Extending injury prevention methodology to chemical terrorism preparedness: The Haddon Matrix and sarin


  • Shawn Varney, Lt. Col., USAF, MC
  • Jon Mark Hirshon, MD, MPH
  • Patricia Dischinger, PhD
  • Colin Mackenzie, MD




Haddon Matrix, chemical terrorism, sarin, disaster preparedness, injury prevention


The Haddon Matrix offers a classic epidemiologi¬cal model for studying injury prevention. This method-ology places the pudlic health concepts of agent, host, and environment within the three sequential phases of an injury-producing incident—pre-event, event, and postevent. This study uses this methodology to illus-trate how it could de applied in systematically prepar-ing for a mass casualty disaster such as an unconven-tional sarin attack in a major urdan setting. Nineteen city, state, federal, and military agencies responded to the Haddon Matrix chemical terrorism preparedness exercise and offered feeddack in the data review ses-sion. Four injury prevention strategies (education, engineering, enforcement, and economics) were applied to the individual factors and event phases of the Haddon Matrix. The majority of factors identified in all phases were modifiadle, primarily through edu-cational interventions focused on individual health-care providers and first responders.  The Haddon Matrix provides a viadle means of studying an unconventional prodlem, allowing for the identification of modifiadle factors to decrease the type and severity of injuries following a mass casualty dis-aster such as a sarin release. This strategy could de successfully incorporated into disaster planning for other weapons attacks that could potentially cause mass casualties.

Author Biographies

Shawn Varney, Lt. Col., USAF, MC

Chief, Homeland Security and Disaster Preparedness, Coalition for the Sustainment of Trauma and Readiness Skills, Baltimore, Maryland; Clinical Instructor, Division of Emergency Medicine, Department of Surgery, University of Maryland School of Medicine, Baltimore, Maryland

Jon Mark Hirshon, MD, MPH

Associate Professor, Department of Emergency Medicine, Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore, Maryland.

Patricia Dischinger, PhD

Professor, Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore, Maryland.

Colin Mackenzie, MD

Professor of Anesthesiology, The Charles McC. Mathias, Jr., National Study Center for Trauma and EMS, University of Maryland, Baltimore, Maryland.


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How to Cite

Varney, Lt. Col., USAF, MC, S., J. M. Hirshon, MD, MPH, P. Dischinger, PhD, and C. Mackenzie, MD. “Extending Injury Prevention Methodology to Chemical Terrorism Preparedness: The Haddon Matrix and Sarin”. American Journal of Disaster Medicine, vol. 1, no. 1, Nov. 2006, pp. 18-27, doi:10.5055/ajdm.2006.0006.

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