Necessary Indicators for Developing a Hazmat Response Team of the Iranian Health System

Abstract

Introduction: Although some countries have set up predetermined programs and specialized teams to deal with hazardous materials (Hazmat) induced events, in other countries including Iran there are many weaknesses in this regard. 
Objective: We aimed to develop the necessary indicators for the formation of teams to deal with Hazmat accidents in the health system based on existing standards and resources as well as the indigenous conditions of Iran. 
Methods: This cross-sectional study was carried out in two stages from 2018 to 2020.  In the first stage, the literature review was performed and the current guidelines, standards, and models presented in other countries were reviewed and related items were extracted. In the second stage, semi-structured and purposeful interviews by managers and physicians specialized in Hazmat incidents working in Iran, were conducted. The interviews were recorded and later the recordings were transcribed and simultaneously the categorizing and coding of the interviews were performed. 
Results: In the first stage, searching through the available resources for the present study identified 12 published references through which 10 indicators to develop a Hazmat team were ultimately extracted. In the second stage, a total of 10 interviews were conducted and data saturation occurred. Based on the results of the content analysis for the main indicators of designing and developing teams, 8 categories and 19 sub-categories were developed. 
Conclusions: By interviewing and localizing the 10 main indicators that were achieved in the first stage, we finally reached the 8 indicators including: Training hazmat team’s members, required equipment for team, response plan, medical surveillance program, hazmat team structure, incident command system, hazmat team qualification of different levels, certification and maintenance of the certificate.

1. Association NFP. NFPA 472 Standard for Competence of Responders to Hazardous Materials/Weapons of Mass Destruction Incidents, 2008 ed. Quincy, Massachusetts USA: NFPA. 2007.
2. World Health Organization. Manual for the public health management of chemical incidents. 2009.
3. Yousefi K, Larijani HA, Golitaleb M, Sahebi A. Knowledge, attitude and performance associated with disaster preparedness in Iranian nurses: a systematic review and meta-analysis. Adv J Emerg Med. 2019;3(4):e42.
4. Sadeghi F, Bahrami A, Fatemi F. The effects of prioritize inspections on occupational health hazards control in workplaces in Iran. J Res Health Sci. 2014;14(4):282-6.
5. Mahdavi A, Azizmohammadlou H. The effects of industrialization on social capital: the case of Iran. Int J Soc Econ. 2013;40(9):777-96.
6. Chemical accidents statistics during 2010-2013. Tehran: Ministry of Labour; 2013. [In Farsi].
7. Jabbari M, Khodaparast E, Sadri K, Kavousi A. A survey on hazardous materials accidents during road transport in Iran. Iran Occup Health. 2014;11(5):30-42.
8. Fatemi F, Ardalan A, Mansouri N, Aguirre B, Mohammdfam I. Industrial chemical accidents: a growing health hazard in the Islamic Republic of Iran. East Mediterr Health J. 2019;25(1):5-11.
9. Esmailian M, Salehnia M-H, Shirani M, Heydari F. Reverse triage to increase the hospital surge capacity in disaster response. Adv J Emerg Med. 2018;2(2):e17.
10. Saberian P, Kolivand P-H, Hasani-Sharamin P, Dadashi F, Farhoud D. Iranian emergency medical service response in disaster; report of three earthquakes. Adv J Emerg Med. 2019;3(2):e13.
11. Melnikova N, Wu J, Orr MF, Centers for Disease Control and Prevention (CDC). Public health response to acute chemical incidents—Hazardous Substances Emergency Events Surveillance, nine states, 1999-2008. MMWR Suppl. 2015;64(2):25-31.
12. Moles T. Emergency medical services systems and HAZMAT major incidents. Resuscitation. 1999;42(2):103-16.
13. Yeung R, Chan J, Ho S. Prehospital response to Hazmat incidents. Hong Kong J Emerg Med. 2002;9(2):90-4.
14. Phelps S. Mission failure: emergency medical services response to chemical, biological, radiological, nuclear, and explosive events. Prehosp Disaster Med. 2007;22(4):293-6.
15. Hoseini A, Musareszaie A, Eslamian J. Awareness of radiological accidents and how to deal with it: A study of nurses and nursing faculties of Isfahan University of Medical Sciences. Iran J Med Educ. 2014;14(1):78-86.
16. Abbasi E, Nosrati A, Nabipour I, Emami SR. Assessment of the level of knowledge of physicians in bushehr province about preparedness and response for nuclear emergency. Iran South Med J. 2005;7(2):183-9.
17. Jahangiri K, Rostami N, Sahebi A. Challenges of Utilizing the Primary Health Safety Index Tool for Assessing the Vulnerability of Healthcare Centers to Disasters. Adv J Emerg Med. 2020;4(1):e1.
18. Schnepp R, Johnson KW. Understanding the NFPA 473 Improved Standard for EMS Hazmat Professionals.
19. Holdsworth D, Bland S, O’Reilly D. CBRN response and the future. J R Army Med Corps. 2012;158(1):58-63.
20. Price J. Hazardous Area Response Teams: celebrating 10 years in the making and counting. J Paramed Pract. 2016;8(8):390-3.
21. What is CBRN? Dundas (Onatrio): Center for Excellence in Emergency Preparedness. Available via URL: http://www.ceep.ca/education/CBRNintrosheet2012.
22. Stewart-Evans J, Hall L, Czerczak S, Manley K, Dobney A, Hoffer S, et al. Assessing and improving cross-border chemical incident preparedness and response across Europe. Environ Int. 2014;72:30-6.
23. Hazmat Team Planning Guidance. Washington, DC: Environment Protection Agency; 1990. Available via URL: https://nepis.epa.gov/Exe/ZyPDF.cgi/10001W3W.PDF?Dockey=10001W3W.PDF. Accessed 3 April 2018.
24. Duarte-Davidson R, Orford R, Wyke S, Griffiths M, Amlôt R, Chilcott R. Recent advances to address European Union Health Security from cross border chemical health threats. Environ Int. 2014;72:3-14.
21. Verson J, Dyga N, Agbayani N, Serafin F, Hondros L. Design and implementation of a medical student hazardous materials response team: the Medical Student Hazmat Team. Int J Emerg Med. 2018;11(1):1-6.
Files
IssueVol 4 No 4 (2020): Autumn (October) QRcode
SectionOriginal article
Keywords
Emergency Medical Services Hazardous Substances Indicator Iran Qualitative Research

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Hasani-Sharamin P, Bagheri H, Salesi M, Dadashi F, Rouhollahei M, Poorheidary G, Shahriary A. Necessary Indicators for Developing a Hazmat Response Team of the Iranian Health System. Front Emerg Med. 2020;4(4):e86.

Downloads

Download data is not yet available.

Most read articles by the same author(s)