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Chemical, biological, radiological and nuclear insecurity
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Chemical, biological, radiological and nuclear insecurity

Last update: 2022-06-08

Key facts

Events may be acute or chronic, from a known or unknown source, localized or widespread. An event may be airborne, waterborne, foodborne or transmitted through contaminated soil.

Main health impacts

Health concern Risk factors
Health effects are specific to the agent, dose and route of exposure. The agent may be an irritant or may have specific toxicity. It can contaminate the skin and eyes or be inhaled or ingested. The main causes of mortality are poisoning leading to organ failure, asphyxia or neurological collapse.
  • Contaminated water and food. 
  • Displacement of affected populations, especially if prolonged. 
  • Inadequate or crowded shelter. 
  • Armed conflicts. 
  • Damaged nuclear power plants. 

Priority actions for teams with community and public health response capacity

Immediate steps
  • Assess environmental and health risk factors.
  • Provide first aid and ensure ambulance transport for injured survivors.
  • Identify and support authorities to manage possible sources of toxic contamination.
  • Define affected zones and forecast of new zones potentially affected (weather/wind patterns, downstream rivers, food chain).
  • Define health risks, health impact and capacity of local health infrastructure to cope.
  • Transport people away from zone of contamination and provide first aid after displacement.
  • Decontaminate victims (where appropriate).
Surveillance 
  • Assess existing surveillance mechanisms (if any). Determine, if there is a need, the extent to which the National Red Cross Red Crescent Society could feasibly support community-based surveillance efforts. If necessary, set up a community-based surveillance system.
  • Activate disease early warning systems.
  • Follow up exposed cases and refer to a health centre, if needed.
  • Look out for new exposures in the community and investigate sources of contamination.
Community-based action and social mobilization
  • Implement Risk Communication and Community Engagement (RCCE) focusing on prevention of exposure through contaminated water and airborne transmission.
  • Move at risk populations to “safe zones”.
  • Support in restoring family links.
  • Assure convenient clothing and accommodation facilities for people forced to move.
  • Social mobilization for emergency vaccination campaigns as needed.
  • Identification in the community of cases of high-risk diseases (see list of disease tools below) and referral to pre-identified health structures. This requires a prior elaboration of a referral pathway, that is, mapping of existing primary health facilities, and assessment of minimum quality care standards and accessibility (including geographic and cost related barriers).
  • Ensure procedures are in place to safely manage human and animal corpses.
  • Ensure access to Mental Health and Psychosocial Support (MHPSS) services for community members and staff/volunteers which may include (but are not limited to): regularly assessing MHPSS needs; providing information on the situation regularly in cooperation with authorities; training volunteers for the provision of psychosocial support (PSS); using mobile teams providing a range of support; embedding PSS into evacuation centre/shelter  facilities; providing special support to vulnerable groups; working closely with authorities in family tracing; coordinating points for further care.
For teams with additional clinical capacity

Please always refer to the appropriate local or international guidelines for clinical management.

List of important primary health care interventions
  • Ensure a functioning system of triage, treatment and ambulance transport for exposed people with referral to secondary level of care for severe cases.
  • Care for psychological trauma.
  • Support continuity of main service delivery including maternal and child services.
  • If disrupted, advocate and/or support authorities to ensure access to services and medication for patients with noncommunicable diseases (NCD) and who require palliative care.
  • Care of minor wounds and skin infections. Tetanus vaccination, if appropriate.
  • If necessary, administer iodine tablets during nuclear disasters in accordance with health authorities’ regulations.