Emergency Health Care Workers' Preparedness and Willingness to Respond to a Dirty Bomb-related Disaster in Pakistan

Disaster Med Public Health Prep. 2025 Sep 29:19:e282. doi: 10.1017/dmp.2025.10208.

Abstract

Objective: Our study examined the association between willingness-to-respond (WTR) and behavioral factors, demographics, and work-related characteristics among emergency department healthcare workers (HCWs) toward a radiological dispersal device (RDD) ("dirty bomb") blast scenario in Pakistan.

Methods: A cross-sectional survey was conducted in August to September 2022 among emergency department HCWs from 2 hospitals in Karachi, Pakistan. Nonprobability purposive sampling was used to recruit participants. Multivariate logistic regression analyses were performed to examine the association between WTR and key attitudes/beliefs, including perceived norms, preparedness, and safety, as well as the EPPM variables.

Results: Among behavioral factors, perceived likelihood that colleagues will report to work duty, perceived importance of one's role, and psychological preparedness showed particularly significant associations with WTR; 53.6% of participants indicated low perceived threat, while 46.43% showed high perceived threat, toward an RDD disaster scenario.

Conclusion: Our findings point to the need to improve WTR toward an RDD event by shifting behavioral factors among HCWs through efficacy-focused training; enhancing WTR through such training strategies is imperative beyond mere delivery of information. Changing norms around response, along with institutional support, may further boost WTR during RDD emergencies.

Keywords: Willingness to respond; dirty bomb; emergency department; health care workers; public health; radiological.

MeSH terms

  • Adult
  • Bombs* / statistics & numerical data
  • Civil Defense* / methods
  • Civil Defense* / standards
  • Civil Defense* / statistics & numerical data
  • Cross-Sectional Studies
  • Emergency Service, Hospital / organization & administration
  • Emergency Service, Hospital / statistics & numerical data
  • Female
  • Health Personnel* / psychology
  • Health Personnel* / statistics & numerical data
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Pakistan
  • Surveys and Questionnaires