Hazmat disaster preparedness in Hong Kong: What are the hazardous materials on Lantau, Lamma, and Hong Kong Islands?

Authors

  • Frank G. Walter, MD, FACEP, FACMT, FAACT
  • Jimmy Tak-shing Chan, MB BS (HKU), FRCSEd, FCSHK, FHKAM (Surgery), FHKCEM, FHKAM (Emergency Medicine)
  • Billie Winegard, MPH
  • Peter B. Chase, MD, PhD, FACEP
  • Farshad (Mazda) Shirazi, MS, MD, PhD, FACEP
  • Yuk-yin Chow, MB BS (HKU), FRCSEd, FRACS (Orthopedics), FHKCOS, FHKAM (Orthopedic Surgery)
  • Melanie de Boer, PhD
  • Kurt Denninghoff, MD

DOI:

https://doi.org/10.5055/ajdm.2008.0028

Keywords:

disaster planning, hazardous substances, epidemiology, toxicology, emergency medicine

Abstract

Objective: Hazmat disaster preparedness is critical, especially as Hong Kong prepares for major international events, such as the 2008 Olympic Equestrian Games. No published medical study describes the identities and quantities of hazardous materials (HMs) in Hong Kong and lists what antidotes are needed for these dangerous goods (DGs). This study describes what HMs are most common in Hong Kong to prioritize disaster preparedness and training.
Design: A descriptive, cross-sectional study.
Setting: The Hong Kong Special Administrative Region, specifically Lantau, Lamma, and Hong Kong Islands.
Sample: The Hong Kong Fire Services Department (HKFSD) Dangerous Goods Database (DGD).
Interventions: Descriptive statistical analyses with Stata 9.2.
Main Outcome Measures: Identifying and quantifying HMs in the HKFSD DGD.
Results: Most HMs do not have antidotes. The most common HMs with recognized antidotes are carbon monoxide, methylene chloride, fluorides, cyanides, nitriles, hydrazine, methanol, and nitrates. The most common categories of DGs are substances giving off inflammable vapors, compressed gases, and corrosive and poisonous substances.
Conclusions: Hazmat disaster preparedness and training should emphasize these most common categories of DGs. Disaster planning should ensure adequate antidotes for HMs with recognized antidotes, ie, oxygen for carbon monoxide and methylene chloride; calcium gluconate and calcium chloride for fluorides; hydroxocobalamin or amyl nitrite, sodium nitrite, and sodium thiosulfate for cyanides and nitriles; pyridoxine for hydrazine; fomepizole or ethanol for methanol; and methylene blue for methemoglobinemia produced by nitrates. Supportive care is essential for patients exposed to HMs because most DGs do not have antidotes.

Author Biographies

Frank G. Walter, MD, FACEP, FACMT, FAACT

Medical Director for the Bureau of Emergency Preparedness and Response, Arizona Department of Health Services; Chief of the Division of Medical Toxicology and Associate Professor of Emergency Medicine, Department of Emergency Medicine; Editor of Advanced Hazmat Life Support (AHLS), Arizona Emergency Medicine Research Center, University of Arizona College of Medicine; Director of Clinical Toxicology for University Medical Center, Tucson, Arizona.

Jimmy Tak-shing Chan, MB BS (HKU), FRCSEd, FCSHK, FHKAM (Surgery), FHKCEM, FHKAM (Emergency Medicine)

Honorary Clinical Associate Professor, Accident and Emergency Medicine Academic Unit, Faculty of Medicine of the Chinese University of Hong Kong; Advanced Hazmat Life Support (AHLS) Regional Director for Hong Kong; Chief of Service for Accident and Emergency Medicine, Alice Ho Miu Ling Nethersole Hospital; Cluster Coordinator for Accident and Emergency Medicine, Service Director for Conflict and Catastrophe Medicine, New Territories East Cluster, Hong Kong Hospital Authority, Tai Po, New Territories, Hong Kong, China.

Billie Winegard, MPH

Research Specialist, Division of Research, Department of Emergency Medicine, Arizona Emergency Medicine Research Center, University of Arizona College of Medicine, Tucson, Arizona.

Peter B. Chase, MD, PhD, FACEP

Director of the Medical Toxicology Residency, Section of Medical Toxicology; Assistant Professor of Clinical Emergency Medicine, Department of Emergency Medicine, Arizona Emergency Medicine Research Center, University of Arizona College of Medicine, Tucson, Arizona.

Farshad (Mazda) Shirazi, MS, MD, PhD, FACEP

Director of Student and Resident Education, Section of Medical Toxicology; Assistant Professor of Clinical Emergency Medicine, Department of Emergency Medicine, Arizona Emergency Medicine Research Center; Assistant Professor of Pharmacology in the Department of Medical Pharmacology, University of Arizona College of Medicine, Tucson, Arizona.

Yuk-yin Chow, MB BS (HKU), FRCSEd, FRACS (Orthopedics), FHKCOS, FHKAM (Orthopedic Surgery)

Honorary Clinical Associate Professor, Department of Orthopedics and Traumatology, Faculty of Medicine of the Chinese University of Hong Kong; Chief of Service for the Department of Orthopedics and Traumatology, Tuen Mun Hospital, Hong Kong Hospital Authority, Tuen Mun, New Territories, Hong Kong, China.

Melanie de Boer, PhD

Director of the Prevention Research Focus Unit & Research Associate Professor in the Department of Emergency Medicine, Arizona Emergency Medicine Research Center, University of Arizona College of Medicine; University of Arizona, Mel and Enid Zuckerman College of Public Health, Tucson, Arizona.

Kurt Denninghoff, MD

Associate Department Head for Research & Professor of Emergency Medicine, Department of Emergency Medicine; Medical Director for the Arizona Emergency Medicine Research Center, University of Arizona College of Medicine; Professor of Optical Sciences, University of Arizona College of Optical Sciences, Tucson, Arizona.

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Published

07/01/2008

How to Cite

Walter, MD, FACEP, FACMT, FAACT, F. G., J. T.- shing Chan, MB BS (HKU), FRCSEd, FCSHK, FHKAM (Surgery), FHKCEM, FHKAM (Emergency Medicine), B. Winegard, MPH, P. B. Chase, MD, PhD, FACEP, F. (Mazda) Shirazi, MS, MD, PhD, FACEP, Y.- yin Chow, MB BS (HKU), FRCSEd, FRACS (Orthopedics), FHKCOS, FHKAM (Orthopedic Surgery), M. de Boer, PhD, and K. Denninghoff, MD. “Hazmat Disaster Preparedness in Hong Kong: What Are the Hazardous Materials on Lantau, Lamma, and Hong Kong Islands?”. American Journal of Disaster Medicine, vol. 3, no. 4, July 2008, pp. 213-3, doi:10.5055/ajdm.2008.0028.

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