Hospital response to chemical terrorism: personal protective equipment, training, and operations planning.

BACKGROUND: Hospitals distant from the immediate site of an incident involving a hazardous materials (HAZMATs) release which could include chemical warfare agents, must develop emergency response plans (ERPs) to protect healthcare professionals if they receive potentially contaminated victims. The ERP must address OSHA, EPA, and JCAHO requirements.

METHODS: The VHA convened groups to develop a hazard and exposure assessment, identify actions for compliance with existing regulatory standards, and review site and operational planning issues. Exposure modeling results were used to derive relationships between operational parameters (time and distance from sites/sources) and potential exposure for healthcare workers.

RESULTS: According to exposure modeling, level C personal protective equipment is adequate to protect hospital staff distant from the chemical release site. Decontamination runoff and contaminated clothing should also be controlled to limit exposure.

CONCLUSIONS: Development and coordination of ERPs must include the local emergency planning committee, with clear assignment of tasks, locations, and training in order to prevent exposures to healthcare workers.