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Chemical incident management for public health physicians

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    Chemical incident management for public health physicians By: d j irwin, d t crombie, v murray. (Pp 43; £40.00) 1999. London: The Stationery Office. ISBN: 0 11 322107 X.

    This small book is the latest in the series on chemical incident management published by the Stationery Office. The authors, all experienced workers in the chemical incident field, have set out to define a series of guidelines that are intended to help the public health physician deal with a chemical incident. As such it is a handbook of “how to do it”. The authors point out that although incidents involving the accidental exposure of people to chemicals are common, the involvement of public health physicians is rare. Despite this, public health physicians have responsibilities for managing aspects of chemical incidents. The book is divided into four sections: prevention, preparedness, response, recovery. Each section is subdivided into sections that deal with specific aspects of each main area. Emphasis is rightly placed on planning and surveillance and the importance of establishing good links with other organisations that have a part to play is stressed. Communications inside the team dealing with the incident and between the team and, for example, the media, are discussed in detail: excellent advice is provided: “Never agree to interviews with solicitors who represent local residents or industry"! Advice is provided on such difficult problems as evacuation versus sheltering. Evacuation is often demanded by the public although the better policy may be to provide advice that will allow people to seal their homes and stay where they are.

    Major chemical incidents are often followed by complaints of delayed or lasting effects. Counselling of those affected and epidemiological investigation of such possibilities is needed. Methods are explained briefly.

    An unusual and particularly useful feature of this book is the wealth of information provided in the appendices. Addresses and telephone numbers of all those who can help in dealing with a chemical incident are provided. Also, examples of questionnaires that can be used to record essential information are provided.

    Dealing with a major chemical incident is rather like fighting a battle, in Clausewitz's words “Everything in war is very simple, but the simplest thing is very difficult”. Clausewitz explained this in terms of friction or the fog of war. This book dissipates the fog likely to accumulate about a chemical incident: read it now—before you need to.