Human decontamination

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Human decontamination is the process of removing hazardous materials from the human body, including chemicals, radioactive substances, and infectious material.

Contents

General principle

Decontamination of humans is usually done by a three-step procedure, separated by sex: removal of clothing, washing, and reclothing. Deconference-pipeline123MW-idraw.png
Decontamination of humans is usually done by a three-step procedure, separated by sex: removal of clothing, washing, and reclothing.

People suspected of being contaminated are usually separated by sex, and led into a decontamination tent, trailer, or pod, where they shed their potentially contaminated clothes in a strip-down room. They then enter a wash-down room where they are showered. Finally, they enter a drying and re-robing room to be issued clean clothing, a jumpsuit, or other attire. Some more structured facilities include six rooms (strip-down, wash-down and examination rooms, for each of men's and women's side as per attached drawing). Some facilities, such as MODEC, and many others, are remotely operable, and function like "human car washes". Common lathering in soap, removes external dust that may contain radioisotopes. [1] It is advised that when lathering, effort should be made not to spread potential dust that deposited onto exposed, unclothed areas of skin, to areas that were once likely clean. [2]

Mass decontamination is the decontamination of large numbers of people. The ACI World Aviation Security Standing Committee describes a decontamination process thus, specifically referring to plans for Los Angeles authorities:

The disinfection/decontamination process is akin to putting humans through a car wash after first destroying their garments. Los Angeles World Airports have put in place a contingency plan to disinfect up to 10,000 persons who might have been exposed to biological or chemical substances.

Decontamination of injured victim Dekon-V.JPG
Decontamination of injured victim

Hospital decontamination

Most hospitals in the United States are prepared to handle a large influx of patients from a terrorist attack. Volunteer hospital decontamination teams are common and trained to set up showers or washing equipment, to wear personal protective equipment, and to ensure the safety of both the victims and the community during the response. From a planning perspective it must be remembered that first responders in Level A or B personal protective equipment (PPE) will have a limited working duration, typically 20 minutes to 2 hours. [3]

Typically these teams use decontamination showers built into the hospital or tents which are set up outside in order to decontaminate individuals. Beyond terrorism incidents, common exposures may be related to factory spills, agricultural incidents, and vehicle accidents. Incidents are common in both urban and rural communities. Hospital decontamination is a component of the Hospital Incident Command System and is required in the standards set forth by the Joint Commission.

Decontamination exercises

Decontamination exercises are frequently used to test the preparedness of emergency plans and personnel. Dofficer-console-mens-side.jpg

Exercises are of three types:

Unified command

Decontamination of persons during a fire brigade exercise employment (Germany) Einmannduschkabine.jpg
Decontamination of persons during a fire brigade exercise employment (Germany)

Collaboration among various levels of authority, and among various countries, is required to address bioterror threats, because contamination knows no boundaries. Disease and contamination do not stop at the border from one country to another. Thus organizations such as NATO, bring together member countries to practice how to contain an outbreak, setup quarantine facilities, and care for displaced persons. [4]

Collection of personal belongings for evidence

"Dofficers" (Decontamination officers in the "doffing" or disrobing area) are often police or military personnel, ready to handle potentially unruly persons who refuse to cooperate with first responders.

For example, the U.S. ARMY SOLDIER AND BIOLOGICAL CHEMICAL COMMAND suggests that:

"The entire incident is a crime scene requiring the collection of criminal evidence and suspicious victim belongings. The preservation of a proper chain of custody must be maintained for all evidence. ... patients could be suspects and their belongings may be evidence. ... Direct patients through a detailed decontamination process and deal with potentially unruly patients. ... Enforce order when persons become uncooperative when asked to remove clothing and relinquish personal items.".

Paul Rega, M.D., FACEP, and Kelly Burkholder-Allen also note, in "The ABCs of Bioterrorism" an additional advantage in decontaminating everyone found at the scene of an incident, because this will help the authorities in searching through everyone's clothes to find suspicious items:

"Removal of clothing in the decon procedure has the additional advantage of detecting weapons or a secondary device on a victim or "pseudo-victim".

Chris Seiple, in "Another Perspective on the Domestic Role of the Military in Consequence Management" suggests that the evidence gathering process of identifying contaminated people and their belongings should also include the process of video surveillance:

The identification of contaminated victims and their personal effects... Victims are also videotaped as they proceed through the decontamination line.
Video Surveillance... Videotaped documentation could later be used in the evidence processes;

Although there are the obvious privacy concerns in surveillance, one can also argue that due to the high risk nature of terrorism, such surveillance is warranted, as it is in other high risk areas like bathing complexes where surveillance is often used because of the risk of drowning. In these cases the importance of safety may often be thought to outweigh privacy concerns.

Handling uncooperative victims

One of the elements that separates a drill from a real-life situation is dealing with panicked or uncooperative victims. Security personnel should be assigned to the area for crowd control and to ensure appropriate flow of individuals in and out of the decontamination area.[ citation needed ]

In a real attack, the perpetrators may be among the victims, or some of the victims may be in possession of contraband, or of evidence that might help law enforcement in solving the crime.[ citation needed ]

Another consideration is that some of the perpetrator victims might refuse to go through decon because this would result in discovery of the contraband they may be hiding.

For example, a person with explosives strapped to his or her body, under their clothing, would likely not be so willing to take it off. Such a victim might try to escape, and need to be restrained for decontamination.

Separate male and female officers (decontamination officers) deal with potentially unruly patients, by restraining the hands using flex cuffs, and cutting off the shirt, then removing shoes and pants normally. This usually requires a couple of officers.

The Belfast Telegraph describes such a situation:

"...holds back hundreds of extras playing traumatised bomb victims. Coated in ash and wrapped up in bandages, these people are staggering around, dazed and confused, like so many shell-shocked World War I soldiers. While troops in riot gear charge forward to reinforce the cordon and use their shields and batons to beat back ... desperately appeal for calm. They ask people to file in an orderly fashion towards the decontamination units being rapidly assembled by fire fighters in inflated orange Chemical Biological Radiation Nuclear (CBRN) suits."

See also [5] Battalion Chief Michael Farri:

They bring a law enforcement agency group with them and they have no problem if somebody needs to be restrained with handcuffs or flex cuffs or whatever to keep them from going from the hot zone to a cool zone; whereas the fire department, we are not geared to do that.... Kwame Holman: Colonel Hammes says his Marines are trained to handle uncooperative people. ... If they're really hysterical, there's some simple techniques from this program called Marine Martial Arts, that teaches various martial arts skills; there are common techniques that police also use to provide pain compliance-- no permanent damage, just enough to get your attention, and allows us to control you. If you still won't, then we can control in flex cuffs, and then we'll flex cuff decontaminate you. And if you're calm at that point, we turn you loose. If you're still not calm, then the police will be asked to give us a hand.

Internal human contamination

Radioactive contamination can enter the body through ingestion, inhalation, absorption, or injection. This will result in a committed dose of radiation.[ citation needed ]

For this reason, it is important to use personal protective equipment when working with radioactive materials. Radioactive contamination may also be ingested as the result of eating contaminated plants and animals or drinking contaminated water or milk from exposed animals. Following a major contamination incident, all potential pathways of internal exposure should be considered.[ citation needed ]

Successfully used on Harold McCluskey, chelation therapy and other treatments exist for internal radionuclide contamination. [6]

See also

Related Research Articles

Radiation protection, also known as radiological protection, is defined by the International Atomic Energy Agency (IAEA) as "The protection of people from harmful effects of exposure to ionizing radiation, and the means for achieving this". Exposure can be from a source of radiation external to the human body or due to internal irradiation caused by the ingestion of radioactive contamination.

<span class="mw-page-title-main">Health physics</span>

Health physics, also referred to as the science of radiation protection, is the profession devoted to protecting people and their environment from potential radiation hazards, while making it possible to enjoy the beneficial uses of radiation. Health physicists normally require a four-year bachelor’s degree and qualifying experience that demonstrates a professional knowledge of the theory and application of radiation protection principles and closely related sciences. Health physicists principally work at facilities where radionuclides or other sources of ionizing radiation are used or produced; these include research, industry, education, medical facilities, nuclear power, military, environmental protection, enforcement of government regulations, and decontamination and decommissioning—the combination of education and experience for health physicists depends on the specific field in which the health physicist is engaged.

<span class="mw-page-title-main">Radioactive contamination</span> Undesirable radioactive elements on surfaces or in gases, liquids, or solids

Radioactive contamination, also called radiological pollution, is the deposition of, or presence of radioactive substances on surfaces or within solids, liquids, or gases, where their presence is unintended or undesirable.

<span class="mw-page-title-main">Goiânia accident</span> 1987 radioactive contamination incident in Brazil

The Goiânia accident was a radioactive contamination accident that occurred on September 13, 1987, in Goiânia, Goiás, Brazil, after an unsecured radiotherapy source was stolen from an abandoned hospital site in the city. It was subsequently handled by many people, resulting in four deaths. About 112,000 people were examined for radioactive contamination and 249 of them were found to have been contaminated.

<span class="mw-page-title-main">CBRN defense</span> Protective measures against hazardous materials warfare

Chemical, biological, radiological and nuclear defense or NBC protection is protective measures taken in situations in which chemical, biological, radiological or nuclear hazards may be present. CBRN defense consists of CBRN passive protection, contamination avoidance, and weapons of mass destruction mitigation.

Mass decontamination is the decontamination of large numbers of people, in the event of industrial, accidental, or intentional contamination by toxic, infective, caustic, polluted, or otherwise unhealthful or damaging substances.

Decontamination foam is a spray-on cleaning solution used on surfaces that have been contaminated with biological or chemical agents. Decon foam has been found to make numerous chemical and biological agents harmless. It is also intended for use in areas where large numbers of people have possibly been contaminated.

it is short for

Crime scene cleanup is a term applied to cleanup of blood, bodily fluids, and other potentially infectious materials (OPIM). It is also referred to as biohazard remediation, and forensic cleanup, because crime scenes are only a portion of the situations in which biohazard cleaning is needed. Incidents which may require this type of cleanup include accidents, suicide, homicides, and decomposition after unattended death, as well as mass trauma, industrial accidents, infectious disease contamination, animal biohazard contamination or regulated waste transport, treatment, and disposal.

Nuclear entombment is a method of nuclear decommissioning in which radioactive contaminants are encased in a structurally long-lived material, such as concrete. This prevents radioactive material and other contaminated substances from being exposed to human activity and the environment. Entombment is usually applied to nuclear reactors, but also some nuclear test sites. Nuclear entombment is the least used of three methods for decommissioning nuclear power plants, the others being dismantling and deferred dismantling. The use of nuclear entombment is more practical for larger nuclear power plants that are in need of both long and short term burials, as well as for power plants which seek to terminate their facility licenses. Entombment is used on a case-by-case basis because of its major commitment with years of surveillance and complexity until the radioactivity is no longer a major concern, permitting decommissioning and ultimate unrestricted release of the property. Considerations such as financial backing and the availability of technical know-how are also major factors.

<span class="mw-page-title-main">Mass casualty incident</span> Incident which results in medical care systems becoming overwhelmed

A mass casualty incident describes an incident in which emergency medical services resources, such as personnel and equipment, are overwhelmed by the number and severity of casualties. For example, an incident where a two-person crew is responding to a motor vehicle collision with three severely injured people could be considered a mass casualty incident. The general public more commonly recognizes events such as building collapses, train and bus collisions, plane crashes, earthquakes and other large-scale emergencies as mass casualty incidents. Events such as the Oklahoma City bombing in 1995, the September 11 attacks in 2001, and the Boston Marathon bombing in 2013 are well-publicized examples of mass casualty incidents. The most common types of MCIs are generally caused by terrorism, mass-transportation accidents, fires or natural disasters. A multiple casualty incident is one in which there are multiple casualties. The key difference from a mass casualty incident is that in a multiple casualty incident the resources available are sufficient to manage the needs of the victims. The issue of resource availability is therefore critical to the understanding of these concepts. One crosses over from a multiple to a mass casualty incident when resources are exceeded and the systems are overwhelmed.

Contamination is the presence of an unwanted constituent in another substance.

<span class="mw-page-title-main">Homeland Security Grant Program</span>

Homeland Security Grant Program (HSGP) is a program in the United States established in 2003 and was designated to incorporate all projects that provide funding to local, state, and Federal government agencies by the Department of Homeland Security. The purpose of the grants is to purchase surveillance equipment, weapons, and advanced training for law enforcement personnel in order to heighten security. The HSGP helps fulfill one of the core missions of the Department of Homeland Security by enhancing the country's ability to prepare for, prevent, respond to and recover from potential attacks and other hazards. The HSGP is one of the main mechanisms in funding the creation and maintenance of national preparedness, which refers to the establishment of plans, procedures, policies, training, and equipment at the Federal, State, and local level that is needed to maximize the ability to prevent, respond to, and recover from major events such as terrorist attacks, major disasters, and other emergencies. The HSGP's creation stemmed from the consolidation of six original projects that were previously funded by the Office of State and Local Government Coordination and Preparedness. The HSGP now encompasses five projects in the program: State Homeland Security Program, Urban Areas Security Initiative, Operation Stonegarden, Metropolitan Medical Response System Program, and Citizen Corps Program. During the 2010 fiscal year, the Department of Homeland Security will spend $1,786,359,956 on the Homeland Security Grant Program.

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<span class="mw-page-title-main">Hazmat diving</span> Underwater diving in a known hazardous materials environment

Hazmat diving is underwater diving in a known hazardous materials environment. The environment may be contaminated by hazardous materials, the diving medium may be inherently a hazardous material, or the environment in which the diving medium is situated may include hazardous materials with a significant risk of exposure to these materials to members of the diving team. Special precautions, equipment and procedures are associated with hazmat diving so that the risk can be reduced to an acceptable level.

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<span class="mw-page-title-main">Suction Assisted Laryngoscopy Airway Decontamination</span>

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References

  1. "Remm server" (PDF).
  2. "Radioactive Contamination and Radiation Exposure | CDC". 23 October 2020.
  3. Jane's Chem-Bio Handbook, third edition
  4. "THE INTERNATIONAL CBRN TRAINING CURRICULUM: NATO Civil Emergency Planning Civil Protection Committee" (PDF).
  5. "Online NewsHour: Guarding the Homeland - September 27, 2002". Pbs.org. Archived from the original on 2014-01-18. Retrieved 2010-06-02.
  6. TREATMENT OF INTERNAL RADIONUCLIDE CONTAMINATION. Borden Institute