Hospital preparedness for victims of chemical or biological terrorism

Wetter, Donald Clark; Daniell, William; Treser, Charles D

doi:10.2105/ajph.91.5.710

Cited by 143 publications

(16 citation statements)

References 33 publications

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“…Chemical or biological weapons of mass destruction represent a new form terrorism. In response to the growing threat of terrorism with chemical and biological weapons, the city and nation should develop a comprehensive emergency health and medical services response policy [ 4 – 7 ].…”

Section: Discussionmentioning

confidence: 99%

Unnatural Deaths in Shanghai from 2000 to 2009: A Retrospective Study of Forensic Autopsy Cases at the Shanghai Public Security Bureau

Fang

Lin

et al. 2015

PLoS ONE

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Shanghai is the most developed city in China and has a soaring population. This study uses forensic epidemiology to determine the relationship between unnatural deaths and the development in Shanghai, based on recently released forensic autopsy cases from the 2000s at the Shanghai Public Security Bureau (SPSB). There were 5425 accidental deaths, 2696 homicides, 429 suicides, 186 natural deaths, and 1399 deaths of undetermined cause. There was a male-to-female ratio of 2.02:1, and the average age was 40.9±18.7 years. Traffic accidents (84.2%) were the number one cause of accidental deaths, which decreased during the study period. Sharp force injury (50.6%) was the leading cause of homicides, different from Western countries, where firearms are the leading cause. Hanging (24.5%) was the leading cause of suicides, whereas drug and chemical intoxication was the leading cause in the previous decade; pesticide ingestion decreased in the 2000s. In addition to traffic accidents, manual strangulation was the leading cause of death in childhood fatalities. Children under age 2 were vulnerable to homicides. In the 2000s, there were a large number of drug overdoses, and illegal medical practices and subway-related deaths first appeared in Shanghai. A new type of terrorist attack that involved injecting people with syringes in public places was reflected in the SPSB archives. The forensic epidemiology and changes in unnatural deaths in this decade reflected their relationship with the law, policy and changes in Shanghai. Illegal medical practices, subway-related deaths and terrorist attacks were closely related to the development in Shanghai. Identifying the risks of unnatural deaths will improve public health.

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Section: Discussionmentioning

confidence: 99%

Unnatural Deaths in Shanghai from 2000 to 2009: A Retrospective Study of Forensic Autopsy Cases at the Shanghai Public Security Bureau

Fang

Lin

et al. 2015

PLoS ONE

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“…An overview of US hospital evacuations 1971-1999 highlights that more than 50% of cases originated for internal hazards, not for natural disasters. (Wetter, Daniell, & Tresser, 2001) Chemical, biological Emergency plans…”

Section: Implementation and Responsementioning

confidence: 99%

“…Research demonstrates that American healthcare facilities are more covered against other types of hazards than fire events (e.g., radiological, chemical, and nuclear attacks, biological accidents, epidemics and pandemics) (Niska & Shimizu, 2011). An extensive body of academic studies in healthcare emergency management focuses on the aforementioned threats (see, among others, Cone & Koenig, 2005;Moore et al, 2015;Wetter et al, 2001). As illustrated in Table 1, academic research on healthcare emergency management seems to predominantly concentrate on other threats than fire events.…”

Section: Planning and Preparationmentioning

confidence: 99%

Implementation of best practices for emergency response and recovery at a large hospital: A fire emergency case study

et al. 2017

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This paper illustrates a study conducted into the managerial practices implemented to mitigate the consequences of a major fire emergency and to promptly restore normal business operations at a large pediatric hospital. Stemming from prior research on crisis response and recovery in critical infrastructures, this investigation demonstrates that factors such as the complexity of the underlying stakeholder networks, the vulnerability of the involved actors, and several temporal and spatial constraints, all contribute in hampering the intervention of crisis managers. In these situations, relying on consolidated best practices may enable more rapid response and more adequate recovery.This study adopts a qualitative approach to build a retrospective case study that highlights the crucial issues that healthcare crisis managers are requested to face when exposed to thorny work conditions: presence of numerous actors from the public and the private sector, involvement of organizations with contrasting interests, need for a balance among public health, cost containment and legitimacy, etc. The findings of the present investigation expand the theoretical knowledge on the dynamics that characterize crises occurring at critical infrastructures and provide practical recommendations for healthcare emergency managers to improve their response to, and recovery from, major fire emergencies.

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“…[2] A quick and consistent response to such incidents can play an important role in reducing the harmful effects of such events on public health as well as its psychological consequences. [1] The prevalence of various diseases caused by biological incidents in the past decades, such as acute respiratory syndrome,[3] influenza[45] Ebola,[67] emerging and re-emerging infectious diseases,[89] bioterrorism events,[1011] and public health emergencies. [12] In addition to the threat of high mortality, can cripple health and medical systems and significantly impair social and economic performance in society.…”

Section: Introductionmentioning

confidence: 99%

“…[16] Hospitals will face numerous challenges confronting massive influx of patients suffering from bioterrorism disasters and emerging infectious diseases that may be contagious as well. [817] Numerous international studies have reported similar outcomes regarding the lack of preparedness of hospitals in facing biological disasters, such as weakness in planning and organizing,[51018192021] communication,[71122] surge capacity,[58182123] resources,[482022] training and education,[610192021222324] infrastructure,[525] medical management,[7122225] supervision,[371822] and safety and security. [71624]…”

Section: Introductionmentioning

confidence: 99%