptibility, self-efficacy, and perceived barriers were significant predictors of willingness to respond in the final models. Willingness to respond among first responders differed significantly between terrorism and nonterrorism radiological disasters and if requested versus required to respond. Willingness to respond may be increased through interventions targeting significant attitudinal and belief predictors and by establishing organizational policies that define expectations of employee response during disasters.

Suggestions to Improve the Effectiveness of National Radiological Emergency Response System

Although the national radiological emergency response system has been improved by incorporating lessons from the Fukushima nuclear power plant accident and recent domestic natural disasters, it has not fully incorporated these lessons. In addition, it cannot deal with a variety of aftermath of the radiological disaster. Even for the same disaster, the national emergency response system should comply with multiple domestic laws in our country. Furthermore, there are a few discrepancies between the articles of the domestic laws that the national radiological emergency response system should address. Therefore, this study investigates the characteristics of radiological disasters, examines articles on the domestic laws related to the national radiological emergency response system, and analyses the Japanese government’s responses to the Fukushima nuclear power plant accident. Based on the results of the review, suggestions for the improvement of the national radiological emergency response system in terms of response organization and framework have been proposed in this study.

Emerging Training Needs of Forensic Scientists: Addressing the Challenges of Chemical, Biological, Radiological and Nuclear Disasters

In cases of chemical and biological terrorism, many citizens are injured which leads to great social impact. Chemical, Biological, Radiological, and Nuclear (CBRN) detection in-service training for forensic teams is indispensable to incorporate expertise to address concerns on weapons of mass destruction. Forensic science laboratories around the world are determined to fight the changing face of crime in the rapidly advancing technical scenarios globally by continually upgrading its technical acumen and embracing new technologies in its domain. The mission of training of forensic scientists is to prepare nationally accepted guidelines for the forensic examination of CBRN related materials and residues.

Systematic review and meta-analysis comparing ventilatory support in chemical, biological and radiological emergencies

Objective:to compare the mean development time of the techniques of direct laryngoscopy and insertion of supraglottic devices; and to evaluate the success rate in the first attempt of these techniques, considering health professionals wearing specific personal protective equipment (waterproof overalls; gloves; boots; eye protection; mask).Method:meta-analysis with studies from LILACS, MEDLINE, CINAHL, Cochrane, Scopus and Web of Science. The keywords were the following: personal protective equipment; airway management; intubation; laryngeal masks.Results:in the “reduction of the time of the procedures” outcome, the general analysis of the supraglottic devices in comparison with the orotracheal tube initially presented high heterogeneity of the data (I2= 97%). Subgroup analysis had an impact on reducing heterogeneity among the data. The “laryngeal mask as a guide for orotracheal intubation” subgroup showed moderate heterogeneity (I2= 74%). The “2ndgeneration supraglottic devices” subgroup showed homogeneity (I2= 0%). All the meta-analyses favored supraglottic devices. In the “success in the first attempt” outcome, moderate homogeneity was found (I2= 52%), showing a higher proportion of correct answers for supraglottic devices.Conclusion:in the context of chemical, biological or radiological disaster, the insertion of the supraglottic device proved to be faster and more likely to be successful by health professionals. PROSPERO record (CRD42019136139).