title: Preparedness of Belgian civil hospitals for chemical, biological, radiation, and nuclear incidents: are we there yet?
abstract: OBJECTIVE
  As one of Europe's most densely populated countries with multiple nuclear installations and a prominent petrochemical industry, Belgium is at some reasonable risk for terrorist attacks or accidental chemical, biological, radiation, and nuclear (CBRN) incidents. We hypothesize that local hospitals are not sufficiently prepared to deal with these incidents.
  
  
  METHODS
  All 138 Belgian hospitals with an emergency department (ED) were sent a survey on their preparedness. Data on hospital disaster planning, risk perception, availability of decontamination units, personal protective equipment, antidotes, radiation detection, infectiologists, isolation measures, and staff training were collected.
  
  
  RESULTS
  The response rate was 72%. Although 71% of hospitals reported being at risk for CBRN incidents, only 53% planned for the same in their disaster plans. Only 11% of hospitals had decontamination facilities in front of or at the ED entrance and only 6% had appropriate personal protective equipment for triage and decontaminating teams. Atropine was available at all centers, but more specific antidotes such as hydroxycobolamine, thiosulphate, or pralidoxime were less available (47, 47, and 19%, respectively). Six percent of hospitals had radiodetection equipment with an alarm function and 14% had a nuclear specialist available 24/7. Infectiologists were continuously available in 26% of the total EDs surveyed. Individual isolation facilities were present in 36% of the EDs, and isolation facilities capable of housing larger groups were present in 9%. University hospitals were significantly better prepared than community hospitals.
  
  
  CONCLUSIONS
  There are serious gaps in hospital preparedness for CBRN incidents in Belgium. Lack of financial resources is a major obstacle in achieving sufficient preparedness.
authors: aDepartment of Emergency Medicine, ZNA Camp Stuivenberg, Antwerp bDepartment of Emergency Medicine, UZ Gasthuisberg cCenter for Research and Education in Emergency Care (CREEC), Leuven dDepartment of Neurology, Erica, Camp Geel, Belgium.
authors: Luc J M
authors: LJ
authors: Mortelmans
authors: Sam
authors: S
authors: Van Boxstael
authors: Harald G
authors: HG
authors: De Cauwer
authors: Marc B
authors: MB
authors: Sabbe
mesh_terms: D000931:Antidotes / Q000600:supply & distribution; D001530:Belgium; D054045:Biological Warfare Agents; D055884:Chemical Hazard Release; D003625:Data Collection; D003666:Decontamination / Q000592:standards; D004189:Disaster Planning / Q000458:organization & administration / Q000592:standards; D004190:Disasters; D004636:Emergency Service, Hospital / Q000458:organization & administration / Q000592:standards*; D006801:Humans; D011481:Protective Clothing / Q000600:supply & distribution; D018788:Radioactive Hazard Release
chemical_list: D000931:Antidotes; D054045:Biological Warfare Agents