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INTRODUCTION

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A hazardous material (hazmat) can be any xenobiotic (solid, liquid, or gas) with the potential to harm. Typically, we are most concerned about xenobiotics that can harm people, although a hazardous material may also harm other living organisms, the environment, or property. Outside of the United States, hazardous materials are often referred to as dangerous goods.

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A “hazmat incident” implies that there was an unplanned or uncontrolled release of, or exposure to, a hazardous material. These terms are also used interchangeably; here we will use hazardous materials. Although there are no specific requirements for an event to be considered a hazardous materials incident, typically there must be the potential for many people or a large area to be affected; otherwise, all toxicologic exposures would fall into this category. Therefore, a hazardous materials incident falls within the larger disaster management framework within a community.

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Hazardous materials include chemical, biologic, and radiologic xenobiotics. In fact, a single event could provide exposure to multiple xenobiotics. Complicating matters, the incident response required for chemical, biologic, or radiologic xenobiotics may differ substantially depending on many factors. For instance, an envelope containing a white powder suspicious for containing anthrax spores that is opened in an office might require decontamination of the exposed people and environment. However, the release of the same anthrax spores surreptitiously at multiple sites may not be recognized until days later because of the delayed onset of symptoms. Certainly, a very different emergency response would be required. Emergency managers and health care professionals must consider all possibilities and adjust the incident response based on the specific xenobiotics involved, the route of the exposure and other variables such as time. This chapter discusses the basic principles used for a confined and quickly identifiable hazardous materials incident.

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In general, a hazardous materials incident response focuses on the care of patients exposed to xenobiotics in the prehospital setting, prepares for multiple casualties, and emphasizes patient decontamination while at the same time trying to prevent exposure and contamination of first responders and health care professionals.

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Every emergency response has the potential to involve hazardous materials and therefore first responders must always appreciate this possibility. A simple motor vehicle collision often releases gasoline into the environment. A victim pulled from a burning building may have carbon monoxide poisoning. A terrorist may contaminate an explosive device with radioactive material (eg, dirty bomb). The early identification that an event involves a hazardous material will allow for better patient care.

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DISASTER MANAGEMENT AND RESPONSE

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Preparedness requires the planning of actions to be taken when a disaster occurs, as well as the practicing with mock exercises of these actions. Preplanning is critical to limit damage from an event, and numerous such hazardous materials incident response plans exist. The recovery phase occurs after the immediate needs and threats to human life are addressed in the ...

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