Hazardous materials events: Evaluation of transport to health care facility and evacuation decisions

The study objective was to analyze hazardous materials event and victim fac tors associated with transportation of victims to a health care facility, a nd evacuation or shelter-in-place of nearby populations. A retrospective re view was conducted on hazardous materials events in Washington State from 1 993 to 1997. Bivariate and multiple logistic regression were used to identi fy risk factors for transportation, evacuation, and shelter-in-place. Over five years, 2,654 victims from 457 events were reported, with 1,859 (70%) t ransported to a health care facility. Evacuation occurred in 279 (61%) even ts and shelter-in-place in 14(3%) events. After excluding 14 deaths, regres sion analysis indicated that victims with trauma (OR 5.87, 95% CI 1.41-24.5 ), thermal burns (6.90, 1.15-41.3), dizziness/other CNS symptoms (1.59, 1.0 0-2.54), and headache (1.54, 1.01-2.35) were most likely to be transported. Chemical releases inside buildings (2.09, 1.06-4.10, compared with transpo rtation events), and involving 3-5 victims (2.86, 1.54-5.31, compared to 1 victim) or greater than or equal to6 victims (8.74, 4.01-19.0), were most l ikely to involve evacuation or shelter-in-place. Events involving sulfuric acid (0.15, 0.05-0.49) and sodium hydroxide (0.19, 0.04-0.94) were least li kely to involve evacuation or shelter-in-place. Prehospital decisions to tr ansport victims to a health care facility and evacuate or shelter-in-place nearby populations are associated with event and victim factors, Further re search is needed to determine if these factors also predict need for medica l care or removal from exposure, and to develop evidence-based prehospital care protocols for hazardous materials exposure victims. Copyright (C) 2001 by W.B. Saunders Company.