Chemical, biological, radiological, nuclear and explosive (CBRNe) events

Purpose: To systematically review published literature for the research question ‘what issues are considered (and changes made) for vulnerable groups as part of the Chemical. Biological, Radiological, Nuclear or explosive (CBRNe) response for casualty collection, decontamination, triage and casualty clearing processes?’ Design: Seven-stage framework from the PRISMA statement for research question, eligibility (definition), search, identification of relevant papers from title and abstract, selection and retrieval of papers, appraisal and synthesis. Data sources: Medline, Embase, Cochrane Library, Web of Science, Scopus (Elsevier), Chemical Abstracts, Assia (Proquest), Sociological abstracts Proquest), Cinahl, HMIC, Health business elite, PsycInfo (ebsco), PILOTS (Proquest) and supplemented by other search strategies (e.g. exploding reference lists). Review methods: The included references were critically appraised using the Mixed Methods Appraisal Tool (MMAT) Results: 1855 papers were returned from the literature search, of which 221 were screened by abstract and 48 by full paper. Eleven papers were included for appraisal, of which 3 achieved a quality score of 50% or over. The papers were categorised into 3 phases on CBRNe response; evacuation, triage and decontamination. Conclusions: Although very little new medium/high quality research is available, the findings are summarised as considerations for building design (route choice and information), communication (including vision, hearing and language differences) and the composition of the response team. It is suggested that evidence-based practice from other care domains could be considered (patient movement and handling) for fire service and ambulance guidelines

Factors affecting phone engagement whilst driving- are they transferable from outside the vehicle?

Mobile phone use whilst driving can be considered to have a negative impact on driving performance; yet mobile phones have become an integrated, useful and often important part of people’s everyday lives. This study therefore investigates whether phone engagement habits and behaviours transfer from outside of the car to when behind the wheel also. It uses a semi-structured interview methodology, with Thematic Analysis, to find if there is anything unique to driving which inhibits drivers from mobile phone usage or is the car considered just another environment in which to use the phone to communicate and be entertained

Ergonomics systems mapping for professional responder inter-operability in chemical, biological, radiological and nuclear events

A European consensus was developed as a concept of operations (CONOPS) for cross-border, multi-professional chemical, biological, radiological and nuclear (CBRN) responses. AcciMaps were co-designed with professional responders from military, fire, ambulance, and police services in UK, Finland and Greece. Data were collected using document analysis from both open and restricted sources to extract task and operator information, and through interviews with senior staff representatives (Gold or Silver Command level). The data were represented on the Accimaps as a high level Socio-Technical Systems (STS) map of CBRN response using the themes of communication, planning, action, and reflection. Despite differences between service sectors and in terminology, a macro systems level consensus was achieved for the command structures (Gold, Silver and Bronze), and Hot Zone responders (Specialist Blue Light Responders and Blue Light Responders). The detailed tasks and technologies have been analysed using Hierarchical Task Analysis (HTA) to represent both complex response scenarios (macro) and detailed technologies (micro interfaces) for detection, diagnosis and decontamination. The outputs from these two systems mapping tools (Accimaps and HTAs) are being used in two field trials/exercises

Mapping Emergency Responders’ Current Procedures in the Event of a CBRNe Incident

When a Chemical, Biological, Radiological, Nuclear or explosive (CBRNe) event occurs a time and safety critical environment instantly exists. In order for emergency services to most efficiently complete their primary task of saving lives it is essential to have effective and well-rehearsed procedures in place. This environment requires many different services to interact with one another including: Fire, Police, Health and Military personnel. Therefore, it is important that each service understand not only their role but also that of the other emergency services (JESIP, 2013). In such a scenario every second can make a difference, with tasks such as triaging, treating and decontaminating casualties all heavily reliant on a swift response. However, this has to be balanced with offering maximal health and safety conditions for the emergency service personnel (NARU, 2015). Emergency personnel from other geographical locations may also be recruited to provide further support, so having a nationally recognised standard procedure for each emergency service is essential to allow smooth interaction between regional emergency crews (NATO, 2014). By taking a Human Factors/ Ergonomics approach to the problem it is essential to first understand what is required of each actor in the system. There are many different methods that can be used to capture a system such as that described above. One example is an Accident Map (AcciMap) (Rasmussen, 1997) - this allows for the different layers in the system to be identified, the lines and methods of communication to be shown as well as any interactions within a system to be acknowledged. With this in mind the aim of a work package within the European Commission (EC) funded TOXI-Triage project (Toxi-Triage, 2016) was to establish procedures in the event of a CBRNe incident for different emergency service providers across a number of EU countries

Systems mapping for technology development in CBRN response

Purpose This project aimed to develop an EU sociotechnical systems map to represent a harmonised concept of operations (CONOPS) as a future development platform for technologies used in multi-services emergency responses to Chemical, Biological, Radiological and Nuclear (CBRN) incidents Methodology AcciMaps were developed to locate where technologies are currently used, and opportunities for new technologies. The AcciMaps were iteratively co-designed with End Users (Fire, Ambulance, Police and Military) across three EU countries (UK, Finland and Greece). Data were collected using document analysis and interviews with senior ranking (Gold or Silver Command level) representatives of the participating end users. Findings Despite differences in terminology and between service sectors, consensus was achieved for the command structures (Gold, Silver and Bronze), and Hot Zone responders (Specialist Blue Light Responders and Blue Light Responders). A Control Room was included as the communication spine. Blue Light Responder activities were limited by their scope of practice and available equipment, for example breathing apparatus. The harmonised EU AcciMap offers a high level sociotechnical systems map of CBRN response. Critical segments have been identified which offer opportunities for technology developments that can add value in terms of response capabilities (e.g. tag and trace). Originality/ Value A large scale major CBRN incident may need cross-border and cross-professional engagement where efficient interoperability is vital. This research is the first EU consensus of a sociotechnical system map for CONOPS. It supports future research for technology development e.g. detection and decontamination equipment design and use, communication, diagnosis and response technologies

D9.1 Report on vehicle survey operator needs

In the era of digitization, technology developments have been making massive and detailed operator performance data easily available, thus upscaling transport technology into a new level of challenging conditions and drastically transforming the framework of operator-vehicle-environment interactions. Consequently, the need for increased understanding of the human factors – distraction, fatigue and drowsiness, health concerns, extreme emotions and sociocultural factors – affecting the behaviour of operators, and the harmonization of them with the current state of transport and data technology, create an opportunity to detect and design customised interventions to mitigate road risks, increase awareness and dynamically upgrade road operators’ performance.The project entitled ‘Safety tolerance zone calculation and interventions for drivervehicle-environment interactions under challenging conditions’ — ‘i-DREAMS’ aims to setup a framework for the definition, development, testing and validation of a context-aware ‘Safety Tolerance Zone’ for driving, within a smart Driver, Vehicle & Environment Assessment and Monitoring System (i-DREAMS). This framework should translate into new road safety interventions, improved driver well-being and transfer of control between human and vehicle, as well as a more eco-efficient driving style since safer driving implies an eco-friendlier behaviour.Taking into account, on the one hand, driver-related background factors (age, driving experience, safety attitudes and perceptions, etc.) and real-time risk-related physiological indicators (e.g. fatigue, distraction, stress, etc.), and on the other hand, driving task-related complexity indicators (e.g. time of day, speed, traffic intensity, presence of vulnerable road users, adverse weather, etc.) a continuous real-time assessment will be made to monitor and determine if a driver is within acceptable boundaries of safe operation (i.e. safety tolerance zone).Initial testing will take place in a driving simulator environment after which promising interventions will be tested and validated under real-world conditions in a testbed consisting of 600 drivers in total across 5 EU countries. Market roadmaps will be developed to support smooth transition of the investigated technologies to the market and experience from use cases in different European countries will be used to disseminate best practices.</div

A headway to improve PTW rider safety within the EU through three types of ITS

Introduction: The current safety situation for Powered Two Wheelers (PTW) within the EU is alarming. According to EU statistics, PTW riders account for 17% of all fatal road injuries in the region and twice as many fatalities per hundred thousand registered vehicles compared with occupants of cars. In recent years, too little attention has been given to Vulnerable Road Users (VRUs), including PTW users, in the development of Intelligent Transport Systems (ITS). Therefore, ITS should be developed that consider PTW riders an integral part of traffic; we focus on three systems that we believe have the potential to improve safety among PTW riders, namely Intersection Safety (INS), the Powered Two Wheeler oncoming vehicle information system (PTW2V), and the Vulnerable road user Beacon System (VBS). The present study aims to estimate quantitatively the safety impacts of the selected ITS for PTW riders in the EU-28, once the systems are fully adopted and meet selected future scenarios for 2020 and 2030. Method: An ex-ante method suggested by Kulmala [1] was further developed and applied to assess the safety impacts of ITS specifically designed for VRUs. As suggested by the method, the analysis started by determining the impact mechanisms through which the selected ITS systems affect the safety of PTW riders. Results: According to the main results, all the systems we studied have a positive impact on PTW rider safety by preventing fatalities and injuries. The greatest effects, based on 2012 accident data and full penetration, could be attained by implementing PTW2V (283 fewer yearly fatalities) and INS (261 fewer yearly fatalities). The weakest effect was found with VBS (216 fewer yearly fatalities). Forecasts for 2030, also based on estimated accident trends and penetration rates, confirm an expected edge for INS and PTW2V in terms of safety

Impact assessment of its applications for vulnerable road users

The EU-sponsored VRUITS project has prioritized ITS applications which have a potential to improve the safety, mobility and comfort of vulnerable road users (VRUs) and performed a quantitative safety, mobility and comfort assessment for the 10 most promising systems. The assessment methodology addresses not only the direct effects of the systems, but also unintended effects and effects through changes in mobility patterns. The 10 selected ITS were: VRU beacon system, Powered Two Wheelers oncoming Vehicle information, Bicycle-to-vehicle communication, Cooperative Intersection safety, Green wave for cyclists, Pedestrian & Cyclist detection with Emergency Braking, Blind spot detection, Intelligent pedestrian traffic signal, Crossing adaptive lighting and Information on bike rack vacancy. The paper presents the quantitative estimates for the impact on safety, mobility and comfort. The outputs of the impact assessment are translated into socioeconomic indicators via a social cost-benefit analysis

Design for behavioural safety

Safety is defined as “The state of being protected from or guarded against hurt or injury; freedom from danger” whereas design is a significant driver of behavioural change which can enable, encourage or discourage particular practices from taking place. Approaches derived from the concept of behavioural change through design have enabled us to change certain practices; however, despite design’s clear influence on human behaviour, the understanding of ‘design for behaviour change’ is still fragmented and limited frameworks exist for its effective implementation in professional and public contexts. However, it is possible to imagine how good design strategies can influence positive behavior and in particular, behaviour that leads to improved safety within a particular system. Thus, the link between design, behavioural change and behavioural safety can be recognized

"Work as Done in the Emergency Department response to CBRN events: A comparative study"

The Emergency Department (ED) is the highest risk area in healthcare. Chemical, Biological, Radiological, and Nuclear (CBRN) events are multi-faceted emergencies which could result in an influx of casualties to arrive in the ED. Responding to a CBRN event presents major challenges to ED staff (first receivers). This study aimed to understand the actions of first receivers in response to CBRN presentations by mapping Work as Done (WAD) in the event of a CBRN incident, using Hierarchical Task Analysis (HTA) to capture and compare the CBRN responses in two NHS Trusts in the UK. WAD was established by presenting first receivers with CBRN scenario cards. Field notes were made, converted to HTAs, and analyzed using thematic analyses. The results found similarities between the 2 Trusts, for example, in isolation and containment. The differences highlighted that although first receivers were adhering to clinical recommendations and governmental guidance for treatment and investigation of CBRN presentations, variation still existed. CBRN events are time critical situations in which the clinical and organizational skills of first receivers should be prioritized. This variation between NHS Trusts can be overcome by standardizing the NHS CBRN response