A decision support framework for characterizing and managing dermal exposures to chemicals during Emergency Management and Operations
Keywords:chemicals, decision analysis, dermal, Emergency Management and Operations, risk analysis, Hazards
Emergency Management and Operations (EMO) personnel are in need of resources and tools to assist in understanding the health risks associated with dermal exposures during chemical incidents. This article reviews available resources and presents a conceptual framework for a decision support system (DSS) that assists in characterizing and managing risk during chemical emergencies involving dermal exposures. The framework merges principles of three decision-making techniques: 1) scenario planning, 2) risk analysis, and 3) multicriteria decision analysis (MCDA). This DSS facilitates dynamic decision making during each of the distinct life cycle phases of an emergency incident (ie, preparedness, response, or recovery) and identifies EMO needs. A checklist tool provides key questions intended to guide users through the complexities of conducting a dermal risk assessment. The questions define the scope of the framework for resource identification and application to support decision-making needs. The framework consists of three primary modules: 1) resource compilation, 2) prioritization, and 3) decision. The modules systematically identify, organize, and rank relevant information resources relating to the hazards of dermal exposures to chemicals and risk management strategies. Each module is subdivided into critical elements designed to further delineate the resources based on relevant incident phase and type of information. The DSS framework provides a much needed structure based on contemporary decision analysis principles for 1) documenting key questions for EMO problem formulation and 2) a method for systematically organizing, screening, and prioritizing information resources on dermal hazards, exposures, risk characterization, and management.
Federal Emergency Management Agency (FEMA): The National Incident Management System (NIMS). Washington, DC: US Depart-
ment of Homeland Security/FEMA, 2008. Available at http://www.fema.gov/national-incident-management-system. Accessed June 9, 2014.
National Library of Medicine (NLM): Wireless Information System for Emergency Responders (WISER). Bethesada, MD: US National Institue for Health (US NIH)/NLM, 2014. Available at http://wiser.nlm.nih.gov/. Accessed June 9, 2014.
NLM: Chemical Hazards Emergency Medical Management (CHEMM). Bethesada, MD: US NIH/NLM, 2014. Available at http://chemm.nlm.nih.gov/. Accessed June 9, 2014.
Dotson GS, Chen CP, Gadagbui B, et al.: The evolution of skin notations for occupaitonal risk assessment: A new NIOSH strategy. Regul Toxicol Pharmacol. 2011; 61: 53-62.
Kales SN, Christiani DC: Acute chemical emergencies. N Engl J Med. 2004; 350: 800-808.
Agency for Toxic Susbtance and Disease Registry (ATSDR): National Toxic Substance Incidents Program (NTSIP) Annual Report—2010. Atlanta, GA: Centers for Disease Control and Prevention (CDC)/ATSDR, 2010. Available at http://www.atsdr.cdc.gov/ntsip/docs/ATSDR_Annual%20Report_031413_FINAL.pdf. Accessed June 9, 2014.
European Union (EU): Regulation (EC) No. 1272/2008 of the European Parliament and of the Council of 16 December 2008 on Classification, Labeling and Packaging of Substances and Mixtures, Amending and Repealing Directives 67/548/EEC and 1999/45/EC, and Amending Regulation (EC) No. 1907/2006. Off J Eur Union. 2008; L353: 1-1355.
Kelsey K, Roisman R, Kreutzer R, et al.: Chlorine gas exposure at a metal recycling facility—California (2010). MMWR. 2011; 60: 951-954.
Laitinen J, Mäkelä M, Mikkola J, et al.: Firefighters’ multiple exposure assessments in practice. Toxicol Lett. 2012; 213: 129-133.
Occupational Safety and Health Administration (OSHA): Dermal Eexposures. Washington, DC: Departmetn of Labor/OSHA, 2008. Available at https://www.osha.gov/SLTC/dermalexposure/index.html. Accessed June 9, 2014.
Occupational Safety and Health Administration (OSHA): Chemical protective clothing. In OSHA Technical Manual Section VIII. Washington, DC: US Department of Labor/OSHA, 1999: chap 1. Available at https://www.osha.gov/dts/osta/otm/otm_viii/otm_viii_1.html. Accessed June 9, 2014.
National Institute for Occupational Safety and Health (NIOSH): Recommendations for Chemical Protective Clothing Database. Cincinnati, OH: CDC/NIOSH, 1999. Available at http://www.cdc.gov/niosh/ncpcl/wcpc.html/. Accessed June 9, 2014.
NIOSH: The Emergency Response Safety and Health Database. Cincinnati, OH: CDC/NIOSH, 2012. Available at http://www.cdc.gov/niosh/ershdb/. Accessed June 9, 2014.
US Department of Transportation (USDOT): 2012 Emergency Response Guidebook - A Guidebook for First Responders During the Initial Phase of a Dangerous Goods/Hazardous Materials Transportation Incident. Washington, DC: USDOT, 2012. Available at http://phmsa.dot.gov/staticfiles/PHMSA/DownloadableFiles/Files/Hazmat/ERG2012.pdf. Accessed June 9, 2014.
US Department of Homeland Security (DHS): Summary—Symposium on Chemical Decontamination of Humans. Washington, DC: US DHS, 2010. Available at http://www.phe.gov/Preparedness/mcm/Documents/summary-chemdecon-20June12.pdf. Accessed June 9, 2014.
Semple S: Dermal exposure to chemicals in the workplace: Just how important is skin absorption? Occup Environ Med. 2004; 61: 376-382.
Wallace WA, DeBalogh F: Decision support systems for disaster management. Public Admin Rev. 1985; 45: 134-146.
Frysinger SP, Deaton ML, Gonzalo AG, et al.: The FALCON decision support system: Preparing communities for weapons of opportunity. Environ Model Softw. 2007; 22: 431-435.
Brown DF, Dunn WE: Application of a quantitative risk assessment method to emergency response planning. Comput Oper Res. 2007; 34(5): 1243-1265.
Peng Y, Zhong Z, Tang Y, et al.: An incident information management framework based on data integration, data mining and multicriteria decision making. Decis Support Syst. 2011; 51: 316-327.
National Academy of Science (NAS): Science and Decisions: Advancing Risk Assessment. Washington, DC: The National Academies Press, 2009. ISBN: 978-0-309-12046-3.
Chermack TJ: Improving decision-making with scenario planning. Futures. 2004; 36: 295-309.
Durbach I, Stewart TJ: Integrating scenario planning and goal programming. J Multi-Crit Decis Anal. 2003; 12: 261-271.
Lv Y, Huang GH, Guo L, et al.: A scenario-based modeling approach for emergency evacuation management and risk analysis under multiple uncertainties. J Hazard Mater. 2013; 246-247: 234-244.
National Institute for Occupational Safety and Health (NIOSH): NIOSH Pocket Guide to Chemical Hazards. Department of Health and Human Services, Centers for Disease Control, NIOSH. DHHS (NIOSH) Publication No. 2005-149. Cincinnati, OH: National Institute for Occupational Safety and Health, 2005.
DOL/OSHA: OSHA Occupational Chemical Database. Washington, DC: United States Department of Labor, 2013. Available at https://www.osha.gov/chemicaldata/. Accessed: March 13, 2014.
European Commission (EC): EINICS (European Inventory of Existing Commercial Chemical Substances). Brussels, Belgium: EC, 2013. Available at http://esis.jrc.ec.europa.eu/. Accessed March 13, 2014.
NIH, NLM Wireless Information System for Emergency Response (WISER): Known Substance List. Bethesda, MD: NIH/NLM. Available at http://webwiser.nlm.nih.gov/knownSubstanceSearch.do. Accessed March 13, 2014.
American Conference of Governmental Industrial Hygienists (ACGIH): Sulfuric acid. In Documentation of Threshold Limit Values and Biological Exposure Indices. Vol 1. 7th ed. Cincinnati, OH: American Conference of Governmental Industrial Hygienists, 2004.
ATSDR: Public Health Statement for Sulfur Trioxide and Sulfuric Acid. 2011. Available at http://www.atsdr.cdc.gov/phs/phs.asp?id=254&tid=47. Accessed March 13, 2014.
American Conference of Governmental Industrial Hygienists (ACGIH): Benzene. In Documentation of Threshold Limit Values and Biological Exposure Indices. Vol. 1. 7th ed. Cincinnati, OH: American Conference of Governmental Industrial Hygienists, 2001.
ATSDR: Toxicological Profile for Benzene. Atlanta, GA: CDC/ ATSDR, 2007. Available at http://www.atsdr.cdc.gov/toxprofiles/tp3.pdf. Accessed June 9, 2014.
NIH, NLM: Toxicology Data Network, Hazardous Substance Data Bank. Bethesda, MD: NIH/NLM, 2010. Available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?HSDB. Accessed March 13, 2014.
Colormetric Laboratories, Inc.: Skin SWYPEs. Available at http://www.clilabs.com/index.php?option=com_content&view=article&id=9&Itemid=9. Accessed March 13, 2014.
Forsberg K, Mansdorf SZ: Quick Selection Guide to Chemical Protective Clothing. 5th ed. New Jersey: John Wiley & Sons, Inc., 2007.
Liu Y, Fan ZP, Zhang Y: Risk decision analysis in emergency response: A method based on cumulative prospect theory. Comput Oper Res. 2014; 42: 75-82.
Zografos KG, Vasilakis GM, Giannouli IM: Methodological framework for developing decision support systems (DSS) for hazardous materials emergency response operations. J Hazard Mater. 2000; 71: 503-521.
Linkov I, Satterstrom FK, Kiker G, et al.: From comparative risk assessment to multi-criteria decision analysis and adaptive management: Recent developments and applications. Environ Sci Technol. 2006; 32: 1072-1093.
Stewart TJ, French S, Rios J: Integrating multicriteria decision analysis and scenario planning: Review and extension. Omega. 2013; 41: 679-688.
Huang I, Keisler J, Linkov I: Multi-criteria decision analysis in environmental sciences: Ten years of applications and trends. Sci Total Environ. 2011; 409: 3578-3594.
Linkov I, Welle P, Loney D, et al.: Use of multicriteria decision analysis to support weight of evidence evaluation. Risk Anal. 2011; 31: 1211-1225.
Yokota F, Thompson K: Value of information literature analysis: A review of applications in health risk management. Med Decis Making. 2004; 24: 287-298.
Forsberg K, Mansdorf SZ (eds.): Quick Selection Guide to Chemical Protective Clothing. 4th ed. New Jersey: John Wiley & Sons, Inc., 2005 44. Frey JH, Fontana A: The group interview in social research. Soc Sci J. 1991; 28: 175-187.
Lurie N, Manolio T, Patterson A, et al.: Research as a part of public health emergency response. New Engl J Med. 2013; 368: 1251-1255.
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