Assessing and Improving Bioterrorism Preparedness among First Responders: A Pilot Study

Article excerpt


During the October 2001 anthrax attacks, it became evident that the United States lacked an effective preparedness protocol for biological threats. Effective protocols should indicate the proper way of dealing with both exposed and sick populations. A variety of first responders, ranging from law enforcement to emergency medical technicians (EMTs), must have up-to-date training in exposure assessment and protection from biological agents (Waeckerle et al., 2001). The Centers for Disease Control and Prevention (CDC), state health departments, and county and local departments have begun to initiate awareness and preventive measures for issues such as influenza, smallpox, and toxic chemicals. As part of bioterrorism-and-all-hazards-public-health-preparedness plans, other agencies and organizations have started forming collaborative groups to prepare communities to protect themselves. Partnerships with community agencies such as local law enforcement, social services, senior services, mental health services, and other agencies were made to better manage the public and successfully operate a mass clinic.

Protection of the respiratory system has become of growing importance. Events such as SARS, the anthrax attacks, the Tokyo subway attacks, and September 11 have increased the need for proper respiratory protection (Seto et al., 2003). Biological agents such as smallpox, plague, and SARS, which may be used in a terrorist attack, can be dispersed as mists via aerosol (Karwa, Currie, & Kvetan, 2005). Respiratory facemasks are an effective means of protecting against exposure to contaminants in that form. These masks give first responders a first line of defense for their respiratory health while they are on the job providing emergency medical services to someone who may be contagious or are working in an area in which the air is contaminated with particulates.

Hunterdon County, New Jersey, established its Respiratory Protection Program (RPP) in April 2004, developing its protocol using the OSHA Respiratory Protection Program as a model. All Hunterdon County public health employees were required to go through a medical-qualification process and fit-testing, with annual reassessment in accordance with OSHA standard 29 CFR 1910.134 regarding respiratory protection.

N-100 respirators are one of nine types of disposable particulate respirators that are available (Yassi et al., 2005). Hunterdon County provides N-100 respirator masks for all Health Department, Prosecutor's Office, and Public Health Nursing and Education staff. These respirators were chosen for use for several reasons: N-100 respirator masks have been approved by NIOSH as providing at least 99.7 percent filtration efficiency against solid and liquid aerosols that do not contain oil (3M Occupational Health and Environmental Safety Division, 2004), and they are protective against biological agents, whether manmade or naturally occurring, that can take the form of aerosols, mists, or fumes (Lange, 2003; Martyny, Glazer, & Newman, 2002). On the basis of reports from the manufacturer of Model 8233 N-100 respirators, it has been determined that use of these masks is a preventive measure, in that the masks reduce exposure to biological agents (3M Occupational Health and Environmental Safety Division, 2004).

The purpose of the study reported here was to provide training and education on the importance of respiratory protection, via N-100 respiratory-protective face masks, in the event of a chemical or biological communicable event; on implementation of an RPP; and on proper fit-testing for usage safety. The program was divided into three phases designed to include three first-responder target populations: Phase I (rescue squads), Phase II (police departments), and Phase III (fire companies). This article focuses on Phase I. The results of the study will be used in the preparation and protection of county rescue squads, fire companies, and police squads to ensure prompt response to disaster and emergency situations. …