Are Dutch Hospitals Prepared for Chemical, Biological, or Radionuclear Incidents? A Survey Study

Prehosp Disaster Med. 2017 Oct;32(5):483-491. doi: 10.1017/S1049023X17006513. Epub 2017 May 8.


Introduction Being one of Europe's most densely populated countries, and having multiple nuclear installations, a heavy petrochemical industry, and terrorist targets, the Netherlands is at-risk for chemical, biological, or radionuclear (CBRN) incidents. Recent world and continental events show that this threat is real and that authorities may be underprepared. Hypothesis The hypothesis of this study is that Dutch hospitals are underprepared to deal with these incidents.

Methods: A descriptive, cross-sectional study was performed. All 93 Dutch hospitals with an emergency department (ED) were sent a link to an online survey on different aspects of CBRN preparedness. Besides specific hospital information, information was obtained on the hospital's disaster planning; risk perception; and availability of decontamination units, personal protective equipment (PPE), antidotes, radiation detection, infectiologists, isolation measures, and staff training.

Results: Response rate was 67%. Sixty-two percent of participating hospitals were estimated to be at-risk for CBRN incidents. Only 40% had decontamination facilities and 32% had appropriate PPE available for triage and decontamination teams. Atropine was available in high doses in all hospitals, but specific antidotes that could be used for treating victims of CBRN incidents, such as hydroxycobolamine, thiosulphate, Prussian blue, Diethylenetriaminepentaacetic acid (DTPA), or pralidoxime, were less frequently available (74%, 65%, 18%, 14%, and 42%, respectively). Six percent of hospitals had radioactive detection equipment with an alarm function and 22.5% had a nuclear specialist available 24/7 in case of disasters. Infectiologists were continuously available in 60% of the hospitals. Collective isolation facilities were present in 15% of the hospitals.

Conclusion: There is a serious lack of hospital preparedness for CBRN incidents in The Netherlands. Mortelmans LJM , Gaakeer MI , Dieltiens G , Anseeuw K , Sabbe MB . Are Dutch hospitals prepared for chemical, biological, or radionuclear incidents? A survey study. Prehosp Disaster Med. 2017;32(5):483-491.

Keywords: CBRN chemical; CREEC Center for Research and Education in Emergency Care; DTPA Diethylenetriaminepentaacetic acid; ED emergency department; EMS Emergency Medical Services; NSEP Netherlands Society for Emergency Physicians; PPE personal protective equipment; and radionuclear; biological; CBRN; disaster preparedness; hospital; the Netherlands.

Publication types

  • Multicenter Study

MeSH terms

  • Bioterrorism
  • Chemical Terrorism
  • Cross-Sectional Studies
  • Disaster Planning*
  • Disasters*
  • Emergency Service, Hospital / standards*
  • Hospitals / standards*
  • Humans
  • Internet
  • Netherlands
  • Outcome and Process Assessment, Health Care*
  • Surveys and Questionnaires
  • Terrorism