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Effective communication has been recognised as an important issue for the management of incidents involving decontamination; evidence shows that failure to communicate effectively may result in increased public anxiety and non‐compliance. This paper aims to examine current provision for communicating with members of the public during decontamination, to facilitate the development of improved responder communication strategies.

To examine the current provision for communicating with members of the public, the authors reviewed open source decontamination guidance documents for responders, as well as 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.

The present research summarises existing evidence relating to how communication strategies employed by responders can shape public responses to decontamination. Analysed alongside current decontamination guidance for emergency responders, this evidence highlights potential gaps in planning for communicating with members of the public during decontamination. It is hoped that this will promote an increased understanding of the importance of communication during these types of incidents, which will in turn facilitate the development of more comprehensive responder communication strategies.

Decontamination following chemical, biological, radiological and nuclear (CBRN)/Hazmat incidents is a critical activity carried out in order to mitigate and contain the risk posed by any hazardous materials involved. Human behaviour plays a crucial role in such incidents, as casualties will have little understanding of the situation they find themselves in, leading to uncertainty in what actions to take. This will result in very difficult circumstances within which first responders must operate. However, the importance of human behaviour appears to be a fundamental element being missed in the preparation, training and planning assumptions being made by emergency services and planners in preparation for these events.

This paper looks to understand the scope of this omission by reviewing relevant literature on the subject and engaging with Fire and Rescue Service personnel and managers in the UK. This study utilised semi-structured interviews with 10 Fire and Rescue Service Mass Decontamination Operatives, four Fire and Rescue Service Hazardous Material Advisers and three Fire and Rescue Service Strategic Officers participating. These interviews were then analysed using a thematic framework to identified key themes from the research which were then validated using two independent researchers to provide an inter-rater reliability measure. Finally, a follow-up validation questionnaire was also developed to test the validity of the themes identified and this was completed by another with 36 Fire and Rescue Service Mass Decontamination Operatives.

Both the literature review and interviews undertaken with emergency responders and mangers demonstrated the crucial importance of accounting for behavioural aspects in these situations especially in regards to the likely levels of compliance to be expected by responders and the potential problem of casualties not remaining at the scene of an incident to undergo decontamination.

This research identifies a number of key themes so far not recognized through any other research and in doing so offers insights into potential flaws in the UK Fire and Rescue Service response planning for CBRN/Hazmat incidents requiring mass decontamination. It is intended that this research will inform further study into the areas identified in order to ensure gaps in planning, training and strategies for mass decontamination operations can be more fully informed and if required allow for a more effective response.

There is an assumption in emergency planning that the public will “panic” or refuse to comply in the event of mass decontamination. This assumption has serious implications for how the public will be managed. The paper aims to discuss these issues.

The authors carried out semi-structured interviews with 13 emergency responders, six of whom had experience of incidents involving decontamination. The authors asked them, first, about their experiences of these events and, second, about their expectations for decontamination involving a large crowd. The aim was to explore the extent to which responders perceived non-compliance and anxiety as (crowd) problems during decontamination, and if so, how they felt that they could be addressed.

Responders with experience of decontamination perceived non-compliance and excessive anxiety to be rare, and suggested that orderly behaviour was more common. However, the majority of emergency responders with no experience of decontamination said they expected panic and non-compliance. They therefore emphasised the importance of “controlling”, rather than communicating with, the public.

The authors argue that “control”-based emergency management strategies can impact negatively on the relationship between the public and responders, and hence hinder effective management of an incident. It would therefore be beneficial to provide training for emergency responders on likely public behaviour during incidents involving decontamination.

This research extends previous research by facilitating a detailed understanding of emergency responders’ experiences and perceptions of managing incidents involving decontamination, and showing how these experiences and perceptions can affect the way in which such incidents are managed.

Reports from small‐scale incidents in which decontamination was conducted suggest that a successful communication strategy is vital in order to increase public compliance with, and reduce public anxiety about, decontamination. However, it has not been possible to examine public behaviour during large scale incidents involving decontamination. The aim of the research reported here was to examine the relationship between people's positive perceptions of responding agencies’ communication strategies and relevant outcome variables, such as level of compliance and level of reassurance, in several field exercises involving mass decontamination.

Data were collected using feedback questionnaires completed by simulated casualties, which contained items relating to casualties’ perceptions of the success of responding agencies’ communication strategies, their confidence in emergency responders, and their compliance with the decontamination process. Path analysis was used to examine the relationships between variables.

Results show a significant relationship between responding agencies’ communication strategies, level of public reassurance, and level of public compliance. The relationship between responders’ communication strategies and the outcome variables was partially mediated by public confidence in responders.

Emergency responders should focus on communication with members of the public as a key element of the decontamination process, as failure to do so could result in high levels of anxiety and low levels of compliance among those who are affected.

This research highlights the importance of effective responder communication strategies. Further, findings indicate the value of examining feedback from field exercises in order to facilitate a greater understanding of public experiences of the decontamination process.

The purpose of this paper is to systematically review published literature for the research question “what issues are considered (and changes made) for vulnerable groups as part of the chemical, biological, radiological, nuclear or explosive (CBRNe) response for casualty collection, decontamination, triage and casualty clearing processes?”.

Seven-stage framework from the PRISMA statement for research question, eligibility (definition), search, identification of relevant papers from title and abstract, selection and retrieval of papers, appraisal and synthesis. Data sources: Medline, Embase, Cochrane Library, Web of Science, Scopus (Elsevier), Chemical Abstracts, Assia (Proquest), Sociological abstracts (Proquest), Cinahl, HMIC, Health business elite, PsycInfo (ebsco), PILOTS (Proquest) and supplemented by other search strategies (e.g. exploding reference lists). The included references were critically appraised using the mixed methods appraisal tool (MMAT).

Results: 1,855 papers were returned from the literature search, of which 221 were screened by abstract and 48 by full paper. In total, 11 papers were included for appraisal, of which three achieved a quality score of 50 per cent or over. The papers were categorised into three phases on CBRNe response; evacuation, triage and decontamination.

The limitations of the search process included the use of emerging exclusion criteria. This may have excluded research that would provide more information in some topic areas but it was felt necessary to set a high publication standard for inclusion to generate trustworthy results and recommendations. The MMAT appraisal tool has been validated for different study types and provided a useful categorisation approach for critical appraisal, albeit resulting in only three included studies. Future reviews could include papers published in a wider range of languages to include research from non-English sources.

These evidence-based results should be used by practitioners to review current operational policies for vulnerable people and plan future improvements. Evacuation accessibility can be described as characteristics for exit, route and obstacles. This takes a systems approach to consider how building planning and layout can have implications for safety critical but low frequency events. Decontamination recommendations include: at least one additional re-robe section per mass decontamination unit and adaptations to the decontamination plan including accessible equipment for non-ambulatory individuals; and additional (specialist) staff in the decontamination team (sign language, interpreters and physical therapists).

Although very little new medium/high quality research is available, the findings are summarised as considerations for building design (route choice and information), communication (including vision, hearing and language differences) and the composition of the response team. It is suggested that evidence-based practice from other care domains could be considered (patient movement and handling) for fire service and ambulance guidelines.

In the USA, terrorist threats captured government attention following 11 September 2001. Cities remain the most likely setting for terrorist incidents. Many cities, building on a successful federal program begun in 1997, have developed metropolitan medical response systems (MMRS) to address the consequences of terrorist incidents. The basic system design has been tested both through drills and incidents – including the attacks on the World Trade Center – and appears to function well. This paper describes the philosophy and elements of the MMRS model. The model has considerable value as a readily exportable strategy for responding to municipal terrorist incidents.

In the event of a hazardous chemical release incident in the UK, affected members of the public would undergo improvised and interim forms of decontamination (the “Initial Operational Response” (IOR)). To enable members of the public to take recommended actions quickly, the Home Office and National Chemical, Biological, Radiological and Nuclear Centre have developed the “Remove, Remove, Remove” pre-incident information campaign. This is designed to raise awareness amongst a broad range of people with a public safety role, as well as members of the general public. The paper aims to discuss these issues.

Public perceptions of the utility of “Remove, Remove, Remove” pre-incident information materials were assessed using focus group discussions and questionnaires.

Perceptions of the “Remove, Remove, Remove” campaign poster were generally positive, and the groups agreed that releasing this type of information prior to an incident occurring is a positive step. There was consensus that the poster contains useful information, and that members of the public would benefit from receiving this information prior to a chemical incident occurring.

The findings from this study have been used to inform the development of the “Remove, Remove, Remove” materials. These materials have been disseminated to all emergency services in the UK to further embed IOR principles, as well as to crowd safety professionals.

The purpose of this paper is to develop an EU sociotechnical systems (STSs) map to represent a harmonised concept of operations (CONOPS) as a future development platform for technologies used in multi-services emergency responses to chemical, biological, radiological and nuclear (CBRN) incidents.

AcciMaps were developed to locate where technologies are currently used, and opportunities for new technologies. The AcciMaps were iteratively co-designed with end users (fire, ambulance, police and military) across three EU countries (the UK, Finland and Greece). Data were collected using document analysis and interviews with senior ranking (Gold or Silver Command level) representatives of the participating end users.

Despite differences in terminology and between service sectors, consensus was achieved for the command structures (Gold, Silver and Bronze), and Hot Zone responders (specialist blue light responders and blue light responders (BLR)). A control room was included as the communication spine. BLR activities were limited by their scope of practice and available equipment, for example, breathing apparatus. The harmonised EU AcciMap offers a high-level STSs map of CBRN response. Critical segments have been identified which offer opportunities for technology developments that can add value in terms of response capabilities (e.g. tag and trace).

A large scale major CBRN incident may need cross-border and cross-professional engagement where efficient interoperability is vital. This research is the first EU consensus of a STS map for CONOPS. It supports future research for technology development, e.g., detection and decontamination equipment design and use, communication, diagnosis and response technologies.

Particularly since the 11 September terrorist attacks in the USA, much attention has been given to the development and implementation of incident management systems (IMS). The IMS is a tool for marshalling pre‐identified and pre‐assembled resources to respond to an emergency or disaster. IMS is particularly useful when personnel and resources from many agencies and jurisdictions are required to manage large incidents successfully. While many IMS have been devised over the years, their use remains intermittent. This paper traces the evolution of IMS, reviews how it can be integrated into jurisdictional emergency and disaster management, and specifies the structures that are used in most incident management systems at the municipal level.