Secondary Contamination

Secondary contamination is the transfer of the contaminate by personnel exposed to the original source. This may occur by fluid or vapor exposure particularly with nerve agents or those which are persistent such as VX.

The following resources which may be helpful are:

  • "Weapons of mass destruction events with contaminated casualties: effective planning for health care facilities." Macintyre, et al. JAMA 2000:283(2);242-249.
  • "Health care facility preparation for weapons of mass destruction." Bradley RN. Prehosp Emerg Care 2000;4(3):261-269.
  • "Safety and Health Programs." OSHA, Code of Federal Regulations: 29CFR1910.120, Section b; US Government Printing Office.
  • "OSHA standards interpretation and compliance letters." OSHA 1992, March 31.
  • Hospitals and community emergency response: What you need to know." OSHA 1997, Report No. 3152; US Government Printing Office
  • "OSHA standards interpretation and compliance letters: Emergency response training necessary for hospital physicians/nurses that may treat contaminated patients." OSHA, Code of Federal Regulations: 29CFR1910.120; US Government Printing Office.
  • "Emergency response to hazardous substance releases." OSHA, Code of Federal Regulations: 29CFR1910.120, Paragraph q; US Government Printing Office.
  • "Personal Protective Equipment." OSHA, Code of Federal Regulations: 29CFR1910.132; US Government Printing Office

Generally it is recommended that in an unknown substance environment level A protection should be initially used until additional information is obtained as to the substance PPE requirements, as well as oxygen and carbon monoxide levels are ascertained. However it is important to keep in mind that this level requires training and skills not commonly seen by physician and nursing staff or some first responder personnel. There are anecdotal reports of successful use of PAPR’s with vapor types of exposure including riot and tear gas agents however additional research is needed in these areas for clarification of guidelines and use.

For many nuclear, radiological and biological agents standard field personal protective equipment is often sufficient. This would include a gown or splash resistant garment, rubber or latex gloves, eye splash protection and a mask such as the N 95 TB mask currently found in many hospital settings. Filtration down to 0.3 microns is important for biological agents. Level A should be likely used in the hot zone when the agent is not known or until identified. Warm zone activities such as decontamination or triage, level B or even C, can be considered depending on the agent and its’ physical characteristics and effects. The cold zone is where the transportation sector is generally placed and this area is after decontamination so standard work garments which include blood and body fluid precautions can be considered depending on the particular situation and incident.

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