Q: You previously discussed decontamination residue becoming an environmental issue after the decon Does this not lead to the delay in decon starting while waiting to establish holding tanks, etc. for the runoff?”
A: Decontamination should be started as soon as feasible, preferably by the first response elements on scene regardless of whether they have advanced hazmat experience. The removal of outer layers of clothing and the use of an absorbent material to blot any residual material is time critical. Targeted cleaning of areas where irritation occurs can be performed as a follow up when more assets arrive unless pain is evident, then water should be applied as soon as feasible.
In the United States, the U.S. Environmental Protection Agency (EPA) issued a statement in 2000 generally allowing responders to prioritize actions to save human lives and protect health. After imminent threats are addressed, responders should immediately take all reasonable steps to contain contamination (including decontamination runoff) and mitigate environmental consequences.
Q: Can applying decon to the outer layer of clothing / PPE push contaminates through the layer quicker as it does with applying it to the skin (i.e. organophospates)?
A: If you are wearing NFPA-certified PPE, decontamination should not be an issue for pushing contaminants through the suit towards skin as the seams, interfaces, and closures are challenged during the certification process to ensure safety. Certified ensembles are challenged with a variety of tests, one of which is the “shower test”. In this test, water treated with a surfactant is sprayed at a high pressure towards the suit from multiple directions. Certified ensembles must pass this continuous challenge for 60 minutes (NFPA 1991), 20 minutes (NFPA 1994 Class 1 and 2), 8 minutes (NFPA 1994 Class 3), or 4 minutes (NFPA 1994 Class 4). This ensures that they are suitable for liquid splashes from multiple directions as well as decontamination processes.
However, many non-certified garments have seams, interfaces, and closures that would make it dangerous to try and decontaminate. In this case, you might need to carefully cut the operator out of the garment. To do this, the areas where cut lines are going to be made should be carefully blotted to minimize any residual contaminant from finding its way into the cut lines.
Q: When comparing 90 seconds of wet decon to blotting, what do you think is the average time involved in blotting and getting the patient into higher medical care?
A: With the blotting process, there is no set up required so you save a considerable amount of time just in that process. By reducing the number of people requiring decontamination by 80%, the demand on emergency responder resources is reduced by 63%. The spot washing, if required, can take just as long as the wet decon process as you are focusing on a specific area requiring individualized attention but it would be focused on the few people requiring it.
Thankfully, in a mass decontamination context, the likelihood of “liquid splash” is very low, therefore removal of the outer layer of clothing will be the >90% solution.
Q: How important is neutralization of a chemical agent using a decontaminate on the outer layer of clothing? What is known about by products that can be produced when using a decontaminates to neutralize a chemical agent? Can they be as hazardous as the agent itself?
A: The neutralization of threat materials on the outside layer of protective clothing is critical to ensure that the potential source for secondary contamination during the doffing process is reduced to as low as possible. For standard neutralization agents like hypochlorite, peroxide, peracetic acid, etc., the degradation products have been characterized, but they are often not quantified.
Using the A-series agents as an example as they are not as widely characterized as most other materials…In this case, raising the pH of the decontamination solution can increase the speed of hydrolysis, however hydrolysis will also cause the production of hydrogen fluoride, hydrogen chloride, hydrogen cyanide, and downstream oximes. While these are far less toxic than the original A-series agent, they are much more volatile and therefore could become more problematic as they move freely while the original A-series agent would have very low volatility. Another potential issue is with the use of bleach or dry bleach powders that tend to produce toxic metabolites which may be nerve agents on their own. Again, they might not be as toxic, but now they might have a higher vapor pressure making them a cause for concern.
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