CBRNE Training Academy

CBRNE Training Academy

HazardsHazardsHazardsHazards

Lecture GoalsLecture Goals

• Define what a hazard is• Define “all hazards” approach• Describe where hazards exist• Explain hazard recognition

• Define what a hazard is• Define “all hazards” approach• Describe where hazards exist• Explain hazard recognition

What is a hazardous substance?

What is a hazardous substance?

• Any substance . . . – Solid– Liquid– Gas– Other

• Capable of harming . . .– People– Property– Environment

• Any substance . . . – Solid– Liquid– Gas– Other

• Capable of harming . . .– People– Property– Environment

What is a hazardous substance?

What is a hazardous substance?

• Any substance to which exposure– “Results or may result in adverse

affects on the health or safety of employees”

– “Any chemical which is a physical hazard or a health hazard”

• OSHA 29 CFR 1910.1200 (c)

• Bottom line: Adversely affects health or safety (not only chemicals . . .)

• Any substance to which exposure– “Results or may result in adverse

affects on the health or safety of employees”

– “Any chemical which is a physical hazard or a health hazard”

• OSHA 29 CFR 1910.1200 (c)

• Bottom line: Adversely affects health or safety (not only chemicals . . .)

“All Hazards”“All Hazards”

“All Hazards”“All Hazards”

• Knowledge that you have• Applied to unknown situations• Common, standard approach

– Instills confidence– Quells fear– Ensures safety, always

Prepared for the mundane =Prepared for the exotic

• Knowledge that you have• Applied to unknown situations• Common, standard approach

– Instills confidence– Quells fear– Ensures safety, always

Prepared for the mundane =Prepared for the exotic

Hazards = Potential Events

Hazards = Potential Events

• Awareness identifies hazards• “Guns don’t kill people . . .”• Potential depends on scale and

scope– Spill coffee– Spill sarin– Spill oil (tanker)

• Awareness identifies hazards• “Guns don’t kill people . . .”• Potential depends on scale and

scope– Spill coffee– Spill sarin– Spill oil (tanker)

What’s in your hospital?What’s in your hospital?

• Lab• Pharmacy• OR• Building Services• Engineering• Environmental

Services• Bio-med• Central Supply

• Lab• Pharmacy• OR• Building Services• Engineering• Environmental

Services• Bio-med• Central Supply

• Respiratory• Dietary• Radiology• Nuclear Medicine• Oncology• Laundry• EMS• ED• Med Air / O2

• Respiratory• Dietary• Radiology• Nuclear Medicine• Oncology• Laundry• EMS• ED• Med Air / O2

Where do hazards exist?Where do hazards exist?

EVERYWHERE

• Setting is artificial distinction– Familiarity creates false comfort

• Things we know, context we don’t– Medical O2 vs. Industrial O2

• Location doesn’t modify nature*• Awareness recognizes potential

harm

EVERYWHERE

• Setting is artificial distinction– Familiarity creates false comfort

• Things we know, context we don’t– Medical O2 vs. Industrial O2

• Location doesn’t modify nature*• Awareness recognizes potential

harm

All HazardsAll Hazards

• People at risk = hazard• Site independent• Preparation and prevention is the

same• Scale and scope is different• Intent is the confounding factor• Remove intent, left with event

• People at risk = hazard• Site independent• Preparation and prevention is the

same• Scale and scope is different• Intent is the confounding factor• Remove intent, left with event

Specific hazardsSpecific hazards

• Things that are infectious• Things that explode• Things that burn, shock• Things that are corrosive• Things that are radioactive• Things that cause cancer• Things that are poisonous through

other means• “Others”

• Things that are infectious• Things that explode• Things that burn, shock• Things that are corrosive• Things that are radioactive• Things that cause cancer• Things that are poisonous through

other means• “Others”

D.O.T. ClassificationD.O.T. Classification

Specific examplesSpecific examples

• Scale, scope and intent

• Things that are familiar• Things in unfamiliar context• Things with malicious intent

• Scale, scope and intent

• Things that are familiar• Things in unfamiliar context• Things with malicious intent

Flammable liquidsFlammable liquids

• Found in all environments• Often overlooked, ignored as risk• Fire and explosive risk

• Let’s take a look at a familiar example…

• Found in all environments• Often overlooked, ignored as risk• Fire and explosive risk

• Let’s take a look at a familiar example…

Flammable liquidsFlammable liquids

Ethyl alcoholEthyl alcohol

Flammable liquidsFlammable liquids

GasolineGasoline

Flammable liquidsFlammable liquids

All HazardsAll Hazards

• Everything is a potential hazard• Hazards have many faces• Recognize the potential exists• Remove the intent• Prepared and ready

• Everything is a potential hazard• Hazards have many faces• Recognize the potential exists• Remove the intent• Prepared and ready

GasesGases

• Found everywhere in a hospital• Flammable, compressed

– Boiling Liquid Expanding Vapor Explosion (B.L.E.V.E.)

• Some are toxic

• Let’s take a look at another familiar example…

• Found everywhere in a hospital• Flammable, compressed

– Boiling Liquid Expanding Vapor Explosion (B.L.E.V.E.)

• Some are toxic

• Let’s take a look at another familiar example…

Chlorine gasChlorine gas

• Severe pulmonary toxin• Causes delayed lung injury

• Severe pulmonary toxin• Causes delayed lung injury

Normal chest x-rayNormal chest x-ray ARDS chest x-rayARDS chest x-ray

Cl2 +Cl2 + ==

My bathroom January 10, 2005

My bathroom January 10, 2005

HClHCl HOClHOCl++

Cl2Cl2

South Carolina January 6, 2005

South Carolina January 6, 2005

Ypres, Belgium April 22, 1915

Ypres, Belgium April 22, 1915

Other gas examplesOther gas examples

Oxygen & other compressed gasesOxygen & other compressed gases

In a different contextIn a different context

All HazardsAll Hazards

• Everything is a potential hazard• Hazards have many faces• Recognize the potential exists• Remove the intent• Prepared and ready

• Everything is a potential hazard• Hazards have many faces• Recognize the potential exists• Remove the intent• Prepared and ready

OxidizersOxidizers

• Enhance / cause combustion of others

• Cause fire by itself, or by releasing O2

• Involved in reactive processes

• Enhance / cause combustion of others

• Cause fire by itself, or by releasing O2

• Involved in reactive processes

OxidizersOxidizers

Ammonium nitrateAmmonium nitrate

OxidizersOxidizers

Ammonium nitrateAmmonium nitrate

OxidizersOxidizers

All HazardsAll Hazards

• Everything is a potential hazard• Hazards have many faces• Recognize the potential exists• Remove the intent• Prepared and ready

• Everything is a potential hazard• Hazards have many faces• Recognize the potential exists• Remove the intent• Prepared and ready

Toxins or poisonsToxins or poisons

• Vast category, hard to generalize• Found everywhere

– Especially in healthcare– Home– Industry

• Lets take a look at an example from the hospital lab . . .

• Vast category, hard to generalize• Found everywhere

– Especially in healthcare– Home– Industry

• Lets take a look at an example from the hospital lab . . .

Toxins or poisonsToxins or poisons

Toxins or poisonsToxins or poisons

Toxins or poisonsToxins or poisons

All HazardsAll Hazards

• Everything is a potential hazard• Hazards have many faces• Recognize the potential exists• Remove the intent• Prepared and ready

• Everything is a potential hazard• Hazards have many faces• Recognize the potential exists• Remove the intent• Prepared and ready

RadioactivityRadioactivity

• Cause harm through energy• Background radiation and specific

sources – Radiology department– Nuclear medicine– Power plants– Industry

• Lets take a look at an example from the nuclear medicine department . . .

• Cause harm through energy• Background radiation and specific

sources – Radiology department– Nuclear medicine– Power plants– Industry

• Lets take a look at an example from the nuclear medicine department . . .

Internal, External, OtherInternal, External, Other

Internal, External, OtherInternal, External, Other

Internal, External, OtherInternal, External, Other

All HazardsAll Hazards

• Everything is a potential hazard• Hazards have many faces• Recognize the potential exists• Remove the intent• Prepared and ready

• Everything is a potential hazard• Hazards have many faces• Recognize the potential exists• Remove the intent• Prepared and ready

Where can we learn more?Where can we learn more?

• On-scene personnel– Police, Fire, EMS, HazMat, etc.– Industrial Safety officer

• Poison Control Center• Labels• Material Safety Data

Sheets (MSDS)

• Emergency ResponseGuidebook (ERG)

• Agency for Toxic Substance& Disease Registry (ATSDR)

• Internet resources

• On-scene personnel– Police, Fire, EMS, HazMat, etc.– Industrial Safety officer

• Poison Control Center• Labels• Material Safety Data

Sheets (MSDS)

• Emergency ResponseGuidebook (ERG)

• Agency for Toxic Substance& Disease Registry (ATSDR)

• Internet resources

Questions?Questions?