RAPID HEALTH ASSESSMENT PROTOCOLS FOR EMERGENCIES
( By WHO - OMS, 1999 )

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9-Presenting results

In presenting the results of your assessment, indicate the following information.


· Define, quantify, and map the populations at risk or already affected by the release or both.

· Determine the likely health effects of the chemical release.

· Estimate the number of cases and deaths, and expected hospital admissions and outpatient attendances for the affected areas and specific facilities.

· Estimate needs for outside assistance, based on preliminary findings (e.g. qualified technical personnel, drugs, logistics, and communications support).


Give recommendations on:


- appropriate triage and case management;

- environmental control strategies to prevent further spread of chemical contaminants;

- the need for population evacuation and how to proceed: means of information and communication with community and relevant organizations, destination of evacuees, means of transport, and routes of evacuation;

- appropriate care for those evacuated to temporary shelters; and

- collection, identification, and management of dead victims.







Box 4.Sample checklist for rapid health assessment in chemical emergencies

The following checklist will be of value in assessing and reporting on chemical emergencies.

1. General information
1.1 date and time of the release
1.2 chemical released
1.3 location of the release


- country
- region
- community

1.4 population centres closest to the release
1.5 time of the assessment

2. Morbidity and mortality
2.1 number of casualties


- mildly affected
- seriously affected

2.2 number of deaths

3. Site of the release
3.1 source
3.2 location of source and address
3.3 Are similar episodes being reported elsewhere?

4. Type(s) of release (describe)
4.1 atmospheric dispersion
4.2 explosion
4.3 fire
4.4 spill
4.5 other

5. Size of release
5.1 quantity of chemicals in the plant or storage site


- weight (kilograms or tonnes)
- volume (m3 or litres)

5.2 amount of the leakage from a pipeline or a chemical tank (litres, tonnes or flow rate)

6. Distribution of release
6.1 meteorological conditions


- temperature
- wind direction
- wind speed (metres per second)
- rainfall
- sunshine or cloud
- weather stability

6.2 geographical characteristics


- valleys
- mountains
- lakes, other waters 6.3 define risk zone
- size (square kilometres)
- area where personal protection is needed
- type of protective clothes needed
- type of respiratory protection

7. Define the populations at risk
7.1 number of individuals close to the release
7.2 number of individual houses close to the release
7.3 Are any of the following close to the release?


- schools
- day-care centres
- hospitals
- shopping centres
- public buildings
- other vulnerable sites

7.4 Is evacuation needed? If so, where?

8. Identification of the chemicals and their byproducts
8.1 observations related to the release


- colour
- odour
- signs and symptoms of exposed humans
- signs of exposed animals and plants
- other observations

8.2 information on the chemicals released


- correct technical name
- trade name(s) of the chemical(s)
- generic name(s)
- synonyms
- UN number, Chemical Abstracts Service Registry number (CAS number)
- placards (on vehicle)
- UN hazard classification
- names of the by-products
- information source(individuals’ names, chemical centres or written documents, data sheets)

8.3 environmental samples collected

- what samples were collected
- qualitative results of chemical analysis (chemicals identified)
- quantitative results(concentration of chemicals in the environment)

9. Toxicological evaluation
9.1 safety information on the chemicals released
9.2 available information on the chemicals in databases and emergency response plan
9.3 physical and chemical properties of the chemicals


- molecular formula (to be completed later)
- molecular weight
- conversion factor (mg/m3 = × parts per million)
- density
- vapour pressure
- boiling point
- flammability point
- critical temperature
- explosiveness
- solubility in water and other liquids

9.4 likely toxic effects of released chemicals


- irritation
- suffocation
- chemical burns
- dermal effects
- effects on eyes
- acute systemic effects
- chronic effects
- most critical health effects
- significant concentrations in air may cause death, serioussymptoms, mild symptoms, or no symptoms

9.5 likely exposure route


- inhalation
- dermal absorption
- ingestion (contaminated water, food)

9.6 sources of further information


- data sheets
- text books
- databases

9.7 possibilities for body burden measurement


- blood samples
- urine samples
- other samples

9.8 list of laboratories where analyses can be carried out


- names of laboratories, addresses, and phone numbers
- backup laboratories

10. Appropriate treatment regimens
10.1 describe (list) symptoms
10.2 describe standardized treatment


- maintenance of vital functions
- decontamination and enhancement of elimination
- general symptomatic treatment
- specific antidotes and their dose
- other specific poisoning treatment

10.3 psychological support(management of stress reaction)
10.4 registry of casualties

11. Emergency medical care and health service needs and capabilities
11.1 identify places where treatment can be given


- hospitals
- health centres
- field hospitals and temporary health centres
- public buildings (schools)

11.2 identify available human resources for therapy and first aid


- doctors
- nurses
- other health personnel
- volunteers

11.3 transport capabilities


- ambulances and other cars
- air transport capabilities
- transport routes available (map)

12. Environmental health assessment
12.1 water supply


- analysis of water safety for chemicals
- analysis of substitute water for chemicals and bacteria
- state of emergency water supply

12.2 food supply


- analysis of food contamination
- availability of safe food

12.3 suitable shelters

13. General response operations
13.1 overall command
13.2 sectors involved (e.g. police and fire brigade)
13.3 public information and communications


- awareness
- reassurance
- instructions

13.4 management of fatalities


- rescue operations for the dead
- morgue
- identification of dead victims
- burials.

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