Hazmat disaster preparedness in Hong Kong: What are the hazardous materials on Lantau, Lamma, and Hong Kong Islands?

Frank G. Walter, MD, FACEP, FACMT, FAACT, Jimmy Tak-shing Chan, MB BS (HKU), FRCSEd, FCSHK, FHKAM (Surgery), FHKCEM, FHKAM (Emergency Medicine), Billie Winegard, MPH, Peter B. Chase, MD, PhD, FACEP, Farshad (Mazda) Shirazi, MS, MD, PhD, FACEP, Yuk-yin Chow, MB BS (HKU), FRCSEd, FRACS (Orthopedics), FHKCOS, FHKAM (Orthopedic Surgery), Melanie de Boer, PhD, Kurt Denninghoff, MD

Abstract


Objective: Hazmat disaster preparedness is critical, especially as Hong Kong prepares for major international events, such as the 2008 Olympic Equestrian Games. No published medical study describes the identities and quantities of hazardous materials (HMs) in Hong Kong and lists what antidotes are needed for these dangerous goods (DGs). This study describes what HMs are most common in Hong Kong to prioritize disaster preparedness and training.
Design: A descriptive, cross-sectional study.
Setting: The Hong Kong Special Administrative Region, specifically Lantau, Lamma, and Hong Kong Islands.
Sample: The Hong Kong Fire Services Department (HKFSD) Dangerous Goods Database (DGD).
Interventions: Descriptive statistical analyses with Stata 9.2.
Main Outcome Measures: Identifying and quantifying HMs in the HKFSD DGD.
Results: Most HMs do not have antidotes. The most common HMs with recognized antidotes are carbon monoxide, methylene chloride, fluorides, cyanides, nitriles, hydrazine, methanol, and nitrates. The most common categories of DGs are substances giving off inflammable vapors, compressed gases, and corrosive and poisonous substances.
Conclusions: Hazmat disaster preparedness and training should emphasize these most common categories of DGs. Disaster planning should ensure adequate antidotes for HMs with recognized antidotes, ie, oxygen for carbon monoxide and methylene chloride; calcium gluconate and calcium chloride for fluorides; hydroxocobalamin or amyl nitrite, sodium nitrite, and sodium thiosulfate for cyanides and nitriles; pyridoxine for hydrazine; fomepizole or ethanol for methanol; and methylene blue for methemoglobinemia produced by nitrates. Supportive care is essential for patients exposed to HMs because most DGs do not have antidotes.


Keywords


disaster planning, hazardous substances, epidemiology, toxicology, emergency medicine

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References


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DOI: https://doi.org/10.5055/ajdm.2008.0028

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