Conor Malone MD
In many countries, hazardous material (HazMat) emergencies like the Sarin attack in Tokyo may seem a very far-off possibility, but the location of such events can be surprising and unpredictable, and a strategy for dealing with them, including their ophthalmological aspects, should be in place even where the risk seems only moderate, said Conor Malone MD, Sligo University Hospital, Sligo, Ireland.
“Hazardous material incidents range from chemical plant accidents to biological warfare and terrorism. The 2018 Salisbury Novichok nerve agent attack in the UK highlighted the small but significant risk of chemical weapons,” Dr Malone told the Irish College of Ophthalmologists Annual Conference in Galway, Ireland.
He noted that hazardous material incidents frequently involve ocular injury with early effects that include eye complaints such as miosis, epiphora, conjunctival irritation, photophobia, eye pain and blepharospasm. Late effects include severe dry eye, corneal ulceration and corneal scarring.
The Irish Government's Department of Defence 2017 National Risk Assessment noted a moderate likelihood of high-impact HazMat incidents. To assess the awareness of HazMat among ophthalmologists in Ireland and to gauge their interest in formal HazMat training, Dr Malone sent an anonymous questionnaire to all clinicians registered with the Irish College of Ophthalmologists, Ireland’s national ophthalmology training body.
PERSONAL PROTECTIVE EQUIPMENT
Among the 51 physicians who responded to the survey, 81% worked at units providing emergency eye care. A majority, 88%, had never treated a HazMat victim, and 82% rated themselves as not at all confident when treating such patients. In addition, 68% were unfamiliar with the four levels of personal protective equipment involved in HazMat care delivery.
However, although only 4% had received HazMat training, 40% were interested or very interested in pursuing a formal HazMat course. Moreover, 83% felt that every ophthalmologist should have, at the very least, received online basic training, like the Basic HazMat Life Support course, Dr Malone said.
“The results of this national survey suggest that there is a gap in ophthalmology training, which could expose clinicians to contamination and could hinder clinical care of HazMat victims,” Dr Malone said.
Dr Malone therefore recommended that every hospital have a copy of their local HazMat emergency plan. Physicians and other healthcare personnel should familiarise themselves with the protective equipment necessary when contaminated patients present to casualty units. Furthermore, all emergency centres should have a clinician who has taken the online basic HazMat training course, he said.
Conor Malone: conmalone@gmail.com
