Communication during mass casualty decontamination: highlighting the gaps

Following the World Trade Centre attacks of September 2001, there has been an increased focus in the emergency planning community on methods of managing chemical, biological, radiological and nuclear (CBRN) incidents. This has, necessarily, included consideration of methods and processes for rapid decontamination of large numbers of potentially contaminated people. Real-life decontamination incidents have suggested that some contaminated casualties may not comply with decontamination protocols, resulting in a high risk of re-contamination or secondary contamination beyond the incident site. Effective communication has been recognised as an important issue for the management of CBRN incidents. To examine the current provision for communicating with the public during incidents involving decontamination, open source decontamination guidance documents for responders were reviewed, as were published reports of emergency preparedness exercises involving decontamination. The review of decontamination guidance documents showed that specific guidance for professional responders on how to communicate with the public during incidents that involve decontamination could be improved. Similarly, the review of published decontamination exercises shows that a stronger emphasis on communication with members of the public is needed, in addition to the use of exercises to evaluate the effectiveness of communication strategies. Future research is required to understand how members of the public are likely to react to incidents involving decontamination, and how communication strategies employed by emergency responders can affect the behaviour of the public during these types of incidents.