Introduction
First responders are usually at risk of injuries and chemical poisoning during rescue missions in emergency situations. Toxic chemical substances that are released during and after a catastrophic event affect the health and safety of first responders adversely (Weinhold, 2010). The chemicals enter the body through natural openings such as the nose, mouth, and skin pores. Inhalation and skin absorption are the most common routes of intoxication. In many instances, acute exposure to toxic substances results in pulmonary edema, coma, chest pain, headaches, and death in severe cases.
First responders such as firefighters and police officers face numerous health hazards such thyroid, brain, thyroid, and bladder cancers. First responders during events such as terrorist attacks, oil spills, and chemical releases require special training in order to protect and improve their health and safety while offering rescue services (Weinhold, 2010). Terrorist attacks comprise one of the emerging threats to first responders due to the rampant use of toxic chemicals as weapons. This emerging trend is exposing rescuers to increased risks of illness and injury because of the adverse health effects caused by the chemicals, their varied modes of action, and their different properties that render them highly lethal.
First responders training
Training is an important aspect of enhancing the safety and security of first responders during emergencies. Pre-event preparation, professional training, and access to information are strategies used by security agencies to reduce the number of casualties during disasters. After a devastating event, it is the responsibility of first responders to conduct rescue missions and address health hazards that could affect their safety as well as that of other crew members (Cashman, 2008). Rescue missions are highly dangerous because responders work in hazardous environments that can cause negative health outcomes if navigated inappropriately (Weinhold, 2010). In order to protect first responders, the Centre for Domestic Preparedness (CDP) offers specialized training at its facility in Anniston, Alabama. The facility was created to train emergency responders in areas such as hazardous materials, public safety communications, law enforcement, fire services, emergency medical services, healthcare, and public health.
Emergencies that threaten the lives, health, and wellbeing of people happen every day. Society relies on law enforcement officers, firefighters, health professionals, and emergency technicians for timely response and assistance during such disasters. Restoration of calm and safety after a disaster is a core responsibility of first responders. The risks posed by chemical hazards at disaster scenes are augmented by the chaos and commotion caused by the numerous activities that take place at those locations. Management of rescue operations, communication, mitigation of health hazards, and organization of people are difficult tasks that increase the risk of first responders’ exposure to chemical hazards (Cashman, 2008). This problem is mitigated through professional training that aims to protect emergency rescuers from injury, illness, and death (Weinhold, 2010). Proper planning, training, and management are effective strategies that enhance the safety of first responders.
The Center for Domestic Preparedness (CDP) identifies, develops, and delivers training to first responders (Center for Domestic Preparedness 2013 Student Handbook, 2013). In addition, it facilitates training programs that are offered by its partners such as National Training and Education Division (NTED), National Preparedness Directorate (NPD), Emergency Management Institute (EMI), and National Fire Academy (NFA). Training incorporates awareness, performance, planning and management aspects of disaster response. Students are taught how to apply their knowledge and skills to plan, prepare, prevent, and respond to terrorism and other catastrophic events (Center for Domestic Preparedness 2013 Student Handbook, 2013).
The Chemical, Ordnance, Biological and Radiological Training Facility (COBRATF) teaches first responders to respond to incidents that involve biological, chemical, and radiological substances. Instruction takes place in a toxic environment that includes biological and chemical materials that first responders are likely to encounter during rescue missions. The Noble Training Facility (NTF) teaches nurses and medical practitioners how to prepare for and respond to disasters (Center for Domestic Preparedness 2013 Student Handbook, 2013). The facility offers skills such as casualty decontamination and emergency treatment. The Advanced Responder Training Complex (ARTC) provides a training environment that gives students an opportunity to put the skills acquired during training into practice (Center for Domestic Preparedness 2013 Student Handbook, 2013). The facility includes simulated real-world environments such as restaurants, offices, and hospitals.
First responders usually receive training in hazardous materials response at the awareness and operational levels. Responders at the awareness level understand the implications of mishandling hazardous substances and possess knowledge on how to recognize and identify toxic substances (Hazardous Materials Guide for First Responders, 2015). On the other hand, responders at the operational level are responsible for protecting people and the environment against hazardous materials (Hazardous Materials Guide for First Responders, 2015). Their training instills skills that empower them to respond defensively to disasters involving toxic materials. They possess skills such as risk assessment, decontamination, and use of protective equipment. During rescue missions, responders at awareness and operational levels perform different roles due to their different training. However, they all possess knowledge and skills on how to avoid contamination and intoxication.
Analysis of emerging threat
The use of toxic chemicals as terrorist weapons is an emerging threat among first responders. Many terrorists are using chemical, biological, radiological, and nuclear (CBRN) materials as weapons and as such pose great risks to public health, safety, and security. The threat of rampant use of chemicals in terrorism is evolving thus increasing the risk of chemical hazards to the public and first responders. Terrorist groups are expanding their knowledge regarding the use of CBRN materials as weapons. Industrial chemicals are used as weapons because of their chemical properties that include toxicity, carcinogenicity, flammability, and explosiveness (Cashman, 2008). Examples of chemicals that pose great health hazards include chlorine, anhydrous ammonia, and hydrogen fluoride.
The release of these chemicals during a terrorist attack is very hazardous because they can be transported easily by wind and as a result poison many people who inhale them. For instance, the release of 40 metric tons of methyl isocyanate in Bhopal, India killed more than 3,000 people and injured many others (Ciottone, 2006). Terrorist groups are capitalizing on the properties of chemicals in order to use them as weapons. The chemicals’ capability to kill many people simultaneously is another reason for their increasing use as weapons. Government reports indicate that chlorine has been used in Iraq as a weapon.
Militias and terrorist groups manufacture bombs containing cylinders loaded with chlorine for use in attacks against police and civilians. A report released by the United Nations Monitoring, Inspection, and Verification Commission (UNMOVIC) showed Al Qaeda launched several attacks on civilians using chlorine bombs. Terrorists use chemicals as weapons mainly because of their toxicity and ease of dissemination after attacks (Cashman, 2008). Their ability to use chemicals as weapons is primarily determined by their target population, availability, and ease of dissemination. They also have become common among terrorists because of their ability to cause instantaneous injuries and death. For instance, organophosphate poisoning is so lethal that a victim dies within a few minutes.
Consequences of emerging threat
First responders are facing heightened risks due to the increasing use of chemicals to manufacture weapons by terrorists. Current reports have shown that chlorine-filled rockets and missiles are being used in Iraq and Syria by Islamic State (ISIS) militants (Batchelor, 2015). For instance, agencies investigating the attacks have confirmed that chemical weapons were used against the Kurdish group in June (Batchelor, 2015). Terrorists are using toxic chemicals to make weapons because they are easy to transport, access, and buy. The chemicals are cheap and therefore, criminals can buy them in large quantities.
On the other hand, they are easily accessible because of their numerous applications in industrial processes for the manufacture of a wide range of products. Terrorists hire chemists to synthesize certain chemicals that are not readily available. The ease of availability and transport of chemicals is a challenge to government agencies concerned with addressing emergencies (Terrorism, 2015). Another reason for the widespread use of chemicals is due to their persistent nature. Many chemicals retain their effectiveness and toxicity for long periods of time after dissemination (Ciottone, 2006).
Rockets and missiles release the chemicals upon impact thus causing air contamination. Air contamination is a health hazard especially for first responders because of the associated consequences as well as the ease of dissemination. Severe headaches, sore throat, muscle pain, loss of concentration, reduced mobility, and burning of eyes and nose are examples of the side effects of chemical poisoning (Batchelor, 2015). First responders receive training on how to protect themselves from chemical hazards during rescue missions. However, the increasing use of highly toxic chemicals and the rising rate of terrorist attacks are posing great hazards to the health and safety of responders. In order to mitigate this problem, CDP is training first responders and providing them with advanced knowledge and skills to enable them respond to Chemical, Biological, Radiological, Nuclear and Explosive (CNRNE) incidents (Hildreth, 2015).
For instance, the Hazardous Materials Technician for CBRNE Incidents is a course that trains first responders to counter CBRNE incidents safely (Hildreth, 2015). Another consequence of the emerging threat is the implication of the toxicity and persistence of certain chemicals. Some chemicals are persistence and therefore remain in the environment for long periods of time (Terrorism, 2015). This makes the decontamination process complex and difficult, and thus increases the risk of exposure for first responders. It is important for rescuers to possess adequate knowledge regarding the persistence and toxicity levels of different chemicals that terrorists use in weapons (Hazardous Materials Guide for First Responders, 2015). Other chemicals do not easily change to gaseous state. Therefore, they present a contact hazard to first responders during rescue missions.
Persistent chemicals cause heavy contamination of scenes and present high risks of poisoning for first responders (Terrorism, 2015). Chemicals are very dangerous because their modes of action vary. They affect blood, nerves, skin, and the respiratory systems. Therefore, they pose high risks to first responders because of their varied means of causing harm. Certain chemicals cause injuries when they are inhaled while others cause act when they come into contact with the skin (Hazardous Materials Guide for First Responders, 2015). First responders need to practice great caution because chemicals have adverse health effects and some react very fast thus making it difficult to receive effective medical attention (Ciottone, 2006).
Guidelines for first responders
The consequences of CBRN emergencies are adverse because they affect the environment, property, and people. Non-Binding Guidelines and Minimum Standards for First Responders were developed to mitigate the adverse effects of chemical hazards during first response missions. They incorporate planning, training, procedures, and equipment applied during CBRN incidents in order to protect people against risks of chemical hazards (Guidelines for First Response to A CBRN Incident, 2015). The guidelines aim to promote best practices among first responders in order to improve preparedness and response to CBRN emergencies. They equip first responders with knowledge regarding the most critical actions that need to be taken during the first 20 minutes of a response mission. Training is an essential component of the pre-planning process that enhances the effectiveness of preparedness and response initiatives. The guidelines are divided into four sections namely information gathering, scene management, saving and protecting lives, and additional support (Guidelines for First Response to A CBRN Incident, 2015).
Information gathering
One of the most important aspects of an effective response is information gathering. It involves collecting information related to the occurrence or the possibility of occurrence of a CNRN disaster. Such information is disseminated through intelligence agencies, the public and emergency service control rooms in order to create awareness and initiate the development of response plans (Guidelines for First Response to A CBRN Incident, 2015). Information gathering can be conducted by first responders at the awareness level. Data collected can include type of hazardous materials, signs of environmental contamination, and symptoms of victim poisoning. Evidence of hazardous substances can be disseminated through transportation of containers with toxic materials to designated locations and through operational response plans.
Capabilities required include CBRN awareness training, information gathering methods, and information dissemination methods. Equipment needed include questionnaires, information technology gadgets, radios, maps, and response plans (Guidelines for First Response to A CBRN Incident, 2015). First responders are required to practice caution when approaching disaster scenes. For instance, they are expected to carry out scene assessment, estimate the number of victims, create incident command, determine the presence of hazardous materials, and estimate the quantities of resources needed (Guidelines for First Response to A CBRN Incident, 2015). Equipment used include protective gear, emergency guides, inter-operable communication devices, and maps. In order to conduct proper information gathering, first responders need certain skills that include information analysis, protection of infrastructure, and effective communication.
Scene management
Scene management involves termination of any access to a disaster location. Victims and outsiders are barred from either exiting or entering the scene respectively. Isolation and quarantine prevent the spread of hazardous materials to other areas. Scene management is important because it facilitates the provision of safe working methods for responders and stops the continued release of toxic substances. The initial actions taken in scene management include consideration of wind direction, establishment of multi-agency command points, and establishment of inner and outer cordon (Guidelines for First Response to A CBRN Incident, 2015). Examples of equipment used include detection, identification, and monitoring devices, cordon tape, and emergency response guides.
Another critical aspect of scene management is containment. Containment involves establishment of quarantine, isolation of contaminated areas, and establishment of decontamination areas (Guidelines for First Response to A CBRN Incident, 2015). Skills need for this process include knowledge of Hazmat management, understanding of decontamination procedures, knowledge of contamination signs and symptoms, and comprehension of medical triage. Establishing traffic cordon, preserving evidence, and establishing multiagency marshalling areas is also very important (Guidelines for First Response to A CBRN Incident, 2015).
Saving and protecting lives
The main priority of first response agencies is to save the lives of victims. Initial assessment efforts are directed towards assessment of victim contamination or intoxication. Saving lives involves creation and implementation of rescue methods, victim decontamination, and medical treatment (Guidelines for First Response to A CBRN Incident, 2015). On the other hand, it involves timely dissemination of information and warning to the public in order to reduce the risk of exposure to hazardous chemicals. In order to save lives, first responders need to evacuate people from contaminated areas to quarantine locations, conduct possible rescues, facilitate creation of safe working methods for rescue teams, and restrict access to cordon areas to protected rescuers only (Guidelines for First Response to A CBRN Incident, 2015). In addition, they need to provide timely warnings to the public, carry out decontamination of property, evaluate the necessity for public order and evacuation, and shut down utilities that pose health risks (Guidelines for First Response to A CBRN Incident, 2015). Tools used include recording systems, protective gear, decontamination devices, detection and identification devices, and means of transport.
Additional support
Immediate operational response is followed by management of consequences such as victim intoxication, injuries, and environmental contamination. Additional support includes identification of hazards, medical help, determination of contamination levels, transportation of victims, and treatment of casualties (Guidelines for First Response to A CBRN Incident, 2015). In many instances, national and international resources are provided to enhance the effectiveness of response efforts. Advice from specialists is required as part of recovery management. For instance, advanced medical practitioners provide psychological support and health monitoring services that are not provided by first responders at the disaster scene (Guidelines for First Response to A CBRN Incident, 2015).
An effective response involves the concerted efforts of different groups of first responders such as police officers, fire fighters, and health care professionals. Services such as hazard prediction, dispersion modeling, radiation monitoring, determination of effects on environment and people, and impact assessment are important for effective management of the after-effects of chemical contamination (Guidelines for First Response to A CBRN Incident, 2015). Support from specialists is incorporated into incident plan in order to make the response process efficient and effective. Providing regular updates, health advice, and time warnings is also imperative. Disaster scene decontamination and restoration is carried out to improve the safety of people who visit the disaster scene.
Conclusion
First responders encounter numerous challenges during rescue missions because of the chemical hazards present at disaster scenes. The risk of exposure to health hazards is mitigated through professional training that equips rescuers with adequate knowledge and skills on how to safely respond to Chemical, Biological, Radiological, Nuclear, and Explosive (CNRNE) incidents. The use of toxic chemicals as weapons by terrorist is an emerging threat in first response. Many chemicals are highly toxic, easy to access, transport, and buy. Therefore, terrorists are using them to cause mass destruction. This emerging threat is posing great risks to first responders because of the adverse health effects of toxic chemicals and the numerous ways in which they can cause harm. This threat is being mitigate through advanced training offered by CDP to first responders.
References
Batchelor, T. (2015). ISIS Targets Civilians with Chemical Weapon Attack in Iraq and Syria. Web.
Cashman, J. R. (2008). Emergency Response Handbook for Chemical and biological Agents and Weapons. New York, NY: CRC Press.
Center for Domestic Preparedness 2013 Student Handbook. (2013). Web.
Ciottone, G. R. (2006). Disaster Medicine. New York, NY: Elsevier Health Sciences.
Guidelines for First Response to A CBRN Incident. (2015). Web.
Hazardous Materials Guide for First Responders. (2015). Web.
Hildreth, R. (2015). 140th Chemical Company to Train This Week. Web.
Terrorism: Chemical Terrorism. (2015). Web.
Weinhold, B. (2010). Emergency Responder Health: What Have We Learned from Past Disasters? Environmental Health Perspectives, 118(8), 346-350.