GROUP A: BIOLOGICAL TERRORISM Bioterrorism is terrorism involving the intentional release or dissemination of biological agents.

These agents are (bacteria, viruses, or toxins), and may be in a naturally occurring or a human-modified form. A bioterrorism attack is the deliberate release of viruses, bacteria, toxins or other harmful agents used to cause illness or death in people, animals, or plants. These agents are typically found in nature, but it is possible that they could be mutated or altered to increase their ability to cause disease, make them resistant to current medicines, or to increase their ability to be spread into the environment. Biological agents can be spread through the air, water, or in food. Terrorists tend to use biological agents because they are extremely difficult to detect and do not cause illness for several hours to several days. Some bioterrorism agents, like the smallpox virus, can be spread from person to person and some, like anthrax, cannot. Bioterrorism is an attractive weapon because biological agents are relatively easy and inexpensive to obtain, can be easily disseminated, and can cause widespread fear and panic beyond the actual physical damage they can cause. PREPAREDNESS Biological agents are relatively easy to obtain by terrorists and are becoming more threatening in the U.S., and laboratories are working on advanced detection systems to provide early warning, identify contaminated areas and populations at risk, and to facilitate prompt treatment. Methods for predicting the use of biological agents in urban areas as well as assessing the area for the hazards associated with a biological attack are being established in major cities. In addition, forensic technologies are working on identifying biological agents, their geographical origins and/or their initial son. Efforts include decontamination technologies to restore facilities without causing additional environmental concerns. Early detection and rapid response to bioterrorism depend on close cooperation between public health authorities and law enforcement; however, such cooperation is currently lacking. National detection assets and vaccine stockpiles are not useful if local and state officials do not have access to them. BIOSURVEILLANCE In 1999, the University of Pittsburgh's Center for Biomedical Informatics deployed the first automated bioterrorism detection system, called RODS (Real-Time Outbreak Disease Surveillance). RODS is designed to draw collect data from many data sources and use them to perform signal detection, that is, to detect the a possible bioterrorism event at the earliest possible moment. RODS, and other systems like it, collect data from sources including clinic data, laboratory data, and data from over-the-counter drug sales.In 2000, Michael Wagner, the codirector of the RODS laboratory, and Ron Aryel, a subcontractor, conceived of the idea of obtaining live data feeds from "nontraditional" (non-health-care) data sources. The RODS laboratory's first efforts eventually led to the establishment of the National Retail Data Monitor, a system which collects data from 20,000 retail locations nation-wide.

On February 5, 2002, George W. Bush visited the RODS laboratory and used it as a model for a $300 million spending proposal to equip all 50 states with biosurveillance systems. In a speech delivered at the nearby Masonic temple, Bush compared the RODS system to a modern "DEW" line (referring to the Cold War ballistic missile early warning system). The principles and practices of biosurveillance, a new interdisciplinary science, were defined and described in the Handbook of Biosurveillance, edited by Michael Wagner, Andrew Moore and Ron Aryel, and published in 2006. Biosurveillance is the science of real-time disease outbreak detection. Its principles apply to both natural and man-made epidemics (bioterrorism). Data which potentially could assist in early detection of a bioterrorism event include many categories of information. Healthrelated data such as that from hospital computer systems, clinical laboratories, electronic health record systems, medical examiner record-keeping systems, 911 call center computers, and veterinary medical record systems could be of help; researchers are also considering the utility of data generated by ranching and feedlot operations, food processors, drinking water systems, school attendance recording, and physiologic monitors, among others.[38] Intuitively, one would expect systems which collect more than one type of data to be more useful than systems which collect only one type of information (such as singlepurpose laboratory or 911 call-center based systems), and be less prone to false alarms, and this appears to be the case. In Europe, disease surveillance is beginning to be organized on the continent-wide scale needed to track a biological emergency. The system not only monitors infected persons, but attempts to discern the origin of the outbreak. Researchers are experimenting with devices to detect the existence of a threat: Tiny electronic chips that would contain living nerve cells to warn of the presence of bacterial toxins (identification of broad range toxins) Fiber-optic tubes lined with antibodies coupled to lightemitting molecules (identification of specific pathogens, such as anthrax, botulinum, ricin) New research shows that ultraviolet avalanche photodiodes offer the high gain, reliability and robustness needed to detect anthrax and other bioterrorism agents in the air. The fabrication methods and device characteristics were described at the 50th Electronic Materials Conference in Santa Barbara on June 25, 2008. Details of the photodiodes were also published in the February 14, 2008 issue of the journal Electronics Letters and the November 2007 issue of the journal IEEE Photonics Technology Letters. Response to bioterrorism incident or threat Government agencies which would be called on to respond to a bioterrorism incident would include law enforcement, hazardous materials/decontamination units and emergency medical units. The US military has specialized units, which can respond to a bioterrorism event; among them are the US Marine Corp's Chemical Biological Incident Response Force and the U.S. Army's 20th Support Command (CBRNE), which can detect,

identify, and neutralize threats, and decontaminate victims exposed to bioterror agents. CAUSE OF BIOLOGICAL TERRORISM Perhaps the principal characteristic of biological agents that could make their use attractive to terrorists is their extreme toxicity, even compared to other weapons of mass destruction. This factor has been expressed in a number of different ways: a US Army general in 1960 is reported to have estimated that just two aircraft, each carrying 10,000 pounds of biological agents over the US, could kill or incapacitate some 60 million Americans (Livingstone 1982: 110); Type-A botulinal toxin, with a mean lethal dose estimated to be as low as a few tenths of a microgram (Kupperman and Trent 1979: 65), has been described as "the most lethal substance known" (Kupperman and Smith 1993: 40; Berkowitz et al. 1972: VIII-40). It has variously been estimated to be a thousand times (Kupperman and Trent 1979: 65) or a hundred thousand times (Kupperman and Trent 1979: 57) more deadly than nerve agents.Theoretically, according to one source, a single ounce of BTX (botulinal toxin) is sufficient to kill 60 million people (Jenkins and Rubin 1978: 224). Another author states that "one-half ounce, properly dispersed, could kill every man, woman, and child in North America" (Livingstone 1982: 110), yet another that just eight ounces of the substance could "kill every living creature on the planet" (Mullins 1992: 102, citing Hersh 1968); some authors maintain that anthrax is an even more deadly agent (Mullins 1992: 102; Kupperman and Trent 1979: 68). According to one study, in principle, if its spores were distributed appropriately, a single gram would be sufficient to kill more than one-third of the population of the US (Kupperman and Smith 1993: 39). Of course, the authors were quick to point out that an attack of such magnitude would not be feasible. However, more realistic, smaller-scale scenarios still posit large numbers of casualties. For example, the US Law Enforcement Assistance Administration reported in March 1977 that a single ounce of anthrax introduced into the airconditioning system of a domed stadium could infect 7080,000 spectators within an hour (Clark 1980: 195). And a 1972 study by the Advanced Concepts Research Corporation of Santa Barbara, California, postulated that an aerosol attack with anthrax spores on the New York City area would result in more than 600,000 deaths (Kupperman and Trent 1979: 68). Some indication of the scale of casualties to be expected from a deliberate attack can be gained from the fact that the accidental release of anthrax from the explosion of what is believed to have been a single biological weapon in Sverdlovsk in 1979 is estimated to have killed between 400 and 1,200 people (Wiener 1991b: 66). Berkowitz et al. describe the toxicity of biological agents as follows: The potency of the pathogens on a weight basis exceeds that of the most toxic chemicals; between a few and a few thousand viable organisms is all that is required to produce infection in many cases. Since pathogens can be prepared in concentrations of the order of 1010microorganisms per gram,

infectious doses range downward from 0.1 microgram per targetindividual. The search capability of the aerosol cloud and the fact that infectious doses are independent of victim bodyweight (because the pathogen reproduces in the host), make thequantity of BW material needed for mass attack quite small indeed. (1972: VIII-54) A number of studies have compared the amounts of biological agent needed in a particular hypothetical attack to that of various chemical agents. For example: according to one source, when dumped into a water supply, one gram of typhoid culture has an impact roughly equivalent to 100 grams of the "V" chemical nerve agent, or nearly 20,000 grams (40 pounds) of potassium cyanide (US Senate Committee on the Judiciary, henceforth SCJ, 1990: 3-4); the US Congressional Office of Technology Assessment cites "UN experts" to the effect that a person drinking 100 milliliters (less than half a cup) of untreated water from a 5 million liter reservoir would become severely sick and perhaps die if the reservoir had been contaminated by 1/2 kg of Salmonella typhi (the cause of typhoid fever), 5 kg of botulinum toxin, or 7 kg of staphylococcal toxin, whereas it would require 10 tons of the chemical agent potassium cyanide to contaminate the reservoir to the same level of toxicity (OTA 1991: 52); and one study maintains that four tons of the nerve agent VX would be required to cause several hundred thousand deaths if released in aerosol form in a crowded urban area, compared to only 50 kg of anthrax spores (Douglass and Livingstone 1987: 17). As the wide range (and sometimes inconsistency) of the above estimates suggests, much remains unknown or uncertain about the precise effects of biological agents. It is clearly highly misleading to extrapolate directly from individual lethal doses of a substance to estimating casualties from mass attacks, given the need for effective delivery of the agent (about which more will be said later). Nevertheless, it cannot be denied that, in terms of sheer lethality, biological agentsin theoryappear to offer a "bigger bang for a buck." In particular, most authors rate them as far more effective than chemical weapons in this respect; some would even extend the comparison to nuclear weapons. In the words of Kupperman and Woolsey: "The terrorist armed with chemical or radiological agents can kill hundreds, possibly thousands of people. By contrast, terrorists armed with biological weaponry can, in principle, kill tens to hundreds of thousands" (Kupperman and Woolsey 1988:5). Elsewhere, Kupperman (former chief scientist at the US Arms Control and Disarmament Agency) has gone even further, stating in 1977 that "biological agents both toxins and living organismscan rival thermonuclear weapons, providing the possibility of producing hundreds of thousands to several millions of casualties in a single incident" (cited in Kupperman and Trent 1979: 633); and in 1989 that "the mortality levels from a biological attack could possibly exceed that of a large nuclear explosion" (Kupperman and Kamen 1989: 103)4. Dr. Graham Pearson, Head of Britain's Chemical and Biological Defence Establishment, has been quoted recently as saying that "Anthrax, sprayed from the back of an aircraft on a cool, calm night, could take out all of Washington DC. This could cause up to

three million fatalities compared to two million from a hydrogen bomb" (Majendie 1994). Other Causes for using Biological Weapons for terrorism. A number of other factors are said to favour the acquisition of biological weapons by terrorists, particularly by comparison with other weapons of mass destruction. Some of these are related to the toxicity issue discussed above. For example, the smaller quantities of agent needed on account of their lethality help reduce the costs and complexity of their production or other acquisition, in turn eliminating the necessity for a large infrastructure of personnel and facilities, which in turn eases the problem of security and avoidance of detection.5 The relative ease and cheapness of their manufacture or acquisition, especially compared to nuclear weapons, is dealt with at greater length later in this paper. Other advantages include: Their indetectability to traditional anti-terrorist sensor systems; as Root-Bernstein puts it: "They cannot be revealed by metal detectors, x-ray machines, trained dogs, or neutron bombardment, as can guns, grenades, and plastic explosives. They can certainly be smuggled through airports as easily as the drugs that flood into Western countries" (1991: 50). This feature also presents difficulties for possible countermeasures, in the form of protective clothing for example, since early detection (before the onset of symptoms, or even for some time afterwards) may not be possible (Kupperman and Trent 1979: 89). Indeed, one particularly "insidious" feature of biological weapons identified by Kupperman and Kamen is "the initial difficulty defenders have in determining whether they are under attack or are merely being struck by a natural epidemic" (1989: 103); the time-lag between release of an agent and its perceived effects on humans reduces the chance of a perpetrator being apprehended (Simon 1989: 10; Burrows and Windrem 1994: 483). As Watkins explains: "After infection the organism multiplies and spreads to others during an incubation period before onset of symptoms. Thus, locating the site of an attack and identifying the perpetrator is complicated" (1987: 195). The particular agent may also leave no signature, allowing for the possibility of anonymous attacks (particularly important where a state sponsor may not wish to be identified) (OTA 1992: 37); an effect similar to that of the so-called "neutron bomb" (enhanced radiation/reduced blast nuclear warhead), in that the damage they cause may be confined to human beings, leaving other material and structures intact (Wiener 1991a: 129 and 1991b: 65); again in contrast to nuclear weapons, their relative degree of flexibility; in Mengel's words: "...biological technologies are quite adaptable to demonstration attacks on small, isolated targets, while retaining a capacity of a larger attack" (Mengel 1976: 446). Similarly, Berkowitz et al. note that "BW....can be used in large or small scale attack, overtly or covertly, and in such a way as to produce indiscriminate or selectively specific effects" (1972: VIII-61); their capacity to reproduce, unlike chemical weapons, allowing a small seed culture to produce a large quantity of agent (Kupperman and Trent 1979: 66), and enabling

much smaller quantities to infect a large population (Jenkins and Rubin 1978: 225); the relative ease of dissemination, again affecting the level of effort and scale of preparation required. As Berkowitz et al. put it: "Unlike the chemical poisons which, for mass dissemination, require complete weapon systems of a type not likely to be available to terrorist organizations, use of biological pathogens is virtually identical with certain BW applications which do not require massive weaponry" (1972: VIII-52). Later, in regard to one particular form of dissemination (aerosolization), they add: "The 'search' capability of the aerosol cloud (it 'seeks out' its victims); its potential for large area coverage; and the fact that the respiratory form of most diseases, the form resulting from aerosol particle inhalation, is usually the most severe form, are the factors which make BW aerosols truly mass destruction weapons" (1972: VIII-54); their capacity to seriously damage the economy of a state (by attacking crops or livestock, for example) or to inflict heavy casualties on military forces, both of which may be impossible using traditional terrorist means (Simon 1989: v and 9); the degree of sheer terror (and hence societal disruption) that they may instill in a target population, even with relatively small-scale attacks, given the particularly horrific nature of biological warfare (Kupperman and Trent 1979: 46).McGeorge asserts that "The mere threat of a credible biological attack is enough to throw governments into a panic" (1988: 20). In Watkins' words: "they produce a degree of terror...comparable only with nuclear weapons" (1987: 197); and, finally, their relative cheapness to produce. As Mullen has put it: "The resources required to mount a credible mass destruction threat with a biological weapon are trivial compared to those required for a credible explosive nuclear threat" (1978: 78). Wiener estimates that "startup can be achieved for less than 1 million dollars" (1991b: 65); Kupperman that it would require "an investment of at most a hundred thousand dollars" (1984: 77). Douglass and Livingstone put it another way:

A sophisticated program designed to produce a fissionable device would probably cost hundreds of millions of dollars, whereas type A botulinus toxin, which is more deadly than nerve gas, could be produced for about $400 per kilogram. A group of C/B experts, appearing before a UN panel in 1969, estimated 'for a large-scale operation against a civilian population, casualties might cost about $2,000 per square kilometre with conventional weapons, $800 with nuclear weapons, $600 with nerve-gas weapons, and $1 with biological weapons.' (1987: 16) According to Berkowitz et al.: "The cost of equipment and facilities [for BW] is somewhat greater than that described for synthesizing the chemical poisons but appreciably smaller than that involved in INW [illicit nuclear weapon] development, and the problems associated with obtaining a seed culture are trivial compared with those to be surmounted in acquiring a supply of SNM [special nuclear material]" (1972: VIII-66). BIOCHEMICAL TERRORISM

Brief History of Chemical Weapons Use Although chemicals had been used as tools of war for thousands of yearse.g. poisoned arrows, boiling tar, arsenic smoke and noxious fumes, etc.modern chemical warfare has its genesis on the battlefields of World War I. During World War I, chlorine and phosgene gases were released from canisters on the battlefield and dispersed by the wind. The first large-scale attack with chlorine gas occurred 22 April 1915 at Ieper in Belgium. The use of several different types of chemical weapons, including mustard gas (yperite), resulted in 90,000 deaths and over one million casualties during the war. Those injured in chemical warfare suffered from the effects for the rest of their lives; thus the events at Ieper during World War I scarred a generation. After witnessing the effects of such weapons in World War I, it appeared that few countries wanted to be the first to introduce even deadlier chemical weapons onto the World War II battlefields. During the Cold War, the United States and the Soviet Union both maintained enormous stockpiles of chemical weapons, amounting to tens of thousands of tonnes. The amount of chemical weapons held by these two countries was enough to destroy much of the human and animal life on Earth. Iraq used chemical weapons in Iran during the war in the 1980s, and Iraq also used mustard gas and nerve agents against Kurdish residents of Halabja, in Northern Iraq. The two recent examples of the use of chemical weapons were the sarin poisoning incident in Matsumoto, a Japanese residential community, in 1994, and the sarin attack on the Tokyo subway in 1995, both perpetrated by the AumShinrikyu doomsday cult. These two attacks refocussed international attention on the potential use of chemical weapons by terrorists, and on the dangers posed by chemical weapons. DEFINITION OF TERMS CHEMICAL TERRORISM The intentional use of weapons designed to kill, injure or incapitate on the basis of toxic or noxious chemical properties. CHEMICAL WARFARE AGENT The actual chemical used. CHEMICAL WEAPON The chemical agent plus the device used to disseminate it. CHARACTERISTICS OF CHEMICAL WEAPON AGENTS LEND THEMSELVES TO TERRORIST USE: Chemicals used in CWAs are widely available, and recipes for CWA production may be found on the Internet. CWAs are transported easily and may be delivered by a variety of routes. Chemical agents often are difficult to protect against and quickly incapacitate the intended targets.

Most civilian medical communities are inadequately prepared to deal with a chemical terrorist attack. Relatively low cost(vs. nuclear weapons)

TYPES OF CHEMICAL AGENTS a. Nerve agents (such as sarin, soman, cyclohexylsarin, tabun, VX) Interfere with normal neurotransmission. First synthesized by Gerard Schrader at IG Farben in pre-WWII Germany b. Vesicating or blistering agents (such as mustards, lewisite) First discovered in 1822 by Belgian scientist, Cesar-MansueteDespretz Chemicals named for causing blister. Sulfur mustards produces cutaneous blisters and erythema on areas directly exposed to the agent. c. Choking agents or lung toxicants (such as chlorine, phosgene, diphosgene) A chemical agent that causes physical injury to the lungs. In extreme cases, membranes swell and lungs become filled with liquid, which can result in asphyxiation resembling drowning. Death results from lack of oxygen; hence, the victim is choked. d. Cyanide Sometimes is described as having a bitter almond smell, but it does not always give off an odor, and not everyone can detect this odor. It prevents the cells of the body from using oxygen. When this happens, the cells die. Medically important sources iatrogenic cyanide toxicity includeNitroprusside and Laetrile. CAUSES OF BIOCHEMICAL TERRORISM Chemical warfare Warfare and associated military operations involving the employment of lethal and incapacitating munitions and agents, typically poisons, contaminants, and irritants. Weapon of Mass Destruction A weapon of mass destruction (WMD) is a weapon that can kill and bring significant harm to a large number of humans (and other life forms) and/or cause great damage to man-made structures (e.g. buildings), natural structures (e.g. mountains), or the biosphere in general. The scope and application of the term has evolved and been disputed, often signifying more politically than technically. Coined in reference to aerial bombing with chemical explosives, it has come to distinguish large-scale weaponry of other technologies, such as chemical, biological, radiological, or nuclear. This differentiates the term from more technical ones such as chemical, biological, radiological, and nuclear weapons (CBRN) AIMS OF BIOCHEMICAL TERRORISM The literature identifies the following aims: creating mass anxiety, fear and panic;

creating helplessness, hopelessness and demoralization; destroying our assumptions about personal security; disruption of the infrastructure of a society, culture or city; Demonstrating the impotence of the authorities to protect the ordinary citizen and his/her environment.

The aims of terrorism do not require massive casualties for their fulfillment: death and physical damage is a means to an end, not an end in itself. Following the two attacks using the nerve gas sarin in the Japanese cities of Matsumoto (1994) and Tokyo (1995), carried out by the AumShinrikyo cult, only 19 deaths occurred but the psychological, social and economic effects of these incidents were enormous EMERGENCY AND DISASTER MEASURES The threat of a biochemical incident raises questions about the training and preparation of front-line professional responders. There can be no reason to assume that such personnel would be immune from the deleterious psychological effects of a terrorist event of this kind; self-selection and a degree of natural personal resilience do not represent an impermeable barrier to the emotional impact of helping survivors of trauma. Thus, such personnel who are likely to be faced with the challenge of dealing with a biochemical terrorist incident are entitled to the best available training and preparation, in both physical and psychological terms. Their training would need to include not only information about the normal and pathological reactions to extreme stressors but also experience in wearing protective clothing (i.e. moon suits) and personal respirators. Barrier clothing can compromise physical function and communication with colleagues and can cause overheating, hyperventilation, fatigue and panic. The appearance of personnel in protective clothing can be disquieting to the onlooker. For this reason,it was agreed that it should not be worn by the FBI while conducting their investigations at the scene. As was described above,the general public also must be considered as key partners in the overall response to a biochemical incident. Similarly,governments should encourage the active cooperaton of the general public (including lay and voluntary bodies) in the preparation of emergency plans. EMERGENCY SERVICE DUTIES TO BE PERFORMED AT A CHEMICAL WEAPON RELEASE: The primary functions that must be performed at any toxic release remain fairly consistent. The top twenty actions that must be taken will generally involve: 1. 2. 3. 4. 5. 6. Incident "Size-up" and assessment Scene Control/establishment of perimeter(s) Product Identification/information gathering Pre-entry examination and determination/donning of appropriate protective clothing & equipment Establishment of a decontamination area Entry planning/preparation of equipment

7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21.

Entry into a contaminated area and rescue of victims (as needed) Containment of spill/release Neutralization of spill/release Decontamination of victims/patients/rescuers Triage of ill/injured BLS Care Hospital/expert consultation ALS care/specific antidotes Transport of patients to appropriate hospital Transport of patients to appropriate hospital Post-Entry evaluation examination of rescuers/equipment Complete stabilization of the release/collection of evidence Delegation of final clean up to responsible party Recordkeeping/after-action reporting Complete analysis of actions/recommendations to action plan

In May 2005, the World Health Assembly adopted revised International Health regulations (IHR) (2) that went into effect in the United States on July 18, 2007. This international legal instrument governs the role of the World Health Organization (WHO) and its member countries, including the United States, in identifying, responding to, and sharing information about Public Health Emergencies of International Concern (PHEIC). The IHR are designed to prevent and protect against the international spread of diseases while minimizing the effect on world travel and trade. Countries that have adopted these rules have a much broader responsibility to detect, respond to, and report public health emergencies that potentially require a coordinated international response in addition to taking preventive measures. The IHR will help countries work together to identify, respond to, and share information about PEHIC. A PHEIC is an extraordinary event that: a. constitutes a public health risk to other countries through international spread of disease, and b. potentially requires a coordinated international response. Other biologic, chemical, or radiologic events might fit the decision algorithm and also must be reportable to WHO. All WHO member states are required to notify WHO of a potential PHEIC. WHOmakes the final determination about the existence of a PHEIC. Health-care providers in the United States are required to report diseases, conditions, or outbreaks as determined by local, state, or territorial law and regulation, and as outlined in each states list of reportable conditions. All health-care providers should work with their local, state, and territorial health agencies to identify and report events that might constitute a potential PHEIC occurring in their location. CDC will further analyze the event based on the decision algorithm of the IHR and notify the U.S. Department of Health and Human Services (DHHS) Secretarys Operations Center (SOC), as appropriate. DHHS has the lead role in carrying out the IHR, in cooperation with multiple federal departments and agencies. TheDHHS SOC is the central body for the United States responsible for reporting potential events to WHO. The United States has 48 hours to assess the risk of the reported event. If authorities determine that a potential PHEIC exists, the WHO member country has 24 hours to report the event to WHO. An IHR decision algorithm has been developed to help countries determine whether an event should be reported. If any two of the following four questions can be answered in the affirmative, then a determination should be made that a potential PHEIC exists and WHO should be notified: Is the public health impact of the event serious? Is the event unusual or unexpected? Is there a significant risk of international travel or trade restrictions? Is there a significant risk of international spread? GROUP B: ARMED CONFLICTS - UK Manual Guidance:

o o

Any difference arising between States and leading to the intervention of members of the armed forces in an armed conflict. An armed conflict exists whenever there is a resort to armed force between States or protracted armed violence between governmental authorities and organised armed groups within a State.

Trends in Armed Conflict 1. Interstate War 2. Civil Conflict or War 3. Asymmetric conflict 4. Nation building or preaching of stabilization 5. Technology Interstate war Sustained armed conflict between two or more states. The number of stats engage in interstate conflict has declined in recent years especially between the great powers. Civil war Armed conflict within the country. However, most armed conflicts occur in Global South (i.e., with its high number of states and large populations). The majority of armed conflicts today are civil wars. Internationalized civil war: an armed conflict between the central government of a country and insurgents with outside intervention by at least one other state. Causes of Armed Conflict 1. First Level of Analysis The origins of war are sometimes found in the psychological processes of leaders (i.e., Saddam Hussein had messianic ambitions) Second Level of Analysis Internal characteristics of the state: geographic location; demographic stress, cultural values; economic conditions; and political institutions. Third Level of Analysis System structure and processes: o Power Distributions: the structure of the state system; how the states are arranged. o Power Trajectories: if the capability of hegemon (leader state) is eroding, war is more likely.

EMERGENCY PREPAREDNESS (AMERICAN RED CROSS) The possibility of public health emergencies arising in the United States concerns many people in the wake of recent hurricanes, tsunamis, acts of terrorism, and the threat of pandemic influenza. Though some people feel it is impossible to be prepared for unexpected events, the truth is that taking preparedness actions helps people deal with disasters of all sorts much more effectively when they do occur. To help, Centers for Disease Control and Prevention (CDC) and the American Red Cross have teamed up to answer common questions and provide step by step guidance you can take now to protect you and your loved ones. 1. Get a Kit Gather Emergency Supplies By taking time now to prepare emergency water supplies, food supplies and disaster supplies kit, you can provide for your entire family. Make a Plan Develop a Family Disaster Plan Families can cope with disaster by preparing in advance and working together as a team. Be Informed Learn How to Shelter in Place Centers for Disease Control and Prevention (CDC) and the American Red Cross have teamed up to answer common questions and provide step by step guidance you can take now. Understand Quarantine and Isolation When quarantine and isolation may be called for, what they are, and how they work. Maintain a Healthy State of Mind Tools for coping with disaster for adults, parents, children, students, and seniors.

2. 3.

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3. -

Emergency & Disaster Measures/Nursing Management Bullet wounds are terrifying and often deadly injuries that happen all too often. In the long run, the only real treatment for it has to be done in a hospital by a trained medical professional. In some cases, though, getting to a doctor might take too long, and you have to act quickly to preserve a life. Here are a few basic tips for first aid for a bullet wound. 1. Call for Medical Help A bullet wound can be deceptive. Even if the wound doesnt appear to be too bad, there could be internal

INTERNATIONAL HEALTH REGULATIONS FOR BIOLOGICAL TERRORISM

damage that you cant see. The first thing you should do is call for emergency assistance. You wont be able to fully treat the wound on your own, and you shouldnt attempt to do so. Focus on saving a life, and leave the advanced stuff for the professionals. 2. Be Safe Where there is one bullet wound, another might be about to follow. There are many causes of bullet wounds, some intentional, some not. But whatever the case, you need to take all necessary precautions to prevent another injury. Getting yourself or others harmed only makes the situation worse. Check for Vital Signs Check for consciousness, respiration, and pulse. If the person is unconscious, try to wake them up. If youve been trained in CPR, you may administer it if the need arises. Try to avoid moving the victim unless circumstances force you to. Halt Bleeding The part of bullet wound first aid that you can have the largest impact with. Stopping blood loss can save a life. a. Elevate the wounded area. b. Apply steady, heavy pressure to the bullet wound. Use whatever is around; cloths, towels, gauze, or clothing. You can even use your hands if nothing else is available. c. Dont remove your bandages if they bleed through. Instead, put more padding on top. d. If possible, secure your makeshift bandage tightly with tape or medical wrappings. This allows you to administer other first aid. e. Dont worry too much about infection. Use clean hands and materials if possible, but make bleeding control your priority. You can always work on infections later. Shock Treatment Extreme blood loss will eventually lead to shock. If this occurs, be prepared to administer shock first aid, as well.

Hurricane Mitch, to giving babies in Zambia their first check-ups, to helping Bosnian children use art therapy to deal with the destruction they have witnessed. There are also opportunities to work with local healthcare professionals who want to improve their conversational English and learn professional terminology. Some medical missions require previous international health experience or fluency in the local language. Ingenuity is always required because medical supplies, equipment, and medicine will be in short supply. The greatest requirement for a medical mission, however, is a sincere desire to put your skills to use in a region in desperate need of your services. How to make a difference Doctors Without Borders (Mdecins Sans Frontires) delivers emergency aid to people affected by armed conflict, epidemics, natural or man-made disasters, or exclusion from health care in more than 60 countries. Volunteers for its medical missions work alongside locally hired staff to provide medical care. Doctors Without Borders is looking for physicians, surgeons, anesthesiologists, registered nurses, nurse practitioners, certified nurse-midwives, midwives, mental health specialists, laboratory scientists and technicians, epidemiologists, logisticians, water and sanitation logisticians, and administrators. Basic requirements for Doctors Without Borders' medical missions include at least two years of professional experience, availability for a minimum of 912 months (sometimes shorter assignments are available for surgeons, anesthesiologists, OB/GYNs, nurses, and nurse anesthetists), flexibility, no recent gap in clinical experience greater than two years, and relevant travel or work outside the United States. Language skills (especially French) are a great plus. International Medical Corps seeks medical personnel for emergency situations and general assignments. Emergency response professionals are needed to be "on call" to mobilize on short notice for disaster relief assignments that can range in duration for a minimum of 2-8 weeks. General medical missions provide care and training in areas such as maternal and child care, HIV/AIDS and other infectious diseases, primary care, mental health, nutrition and agriculture, and sanitation and hygiene. AMIGOS offers medical missions for high school and college students (at least 16 years old by September 1st of the year of volunteer service). These 6-8 week summer projects in Latin America involve home improvement measures, health education, and (light) construction of health-related facilities. Students typically live with families in small communities in rural and semiurban areas and work with 2-3 other AMIGOS. Aina Aina facilitates initiatives in the area of education, information and communication for and with the support of local actors by rallying high-skilled international volunteers and local experts. Its mission is to foster the democratization process and to take part in the building or rebuilding of civil society in countries where it operates. Association-ASMAE ASMAE - Association Sur Emmanuelle is an international NGO devoted to children. Independent, secular and apolitical, ASMAE is

open to all. ASMAEs actions support the most underprivileged children, helping them to gain autonomy through education, healthcare and psychosocial assistance. ASMAE is active in 9 countries on 3 continents: Egypt, Lebanon, Sudan, Mali, Philippines, Madagascar, India, Burkina Faso, and France. ACTS OF WAR I. Explanation War is conflict between relatively large groups of people, which involves physical force inflicted by the use of weapons Warfare has destroyed entire cultures, countries, economies and inflicted great suffering on humanity. Other terms for war can include armed conflict, hostilities, and police action. Acts of war are normally excluded from insurance contracts and disaster planning II. Causes HUMAN-INDUCED DISASTERS A serious disruption triggered by a human-induced hazard causing human, material, economic or environmental losses, which exceed the ability of those affected to cope. a. Technological disaster Danger associated with technological or industrial accidents, infrastructure failures or certain human activities which may cause the loss of life or injury, property damage, social or economic disruption or environmental degradation, sometimes referred to as anthropological hazards. Examples include chemical attack, nuclear release and radioactivity, toxic waste, (explosions fires spills). Chemical Attack Nuclear Release Toxic waste Bioterrorism

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According to the U.S. Centers for Disease Control and Prevention (CDC): A bioterrorism attack is the deliberate release of viruses, bacteria, toxins or other harmful agents used to cause illness or death in people, animals, or plants. These agents are typically found in nature, but it is possible that they could be mutated or altered to increase their ability to cause disease, make them resistant to current medicines, or to increase their ability to be spread into the environment. Biological agents can be spread through the air, water, or in food. Terrorists tend to use biological agents because they are extremely difficult to detect and do not cause illness for several hours to several days. Some bioterrorism agents, like the smallpox virus, can be spread from person to person and some, like anthrax, cannot. examples- anthrax, smallpox, Water supply threats (for example,, Vibrio cholerae, Cryptosporidium parvum), SARS, H1N1 a strain of influenza, HIV/AIDS

RECENT STUDIES ACCORDING TO WHO/DISASTER CONTROL Man-made disaster control Medical missions give doctors, nurses, and other healthcare workers the opportunity "to help people" in the way they dreamed of when they were kids. Medical missions bring hope to the three billion people throughout the world who live without basic healthcare services. The World Health Organization states that 57 countries face a health workforce crisis. Each of these countries has fewer than 23 health workers (doctors, nurses, midwives) per 10,000 people. Medical missions aim to bridge that gap. Volunteers for medical missions are true heroes to those in need. Before medical missionaries for Doctors Without Borders (Mdecins Sans Frontires) went to Point Pedro Hospital in Sri Lanka a hospital serving 150,000 people in an area of armed conflict there was no surgeon, no anesthetist, and no emergency physician. Other medical missions have done everything from vaccinating people in El Salvador in the wake of

Anthrax SARS III. Emergency and Disaster Measure Technological disaster Safety measures in case of chemical attack Use the following precautions: Avoid exposure as much as possible. Cover the whole body to avoid direct skin contact (Use shoes, caps, body suits, gowns, rubber gloves and masks) and eye contact (Eye shields or protective glasses) Decontamination is mandatory to prevent continued exposure to the agent. Medical personal and helpers should wear chemical (butyl rubber) gloves during decontamination because latex gloves are not adequate. Victims should remove clothing and any visible agent on the skin, and move to an area free of vapor hazards. Physical removal of the agent is important. It can be done by wiping off the agent with dry powders (such as flour, powdered soap, or dirt), showering, washing with soap and water, washing with 0.5% hypochlorite solution, or using resin decontaminants. Eyes should be irrigated with water or saline Victims should be admitted to the intensive care unit after the decontamination. One animal study suggests that rapid application of providone iodine ointment (iodine) within 20 minutes of exposure to mustard liquid may protect the skin from vesication (blistering). Use of barrier creams may prevent dermal toxicity. Treat chemical burns in the hospital in ways that are similar to treatment of thermal burns: analgesia, infection control, and fluid replacement. Antibiotic ointments and silver sulfadiazine creams are recommended for topical burn care. Dermal hypersensitivity may respond to antihistamines or oral or systemic corticosteroids (steroids). All patients with ocular exposure should have contact lenses removed, and be thoroughly rinsed with saline. Topical mydriatics (medication to dilate the eye) antibiotics, and limited steroids (1224 hours) have been recommended. Mild respiratory exposure may respond to antitussives, warm humidified air, and bronchodilators (medication to relieve the spasm of the airway) for wheezing or bronchospasm. Persistent symptoms may suggest bronchitis, pneumonia, or pneumonitis, and will require more aggressive therapies Emergency measures of radiation The growth and use of radioactive product has increased considerably since about 1930. Radioactive sources have become part of normal school equipment and although the sources are very weak, it is essential to take stringent safety precautions. The following precautions are to be taken: The sources should only be handled by the forceps provided and never touched by hand. They should never be pointed towards a person.

Food should not be taken where the sources are being used, because it may become contaminated. Never smoke near a radioactive source. The user should wear rubber gloves, and hands should be washed after the sources have been put away safely.

According to the regulations and requirements of the Law on Prevention and Control of Contagious Diseases and relevant government documents, the authorities of Beijing Municipality have released 10 epidemic control measures to combat severe acute respiratory syndrome (SARS). 1. 2. 3. Prevention first Combating disease with community effort Epidemic situation known and societys supervision encouraged 4. Travel into and out of Beijing by plane, train or bus subject to quarantine 5. Strengthen prevention measures in schools and kindergartens 6. Strict control measures on migrant workers and construction sites 7. Enhance control measures for large-scale events and at cultural and entertainment facilities 8. Strengthen control measures for conference, tourism or study tours outsideBeijing 9. Improve medical treatment with better technology and management 10. Give help and support to frontline medical staff IV. Emergency and Disaster Management Disaster preparedness, including risk assessment and multidisciplinary management strategies at all system levels, is critical to the delivery of effective responses to the short, medium, and long-term health needs of a disaster-stricken population. (International Council of Nurses, 2006) MAJOR 1. 2. 3. 4. 5. ROLES OF NURSE IN DISASTERS Determine magnitude of the event Define health needs of the affected groups Establish priorities and objectives Identify actual and potential public health problems Determine resources needed to respond to the needs identified 6. Collaborate with other professional disciplines, governmental and non-governmental agencies 7. Maintain a unified chain of command 8. Communication

The U.S. Postal Service suggests that individuals should watch for mail/parcels that: are unexpected or from someone unfamiliar to you. addressed to someone no longer with your organization or are otherwise outdated. have no return address or have one that can't be verified as legitimate. are of unusual weight, given their size or are lopsided or oddly shaped. are marked with restrictive endorsements such as "Personal" or "Confidential" have protruding wires, strange odors or stains. show a city or state in the postmark that doesn't match the return address. What should I do if I've received a suspicious parcel in the mail? Do not try to open the parcel! Isolate the parcel. Evacuate the immediate area surrounding the parcel. Call Public Safety at ext. 6320 to report that you've received a suspicious piece of mail. Other Safety Measures: If you receive an envelope that appears to be empty: o Place the envelope in plastic bag. o Do not pass the envelope to others for inspection. o Wash your hands with soap and water. o Call Public Safety at extension 6320 and notify your supervisor. If you receive an envelope containing powder, and the powder spills out onto surface: o Do not clean up the powder. Keep others away. o Wash your hands with soap and water. o Do not try to brush the powder off of your clothes. o Avoid contact with others. o Call Public Safety at extension 6320 and notify your supervisor. o If possible, shut down any fans or air ventilation systems. o Leave the room and close the door, or section off the area to prevent others from entering (i.e., keep others away). o Remove clothing and place in a plastic bag as soon as possible. o Shower with soap and water as soon as possible. Do not use bleach or other disinfectants. o Put on fresh clothing. o Make a list of all people who had contact with the powder and give list to Public Safety. Ten-Point Safety Measures Against SARS

V. WHO recent study New psychological first aid guide to strengthen humanitarian relief Improving the mental health of disaster affected populations Joint news release WHO/War Trauma Foundation/World Vision Int. 16 AUGUST 2011 | GENEVA - Humanitarian emergencies such as earthquakes, extreme drought, or war - not only affect peoples physical health but also their psychological and social health and well-being. Psychological first aid guide for fieldworkers On World Humanitarian Day, celebrated on 19 August, WHO, the War Trauma Foundation (WTF) and World Vision International (WVI) announce the release of aPsychological first aid: Guide for fieldworkers. In the last five years the psychological damage left in the wake of tsunamis, earthquakes, droughts and

conflicts has proven as devastating as the physical damage", says Dr Bruce Aylward, WHO Assistant DirectorGeneral for Polio, Emergencies and Country Collaboration. "Recognizing that we can do more and do better for the mental health of disaster affected populations, WHO and partners have developed this guide to ensure that standards and best practices are consistently applied in humanitarian settings. Psychological first aid covers both social and psychological support and involves the provision of humane, supportive and practical help to people suffering from serious crisis events.

ROAD ACCIDENTS The World Health Organization use the term road traffic injury. Other terms that are commonly used include , car accident, car crash , road accident. occurs when a vehicle collides with another vehicle, pedestrian, animal, road debris, or other stationary obstruction, such as a tree, may result in injury, death and property damage. Causes 1. Human factors Human factors in vehicle collisions include all factors related to drivers and other road users that may contribute to a collision. Examples include driver behavior, visual and auditory acuity, decision-making ability, and reaction speed. 2. Motor vehicle speed That the evidence shows that the risk of having a crash is increased both for vehicles traveling slower than the average speed, and for those traveling above the average speed. That the risk of being injured increases exponentially with speeds much faster than the median speed. That the severity of a crash depends on the vehicle speed change at impact. 3. Driver impairment Driver impairment describes factors that prevent the driver from driving at their normal level of skill. Common impairments include: a. Alcohol vehicular deaths were associated with alcohol use. b. Physical impairment Poor eyesight and/or physical impairment, with many jurisdictions setting simple sight tests and/or requiring appropriate vehicle modifications before being allowed to drive. c. Youth Insurance statistics demonstrate a notably higher incidence of accidents and fatalities among teenage and early twenty-aged drivers, with insurance rates reflecting this data. Teens and early twenty-aged drivers have the highest incidence of both accidents and fatalities among all driving age groups. This was observed to be true well before the advent of mobile phones. Females in this age group suffer a somewhat lower accident and fatality rate than males but still well above the median across all age groups. d. Old age Old age, with some jurisdictions requiring driver retesting for reaction speed and eyesight after a certain age. Sleep deprivation Drug use Including some prescription drugs, over the counter drugs (notably antihistamines, opioids and muscarinic antagonists), and illegal drugs. Distraction Research suggests that the driver's attention is affected by distracting sounds such as conversations and operating a mobile phone while driving.

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Simple, practical guidance This guide - which can be taught to humanitarian workers within one day for immediate use - was developed in order to have widely agreed upon psychological first aid materials for use in low and middle income countries. It reflects the emerging science and international consensus on how to provide basic support to people in the immediate aftermath of extremely stressful events. Endorsed by 24 large international agencies, this guide gives simple, practical guidance for supporting people in ways that respect their dignity, culture and abilities. This guide will enable humanitarian and emergency workers from all over the world to provide basic but vital psychosocial support to people in acute distress, including helping distressed relief workers themselves. "Knowing how to support someone who has just experienced a crisis event - to listen, to comfort and to help them regain control of their situation in practical ways - is key in crisis situations. This guide will help humanitarian aid workers and others to offer support in ways that respect the culture, dignity, abilities and rights of survivors - wherever they are in the world." says Dr Leslie Snider, Senior Programme Advisor at the War Trauma Foundation in the Netherlands. Providing psychological support The guide orients humanitarian workers on how to give basic psychological support, i.e. to listen without pressing the person to talk; to assess a person's needs and concerns; to help ensure that basic physical needs are met; and to provide or mobilize social support, and to protect people from further harm. The guide emphasizes support and protection to people who may need special attention in crises, including separated children and adolescents, people with disabilities, and people at risk of discrimination or violence. This guide will enable us to rapidly scale up basic psychological first aid for adults and children throughout all our development and humanitarian emergency programming in almost 100 countries around the world reports Dr Stefan Germann, Director of Global Health Partnerships at World Vision International. The guide will be available in different languages. GROUP C: EMERGENCY ASSISTANCE: TO ROAD ACCIDENT VICTIMS

Road design serious crashes had contributing factors related to the roadway or its environment. Vehicle design and maintenance a. Seatbelts Research has shown that, across all collision types, it is less likely that seat belts were worn in collisions involving death or serious injury, rather than light injury; wearing a seat belt reduces the risk of death by about two thirds. b. Maintenance A well-designed and well-maintained vehicle, with good brakes, tires and well-adjusted suspension will be more controllable in an emergency and thus be better equipped to avoid collisions.

Although there is great diversity in application, there is general agreement on the principles of an effective emergency medical service. The essential functions of such a service are as follows: the provision of first aid and medical care to the casualties at the roadside; the transport of the casualty to a hospital; and the subsequent provision of more definitive treatment. The typical components of an ambulance service in a developed country are as follows: a notification and communication system; central control and coordination of operations; effective rescue and medical aid at the scene; and transport to a hospital and the provision of definitive care in an emergency department. PRIORITY ACTIONS NEEDED 1. Provide basic first aid information on treatment of accident victims (how to stop bleeding, choking, etc.) to all drivers (e.g., at the back of the highway code and through targeted publicity campaigns). 2. Train police, fire, and any other emergency service personnel in basic first aid. 3. Develop local and regional trauma plans based on study of postaccident assistance and consequences for road traffic accident casualties.

e. f.

The role of emergency medical services in minimizing the consequences of road traffic crashes lies immediately after the crash. The functions of an emergency medical service can be defined as: 1) the provision of first aid and medical care to accident victims at the roadside; 2) the transport of the victim to a hospital; and 3) subsequent provision of a more definitive treatment. While the quality of care provided by the emergency wards in hospitals is clearly of critical importance, it is beyond the scope of these brief sector guidelines and the focus here is on the care and transport of road traffic accident victims from the accident scene

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until reaching the hospital emergency ward or the nearest medical facilities. WHY IS EMERGENCY MEDICAL ASSISTANCE NEEDED? About 50 percent of road traffic deaths happen within 15 minutes of the accident as a result of injuries to the brain, heart, and large blood vessels. A further 35 percent die in the next 1-2 hours of head and chest injuries, and 15 percent over the next 30 days from sepsis and organ failure. The time between injury and initial stabilization is the single most import ant factor in patient survival, with the first 30- 60 minutes being the most important. The most serious injuries resulting from traffic accidents are head, spinal, and internal soft tissue damage to vital organs. Early treatment and stabilization of these typical accident injuries can enhance a patients timely and full recovery. Delay or wellintentioned but inappropriate first aid, can result in death or permanent disability. Medical experience around the world has demonstrated that stabilization of the injured person and hospitalization to a specialist center, within what they describe as the golden hour, increases the patients potential for survival and full recovery. Ambulance services are intended to meet the following needs: 1) 2) 3) 4) 5) rapid response to life threatening or serious incidents; preservation of life at the scene; prehospital life support and patient stabilization; and reduction in death and serious injury for accident victims 12.

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EMERGENCY DISASTER MEASURES AND MANAGEMENT IN ROAD ACCIDENTS 1. Deal with the immediate danger. 2. Assess the situation: what are the dangers? (These might include approaching traffic, leaking petrol, broken glass etc). 3. Fire and further collisions are the immediate dangers after a crash. 4. Do not allow anyone to smoke; there could be inflammable substances present. 5. Any vehicles involved in the crash should be approached with care. If it is safe to do so, turn off all engines, and alert oncoming traffic to the danger ahead. 6. Get Assistance. Attempt to get the help of any bystanders. 7. Ensure the relevant emergency services are called as soon as possible. They will require the precise location and the number of casualties and vehicles involved in the incident. 8. Help for those involved. 9. Do not move casualties who remain in their vehicles, unless they are in danger by doing so. Never remove a motorcyclists helmet unless deemed necessary. 10. Provide the necessary emergency care. Before caring for the casualties you should ensure you are not putting yourself in danger. 11. Check airway If it is safe to approach the injured person, do so, but dont move them Is the casualty responsive, ask them questions and if necessary shake them gently by the shoulders. Ensure

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normal breathing and that their airways are not blocked and are kept open. If necessary place a hand on their forehead and two fingers from the other hand under the chin and gently tilt the head backwards. Check to ensure breathing normally for up to 10 seconds if necessary. If they are not breathing correctly compressions should be administered to keep circulation going. This is done by placing both hands in the centre of the chest and pressing down approximately 4cm to 5cm at a rate of about 100 compressions per minute. This should be done for about 30 compressions then the head should be tilted back gently, the casualty's nostrils pinched together and two breaths of about one second administered with your mouth over theirs. Then repeat the process until normal breathing resumes. If the casualty is a child it may only be necessary to use one hand for the compressions, and use gentler breaths for small children. If the casualty is breathing but unconscious, place them in the recovery position if safe to do so until medical assistance arrives. If there is bleeding, first check if there are any objects in the wound. If the wound is clear of objects apply firm pressure over the wound. If there are objects embedded in the wound do not press them, and build up padding around the object. If a first aid kit is available fasten a pad to the wound with a bandage. If not using the cleanest materials available fasten a makeshift pad to the wound with cloth, this may mean ripping up clothing. If limbs are not broken but are bleeding, lift them above the level of the heart to reduce blood loss. If blood circulation is restricted for more than a short length of time long-term injuries could occur. If there are burns do not remove anything that may be stuck to it. The burn should be cooled if possible by dousing it in clean cold water for at least 10 minutes. Casualties may be suffering from shock so must not be given food or drink. Try and keep them warm and comfortable but avoid unnecessary movements. Try not to leave them alone they may wander off, and give them plenty of reassurance

material damage to her, collision or grounding, disablement, and also material damage caused by a ship. The oceanic area is very vast and therefore the variations in accidents are also numerous. The effects of the occurrences of marine accidents include not just humans but also the marine creatures and the marine environment and ecosystem. 1. Offshore Oil Rig Mishaps: Offshore oil rigs constitute great danger in terms of their heavy machinery and the complexities of the processes involved. Even a minor error by way of negligence of a simple process or overlooking in the working of a machinery part can lead to immense damaging consequences across the world. Cruise Vessel Mishaps: Cruise vessels form a very important part in the vacation itinerary of people. However, a major type of maritime accident occurs in cruise vessels. Cruise vessels could capsize or face tough weather conditions causing the ship to develop major problems. Another important case of accidents in cruise ships is because of the negligence on the part of workers. As per statistical data nearly 75% of fires are caused because of a mere mistake by people working on the cruise ship. Commercial Fishing Mishaps: Even fishing for commercial purposes can lead to fatal incidents being caused. Inexperienced fishermen sometimes even experienced ones can fall overboard. Harsh weather conditions can also could severe damages to a commercial fishing expedition. Accidents on Tugboats: Tugboats are those which help move huge ships to enter docks. They are small in nature but are powerful to ensure that the large vessels are handled safely. But sometimes because of the blockage of the visibility of tugboats by the larger vessels, maritime accidents occur. Also human error on the part of the pilot of the tugboat can also lead to unwanted and unexpected tugboat mishaps. Accidents on Crude Oil Tankers and Cargo Ships: The major cause of accidents on cargo tankers is explosions. Since the very nature of the materials these tankers transport is dangerous and highly flammable, even the most minor of explosions can cause enormous losses. According to statistics, one of the main reasons for oil tanker accidents occurring is because of workers negligence nearly 84-88%. Grounding of Ships: Ship grounding occurs when the bottom of the ships hull scrapes through the ocean-bed. This type of maritime accident has a lot of impact on the ships hull and more on the overall oceanic area where the grounding has started to occur and has finally culminated. The danger to workers aboard the ship is another important consequence because of the mishap. Maritime Accident because of Drugs and alcohol: Drug or substance abuse is a major problem across the world. Even in the marine world, substance abuse can cause irreparable damage. If the workers of a particular ship engage in substance abuse or alcohol, the addiction-induced frenzy could cause the worker to behave erratically and thereby lead to an unwanted maritime accident on board ships.

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MARINE TRANSPORTATION ACCIDENTS Waterways are critically important to the transportation of people and goods. Waterways, carrying 80% of the worlds total transport, are essential for domestic and international trade. The negative impacts of maritime transportation range from pollution associated with accidents to the environmental disturbances.. Existing maritime safety and security standards are important in controlling and mitigating the effects of pollutants on the marine environment. Marine Accident means one or more than one marine undesired incident which results in personal injury, damage or loss. Accidents include loss of life or major injury to any person on board, the actual or presumed loss of a ship, her abandonment or

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Crane Mishaps: Just like crane operations on the land, marine crane operations on ports and on ship are also risky. The risk is further stressed because of the oceanic operations where the cranes are required. Because of faulty wires or winches, crane workers can lose their life or in a worst case scenario, be alive but with irreparable physical handicap. Alternatively, accidents because of crane operations are also caused because of negligence and inexperience on the part of the worker. 9. Accidents in Shipyards: The shipyard is the place where the ship is assembled and constructed in its entirety. Fitting and welding accidents are common in the shipyard which could spare the worker his life but hamper the workers overall working abilities. Similarly constant inhaling of poisonous fumes also becomes another shipyard accident cause. 10. Maritime Accidents on Diving Support Vessels: People who want to explore the mysteries of the deep sea use a diving support craft to take a plunge into the water. However if the diving support craft is unfit and if the crew also happens to be really unfit to oversee and manoeuvre the whole operation effectively, a major accident can be caused 11. Accidents on Barges: Barge mishaps occur mainly because of the overall build of the barges themselves, which allows them limited movement on the water and because of the problems of the barge-towing equipments. These problems could be caused due to inexperience on the part of the person at the helm of the towing boats or due to usage of faulty towing cables. 12. Cargo Hauling Accidents: Cargo hauling maritime accidents are those accidents caused to workers who work as cargo haulers. However, according to several maritime accident investigations, it has been reported that cargo hauling workers overstate their cargo-hauling injuries. The maritime accident investigation, consequentially reports that because of this, this profession has one of the most severe rate of work-place absenteeism. It can be seen from the above mentioned types of maritime accidents, that mistakes on the part of the workers and operators play a major role in the accidents being caused. But in order to find out what was the actual cause of the marine accident, a maritime accident investigation is necessary. Causes of Major Maritime Accidents Maritime accidents can be caused by a range of complex factors, including (but not limited to): equipment malfunctions extreme weather conditions human error (i.e. the negligence, recklessness or inexperience of a captain, crew or passengers) intoxication of a vessel's operator(s) EMERGENCY & MEASURES EMERGENCY MEASURES ON MARINE ACCIDENTS Water Accident Response:

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Bring the victim to the surface as soon and as safely as possible. On the surface call for emergency assistance, then check victims airway. Start E.A.R. if required, taking care not to flood his lungs with water entering his mouth or nose. Remove to boat or to shore as safely as possible, taking care that no other injuries are sustained. Once in the boat or on shore, the most experienced rescuer takes control of the victim. He/She: a. Assesses the victim and the overall situation. b. Removes the victim to safety. c. Uses the Life Support Flow Chart to evaluate the collapsed victim. d. Checks victim's response to

c. d.

Minimize Heat Loss Signal Rescuers If you fall into the water and do not have on a life jacket get one and hold on to it or put it on. Putting on a vest while in the water is extremely difficult, but can be done. If you have never practiced this maneuver, you may find that you end up expending a huge amount of precious energy trying to get into the vest. Cold-water immersion is a sudden full body entry into cold water and it kills. Knowing how the body reacts to cold-water immersion can prepare boaters to correctly respond to this life-threatening situation and improve the chances of survival. If you fall into cold water (less than 55 degrees Fahrenheit), and are completely immersed, you may experience cold shock. Cold shock may cause an involuntary gasping, which, if you are underwater, means you can inhale water. Do not allow water to enter your airway!

Once the victim is staballised use 100% oxygen via properly fitting mask. Turn onto left side. Prevent further injury to limbs, skull and from cold.. Reassure victim if concious. Do not move the victim unless he is stable. When moving to enable E.A.R / E.C.M. avoid twisting or forward movements of the head and neck. Transportation in a boat requires great care and attention. Preform recovery checks every minute. Do not leave the victim at any stage. Self-Rescue: What to do if you end up in the water a. Dont Panic b. Get Out of the Water

Follow these steps for increasing your chances of survival (regardless of the water temperature): Prepare for cold-water conditions by always dressing for the water temperature and wearing appropriate flotation. Wear a float coat, survival suit, or wet suit (long or short) during cold weather. Always prepare for cold-water immersion when the combined water and air temperature is less than 110 degrees Fahrenheit. A boaters chances of surviving a cold-water immersion depend on being able to keep you head out of the water (wearing a life jacket), controlling breathing, retaining heat and quick rescue by self or others. Think about how you would reenter your boat if you capsized or fell overboard. If your boat is taking on water, avoid entry into the water as long a possible. Once you surface, control your breathing, and stay calm. Panicking doesnt help. Try to get back into the boat, whether over the gunnel or the stern. It takes an enormous amount of energy and physical strength to hoist yourself from the water into a boat. You will have to grab on to some part of the boat and pull yourself up and out of the water to a point where at least your chest is up and over the gunnel. Once the chest is partially inside the boat, kick your feet as if swimming and at the same time pull your body into the boat. If you cannot get into the boat, stay with the boat. Most boats have enough built-in floatation to remain at or above the water surface. Attempt to get as much of your body out of the water as possible to lessen heat loss and provide flotation. Use the H.E.L.P position Heat Escape Lessening Posture by pulling your knees into your chest, cross feet, cross arms over chest and float. If you cannot get into the boat, and because of the cold water, you may experience the inability to swim because of muscle contraction and drowning may occur. If you have nothing to hold on to, and are not able to grab flotation material, improvise. One way to improvise for a warm water environment is to take off long pants, tie leg ends together, pull the zipper up and blow air into the

legs (you will have to submerge your head to perform this task). This works well with blue jean material and will hold air for several minutes. As air escapes, blow more air into the waist opening. If near the shoreline or other boats, yell or scream for help. If signaling devices are available, use them to attract attention, but save one or two until you actually see a potential rescuer. Any shiny object can be used to attract attention. Attempt to maneuver to the nearest shore or shallow water.

Rescue of Others If a passenger of your boat falls overboard, and you are the operator, follow these steps for retrieval: Note which side the person fell overboard, and turn the boat to the same side. This action forces the stern (and the propellers) away from the person. Keep a constant eye on the person in the water and throw a flotation device to them. If you have GPS, lock in a waypoint. Sound the danger signal of 5 or more short and rapid blasts to alert all other boats that there is an emergency situation in the area. Approach the person by directing the boat into the seas and/or wind. This action prevents the boat from drifting into the person and allows the operator better maneuverability. Maneuver along side the person, and once close, bring engine(s) to neutral and shut off the engines. Once along side, toss the person a line or extend a boat hook and pull them to the boat. Assist the person to the swim platform, or lowest freeboard area of the boat. As you assist the person into the boat, STAY AS LOW AS POSSIBLE, either on your knees or with knees bent and feet spread well apart, to prevent yourself from being pulled into the water. Maintaining balance is crucial. Once recovered, check person for signs of trauma. RUNNING AGROUND Running aground can happen to the best mariner. Knowing how to navigate and gaining local knowledge of the area will greatly reduce risk of grounding your boat. The local boaters know where the hidden dangers lie! Boating accidents continue to indicate that a lack of understanding of local conditions contributes to boating fatalities. There are different degrees of being aground. You can be hard aground meaning you hit so hard that the hull imbedded into the bottom material, the hull may be breached (has a hole) or the forward motion of the boat is immediately stopped. Soft aground means you bumped the bottom, or moved into a very soft type of bottom, such as sand or mud. Actions to take if aground Everyone puts on a life jacket. Remain calm. DO NOT put the engines in reverse in an attempt to undue what has already happened. Assess the damage. Check all bilge areas for signs of water. Listen to gas and water tank vents for sounds of

rushing air. Rushing air means water is entering the tanks and forcing air out through the vents. If necessary, anchor the boat. If you are in tidal waters, find out the status of the tide. If it is incoming, you may be able to wait for the water level to rise and lift your boat enough to motor out of the area. If you bent the propeller, the rudder or damaged the shaft or its support, you will immediately notice a violent vibration when you reengage the engine. If this happens, stop your boat, anchor if feasible and call for assistance. Continuing to operate your boat with damage can cause even more serious damage. If there are no obvious signs of structural damage, you have a few choices to consider - is the tide incoming or outgoing? Will the tide be enough to re-float the boat? If there is no tide, determine if you can maneuver the boat out of the area (generally in the reverse direction) without causing damage. Raise the motor or outdrive to the point where it is just under the surface of the water and have passengers move to the opposite side of the boat from the impact area. Place the engine in reverse and use just enough throttle to move the boat.

Everyone must put on a life jacket. Radio or call for immediate assistance.

If you decide to fight the fire, follow these steps: a. Attempt to stop the source of the fire (fuel lines, electrical panel, etc). b. Maneuver the boat so the prevailing wind helps blow the smoke or flames to the outside of the boat (for a stern fire, point the bow into the wind; for a fire near the bow, point the stern into the wind). c. When using a fire extinguisher, remember the word PASS: P ull the pin A im the extinguisher at the base of the flames S queeze the handle trigger S weep back and forth into the flame base Note - many of the newer boats with I/O engines have an opening in the engine cover (called a port) where the extinguisher nozzle is inserted, allowing you to apply the extinguishing agent without lifting the cover. After the Fire is Out Be aware that the fire may restart at any time. Keep a constant watch on the area. Do not attempt to restart the engine until you are certain of the fire source. If no towing assistance is available, use flares to signal for assistance. If the engine and steering are still functional, return to the nearest safe landing. CARBON MONOXIDE (CO) POISONING Carbon monoxide is an odorless, colorless, tasteless gas that can be toxic even in small quantities and is produced by internal combustion engines, generators, and other equipment commonly used by boaters. The effects of carbon monoxide can overcome people who are on and around boats. The symptoms of CO are so similar to seasickness (nausea, dizziness, mild headache, light-headedness) many boaters may not know they are suffering from the effects of CO. Generator exhaust and swim platforms are a deadly combination. When the generator is running, CO builds up in the swim platform cavity, as well as rear deck space. CO levels can be so high that it creates an imminent danger of death for anyone who enters the cavity even for a very short period of time. CO poisoning is an extremely dangerous matter that could result in serious injury or death. All boat ownersmust heed this warning. Treatment of CO Poisoning Evacuate Move the person to fresh air. Seek immediate medical attention. Ventilate - Open doors, windows, hatches and canopies. Investigate Find the source of the CO and take corrective measures to prevent further contamination. EMERGENCY & DISASTER MANAGEMENT

FIRE FIGHTING A boat fire is a serious marine emergency. You have only seconds to make a decision to fight the fire or abandon the boat. Classification of Fire Extinguishers B = flammable liquids C = electrical Extinguishing Agent

A = combustible materials Water CO2 Dry Chemical

Fire prevention Keep extinguishers properly charged. Periodically check per the manufacturers suggestion. Know location of fire extinguisher(s) and have them readily accessible. Keep all flammable liquids in a proper storage container. Do not smoke around flammable liquids or keep open flames. Check all fuel line connections frequently. Inspect electrical wiring. Keep battery terminals clean. The Fire Triangle Fire needs three elements to start or continue burning. The three elements are Heat, Fuel, and Oxygen. To extinguish a fire, one of the three sides of the fire triangle must be removed. A Type-B, USCG-approved fire extinguisher removes the oxygen by placing a layer of chemical between the fuels which prevents oxygen from reaching the fuel. Firefighting At the first sign of fire, prepare to either fight the fire or abandon ship. Immediate action is essential. Never put the lives of your passengers at risk to save the boat. Staying onboard too long can be worse than abandoning ship.

Rescue An injured diver must be removed from the water as quickly as possible. If the diver is unconscious and beneath the surface of the water, then they should be surfaced and decompressed in the head upright, normal anatomic position with special attention being paid by the rescuer to the maintenance of a patent airway. Surfacing feet first would delay the initiation of mouth to mouth for a short period. Air would continue to be forced from the lungs by ascent either way you raise the diver. PADI states that head up is the appropriate method. On the surface, the 'do-ci-do' left sided position is what is being taught for mouth to mouth initiation of breathing. Getting the unconscious diver to the surface as fast as reasonably possible, head up and with the regulator in place would be my recommendation. NOAA does not address this in their new manual and I cannot find any reference to position of retrieval in the Navy manual. A SCUBA diver in this context should have their regulator placed in their mouth, but no attempt at "purging" gas into the injured diver should be made. Divers using rebreathing systems, full-face masks, band masks or helmets should be "flushed-through' with fresh gas, preferably from an alternative emergency gas supply, before swimming them to the surface or recovering them to a platform or bell. Specific techniques for recovery of a diver into and resuscitation of a diver in a bell or hyperbaric rescue vessel are needed and must be practiced. In the absence of such a platform, the injured diver should be made positively buoyant by removing their weight-belt and perhaps by inflating their buoyancy-compensator (providing it neither limits access for the rescuer nor causes the injured diver to float "facedown'). The injured diver's air tank should be left in-situ as it acts as a keel. The rescuer should adjust their own buoyancy by buoyancy-compensator inflation and not by dropping their weightbelt in case they lose hold of the injured diver and have to recover them again from underwater. The utility of expired-air-resuscitation (EAR) in the water, either directly or via a snorkel, is debatable. Certainly there is a significant difference between conducting EAR in a swimming pool and in the ocean in this context, effective in-water EAR is only possible with continual practice in the ocean and, in general, an injured diver's best interests are usually served by protecting their airway and getting them out of the water as quickly as possible. RESUSCITATION Effective EAR and chest compression ( which obviously should not be attempted in the water ) are life-saving if cardiorespiratory arrest occurs, regardless of the cause of the injury. Techniques should not vary between the diver who has drowned and the diver who has been envenomated, nor should it be altered for a hypothermic diver (in whom it must never be abandoned until after re-warming has been completed). POSITION

If any form of decompression illness (DCI) is suspected, then the diver must be laid flat and not allowed to sit-up or stand as this may cause bubbles to distribute from the left ventricle and aorta to the brain. Although such posture-induced phenomena are unusual (rare), they have a very poor outcome. This posture must be maintained until the injured diver with DCI is inside a recompression chamber (RCC). A headdown posture is no longer advocated as it may increase the return of and subsequent "arterialization" of venous bubbles, it causes cephalic-venous engorgement such that subsequent middle-ear inflation (e.g. in a RCC during treatment) is very difficult, it limits access for resuscitation and assessment, and, in animal-model studies it actually retards the recovery of brain function in comparison to the horizontal posture. OXYGEN With the exception of oxygen toxicity, administration of 100% oxygen is useful in all diving accidents. Although divers who have pulmonary oxygen toxicity need to breathe a PiO2 of less than 0.6 Bars, many of those who have had an oxygen-induced convulsion will subsequently become hypoxic and need oxygen administration. To administer 100% oxygen, a sealing anesthetic-type mask is needed (unless a mouthpiece and nose-clip in a conscious diver or an endotracheal tube is used) and a circuit with high gas flowrates and a gas reservoir must be used. Air breaks, to retard pulmonary damage, may be needed, but should be minimized as must all other interruptions. This is one of the reasons why oral rehydration is not particularly useful. It is noteworthy that administration of 100% oxygen is the definitive treatment of the salt-water aspiration syndrome and most pulmonary barotrauma, including the majority of pneumothoraces. Indeed, chest cannulation is rarely needed. Transportation As for any retrieval of an injured person, stabilization of the diver must precede transportation. This will include resuscitation, delivery of oxygen, insertion of an intravenous line, correction of hypothermia (in divers in the field this should be based on passive re-warming using dry clothes and blankets) or hyperthermia (most likely in closed-diving systems and again the response will need to be specifically developed and practiced), control of hemorrhage and splinting of fractures. A record of oxygen administration and fluid balance is essential. If DCI is suspected, then the retrieval must not exceed 1000 ft above sea level. A transportable recompression chamber is ideal, but hyperbaric transportations are logistically difficult and considerable time-savings are needed to justify this activity. Many aircraft can be pressurized to "sea-level' during flight, although this usually limits the altitude at which they can fly (and hence makes the retrieval slower and more fuel-expensive). Unpressurized aircraft are intrinsically unsuitable and must fly at less than 1000 feet, which is often not possible. Road transport may also be inappropriate depending upon the road's altitude, contour and surface RECENT STUDIES

Code for the Investigation of marine casualties and incidents A.849(20) and A.884(21) (MSC 68/23/add.I, annex 8) This Code recognises that under IMO Conventions each Flag State has a duty to conduct an investigation of any casualty occurring to any ships when it judges that such an investigation may assist in determining what changes in the present regulations may be desirable or if such a casualty has produced a major deleterious effect upon the environment. This Code also takes into account that under the provisions of UNCLOS Article 94, a Flag State shall cause an inquiry to be held, by or before a suitably qualified person, into certain casualties or incidents of navigation on the high seas. However, the Code also recognises that where a casualty occurs within the territorial sea or internal waters of a State, that State has a right, under UNCLOS Article 2, to investigate the cause of any such casualty which might pose a risk to life or the environment, involve the coastal States search and rescue authorities, or other wise affect the coastal State. The FSS Fire Safety Systems Code has: Fire extinguishers Fixed gas fire-extinguishing Fixed foam fire extinguishing systems Fixed pressure water-spraying and Automatic sprinkler, fire detection and fire alarm Fixed fire detection and fire alarm Fixed emergency fire Fixed deck foam Inert gas systems MAIIF (Maritime Accident Investigators International Forum) MAIIF is an international non-profit organization dedicated to the advancement of maritime safety and the prevention of maritime pollution through the exchange of ideas, experiences and information acquired in marine accident investigations. Its purpose is to promote and improve marine accident investigation, and to foster cooperation and communication between marine accident investigators. MARINA Maritime Industry Authority c/o Department of Transport and Communication PPL Building, UN Avenue, Manila Philippines The Philippines Maritime Authority is an agency of the Philippine government under the Department of Transportation and Communications responsible for integrating the development, promotion and regulation of the maritime industry in the Philippines. It was created on the 1st of June, 1974 with the issuance of Presidential Decree No. 474 to integrate the development, promotion and regulation of the maritime industry in the country. The regulatory function of the MARINA was increased with issuance of EO No. 1011 which abolished the Board of Transport and transferred the quasi-judicial functions pertaining to water transportation to the MARINA. On 30 January, 1987, EO No. 125 was issued reorganizing the Department of Transportation

and Communications. The powers and functions of the department and the agencies under its umbrella were redefined and have further strengthened the responsibility of the MARINA to the industry

INJURIES ON UK FLAGGED VESSELS ASSOCIATED WITH OFFSHORE INDUSTRY (1991 2004) Amputation of hand/ fingers/ toe Bruising Burns/ scalds other Chemical poisoning/ burns from contract or inhalation Concussion/ unconsciousness due to head injury Crush injury Cuts/ wound/ lacerations Death - confirmed Dislocations Eye injuries Fracture of the skull/ spine/ pelvis/major bone in arm or leg Hypothermia body temperature too cold Other Strains other strains/ sprains/ torn muscles/ ligaments Strains strained back Unknown Total 5 49 3 4 7 32 51 6 10 5 60 4 27 40 40 38 41 2

situations these incidents can be completely avoided through careful preparation and effective safety techniques. When flight crew and pilots do their jobs correctly, aviation accidents are much less likely to occur. If your life has been impacted by an aviation accident, it is important to understand the conditions surrounding this event. You should be familiar with your legal rights and the actions you may be able to take against those who are responsible for the chaos you have endured. By speaking with a compassionate aviation attorney you can alleviate some of the suffering you have gone through. Do not hesitate to move forward towards a brighter future. Speak with an experienced lawyer today. 1. Decent and Landing Accidents Descent and landing accidents account for 36 percent of all general aviation mishaps and the most common type of accident. There are five stages of the descent and landing process. These include descent, approach, landing, go-around or aborted landing, and taxi. When a problem occurs during any of the five steps, an accident could result. Although not all accidents result in death, there is an increased likelihood of injury and fatalities may occur. Naturally, such consequences of an otherwise typical descent and landing can be incredibly painful for pilots and passengers alike. Individuals and family affected by descent and landing accidents should be fully aware of their legal rights. Any type of aviation accident can be a demanding and stressful time for you. Seeking help from an experienced attorney can help make sense out of chaos. 2. Aborted Landings An aborted landing is a circumstance where the pilot of a plane must take control and abandon his or her landing plan for a safer alternative. This usually requires a second go-around followed by a successful landing, but sometimes complications can arise. Aborted landings are done out of necessity and to ensure the safety of all pilots and passengers involved. Frequently, aborted landings are a result of runway obstructions. Sometimes other planes may be sitting on the runway when a pilot is preparing to land, requiring the other planes to move out of the way and the landing plane to make a detour. Unfortunately, sometimes aborted landings can go horribly wrong and tragic aviation accidents can result. It is imperative to know your legal rights as a passenger of an airplane. It is the pilots job to know when an aborted landing is appropriate and required. If you have been involved in an aviation accident resulting from an aborted landing, contact an experienced attorney today. By working with legal experts you can recoup medical expenses and prepare for the future. 3. Defective Landing Gear Landing a plane safely is perhaps the most important part of a pilots job. Sometimes this task is complicated not through the fault of a pilot but as a result of defective landing gear on the plane itself. It is not difficult to imagine the complications and disasters defective landing gear could cause. Defective landing gear situations can lead to panic and horrible accidents. One famous case of such circumstances resulted in the 1972 plane crash of Easter Air Lines Flight 401, in which nearly

100 people were killed. Defective landing gear can lead to some of the most dangerous and horrendous aviation tragedies imaginable. Fortunately, passengers and pilots have legal rights and actions they can take in cases involving defective landing gear. Investigators in the past have found manufacturer defects in landing gear devices that have lead to extensive compensation to victims and their families. If you or someone you care about has been victim of an aviation accident involving defective landing gear, the time has come to contact an experienced attorney. Do not wait any longer to get receive the justice you and your family deserves. 4. Taxi and Takeoff Accidents One of the most important parts of a flight is the preflight and planning stages of the operation. This involves preflight inspections for safety, flight preparation, taxiing, and takeoff. When combined, taxi and takeoff accidents account for about 22 percent of all commercial jet airplane accidents and about 22 percent of all fatalities. Although taxi and takeoff accidents may not always be visually dramatic, they can still cause fatalities and injuries. Additionally, the amount of psychological trauma sustained by those involved with a taxi or takeoff accident is immeasurable. It is important for you to be fully aware of your legal rights. If you have been affected by a taxi or takeoff accident, you deserve to have an experienced attorney investigate your case. In some circumstances the trauma you have suffered from could have been avoided by a pilot conducting his duties correctly. Contact a legal professional today and schedule a consultation regarding your taxi or takeoff accident. 5. Preflight Accidents Before taking off, it is the responsibility of the pilot or airline to perform a complete inspection of the plane to make absolutely certain it is safe to be airborne. This process involves the checking of gauges, displays, instruments, and all parts of the plane to ensure its safety. There have been cases in the past where operators have failed to perform adequate preflight inspections. The results can be absolutely catastrophic. Whether there are no injuries or hundreds of deaths, it is a tragedy any time a preventable aviation accident occurs. If your life has been affected by a preflight accident it is important for you to know your legal rights. You deserve to receive compensation commensurate to your suffering. Do not hesitation to contact an experienced aviation attorney today. 6. Climbout Accidents The period of flight during takeoff and climbout can be extremely dangerous for pilots and passengers alike. Much of the uncertainty during this time can be prevented with effective flight planning. However, when pilots or staff members fail to be vigilant in planning their ascent, climbout accidents may be more likely to occur.

Causes and Common Types of Aviation Accidents. Types of Airplane Accidents:Decent and Landing AccidentsTaxi and Takeoff AccidentsMechanicalFailuresPilot Errors and NegligenceFuelMismanagementInclementWeatherOther Causes An aviation accident is the worst nightmare of every pilot or passenger that has ever ridden in an aircraft. Although air travel is one of the safest forms of transportation, accidents do happen with dramatic and terrifying results. The causes of these aviation accidents vary greatly depending on specific circumstances and problems that may develop during the flight process. Descent and landing accidents, taxi and takeoff mishaps, mechanical failures, pilot errors, fuel mismanagement, and poor weather are only some of the many plights that can lead to injuries or death in the sky. Although popular opinion may suggest that aviation accidents are caused by bad luck, in many

Wind conditions can dramatically influence flight plans during climbout. Without compensating for gusty winds, the plane may be pitched from side to side which can result in a crash. Similarly, if adequate airspeed is not maintained during climbout the plane may stall and a severe aviation accident may result. If you or someone you care about has been involved in a takeoff or climbout accident, it is essential that you are made aware of your legal rights. In some cases, these types of aviation accidents can be prevented through effective planning. Speak with an experienced aviation attorney today to determine a course of action to take. 7. Mechanical Failures No form of transportation is completely safe, and no machine is completely foolproof. Murphys Law states that anything that can go wrong will go wrong. Tragically, this sometimes applies to aviation accidents when mechanical failures occur. Mechanical failure is responsible for 13 percent of all commercial airplane accidents from 1950 through 2004. Aircraft are complicated instruments that require the use of extensive electronics and technology. Although usually safe, there are circumstances when a single malfunction or failure can lead to catastrophic accidents. Unfortunately, when these accidents occur on commercial airlines hundreds of lives are jeopardized. If your life has been affected by an aviation mechanical failure, it is important for you to know your legal rights. By contacting an experienced attorney you can prevent other families from suffering from the same hardships you have gone through. Nobody should perish as a result of faulty manufacturing. You owe it to yourself and others to speak with a lawyer today. 8. Electrical Malfunctions Aging electrical systems on older airplanes can cause severe aviation accidents. Electrical malfunctions can be deadly because electrical systems control many of the instruments pilots rely on to fly steadily. When these instruments are unreadable, pilots must fly blindly and the lives of pilots and passengers are put at risk. Some of the wires used in electrical systems are not insulated adequately and as a result lack durability and fire resistance. Electrical fires on airplanes have deadly consequences. Additionally, electrical malfunctions may cause certain systems on the plane to act erratically, making control of the airplane challenging or completely impossible. If your life has been affected by an aviation accident, you owe it to yourself and your family to contact an experienced attorney. An investigation into the causes of the accident may suggest that an electrical malfunction took place. This finding could lead to your family receiving reparations for your suffering. Do not hesitate to take steps to obtain your legal rights. Speak with a legal expert today. 9. Fixed-Wing Accidents When most people think of an airplane, the mental image they conjure up is that of a fixed-wing aircraft. The term fixed-wing can

apply to monoplanes, biplanes, and triplanes. Fixed-wing airplanes are by far the most commonly used vehicles for commercial and recreational recreation. No form of transportation is completely safe, and when fixed-wing accidents occur the effects can be tragic. The visual image of a plane crash has created a fear of flying in countless people, and although not every fixed-sing accident results in death they can certainly be described as traumatic experiences for pilots, passengers, and witnesses. It is important for victims of fixed-wing accidents to be aware of their legal rights. By speaking with an experienced aviation attorney, you can relieve your suffering and move forward. You deserve to live an unencumbered life free from the extensive pain fixed-wing accidents can cause. Do not hesitate to speak with a legal professional today. 10. Engine Failure Engine failure is a mechanical problem that can easily lead to aviation accidents. There are many reasons engine failure may occur, including an insufficient fuel supply and the breaking of engine parts. Pilots and crew are specially trained to manage engine failure as best they can by gliding the plane to a safe landing, but sometimes the aviation accidents resulting from this mechanical problem can be horrific. It is important to note that not all engine failures result in accidents. In certain situations, pilots can regain control of the aircraft without much difficulty. However, when engine failure occurs and an aviation accident results it is an indication of significant problems and risks. If your life has been affected by an aviation accident caused by engine failure, you need to be aware of your legal rights. Take the time to discuss your case with an experienced lawyer who can help provide closure to your suffering. One brief phone call today could result in a brighter future tomorrow.

The rudder on an aircraft is an essential component on the tail that is used by the pilot to control the yaw axis. In aviation, the yaw axis describes the rotation about the vehicles normal axis or center of mass. The rudder of an airplane is usually controlled by foot pedals, and when the pedals or rudder are defective the pilot becomes unable to fully control the plane. The Boeing 737 is the worlds most widely used commercial airliner with over 3,000 in service. The 737 also has been shown to have rudder malfunctions and defects when the plane is flown at low speeds. This condition has resulted in several terrible aviation accidents. Fortunately, the families of some victims knew their legal rights and sought compensation for their suffering. If you have been involved in an aviation accident due to a defective rudder, it is essential that you also know your legal rights. By speaking with an aviation attorney you can benefit from his or her experience in settling cases similar to yours. You owe it to yourself and your loved ones to be vigilant and seek justice for the loss you have suffered. 13. Defective Gauges/Instruments The gauges and instruments in the cockpit of an aircraft allow the pilot to control the vehicle he or she is flying. These gauges and instruments provide power, fuel supply, temperature, altitude, speed, position and other information that allows the aircraft to operate safely. When a pilot encounters defective gauges or instruments he or she loses the ability to fully understand certain aspects of the vehicle they are flying. Being unaware of this vital information naturally results in aviation accidents for even the most experienced aviators. Most pilots are taught to trust their instruments instead of their own intuition. Defective gauges and instruments have lead to some horrific mishaps for pilots, passengers, and people on the ground. If you have been involved in an aviation accident that may have resulted from defective gauges or instruments, contact a legal expert as soon as possible. No form of electronics is completely foolproof, but you deserve to have quality products working for you when airborne. Do not hesitate to seek justice for your suffering. Speak with an experienced attorney today. 14. Pilot Errors and Negligence When most people make mistakes at their jobs, their employment can be terminated. When pilots are negligent or make errors while on the job, there is the potential for hundreds of lives to be terminated. Pilots receive extensive training designed to prepare them to handle a wide variety of situations, but there are times when fatal mistakes are made. Pilot error accounts for 37 percent of all commercial airplane accidents from 1950 through 2004. There are a variety of errors pilots and flight crew can make that result in aviation accidents. These could include a lack of planning, maintenance problems, faulty maneuvers, and in some cases simple irresponsibility. It is truly tragic that the oversight of some could result in the fatalities of others.

11. Defective Landing Gear When mechanical problems affect the landing gear of an aircraft, a pilots ability to land safely is compromised. Defective landing gear can result in panic and quick decisions that have lead to truly tragic aviation accidents in the past. Nearly 100 people perished when Easter Air Lines Flight 401 crashed in 1972. It was later determined that defective landing gear caused this tragic accident. Fortunately, pilots and passengers can take legal action against companies that manufacture defective landing gear systems. Some of these cases can result in financial compensation for suffering and ensured safety for future flights by preventing the installation of defective landing gear in the future. If you have been affected by an aviation accident involving defective landing gear, speak with an experienced aviation attorney today. You owe it to your family and the families of other victims to activate your legal rights and obtain justice. 12. Defective Rudder

If you have been affected by an aviation accident that resulted from pilot error or negligence, you deserve justice for the loss you have suffered. Experienced aviation attorneys specialize in cases like yours and can help you make sense of the chaos that has entered your life. Contact a legal professional today. 15. Faulty Flight Maneuvers Faulty flight maneuvers can be avoided when pilots are cautious and act professionally. Steep turns, slow flight, stalls and stall recovery, spins and spin recovery, and forced landings are all procedures that pilots should have mastered before earning their license. Sadly, in rare situations some licensed pilots make mistakes that can cost the lives of themselves or innocent others. These faulty flight maneuvers can be in response to external factors, but in the end a pilots inability to make the right decisions can lead to a serious aviation accident. Accidents that can arise from faulty maneuvers in flight may include collisions between planes, spins, crashes, and botched takeoffs or landings. If you or someone you care about has suffered from a pilots faulty flight maneuver, it is essential that you understand your legal rights. Nobody deserves to pay for the mistakes of others. Speak with an experienced lawyer about obtaining justice today. 16. Pilot Heart Attack/ Stroke Pilots are under tremendous amounts of stress while flying. It is their duty to ensure the safety of themselves and all the passengers on board. US Navy studies have found that most pilots experience an increase in their heart rate when landing or taking off that can be explained by the high level of concentration required to perform these tasks safely. Whatever the causes may be, if a pilot suffers from a heart attack or stroke while operating an aircraft he or she is increasingly likely to lose control of the vehicle and cause an aviation accident. With a pilot incapacitated, it is up to the flight crew and air traffic control to guide passengers to safety. If the combined efforts of these people are not successful, injury or death is likely to occur. It is important to know your rights if your life has been impacted by a pilots heart attack or stroke. Have an aviation attorney review your case to determine what legal action you may be able to take against those who are responsible for your loss. With the help of an experienced lawyer you may be able to bring closure to this troubled time. 17. Pilot Intoxication Federal law dictates that pilots cannot drink alcohol within eight hours of a flight. This is because the level of attention to safely pilot an aircraft is extremely high. Studies have suggested that the number of serious errors made by pilots dramatically increases at blood alcohol concentration (BAC) levels as low as 0.025%. The effects of alcohol consumption can impact pilots who are not intoxicated at the time of flying. A hangover effect can be extremely dangerous for individuals attempting to operate aircraft. Symptoms of a hangover include headache, dizziness, dry mouth, stuffy nose, fatigue, upset

stomach, irritability, impaired judgment, drowsiness, and increased sensitivity to bright light. It is not safe for a pilot to fly with these symptoms. A pilots ability to remain alert and safe is severely impaired when he or she is intoxicated. Pilot intoxication is no mistake. If you have been impacted by an aviation accident that arose out of pilot intoxication, you owe it to yourself and your loved ones to speak with an attorney about your legal rights. Justice must be sought for individuals who risk the lives of themselves and others by attempting to pilot an aircraft while intoxicated. 18. Pilot Epileptic Attack People diagnosed with epilepsy are forbidden by law to fly aircraft by the Federal Aviation Administration. This is due to the incapacitating effects an epileptic seizure could have on a pilot. Although there are different forms of epilepsy and a wide range of seizure severity, individuals suffering from epilepsy may not become licensed pilots. Pilots may experience seizures caused by other conditions while in flight that can result in aviation accidents. When individuals are found to suffer from seizures, they are usually deemed unable to fly. If they continue to fly, they are putting themselves and others at risk. It is wrong to endanger the lives of others as a result of ones own negligence. If you have suffered from an aviation accident arising from a pilots epileptic attack, it is in your best interests to contact an aviation attorney today. By working with an experienced professional you can determine your legal rights and bring your pain to an end. 19. Fuel Mismanagement Fuel mismanagement often results in some of the most avoidable aviation accidents. There are two main forms of fuel mismanagement: fuel exhaustion and fuel starvation. Fuel exhaustion takes place when the aircraft is completely out of fuel, while fuel starvation occurs when fuel remains but the pilot does not switch tanks after one runs dry. Pilots and flight crew have a responsibility to plan every aspect of their flight, including fuel usage. By underestimating the amount of fuel required for a journey, they are putting the lives of others at risk. General aviation fuel accidents occur at a rate of three per week. In addition to the two types of fuel mismanagement already described, other fuel problems that can result in aviation accidents include leaks, the use of wrong fuel, and fuel pump malfunctions. It is important to know your legal rights if you have been affected by an aviation accident stemming from fuel mismanagement. Contact an experienced attorney immediately to learn more about the actions you can take to ensure the well-being of yourself and your loved ones. 20. Gas/ Fuel Leak When a gas or fuel leak occurs, fuel mismanagement is likely to occur. When pilots plan their flights they load their aircraft with fuel accordingly. The onset of a leak can severely shorten the amount of time one may safely fly. Pilots must act quickly when they observe a leak taking place. In some instances, by acting

quickly and appropriately pilots may be able to avert an aviation accident. Gas and fuel leaks are often the result of a manufacturing problem, but the management of these defects is the responsibility of the pilot and flight crew. When pilots act accordingly, disasters can be avoided and fuel leaks can result in a minimal level of interference with prior flight plans. Gas and fuel leaks are a nightmare for both passengers and pilots. The simple fact is that this mishap can easily be avoided. Speak with an attorney about your legal rights and learn more about the actions you can take to obtain justice against those responsible for the accident that has impacted your life. 21. Wrong Fuel Usage It is extremely important for the correct fuel to be used in aircraft engines. Reciprocating engines require avgas, while turbine engines must run on jet fuel. Engine damage and other malfunctions are common consequences of using the wrong fuel. In some cases damage may occur slowly over time but in other circumstances overheating or combustion may take place. In many cases, incorrect fuel usage is a result of misleading signs or inattentive personnel performing the refueling. In these instances, wrong fuel usage is completely preventable. The risks of this form of fuel mismanagement affect owners, pilots and passengers alike. The owners suffer because their airplanes are damaged, pilots must deal with the stress of responding to the engine problems caused by wrong fuel usage, and the safety of passengers is compromised. Due to the potential consequences of wrong fuel usage, it is important for aircraft owners, pilots, and passengers to be familiar with their legal rights in these instances. An experienced aviation attorney can help you plan a course of action to take against those responsible for you being harmed. If you have been affected by a wrong fuel usage incident, speak with an experienced lawyer today. 22. Fuel Pump Malfunction Aircraft fuel is what feeds engines and allows a vehicle to become and remain airborne. When the supply of fuel is interrupted, the fate of the aircraft is jeopardized. The fuel pump of an aircraft allows fuel to be distributed from tanks to the engines. When fuel pump malfunctions occur the results can be deadly. Fuel pump malfunctions can result in an inoperative fuel pump and subsequent fuel starvation. Fuel remains on the plane, but it is inaccessible because there is no way for it to reach the engines. When this takes place an aircraft must rely on its gliding ability to land safely. The lives of everyone on board are the responsibility of the pilot and flight crew. Clearly, fuel pump malfunctions can create painfully stressful and lethal aviation accidents. The simple truth is that no aircraft should carry parts that fail. Everyone component must be continually checked for malfunctions that could compromise the safety of those on board. If you are victim of a fuel pump malfunction that has impacted

your life, it is imperative that you exercise your legal rights. Do not wait another moment to speak with an aviation attorney who can help you make sense of your case and return you to the comfortable life you once lived. 23. Inclement Weather Over an eleven year period there were over five thousand light aircraft accidents in the United States relating to inclement weather. Of these, over 1,700 resulted in fatalities. Although poor weather conditions are beyond the control of pilots, airlines, and flight crew, these people have a responsibility for the safety of their passengers. When the decision is made to go ahead with a flight despite weather advisories, the lives of others are put at risk. If your life has been impacted as a result of an aviation accident arising from inclement weather, contact an attorney to learn about your legal rights. You may be eligible to receive compensation for your suffering. Your vigilance today could help prevent additional aviation accidents tomorrow. 24. Lightning It is estimated that on average each commercial airplane in the United States is struck by lightning at least once per year. Although it is extremely rare for aviation accidents to directly result from lightning contact, complications and other distractions may occur that could divert a pilots attention from his or her flight plan. Commercial airliners are most likely to be hit by lightning, but great precautions are taken in the design of the aircraft to ensure its safety. Light aircraft are less likely to be struck by lightning but are more likely to be damaged as a result of extreme turbulence caused by the lightning storm. Aircraft with the biggest risk to be struck by lightning are experimental, because these vehicles do not follow strict FAA regulations and may be constructed of materials that are not adequately protected against lightning. Unfortunately, aviation accidents caused by lightning do occur. In some cases, a pilots overconfidence in hazardous weather can lead to his or her aircraft being struck by lightning. If your life has suffered as a result of a lightning related aviation accident, speak with an attorney about the legal actions you may be able to take. 25. Wind and Wind Shear During an eleven year period, 48 percent of light aircraft weather accidents were caused by winds blowing aircraft off the side or end of a runway on takeoff. Although light aircraft are most affected by winds, larger aircrafts can be unexpectedly moved around as well. When this occurs a sense of panic may fill the cabin as passengers question their own safety and the competence of their pilots. Turbulence is a stream of irregular winds that can influence the steadiness of an airplane flight. Although it is usually impossible to predict, turbulence and other wind conditions can be avoided or managed effectively by experienced pilots. It is a pilots responsibility to respond appropriately to wind conditions or any other form of inclement weather.

If your last flight was made uncomfortable due to your pilots inability to adjust to wind, you should speak with an attorney about your legal rights. Nobody should have to fear for their lives when flying. You deserve a comfortable flight with an experienced crew. Do not hesitate to discuss your case with an aviation lawyer today. 26. Snow As anyone might suspect, flying in the snow can be a dangerous adventure. Pilots should not fly in whiteout conditions such as blizzards. At these times visibility is often so poor that instruments must be relied upon almost exclusively to determine ones position and surroundings. There are certain precautions that must be taken during winter and snow flying. Extreme temperatures can cause some mechanical operations to jam and cause ice to form on aircraft. The presence of ice and snow on an aircraft can cause many unwanted problems and complications. It is the responsibility of the pilot and flight crew to practice their training and ensure a safe flight in snowy conditions. When pilots attempt to fly in unsafe weather conditions they not only endanger their own lives, but also the lives of passengers and people on the ground. If you are victim of a snow-related aviation accident, do not hesitate to speak with an experienced attorney who specializes in aviation accidents. You will be informed of legal actions you can take to receive compensation for your suffering. 27. Rain Rain and thunderstorms can be extremely hazardous to aviation. Turbulence, cumulus clouds, high winds, ice, hail, lightning, loss of visibility, electrostatic discharge, tornadoes, altimetry errors, and wet runways often accompany rain and must be managed by pilots and flight crews. In most situations, pilots are instructed to avoid severe thunderstorms and rain due to the risks they may pose for passengers and crew. In 1999, American Airlines Flight 1420 crashed while attempting to land in a thunderstorm in Little Rock, Arkansas. The large amount of rainfall had made the runway slick, causing the plane to lose control and break apart. There were eleven fatalities in this plane crash and American Airlines admitted liability for the accident. A settlement greater than 14 million dollars was reached for victims of the crash. If you are a victim of an aviation accident caused by rain, you may be eligible to receive compensation for your suffering. An aviation attorney can help you fight for whats right and get you back on your feet after an accident derails your life. You deserve a quick return to life before the accident, and expert legal assistance can help you achieve this dream. 28. Other Causes of Airplane Accidents Beyond the obvious hazards that can contribute to an aviation accident, other causes exist. It is important for these possibilities to be taken into consideration so that the lives of passengers and other innocent people are not jeopardized by the shortsightedness of crew.

Other causes of aviation accidents include bird hazards, mid-air collisions, air traffic control errors, structural defects, lack of maintenance, air show accidents, and search and rescue operations. These factors often receive less attention than decent and landing accidents, taxi and takeoff accidents, mechanical failures, pilot errors, fuel mismanagement, and inclement weather. However, the other causes of aviation accidents can have equally deadly results. If you or someone you care about has been a victim of an aviation accident due to other causes, you owe it to yourself and your family to discuss your case with an attorney. An experienced and understanding lawyer can investigate your experiences and determine an appropriate course of action to take against those responsible for your suffering. Do not hesitate to move forward with your life and contact a highly regarded attorney today. 28. Bird Hazards Although many people may not realize it, birds are a common threat to airline safety. A number of fatal accidents have been caused by bird strike, one of which killed 62 passengers in 1960. Bird strike is such a serious problem that the FAA estimates it costs United States aviation $480 million each year. Bird strike (also called BASH-bird aircraft strike hazard) occurs when there is a collision between a bird and an aircraft. The speed of impact is such that even light objects like birds can cause destructive damage to a fast-moving vehicle. In most cases, birds impact the engine and can cause thus cause a plane to completely lose its ability to fly. Because bird hazards have been such a significant problem throughout the history of aviation, pilots are trained to avoid bird collisions and most airports have taken measures to make their runway areas inhospitable to winged animals. However, some people may act negligent in addressing bird strike. If bird hazards have caused an aviation accident that has interrupted your normal life, it is in your best interests to discuss your situation with an experienced aviation attorney. By being informed about your legal rights you may be able to bring order to this chaotic time of your life. 29. Mid-Air Collisions A mid-air collision is every pilot and passengers worst nightmare and one of the most dramatic types of aviation accident. Mid-air collisions are almost always due to human error, and are entirely preventable. Pilots receive training to avoid potentially dangerous situations, but when this preparation is overlooked fatal consequences may occur. During a three-year study of midair collisions involving civilian aircraft, the National Transportation and Safety Board (NTSB) found that most mid-air collisions occur during daylight hours under good visibility. Additionally, the study indicated that no pilot regardless of experience is immune to mid-air collisions, and most collisions occurred during pleasure flights with no flight plan filed. This study only further emphasizes that mid-air collisions are a result of pilot shortsightedness and can be avoided.

It is tragic to be involved in a mid-air collision in any form. Pilots, passengers, and innocent bystanders on the ground may all be fatally injured. If you or someone you care about has been affected by a mid-air collision, you need to know what your legal rights are. By contacting an aviation attorney you can learn about the actions you can take to receive the compensation you deserve for medical expenses and suffering. 30. Air Traffic Control Errors Not all air traffic control errors result in aviation accidents. Many errors are only described as close calls, where a mistake was made but no accident took place. However, nobody wants to put their life at risk with close calls when they are traveling hundreds of miles per hour at thousands of feet above ground. Recent reports of air traffic controllers acting dangerously only bring more attention to the potential consequences of their actions. In 2005 it was reported that by August 200 mistakes had been made by New York air traffic controllers, compared to 24 for all of 2004. Air traffic controllers have responsibilities just as pilots do. Mistakes and lapses in vigilance can result in aviation accidents and losses of life. If you or someone you care about has been affected by air traffic control errors, it is important that you activate your legal rights. By speaking with an aviation attorney you can learn about the actions you can take to receive compensation and justice for your suffering. Nobody deserves to endure the consequences of anothers mistakes. Contact an experienced lawyer today. 31. Structural Defects Structural defects can lead to dramatic and unpredictable aviation accidents. Defects can range from faulty or aging wires to corrosion and fuselage loss. In 1988, a Boeing 737 flown by Aloha Airlines experienced a ruptured fuselage, tearing part of the cabin apart and blowing a flight attendant off the plane and to her death. The accident was caused by problems with the adhesive bonding process, a problem Boeing was already aware of. Structural problems in aircraft are usually related to corrosion, surface cracks, fatigue cracks, and skin disbonds. Aging aircraft may experience structural defects from general use and lack of maintenance. When these problems go undetected, the lives of passengers and flight crew are endangered. You deserve to travel safely. Structural defects jeopardize your safety and may arise from negligence. If your life has suffered due to an aviation accident caused by structural defects, do not hesitate to contact an experienced aviation attorney. You may be eligible to receive compensation for your suffering and seek justice against those who harmed you. 32. Lack of Maintenance on an Airplane. Without maintenance, any aircraft will eventually become a serious hazard. Commercial, military, and private aviation organizations employ aircraft maintenance technicians to constantly work on aircraft to keep them safe and in working order. In the vast majority of cases, the work done is timely and of high quality, contributing the overall safety of flight as a mode of transportation.

However, mistakes can occur and a lack of proper maintenance can lead to structural problems and fuel mismanagement. Aircraft maintenance technicians must be able to address existing and potential problems faced by the aircraft they work on. When these problems are not rectified, aviation accidents are likely to occur. If youve been victim of an aviation accident that you suspect was caused by a lack of maintenance, discuss your case with an aviation lawyer. A legal expert can help you make sense out of the accident that has affected your life and determine a course of action to take against those that interfered with your happiness. EMERGENCY & DISASTER MEASURES AND MANAGEMENT FIRST RESPONSE Immediately SURVEY the scene for obvious hazards (Munitions, Fuel, Instability, etc.) RESCUE survivors. If possible, enter wreckage from UPWIND SIDE MOVE survivors to safe place OBTAIN emergency medical care as needed SEARCH the wreckage for concealed survivors PROTECT the environment from further damage (fuel or foam runoff, etc) CONTROL additional property damage NOTIFY the nearest military installation Fire Chief or Command Post PRESERVE the site as intact as possible for investigators DO NOT MOVE anything not necessary for rescue or damage control As Soon As Time Permits GUARD the wreckage SEARCH for additional victims, parts or wreckage along the flight path IDENTIFY witnesses for later interview REPORT the accident to an FAA Airport Control Tower or service center DIAGRAM the scene or take official departmental photographs REFER news media / photographers requests to a military information officer Rescue Safety Guide Like any disaster, an aircraft accident may require actions that do not fall into a predictable pattern. When in doubt, take the course of action your own experience, training and judgement dictate in order to minimize the risk to victims and rescue personnel. If survivors are in the wrecked aircraft and rescue appears feasible, remember: STAY CLEAR FROM FRONT AND REAR OF EXTERNALLY CARRIED TANKS OR PODS. These may contain missiles or rockets whose explosive wake is hazardous. Never disturb bullets, bombs or other armament thrown clear from the aircraft as they may explode. Heat, fire or shock may make munitions very unstable. If possible, put warning marker flags at munitions items when they are located.

SAFEST APPROACH TO THE CRASH IS GENERALLY FROM UPWIND, TO THE SIDE OF THE AIRCRAFT FUSELAGE. Munitions or fuel may be scattered along the crash path. Weapons may fire forward, or create a blast to the back. Concealed survivors may be tangled in debris behind the main wreckage. ACCESS HATCHES, RESCUE POINTS, AIRCRAFT EXITS. Location of escape hatches, doors, and exits from all U.S. and most NATO military aircraft are indicated by OrangeYellow markings on the outside of the aircraft. On jet aircraft a Red Rescue Arrow will indicate the rescue points. Instructions are stenciled at this arrow for the jettisoning of canopies or hatches. USE CARE IN JETTISONING CANOPIES OR HATCHES. They are often blown away from the aircraft by explosive devices. When operating the jettison controls, always position yourself well to the side and clear of the canopy/hatch. A Red Rescue Arrow points to the canopy/hatch jettison controls. Follow all stenciled instructions at the arrow and in the Warning Triangle near it. If unreadable, the following steps generally apply. Near the warning triangle, you will find a small door with controls inside. Push a release button to open the small door. Inside is a T Handle, connected to a 10-foot cable. Stand clear of hatch or canopy. Pull the T Handle out all the way. Canopy or hatch will be blown off with explosive force. EJECTION SEAT WARNING. LOOK FOR WARNING MARKINGS ON THE AIRCRAFT, AND BEWARE HAZARDS OF EJECTION SEATS. Aircraft with ejection seats have Warning Triangles painted near crew rescue points. Use extreme care not to actuate the seat, before, during or after rescue. Do not raise, move, or tamper with the armrests of crew seats, or any controls painted YELLOW and BLACK . These controls fire the ejection seats. Do not move any controls, handles or levers in the cockpit unless you are thoroughly familiar with that particular aircraft. Ejection systems vary among models and types. Before removing survivors, always unfasten seatbelt, shoulder and/or parachute harness and oxygen mask as well as radio cords and oxygen tubes. Cut any wire, tube or harness if needed. Cutting will not actuate an ejection. Time permitting, knot the Oxygen line to reduce fire hazard. DO NOT MOVE VICTIMS EXCEPT AS NEEDED TO PROTECT THEM FROM FIRE OR OTHER INJURY UNTIL EMERGENCY MEDICAL PERSONNEL ARRIVE. If there is no military medical assistance nearby, request a civilian doctor and Emergency Medical Technicians/Paramedics be summoned to the scene. Have EMTs or other trained personnel prepare injured personnel for transport to a trauma center or nearest hospital. Notify the hospital of the number of inbound patients and apparent nature of injuries.

AVOID DISTURBING THE WRECKAGE. Except as necessary for rescue, do not disturb the wreckage. An intact site is necessary for the crash investigation team. KEEP BYSTANDERS AND UNAUTHORIZED PERSONNEL AWAY. NO SMOKING.

Experience has shown that everyone involved in the response effort should participate in critical incident stress debriefing.

Reporting the Accident (Do Not Delay Reporting Because Some Information is Unknown) Call the nearest military installation: Phone: Give your name, phone number, official position and location. Report that a military aircraft has crashed. Give as accurate a geographical location as you can, and tell how to reach the crash site. If coordinates are not known, describe in terms of landmarks, distances from towns, or road features Identify the aircraft if possible: Any numbers or letters painted on the tail. Any other numbers from the nose Type of aircraft (Fighter, cargo, bomber, helicopter) or model if known: Additional Information to Report to the Military What happened? Number of people who parachuted from the aircraft Number of victims at crash site: Any injuries of people on the ground? Medical help needed from the military? Fire Fighting or Rescue help needed from the military? Fatalities or Injuries (Confirmed or Unconfirmed): To what hospital have injured been taken? Do not hang up until you are sure the information is understood, and you have answered any questions from the other end. Advise local officials to inform the State Office of Emergency Management. National Guard Command Center, and/or the Governors Office. Medical Care for Survivors Render first aid and provide all needed emergency medical care for survivors, with or without directions from the military. As needed, transport victims to hospitals/trauma centers. Use Life Flight if needed. If anyone is concerned about payment for services,advise them that the nearest U.S. military installation will provide them with full and cooperative assistance in billing procedures, payment and claims processing. Notify the nearest military facility of the location of all survivors, their names and conditions if known. If fatalities have occurred, a military medical examiner will work closely with the local coroner or medical examiner. Do not remove remains from the wreckage unless absolutely essential prior to arrival of the military medical examiner. Stress Management for Responders The continued health and well being of a communitys response force is absolutely vital. It may take months or years before the impact of a major disaster shows its full impact on a public service department.

RECENT STUDIES ACCORDING TO W.H.O OR DISASTER CONTROL Transport accidents Current yearly numbers of road traffic accidents in the WHO European Region are still unacceptably high, with around 2 million accidents with injuries, 120 000 deaths and 2.5 million injured people. One in every three road traffic deaths involves a person younger than 25 years. Road accidents account for most fatal transport accidents, both in terms of absolute number of deaths and of deaths per kilometre travelled. For example, in 1995, in the European Union 44 000 people were killed in road accidents, while 936 people died in railway accidents. Death rates per thousand million kilometres travelled were about three times higher for road than for rail transport (11 and 3.4 fatalities per thousand million kilometres, respectively). Worldwide statistics on air safety report that in 1997 there were a total of 916 fatalities in air accidents involving scheduled flights, corresponding to 0.4 fatalities per thousand million kilometres of travel worldwide. As for lives lost at sea, worldwide statistics report a total of 690 fatalities in 1996. Traffic accident mortality rates have been falling over the past decade across the Region, but there is still an almost ten-fold difference between the highest and lowest rates. Vulnerable road users such as pedestrians and cyclists account for 3035% of deaths. The severity of accidents among pedestrians is almost twice as high as that in car occupants.

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NA- TECH stands for Natural- Technological disasters technological accident triggered by a natural event. it is a combination of natural disaster which triggered secondary disasters such as explosions, fires, floods and toxins released into the air after an earthquake. an example of a NA-TECH disaster occurred in Japan when earthquake triggers the explosion of the nuclear tank.

DISASTERS VARY AMONG: 1. 2. Speed of onset Is quick with floods and tornadoes, whereas hurricanes generally are slow to develop. Controllability refers to the degree to which interventions can be used to control the disaster, such as using dams for flood control. Earthquakes, for example, have very little controllability. Duration of impact A tornado may be on the ground for only a few minutes, whereas a floods impact usually lasts for days The worst combination of variables from the viewpoint of damage is the disaster that is rapid in onset, gives no warning, and lasts a long time. An earthquake with strong aftershocks is such a disaster. Length of forewarning is the period between warning and impact. Communities in the path of a hurricane may have the luxury of a 24hours warning, whereas tornado warning may provide only a few minutes of preparation. Scope and intensity of impact refers to geographic and social space dimension. A disaster such as tornado may be limited to a mile or two, whereas a flood may involve hundreds of miles. The population density of an area influences this variable and can lead to widespread consequences. CAUSE OF NA-TECH DISASTERS: Simultaneous occurrence of a natural disaster and a technological accident. EMERGENCY AND DISASTER MEASURES: prepares to take the lead in the critical work of responding to a wide range of natural and man-made disasters and civil emergencies.

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Aircraft Crashes Record Office (ACRO) International civil aviation organization The Geneva-based Aircraft Crashes Record Office (ACRO) compiles statistics on aviation accidents of aircraft capable of carrying more than six passengers, not including helicopters, balloons, or fighter airplanes. The ACRO announced in 2008 that the year 2007 was the safest year in aviation since 1963 in terms of number of accidents. There had been 136 accidents registered (compared to 164 in 2006), resulting in a total of 965 deaths (compared to 1,293 in 2006). Since then, both 2009 and 2010 saw fewer registered accidents, 122 and 130, respectively. 2004 was the year with the lowest number of fatalities since the end of World War II, with 771 deaths. The year with most fatalities was 1972, with 3,214 deaths. The European Aviation Safety Agency (EASA) is tasked by Article 15(4) of Regulation (EC) No 216/2008 of the European Parliament and of the Council of 20 February 2008 to provide an annual review of aviation safety. GROUP D: COMBINATION or NA-TECH DISASTER

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Emergency management is a strategic process, and not a tactical process, thus it usually resides at the Executive level in an organization. -It normally has no direct power, but serves as an advisory or coordinating function to ensure that all parts of an organization are focused on the common goal. relies on a thorough integration of emergency plans at all levels of the organization, and an understanding that the lowest levels of the organization are responsible for managing the emergency and getting additional resources and assistance from the upper levels.

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Involves: mitigation, preparation, response, and recovery. Mitigation Personal mitigation is mainly about knowing and avoiding unnecessary risks. This includes an assessment of possible risks to personal/family health and to personal property. One example of mitigation would be to avoid buying property that is exposed to hazards, e.g., in a flood plain, in areas of subsidence or landslides. Home owners may not be aware of a property being exposed to a hazard until it strikes. a. Structural Mitigation o This involves proper layout of building, particularly to make it resistant to disasters. b. Non Structural Mitigation o This involves measures taken other than improving the structure of building. Preparedness Personal preparedness focuses on preparing equipment and procedures for use when a disaster occurs( i.e., planning). Preparedness measures can take many forms including the construction of shelters, installation of warning devices, creation of back-up life-line services (e.g., power, water, sewage), and rehearsing evacuation plans Response The response phase of an emergency may commence with search and rescue but in all cases the focus will quickly turn to fulfilling the basic humanitarian needs of the affected population. Recovery The recovery phase starts after the immediate threat to human life has subsided.

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A battery operated radio. It might be your only source of information. Some spare batteries to run your flashlight/torch and the radio If you use cordless phones, have a regular phone also connected. Cordless phones need electrical power to operate. In case of electrical failures, the cordless phones might not work EMERGENCY & DISASTER NURSING MANAGEMENT Disaster nursing refers to nursing services offered to the victims of disaster who experiences trauma caused by disaster. Disaster produces several kinds of trauma. a. b. c. d. Physical Fractures, burns, injuries and infections. Physiological Shock and electrolyte imbalance Psychological Anxiety, depression, substance abuse, stress reaction. Socio-economic Unemployment, Homelessness, Environmental destruction, disorganization.

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Mock trails/training The training of various inter-disciplinary forces like school children, voluntary organizations can be imparted by community health nurse and her team, Mass awareness The community should have the knowledge of all the Channel communication system, stand by equipment supplies and other resources; otherwise disaster preparedness will be failure Education Mass awareness through media, booklets, panel discussion, films and televisions information is very essential.

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Nursing Management Management of diarrheas and dehydration. Management of acute respiratory infections. Setting up a health information system. Safe drinking water supply. Sanitation. Training and support for health workers. Other basic services. Immunization and preventive health

Basic community Education should incorporate the following essentials: a. Setting up the first aid post b. Causality evaluation c. Basic hygiene and sanitation d. Safety measures e. Maintenance of food and water supply f. Maintenance of law and order. g. Provision of shelters h. Rescue streaming i. Significance of traffic control and communication j. Use of fire services k. Hazards of radiation and preventive measures l. Prevention of future disasters. m. Grant in aid n. Rehabilitation o. Patient Education: GROUP E: Radiological/Nuclear What Is Radiation? Radiation is a form of energy that is present all around us. Different types of radiation exist, some of which have more energy than others. Amounts of radiation released into the environment are measured in units called curies. However, the dose of radiation that a person receives is measured in units called rem. How Can Exposure Occur? People are exposed to small amounts of radiation every day, both from naturally occurring sources (such as elements in the soil or cosmic rays from the sun), and man-made sources. Man-made sources include some electronic equipment (such as microwave ovens and television sets), medical sources (such as x-rays, certain diagnostic tests, and treatments), and from nuclear weapons testing. The amount of radiation from natural or artificial sources to which people are exposed is usually small; a radiation emergency (such as a nuclear power plant accident or attack with a nuclear weapon or dirty bomb) could expose people to small or large doses of radiation, depending on the situation.

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Disaster Management First and foremost, remember, after a disaster, you might not have stores open. Everything might be closed down. Hence, its important that you have all the life-saving material with you well in advance. Here is a list of items that you should have with you, which can help you stay without utilities for a few days: 1. Non-perishable food to last you several days. These should be something, which do not require cooking, have high shelf-life, without need for refrigeration or other special conditions, and, preferably take lesser space to store so that you can store adequate amount for a few days. These include: canned food items, dry-fruits, high protein biscuits etc. 2. Drinking water to last you several days. 3. Some blankets etc. to keep you warm, in case houses are damaged. Remember, there might not be electricity and/or gas-connections to provide you heating. 4. A supply of your medicines for several days. 5. Flashlight which operates on batteries. It might help you navigate your way in darkness, if electrical system has failed In addition to above the following psychosocial intervention are provided by the nurses: Crises intervention / counseling Group work Telephone contact services. Disaster response managements Health education Community services like facilitation of self help groups etc. Community measures in Disaster Pre disaster phase, appropriate management of disaster requires advance planning. A nurse should be the part of the team for disaster planning. a. Community Participation It is the process by which individuals, families and communities assume the responsibility of promoting their own health and welfare. The community heath nurse maintains the link between professional group pf experts in disaster management and community.

About 80% of human exposure comes from natural sources and the remaining 20% comes from man-made radiation sources - mainly medical x-rays. Contamination refers to particles of radioactive material that are deposited anywhere that they are not supposed to be, such as on an object or on a person's skin. Internal contamination refers to radioactive material that is taken into the body through breathing, eating, or drinking. Exposure occurs when radiation energy penetrates the body. For example, when a person has an x-ray, he or she is exposed to radiation.

point of impact, potentially increasing people's risk of developing cancer over time. Radiation damage Introduction: Radiation damage to cells in the body can happen after a person receives radiation therapy to treat cancer. It can also happen if a person is exposed to radiation through x-ray imaging, nuclear power, or fallout from nuclear weapons. If severe enough, radiation damage may cause cancer, birth defects, and other serious health problems. Doctors try to protect people undergoing radiation therapy for cancer by using low doses, being precise about where the radiation is targeted, and minimizing side effects. Usually side effects go away after the treatment stops. Signs and Symptoms: Radiation damage can cause a number of symptoms. These are common side effects when a person undergoes radiation treatment for cancer: Hair loss Stomach upset, nausea, vomiting, diarrhea Low white blood cells (leucopenia) Red and itchy skin at the site of the radiation Sore mouth or mouth ulcers (oral mucositis) Radiation sickness or radiation emergency happens after exposure to a large amount of radiation. Acute radiation sickness occurs within 24 hours of exposure. Chronic radiation syndrome is a range of symptoms occurring over a period of time. These symptoms can happen immediately or months or years after exposure to radiation: Radiation syndrome -- fatigue, weight loss, nausea, vomiting, diarrhea, sweating, fever, headache. With bleeding and complications affecting the digestive system, nervous system, heart, and lungs Central nervous system diseases Kidney, liver, or gastrointestinal problems Poor growth in children Skin conditions Pericarditis (inflammation of the sac around the heart) Lung infections or conditions, respiratory failure Vision problems, including cataracts Problems with the reproductive organs What Causes It? Damage happens when radiation interacts with oxygen, causing certain molecules to form in the body. These molecules can damage or break strands of DNA in cells. The cells may die. Who's Most At Risk? People who have been exposed to radiation and who also have the following conditions or characteristics are at risk for developing radiation damage: High dose of radiation exposure Young age at time of exposure Use of chemotherapy, antibiotics Exposure to radiation before birth (while in the womb) RECENT STUDIES AND PUBLICATIONS OF WHO

WHO Japan protective measures continue June -- Japan's Nuclear and Industrial Safety Agency has announced that the amount of radiation emitted during the first week of the Fukushima nuclear plant incident is double the initial estimate. At this time, based on the updated information, there are no additional measures recommended beyond earlier actions taken, but the situation is under assessment. Earlier public health actions implemented immediately after the incident (i.e. evacuation, sheltering), as well as the additional protective actions taken later based on the results of the environmental monitoring (relocation of populations in other villages), have been the correct protective measures to protect those populations from radiation exposure. These measures reflect basic principles on protecting populations against radiation. The Fukushima I Nuclear Power Plant Fukushima Dai-ichi also known as Fukushima Dai-ichi (dai-ichi means "number one"), is a disabled nuclear power plant located on a 3.5-square-kilometre (860-acre) site in the towns of Okuma and Futaba in the Futaba District of Fukushima Prefecture, Japan. First commissioned in 1971, the plant consists of six boiling water reactors (BWR). These light water reactors drove electrical generators with a combined power of 4.7 GWe, making Fukushima Daiichi one of the 15 largest nuclear power stations in the world. Fukushima I was the first nuclear plant to be constructed and run entirely by the Tokyo Electric Power Company (TEPCO). The plant suffered major damage from the 9.0 earthquake and subsequent tsunami that hit Japan on March 11, 2011 and is not expected to reopen. The earthquake and tsunami disabled the reactor cooling systems, leading to nuclear radiation leaks and triggering a 30 km evacuation zone surrounding the plant. On April 20, 2011, the Japanese authorities declared the 20 km evacuation zone a no-go area which may only be entered under government supervision. WHO FAQs: Japan nuclear concerns 12 May 2011 What is the current risk of radiation-related health problems in Japan for those residing near the reactor in comparison to those in other parts of Japan? Radiation-related health consequences will depend on exposure, which is dependant on several things, including: the amount and type of radiation released from the reactor; weather conditions, such as wind and rain; a persons proximity to the plant; and the amount of time spent in irradiated areas. The Government of Japans recent actions in response to events at the Fukushima Daiichi nuclear power plant are in line with the existing recommendations for radiation exposure. The Government has evacuated individuals who were living within a 20-kilometre radius around the Fukushima Daiichi plant. Those living between 20 km and 30 km from the plant are being asked to evacuate voluntarily. In general, people living farther away are at lower risk than those who live nearby. Now, in light of new information on levels of environmental radioactivity in the 20-30 km zone and some surrounding areas beyond the 30km zone, the Government of Japan is preparing new planned

What Happens When People Are Exposed to Radiation? Radiation can affect the body in a number of ways, and the adverse health effects of exposure may not be apparent for many years. These adverse health effects can range from mild effects, such as skin reddening, to serious effects such as cancer and death, depending on the amount of radiation absorbed by the body (the dose), the type of radiation, the route of exposure, and the length of time a person was exposed. Exposure to very large doses of radiation may cause death within a few days or months. Exposure to lower doses of radiation may lead to an increased risk of developing cancer or other adverse health effects later in life. What Types of Disasters Might Involve Radiation? Possible terrorist events could involve introducing radioactive material into the food or water supply, using explosives (like dynamite) to scatter radioactive materials (called a dirty bomb), bombing or destroying a nuclear facility, or exploding a small nuclear device. Although introducing radioactive material into the food or water supply most likely would cause great concern or fear, it probably would not cause much contamination or increase the danger of adverse health effects. Although a dirty bomb could cause serious injuries from the explosion, it most likely would not have enough radioactive material in a form that would cause serious radiation sickness among large numbers of people. However, people who were exposed to radiation scattered by the bomb could have a greater risk of developing cancer later in life, depending on their dose. A meltdown or explosion at a nuclear facility could cause a large amount of radioactive material to be released. People at the facility would probably be contaminated with radioactive material and possibly be injured if there was an explosion. Those people who received a large dose might develop acute radiation syndrome. People in the surrounding area could be exposed or contaminated. Clearly, an exploded nuclear device could result in a lot of property damage. People would be killed or injured from the blast and might be contaminated by radioactive material. Many people could have symptoms of acute radiation syndrome. After a nuclear explosion, radioactive fallout would extend over a large region far from the

evacuation zones from which residents will be evacuated within the coming month. In addition, an emergency evacuation preparedness zone has also been identified in which residents are being asked to prepare their affairs in case they are asked to evacuate. These zones also follow administrative boundaries and extend beyond the 30 km radius.

Kamchatka, and Magadan regions, in the Primorsky and Khabarovsk territories of the Russian Federation and in the Chukotka Autonomous District. As of 18 March 2011, radiation levels in this area remain normal. Following the earthquake and tsunami in Japan on 11 March 2011, and the continuing nuclear power plant crisis, WHO headquarters is working closely with the WHO Regional Office for the Western Pacific, as well as other United Nations agencies to give advice and support. Generic Procedures For Medical Response During a Nuclear or Radiological Emergency The aim of this publication is to serve as a practical resource for planning the medical response to a nuclear or radiological emergency. It fulfils in part functions assigned to the IAEA under Article 5.a(ii) of the Convention on Assistance in the Case of a Nuclear Accident or Radiological Emergency (Assistance Convention), namely, to collect and disseminate to States Parties and Member States information concerning methodologies, techniques and available results of research relating to such emergencies. Effective medical response is a necessary component of the overall response to nuclear or radiological (radiation) emergencies. In general, the medical response may represent a difficult challenge for the authorities due to the complexity of the situation, often requiring specialized expertise, and special organizational arrangements and materials. To be effective, adequate planning and preparedness are needed. In March 2002, the IAEAs Board of Governors approved a Safety Requirements publication Preparedness and Response for a Nuclear or Radiological Emergency, jointly sponsored by seven international organizations, including the World Health Organization (WHO), which establishes the requirements for an adequate level of preparedness and response for a nuclear or radiological emergency in any State. The Safety Requirements state, inter alia, that arrangements shall be made for medical personnelto be made aware of the medical symptoms of radiation exposure and of the appropriate notification procedures and other immediate actions warranted if a nuclear or radiological emergency is suspected. [para 4.77]. In 2004, the IAEA General Conference, in resolution GC(48)/RES/10, encouraged Member States to implement the Safety Requirements for Preparedness and Response to a Nuclear or Radiological Emergency. The 2003 General Conference in resolution GC(47)/RES/7 encouraged Member States to adopt IAEA standards, procedures and systems developed as part of international cooperation and to contribute to the international efforts to develop a consistent, coherent and sustainable joint programme for improved and more efficient international response to nuclear and radiological emergencies. This manual, if implemented, should help to contribute to coherent international response. The manual provides the practical tools and generic procedures for use by emergency medical personnel during an emergency situation. It also provides guidance to be used at the stage of preparedness for development of medical response capabilities.

Is there a risk of radioactive exposure from food contamination? Yes, there is a risk of exposure as a result of contamination in food. However, contaminated food would have to be consumed over prolonged periods to represent a risk to human health. The presence of radioactivity in some vegetables and milk has been confirmed and some of the initial food monitoring results show radioactive iodine detected in concentrations above Japanese regulatory limits. Radioactive caesium has also been detected. Local government authorities have advised residents to avoid these food and have implemented measures to prevent their sale and distribution. Are there health risks to people living outside of Japan from radiation emitted into the atmosphere from damaged Japanese nuclear power plants? Thus far, there are no health risks to people living in other countries from radioactive material released into the atmosphere from the Japanese nuclear power plants. Radiation levels measured to date in other countries are far below the level of background radiation that most people are exposed to in every day circumstances. Radiation levels are being monitored by the Preparatory Commission for the Comprehensive Nuclear-Test-Ban Treaty Organization (CTBTO), which operates 63 surveillance stations around the world. Health update: nuclear reactor crisis in Japan WHO warns against self-medicating against radiation WHO is cautioning people concerned about the radiation issues in Japan against self-medicating with potassium iodide or taking products containing iodine. The advice follows reports of people using these substances in response to radiation leaks from nuclear power plants in Japan. Potassium iodide should be taken only when there is a clear public health recommendation to do so. WHO is committed to saving lives and reducing suffering in times of crisis, said Zsuzsanna Jakab, WHO Regional Director for Europe. With the 25th anniversary of the Chernobyl disaster next month, we are all very aware of the possible consequences of nuclear accidents, and our hearts go out to the Japanese people at this time, as they struggle to cope with enormous fortitude with a series of catastrophes. Radiation levels in eastern provinces of Russian Federation remain normal Rospotrebnadzor, the Russian Agency for Consumer Rights and Human Well-being, is monitoring radiation levels in the Sakhalin,

The manual also addresses mass casualty emergencies resulting from malicious acts involving radioactive material. This part was supported by the Nuclear Security Fund. The manual was developed based on a number of assumptions about national and local capabilities. Therefore, it must be reviewed and revised as part of the planning process to match the potential accidents, threats, local conditions and other unique characteristics of the facility where it may be used. The IAEA wishes to acknowledge the contribution of the WHO, which is co-sponsoring this publication. The IAEA officer responsible for this publication was E. Buglova of the Division of Radiation, Transport and Waste Safety, Department of Nuclear Safety and Security. INFORMATION on Nuclear accidents and radioactive contamination of foods 30. March 2011 This document is intended to provide basic background information and not to give a complete overview. It will be updated as appropriate. Introduction Radioactive isotopes of elements (radionuclides) are naturally present in the environment, and that includes our bodies and our food and water. We are exposed to radiation (also known as background radiation) from these radionuclides on a daily basis. Radiation comes from space (i.e., cosmic rays) as well as from naturally-occurring radioactive materials (radionuclides) found in the soil, water and air. Radioactivity can be detected in food and water and the concentration of naturally-occurring radionuclides varies depending on several factors such as local geology, climate and agricultural practices. People can also be exposed to radiation from man-made activities, including medical diagnostic intervention. Radioactivity can contaminate food after it has been discharged into the environment from industries that concentrate natural radionuclides and from civil or military nuclear operations. Whether, man-made or natural in origin, radioactive material passes through the food chain in the same way as non-radioactive material. The degree of harm to human health depends on the type of radionuclides and the length of time people are exposed to it. The amount of radiation people are exposed to varies from place to place and among individuals. In the event of releases of radioactivity following an emergency at a nuclear power plant, land, rivers, sea and structures in the vicinity of the power plant can become contaminated with a mixture of radionuclides generated inside the reactor, also known as nuclear fission products. Individuals can therefore become exposed to radiation from these fission products. Radionuclides in food Background levels of radionuclides in foods vary and are dependent on several factors, including the type of food and the geographic region where the food has been produced. The common radionuclides in food are potassium-40 (40K), radium-226 (226Ra) and uranium 238 (238U) and their associated progeny. In general, 40K is the most commonly occurring natural radioisotope. In milk, for example, levels of 40K measure around 50 Bq/L, and for meat, bananas and other potassium rich products, levels may

measure at several hundreds Bq/kg. Other natural radioisotopes exist in much lower concentrations, and originate from the decay of uranium and thorium. When large amounts of radioisotopes are discharged into the environment, they can affect foods by either falling onto the surface of foods like fruits and vegetables or animal feed as deposits fromthe air or through contaminated rainwater/snow. Radioactivity in water can also accumulate in rivers and the sea, depositing on fish and seafood. Once in the environment, radioactive material can also become incorporated into food as it is taken up by plants, seafood or ingested by animals. Although many different kinds of radionuclides can be discharged following a major nuclear emergency, some are very short-lived and others do not readily transfer into food. Radionuclides generated in nuclear installations and that could be significant for the food chain include; radioactive hydrogen (3H), carbon (14C), technetium (99Tc), sulphur (35S), cobalt (60Co) strontium (89Sr and 90Sr), ruthenium (103Ru and 106Ru), iodine (131I and 129I), uranium (235U) plutonium (238Pu, 239Pu and 240Pu), caesium (134Cs and 137Cs), cerium (103Ce), iridium (192Ir), and americium (241Am). The radionuclides of most concern for possible transfer to foods have been considered when setting the Codex Guideline levels described below. Of immediate concern is iodine-131, it is distributed over a wide area, found in water and on crops and is rapidly transferred from contaminated feed into milk. However, iodine-131 has a relatively short half-live and will decay within a few weeks. In contrast, radioactive caesium which can also be detected early on, is longer-lived (Cs-134 has a half life of about 2 years and Cs-137 has a half life of about 30 years) and can remain in the environment for a long-time. Radioactive caesium is also relatively rapidly transferred from feed to milk. Uptake of caesium into food is also of longterm concern. Other radioisotopes that could be of long-term concern if released, are strontium and plutonium. Strontium-90 has a half life of about 29 years and plutonium has a much longer half life than that (Pu238: 88 years, Pu-239: 24100 years, Pu-240: 6564 years). However, both strontium and plutonium are relatively immobile in the environment and are of concern more locally, thus it is unlikely to cause a problem in international food trade in the immediate and medium-term. Commodities of concern Open-air vegetables and plants can be affected by the atmospheric release of radionuclides, resulting in radioactive contamination. Thus, radionuclides tend to be detected from leafy vegetables especially the ones with large leafy parts in the early phase after a nuclear accident. Milk is also associated with the early-phase contamination due to the rapid transfer of radioactive iodine and "relatively" rapid transfer of radioactive caesium from contaminated feed into milk. Over time, radioactivity can also build up within food, as radionuclides are transferred through soil into crops or animals, or into rivers, lakes and the sea where fish and other seafood could

take up the radionuclides. Foods collected from the wild, such as mushrooms, berries and game meat, may continue to be a radiological problem for a long time. Fish and aquatic microflora may bioconcentrate certain radionuclides, but due to the high dilution of radionuclides in water, contamination tends to be confined relatively locally. Health effects The main health concern for consumers in the long term due to high radiation exposure is development of cancer. Cancer types and target organs depend on the radionuclides. IAEA estimates that on average, our radiation exposure due to all natural sources amounts to about 2.4 mSv a year - though this figure can vary, depending on the geographical location by several hundred percent. In Canada, the average dose due to naturally occurring background radiation is about 2 mSv per year, of which about one-half comes from the inhalation of naturallyoccurring radon and its short-lived decay products. About 0.7 mSv per year, nationally-averaged, arises from cosmic and terrestrial gamma radiation. The portion of the background dose resulting from ingestion of natural radionuclides in food is about 0.25-0.4 mSv per year. Consuming contaminated food will increase the amount of radioactivity inside a person and therefore increase their exposure to radiation, thereby possibly increasing the health risks associated with radiation exposure. The exact health effects will depend on which radionuclides have been ingested and the amount being ingested.

caesium-137 enters the body, it is distributed fairly uniformly throughout the body's soft tissues, resulting in exposure of those tissues. Compared to some other radionuclides, caesium-137 remains in the body for a relatively short time. Like all radionuclides, exposure to radiation from caesium-137 results in an increased risk of cancer. Other radionuclides could be of concern, depending on the nature of the nuclear accident and release of specific isotopes. International standards and guidance The Codex Guideline Levels The Codex Alimentarius Commission (Joint FAO/WHO Food Standards Programme) has developed the guideline levels for certain radionuclides in food following a nuclear emergency (General Standard for Contaminants and Toxins in Food and Feed (GSCTFF), CODEX STAN 193-1995, page 33-37). The Guideline Levels have been first developed in 1988 and then revised in 2006 to increase the number of radionuclides covered. These Guideline Levels are applied to foods destined for human consumption and traded internationally, which have been contaminated following a nuclear or radiological emergency. If radionuclide levels in food do not exceed the corresponding guidelines levels, the food should be considered as safe for human consumption as far as generic radiological protection of food consumers is concerned. The following text is from the GSCTFF and provides the proper context: Scope: The Guideline Levels apply to radionuclides contained in foods destined for human consumption and traded internationally, which have been contaminated following a nuclear or radiological emergency1. These guideline levels apply to food after reconstitution or as prepared for consumption, i.e., not to dried or concentrated foods, and are based on an intervention exemption level of 1 mSv in a year. Application: As far as generic radiological protection of food consumers is concerned, when radionuclide levels in food do not exceed the corresponding Guideline Levels, the food should be considered as safe for human consumption. When the Guideline Levels are exceeded, national governments shall decide whether and under what circumstances the food should be distributed within their territory or jurisdiction. National governments may wish to adopt different values for internal use within their own territories where the assumptions concerning food distribution that have been made to derive the Guideline Levels may not apply, e.g., in the case of wide-spread radioactive contamination. For foods that are consumed in small quantities such as spices, that represent a small percentage of total diet and hence a small addition to the total dose, the Guideline Levels may be increased by a factor of 10. Radionuclides: The Guideline Levels do not include all radionuclides. Radionuclides included are those important for uptake into the food chain; are usually contained in nuclear installations or used as a radiation source in large enough quantities to be significant potential contributors to levels in foods, and; could be accidentally released into the environment from typical installations or might be employed in malevolent actions.

Examples for exposure from contaminated foods: Adult eating 200g spinach contaminated with 1000Bq/kg of Cs-137 resulting in 0.0026 mSv additional exposure 3 [0.2 (kg)1000 (Bq/kg) 1.310-5(mSv/Bq)] One-year old child consuming 0.5 L milk contaminated with 100 Bq/L of I-131 resulting in 0.009 mSv additional exposure [0.5 (L)100 (Bq/L) 1.810-4(mSv/Bq)] Radioactive iodine (I-131) in food is of immediate concern due to its rapid transfer to milk from contaminated feed and its accumulation in the thyroid gland. I-131has a relatively short halflife (8 days) and will therefore naturally decay over a short time frame. If radioactive iodine is breathed inor swallowed, it will concentrate in the thyroid gland and increase the risk of thyroid cancer.The uptake of radioactive iodine into the thyroid gland can be decreased or prevented by ingestion of non-radioactive iodine, by taking potassium iodide pills. Once the thyroid is saturated with iodine, no further iodine can be incorporated. Iodized table salt should not be used as an alternative to potassium iodide pills as it does not contain sufficient iodine to saturate the thyroid, and high salt intake may have adverse health effects. Radioactive caesium (Cs-134 and Cs-137), in contrast to radioactive iodine, has a long half-life (Cs-134: 2 years, Cs-137: 30 years). Radioactive caesium can stay in the environment for many years and could continue to present a longer term problem for food, and food production, and a threat to human health. If

Radionuclides of natural origin are generally excluded from consideration in this document. GROUP F: FIRE AND BURN DISASTER DEFINITION For longer than recorded history, fire has been a source of comfort and catastrophe for the human race. Fire is rapid, self-sustaining oxidation process accompanied by the evolution of heat and light in varying intensities. Fire is believed to be based on three elements being present: fuel, heat and oxidizer. Fire disasters can occur above the ground (in tall buildings and on planes), on the ground, and below the ground (in mines). Sometimes they occur in circumstances that are unexpected or unpredictable. Types: All fire incidents can be divided in many ways depending on the cause of fire outbreak, but broadly there are two types of fires, one is natural and other is manmade. Forest fires can be either due to natural or manmade reasons. All residential and nonresidential structural fires are largely manmade. Similarly, all industrial and chemical fires are due to explosions or fires made by humans or due to machine failures. Natural: Fires which are considered as natural are basically earthquake, volcanic eruption and lightning - generated fires. The fire and explosion risk associated with an earthquake is a very complex issue. Compared with ordinary (normal) fires the fire and explosion hazard related to earthquakes can constitute a substantial and heavy risk. Damage to natural gas systems during an earthquake is a major cause of large fires. Again probably the most significant direct impact of power systems on fire following an earthquake is that electric power is a major fire ignition source. In addition to dropped distribution lines, power circuits in damaged houses are another major ignition source. There have been cases where as many as two-thirds of all ignitions after an earthquake has been attributable to power system. Manmade: Fire caused by human/machine errors are considered as manmade fires, e.g. industrial or chemical fire disasters, fires at social gatherings due to Electrical short circuit fires, accidental fire and kitchen-fires. Rural and urban residential and non-residential structural fires are also largely manmade fires. Any confined fire could be due to many reasons like, cooking, fire confined to container, chimney or fuel fire confined to chimney, incinerator overload or malfunction, fuel burner/boiler malfunction, and trash fire. Concepts involved in Fire Disaster: Thermal agent disaster: o A disaster causing severe losses in human lives and material goods as a result of massive heat production. This definition expresses the relationship between a generic cause of the event (massive heat production) and the consequences for human beings and material goods. It is an exclusively mathematical

expression of the damage caused, i.e. of the number of the dead and injured, and the extent of damage to material goods. Burn disaster o Can be defined as the overall effect of the massive action of a known thermal agent on living beings. It is characterized by a high number of fatalities and of seriously burned patients with a high potential rate of mortality and disability. Its extent may be aggravated if appropriate rescue operations are delayed. Some decisive factors involved here are the type of causal agent, the type of pathology caused, the overall characteristics of the harmful action of the thermal agent, the immediate evaluation of its gravity in relation to emergency care, and the modalities of rescue operations.

If your home has sustained flood or water damage, and you can safely get to the main breaker or fuse box, turn off the power. Assume all wires on the ground are electrically charged. This includes cable TV feeds. Be aware of and avoid downed utility lines. Report downed or damaged power lines to the utility company or emergency services. Remove standing water, wet carpets and furnishings. Air dry your home with good ventilation before restoring power. Have a licensed electrician check your home for damage.

CAUSES / CONTRIBUTING FACTORS Causal factors include heat source, equipments involved in the ignition, item first ignited, and factors contributing to ignition. These factors describe what, how and why some form of heat ignited the specific material involved. Causes include: Cooking/heating equipment Intentional Electrical Open flame or ember Appliance, tool or air conditioning Child playing Other heat source Natural causes: earthquake, volcanic eruption and lightening Smoking material

Generator safety Follow the manufacturer's instructions and guidelines when using generators. Use a generator or other fuel-powered machines outside the home. CO fumes are odorless and can quickly overwhelm you indoors. Use the appropriate sized and type power cords to carry the electric load. Overloaded cords can overheat and cause fires. Never run cords under rugs or carpets where heat might build up or damage to a cord may go unnoticed. Always refuel generators outdoors. Never connect generators to another power source such as power lines. The reverse flow of electricity or 'backfeed' can electrocute an unsuspecting utility worker. Heating safety Kerosene heaters may not be legal in your area and should only be used where approved by authorities. Do not use the kitchen oven range to heat your home. In addition to being a fire hazard, it can be a source of toxic fumes. Alternative heaters need their space. Keep anything combustible at least 3 feet away. Make sure your alternative heaters have 'tip switches.' These 'tip switches' are designed to automatically turn off the heater in the event they tip over. Only use the type of fuel recommended by the manufacturer and follow suggested guidelines. Never refill a space heater while it is operating or still hot. Refuel heaters only outdoors. Make sure wood stoves are properly installed, and at least 3 feet away from combustible materials. Ensure they have the proper floor support and adequate ventilation. Use a glass or metal screen in front of your fireplace to prevent sparks from igniting nearby carpets, furniture or other combustible items. And remember... Do not use alternative heating devices to dry clothes or furnishings. Be careful when using candles. Keep the flame away from combustible objects and out of the reach of children. Never thaw frozen pipes with a blow torch or other open flame. Use hot water or a device, like a hand-held dryer,

Contributing factors: Wood shingle / thatched roofs High wind Congested access Inadequate water distribution system Lack of exposure protection Inadequate public protection (i.e. fire department inadequacies) Unusual hot or dry weather conditions Delay in discovery of fire Inadequate personal fire protection Delay in raining the alarm EMERGENCY AND DISASTER MEASURES Chemical safety Look for combustible liquids like gasoline, lighter fluid, and paint thinner that may have spilled. Thoroughly clean the spill and place containers in a well-ventilated area. Keep combustible liquids away from heat sources. Electrical safety

evaluated by a nationally recognized laboratory such as Underwriters Laboratories (UL). Some smoke alarms may be dependent on your home's electrical service and could be inoperative during a power outage. Check to see if your smoke alarm uses a back-up battery and install a new battery at least once a year. Smoke alarms should be installed on every level of your home. All smoke alarms should be tested monthly. All batteries should be replaced with new ones at least once a year. If there is a fire hydrant near your home, keep it clear of debris for easy access by the fire department.

If you are a tenant, contact the landlord. If you have a safe or strong box, do not try to open it. It can hold intense heat for several hours. If the door is opened before the box has cooled, the contents could burst into flames. If you must leave your home because a building inspector says the building is unsafe, ask someone you trust to watch the property during your absence.

RECENT STUDIES DERIVED FROM WHO AND DISASTER CONTROL Facilities and equipment Improved functions as a control tower in disaster control operations Fire and Disaster Management Agency's functions include the opening of disaster control headquarters and the smooth implementation of disaster information gathering operations, besides the promotion of law system development to ensure prompt, adequate emergency measures in a time of need. It links the central government and the regional governments with the earthquake information network system, takes command of fire fighting and rescue operations as the general headquarters of Emergency Fire Response Teams and inputs necessary materials and equipment from time to time in cooperation with other relevant organizations.Vehicle with an onboard satellite communications Installed in facilities used as the base for instructions, it serves as a relay point for information collected from the stricken area. In addition, it is dispatched to the stricken area to distribute images of the stricken area to governmental organizations and the local authorities and secure lines for images, voice and facsimile in cooperation with the stricken area, the Fire and Disaster Management Agency and the local authorities. Equipment In-car satellite land stations, telephones, facsimiles, PHS base stations, highly-sensitive cameras, VCRs, search lights, personal computers, helicopter TV automatic follow-up receivers, etc. When a large-scale disaster occurs, it approaches and reaches the forefront of the disaster source using its powerful roadability, and collects information and secures communications. Transportable satellite land stations, in-car radio sets, mobile radio sets, mobile loudspeakers, personal computers, engine generators, collapsible beds, toilets, shower rooms, etc. It is unpredictable when and where a large-scale disaster would occur. To cope with such disasters, it is essential to speedily mobilize helicopters. On the rooftop of the central joint government building where the Fire and Disaster Management Agency resides, a heliport is established so that it can be used for dispatching the Agency's personnel to the disaster area in case such a disaster occurs. Thus, it strongly supports the agency as the control tower. BOMB DISASTER DEFINITION: The use of a speculative radiological weapon that combines radioactive material with conventional explosives. Bombing through the use of conventional explosives (weapons that are in relatively wide use that are not weapons of mass destructionweapons like small arms and light weapons, sea and land mines, as well as (non-nuclear) bombs, shells, rockets, missiles, cluster munitions and detonated bombs) is unlikely to cause many

EMERGENCY AND DISASTER MANAGEMENT What to do During a Fire If your clothes catch on fire, you should: Stop, drop, and roll - until the fire is extinguished. Running only makes the fire burn faster. To escape a fire, you should: Check closed doors for heat before you open them. If you are escaping through a closed door, use the back of your hand to feel the top of the door, the doorknob, and the crack between the door and door frame before you open it. Never use the palm of your hand or fingers to test for heat - burning those areas could impair your ability to escape a fire (i.e., ladders and crawling). HOT DOOR COOL DOOR Do not open. Escape Open slowly and ensure through a window. If you fire and/or smoke is not cannot escape, hang a blocking your escape white or light-colored route. If your escape sheet outside the route is blocked, shut window, alerting fire the door immediately fighters to your and use an alternate presence. escape route, such as a window. If clear, leave immediately through the door and close it behind you. Be prepared to crawl. Smoke and heat rise. The air is clearer and cooler near the floor. Crawl low under any smoke to your exit - heavy smoke and poisonous gases collect first along the ceiling. Close doors behind you as you escape to delay the spread of the fire. Stay out once you are safely out. Do not reenter. Call the Fire Emergency Hotline nearest in your place.

FIRST AID Stop -Stay absolutely still. Do not try to run. Drop- Fall to the ground. Roll -Flames need oxygen to keep them burning. Rolling on the ground will stop them from getting any oxygen and help put the flames out. Wrap- something like a woollen blanket, floor rug or clothing around the person to smother the flames as they roll on the floor. Cool- cool the burnt skin with cold water (a shower is good if there is one), and keep it under the water until help arrives. Make sure that both the person hurt and you are safe (for example, well away from the fire, or chemicals or power source). Call for help. Take off any clothes or jewellery around the burned part of the body. Use cold running water to cool the burn for 20 minutes (under the shower is good.) DO NOT USE ICE Do not break blisters Putting cool wet clothes on is okay if there is no tap but they have to be kept wet and cool! Keep the person warm with extra clothes or a blanket on the unburnt parts of the body. See a doctor or health professional if the burn is bigger than a large coin. It is important to cool the burn for at least 20 minutes to stop damage to the tissue under the skin. If blistering has occurred, whether before or during this procedure, continue with the same treatment. Blisters should be protected and not burst. A blister provides the skin with a sterile fluid environment, which will protect and prevent bacteria from entering and infecting the area. Reddened areas, where the skin is unbroken, can be dressed with clean bandages or similar for comfort and pain relief. If large or broken blisters are present do not apply a dry dressing. The wound should be protected by either a plastic bag (suitable for hand or foot injuries), or cling film gently applied until medical treatment is obtained. Awkward locations such as nose, ears and cheeks etc should also be treated with water. Obviously it is more difficult to place these areas under running water but clean material can be used as a water pad. This pad should be frequently changed to ensure the area remains cool.

What to do After a Fire If you are with burn victims, or are a burn victim yourself, call Fire Emergency Hotline, cool and cover burns to reduce chance of further injury or infection. If you detect heat or smoke when entering a damaged building, evacuate immediately.

deaths. Some people do not consider this to be a weapon of mass destruction, but rather, a weapon of mass disruption because its purpose would presumably be to create psychological, not physical, harm through ignorance, mass panic, and terror. WHY PEOPLE RESORT TO BOMBING Terrorism War To cause chaos or to create an atmosphere of anxiety and panic which will, in turn, possibly result in a disruption of the normal activities at the facility where the device purportedly located. To inculcate fear towards the people. Act of threatening people to get what they wanted or an act of revenge for not being able to get what they desired the most. EMERGENCY & DISASTER MEASURES: 11 STEPS TO SURVIVAL: a. Step 1: Know the effects of explosions. b. Step 2: Know the facts about radioactive fallout. c. Step 3: Know the warning signal and have a batterypowered radio. d. Step 4: Know how to take shelter. e. Step 5: Have fourteen days emergency supplies. f. Step 6: Know how to prevent and fight fires. g. Step 7: Know first aid and home nursing. h. Step 8: Know emergency cleanliness. i. Step 9: Know how to get rid of radioactive dust. j. Step 10: Know your municipal plans. k. Step 11: Have a plan for your family and yourself. The fallout chamber - n =othing is more important than this in terms of protecting from nuclear fallout. The radiation from nuclear fallout can be dangerous for up to several days after an explosion and can seep through any material. However, it loses it's negative attributes as it passes through things, so the thicker the wall between you and it the better. Hence, a fallout room. A fallout room should be as safe as possible. Further, it would be smart to have this within your own home as it may be dangerous to leave. Thus, if your fallout chamber can be within your home, go with that ( and wait to hear from local emergency authorities ). Regardless, here are some best practices and things to consider when designing/ deciding on a fallout room or chamber ( called such because it's designed to protect from fallout ). 1. Make sure your fallout room is within a well insulated structure. Bungalows, cabins, trailer homes, and the like don't tend to fit the bill. Therefore, if you live in one of these it might be prudent to make plans to take shelter with a loved one or friend very close by. 2. Choose the place furthest from the outside walls within your home. Oftentimes, this is the cellar or basement. The greater the distance you are from the radiation, the better. 3. Still, the mere walls of your home may not be enough. You'll want to shut off openings like windows, etc. In addition, you'll want to bolster the walls around you with

dense materials like bricks, sand, concrete, wood, and even furniture. This is why planning is important. Further, have these things on hand before the event occurs ( in your fallout chamber ). Along with this, it might be prudent to have a hammer, some nails, and wood housed in your fallout chamber in case building or adding on is required. Of course, if the extra materials are already built in, you'll be best off. Thus, you'll have to decide just how worried you are in advance. All of this said, the fallout room may not be enough ( particularly during the first couple of days after detonation when things are most dangerous ). Thus, you'll want to build some kind of fallout inner shelter within your fallout room. One way to do this is to use doors reinforced on the outside with sand or another bolstering material. Another option is to hide within a closed off cupboard. Regardless, make sure that you take care to close off openings to this as well. Further, build it so that it won't fall apart. However, you should also make sure that it and your fallout room will allow a sufficient amount of oxygen in. All of this said, the fallout inner shelter within your fallout room may only need to be used for a couple of days. However, you can plan on spending upwards of fourteen days or more in your fallout room. Thus, there are some supplies you should definitely have on hand if such an occurrence were to take place.

8. 9. 10. 11. 12. 13.

putting things out of the room at all until at least two days after the event ). Have a portable stove and pots / pans. Have flashlights, candles, and matches. Have cloths, brushes, and brooms for cleaning. Have soap on hand with towels. Have a first aid supply kit. And just as important, have things to keep you busy like books, paper, and pens.

EMERGENCY & DISASTER MANAGEMENT: In the event of an explosion, a national emergency response plan would be activated and would include federal, state, and local agencies. Following are some steps recommended by the World Health Organization if a nuclear blast occurs: If you are near the blast when it occurs: Turn away and close and cover your eyes to prevent damage to your sight. Drop to the ground face down and place your hands under your body. Remain flat until the heat and two shock waves have passed.

4.

Supplies to have on hand in your fallout room 1. Have enough food for 14 days. Though you may have some perishable items on hand, the majority of food should be able to last. Further, you should choose to eat the perishable items first ( obviously ). 2. Have enough water for 14 days. In fact, try to have extra supplies of this on hand ( you'll almost certainly need to buy jugs of water in advance in order to accomplish this ). Remember, also to cover and secure your food and water. If radioactive dust gets on to it, there's no real way to get it off. 3. Have a radio and extra batteries as this will be your only real connection to emergency contacts and the outside world. Without this, you won't know what to do or when to do it. 4. Have tin openers, cutlery, bowls, plates, and etc. for obvious reasons. 5. Have warm clothing on hand. Gloves and boots may be especially important in order to protect the outer extremities. 6. Have bedding on hand. This should be both comfortable and warm. 7. Have bathroom supply products. Consider knowing where you will toilet in advance. Since you cannot waste water in a toilet- and may not even have one in your fallout room- have buckets, bags for waste, and disinfectants/ cleaners with you as well. It may be smart to have a garbage / dustbin right outside of your fallout room to store human and food waste materials ( consider not

If you are outside when the blast occurs: Find something to cover your mouth and nose, such as a scarf, handkerchief, or other cloth. Remove any dust from your clothes by brushing, shaking, and wiping in a ventilated area?however, cover your mouth and nose while you do this. Move to a shelter, basement, or other underground area, preferably located away from the direction that the wind is blowing. Remove clothing since it may be contaminated; if possible, take a shower, wash your hair, and change clothes before you enter the shelter. If you are already in a shelter or basement: Cover your mouth and nose with a face mask or other material (such as a scarf or handkerchief) until the fallout cloud has passed. Shut off ventilation systems and seal doors or windows until the fallout cloud has passed. However, after the fallout cloud has passed, unseal the doors and windows to allow some air circulation. Stay inside until authorities say it is safe to come out. Listen to the local radio or television for information and advice. Authorities may direct you to stay in your shelter or evacuate to a safer place away from the area. If you must go out, cover your mouth and nose with a damp towel. Use stored food and drinking water. Do not eat local fresh food or drink water from open water supplies. Clean and cover any open wounds on your body. If you are advised to evacuate:

Listen to the radio or television for information about evacuation routes, temporary shelters, and procedures to follow. Before you leave, close and lock windows and doors and turn off air conditioning, vents, fans, and furnace. Close fireplace dampers. Take disaster supplies with you (such as a flashlight and extra batteries, battery-operated radio, first aid kit and manual, emergency food and water, nonelectric can opener, essential medicines, cash and credit cards, and sturdy shoes). Remember your neighbors may require special assistance, especially infants, elderly people, and people with disabilities.

Health effects of the Chernobyl accident: an overview Fact sheet N 303 Background On 26 April 1986, explosions at reactor number four of the nuclear power plant at Chernobyl in Ukraine, a Republic of the former Soviet Union at that time, led to huge releases of radioactive materials into the atmosphere. These materials were deposited mainly over countries in Europe, but especially over large areas of Belarus, the Russian Federation and Ukraine. An estimated 350 000 clean-up workers or "liquidators" from the army, power plant staff, local police and fire services were initially involved in containing and cleaning up the radioactive debris during 1986-1987. About 240 000 liquidators received the highest radiation doses while conducting major mitigation activities within the 30 km zone around the reactor. Later, the number of registered liquidators rose to 600 000, although only a small fraction of these were exposed to high levels of radiation. In the spring and summer of 1986, 116 000 people were evacuated from the area surrounding the Chernobyl reactor to non-contaminated areas. Another 230 000 people were relocated in subsequent years. Currently about five million people live in areas of Belarus, the Russian Federation and Ukraine with levels of radioactive caesium deposition more than 37 kBq/m2 1 . Among them, about 270 000 people continue to live in areas classified by Soviet authorities as strictly controlled zones (SCZs), where radioactive caesium contamination exceeds 555 kBq/m2. Evacuation and relocation proved a deeply traumatic experience to many people because of the disruption to social networks and having no possibility to return to their homes. For many there was a social stigma associated with being an "exposed person". In addition to the lack of reliable information provided to people affected in the first few years after the accident, there was widespread mistrust of official information and the false attribution of most health problems to radiation exposure from Chernobyl. This fact sheet gives an overview of the health effects of the Chernobyl accident that can be established from high quality scientific studies. For people most affected by the accident, provision of sound, accurate information should assist with their healing process.

WHO health effects review Within the UN Chernobyl Forum initiative the World Health Organization (WHO) conducted a series of expert meetings from 2003 to 2005 to review all scientific evidence on health effects associated with the accident. The WHO Expert Group used as a basis the 2000 Report of the United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR), updated with critical reviews of published literature and information provided by the governments of the three affected countries. The Expert Group was composed of many scientists who had conducted studies in the three affected countries as well as experts world wide. Special health care programmes, established to treat people in the three countries which were most affected by the accident, were also considered. This resulted in a WHO report on "Health Effects of the Chernobyl Accident and Special Health Care Programmes" (see www.who.int/ionizing_radiation). The WHO Expert Group placed particular emphasis on scientific quality, using information mainly in peer-reviewed journals, so that valid conclusions could be drawn. In addition, comparisons were made with the results from studies of people involved in previous high radiation-exposure situations, such as the atomic bomb survivors in Japan. Radiation exposure Ionizing radiation exposure is measured as "absorbed dose" in gray (Gy). The "effective dose" measured in sievert (Sv) takes account of the amount of ionizing radiation energy absorbed, the type of radiation and the susceptibility of various organs and tissues to radiation damage. For most exposures from the Chernobyl accident, absorbed doses are similar to effective doses (i.e. 1Gy is approximately equal to 1 Sv). As human beings we are continually exposed to ionizing radiation from many natural sources, such as cosmic rays, and naturally occurring radioactive materials in all the foods we eat, fluids we drink and air we breath. This is called natural background radiation. UNSCEAR reports that the average natural background radiation dose to human beings worldwide is about 2.4 mSv2 each year, but this varies typically over the range 1-10 mSv. However, for a limited number of people living in known high background radiation areas of the world, doses can exceed 20 mSv per year. There is no evidence to indicate this poses a health risk. For most people more than half of their natural background radiation dose comes from radon, a radioactive gas that can accumulate in homes, schools and workplaces. When inhaled, the radiation exposure from radon may lead to lung cancer. Radiation doses to humans may be characterized as low-level if they are comparable to natural background levels. Doses received from the Chernobyl accident Below are the total average effective doses accumulated over 20 years by the highest Chernobyl exposed populations. These can be compared with the average doses people normally receive from natural background over 20 years. Doses from typical medical procedures are also given for comparison purposes. Population (years exposed) Number Average total in 20 years

Liquidators (19861987) (high exposed) Evacuees (1986) Residents SCZs (>555 kBq/m2) (19862005) Residents low contam. (37 kBq/m2) (1986 2005) Natural background

240 000 116 000 270 000 5 000 000

(mSv)1 >100 >33 >50 1020

2.4 48 mSv/year (typical range 1 10, max >20) Approximate typical doses from medical x-ray exposures per procedure: Whole body CT 12 mSv scan Mammogram 0.13 mSv Chest x-ray 0.08 mSv While the effective doses of most of the residents of the contaminated areas are low, for many people, doses to the thyroid gland were large from ingestion of milk contaminated with radioactive iodine. Individual thyroid doses ranged from a few tens of mGy to several tens of Gy. Apart from the people exposed to high levels of radioactive iodine mentioned above, only those liquidators who worked around the stricken reactor in the first two years after the accident (240 000), the evacuees (116 000), some of whom received doses well in excess of 100 mSv, and the residents of the highly contaminated SCZs (270 000), received doses significantly above typical natural background levels. Current residents of the low contaminated areas (37 kBq/m2) still receive small doses above natural background levels, but these are well within the typical range of background doses received world-wide. For comparison, the high radiation dose a patient typically receives from one whole body computer tomography (CT) scan is approximately equivalent to the total dose accumulated in 20 years by the residents of the low contaminated areas following the Chernobyl accident. Thyroid cancer A large increase in the incidence of thyroid cancer has occurred among people who were young children and adolescents at the time of the accident and lived in the most contaminated areas of Belarus, the Russian Federation and Ukraine. This was due to the high levels of radioactive iodine released from the Chernobyl reactor in the early days after the accident. Radioactive iodine was deposited in pastures eaten by cows who then concentrated it in their milk which was subsequently drunk by children. This was further exacerbated by a general iodine deficiency in the local diet causing more of the radioactive iodine to be accumulated in the thyroid. Since radioactive iodine is short lived, if people had stopped giving locally supplied contaminated milk to children for a few months following the accident, it is likely that most of the

increase in radiation-induced thyroid cancer would not have resulted. In Belarus, the Russian Federation and Ukraine nearly 5 000 cases of thyroid cancer have now been diagnosed to date among children who were aged up to 18 years at the time of the accident. While a large number of these cancers resulted from radiation following the accident, intense medical monitoring for thyroid disease among the affected population has also resulted in the detection of thyroid cancers at a sub-clinical level, and so contributed to the overall increase in thyroid cancer numbers. Fortunately, even in children with advanced tumours, treatment has been highly effective and the general prognosis for young patients is good. However, they will need to take drugs for the rest of their lives to replace the loss of thyroid function. Further, there needs to be more study to evaluate the prognosis for children, especially those with distant metastases. It is expected that the increased incidence of thyroid cancer from Chernobyl will continue for many years, although the long-term magnitude of the risk is difficult to quantify. Leukemia and non-thyroid solid cancer Ionizing radiation is a known cause of certain types of leukaemia (a malignancy of blood cells). An elevated risk of leukemia was first found among the survivors of the atomic bombings in Japan some two to five years after exposure. Recent investigations suggest a doubling of the incidence of leukaemia among the most highly exposed Chernobyl liquidators. No such increase has been clearly demonstrated among children or adults resident in any of the contaminated areas. From the experience of the Japanese bomb survivors it is possible that a large proportion of the leukaemia cases that could be linked to Chernobyl have already occurred, now that 20 years have passed since the accident. However, further studies are needed to clarify this. While scientists have conducted studies to determine whether cancers in many other organs may have been caused by radiation, reviews by the WHO Expert Group revealed no evidence of increased cancer risks, apart from thyroid cancer, that can clearly be attributed to radiation from Chernobyl. Aside from the recent finding on leukaemia risk among Chernobyl liquidators, reports indicate a small increase in the incidence of pre-menopausal breast cancer in the most contaminated areas, which appear to be related to radiation dose. Both of these findings, however, need confirmation in well-designed epidemiological studies. The absence of demonstrated increases in cancer risk apart from thyroid cancer is not proof that no increase has occurred. Based on the experience of atomic bomb survivors, a small increase in the risk of cancer is expected, even at the low to moderate doses received. Such an increase, however, is expected to be difficult to identify. Mortality According to UNSCEAR (2000), 134 liquidators received radiation doses high enough to be diagnosed with acute radiation sickness (ARS). Among them, 28 persons died in 1986 due to ARS. Other liquidators have since died but their deaths could not necessarily be attributed to radiation exposure. An increased number of cancer deaths can be expected during the lifetime of persons exposed to radiation from the accident. Since it is currently impossible to determine which individual cancers were

caused by radiation, the number of such deaths can only be estimated statistically using information and projections from the studies of atomic bomb survivors and other highly exposed populations. It should be noted that the atomic bomb survivors received high radiation doses in a short time period, while Chernobyl caused low doses over a long time. This and other factors, such as trying to estimate doses people received some time after the accident, as well as differences in lifestyle and nutrition, cause very large uncertainties when making projections about future cancer deaths. In addition, a significant non-radiation related reduction in the average lifespan in the three countries over the past 15 years caused by overuse of alcohol and tobacco, and reduced health care, have significantly increased the difficulties in detecting any effect of radiation on cancer mortality. Although there is controversy about the magnitude of the cancer risk from exposure to low doses of radiation, the US National Academy of Sciences BEIR VII Committee, published in 2006, a comprehensive review of the scientific evidence, and concluded that the risk seems to continue in a linear fashion at lower doses without a threshold (this is called the linear no-threshold or LNT model). However, there are uncertainties concerning the magnitude of the effect, particularly at doses much lower than about 100 mSv. The Expert Group concluded that there may be up to 4 000 additional cancer deaths among the three highest exposed groups over their lifetime (240 000 liquidators; 116 000 evacuees and the 270 000 residents of the SCZs). Since more than 120 000 people in these three groups may eventually die of cancer, the additional cancer deaths from radiation exposure correspond to 3-4% above the normal incidence of cancers from all causes. Projections concerning cancer deaths among the five million residents of areas with radioactive caesium deposition of 37 kBq/m2 in Belarus, the Russian Federation and Ukraine are much less certain because they are exposed to doses slightly above natural background radiation levels. Predictions, generally based on the LNT model, suggest that up to 5 000 additional cancer deaths may occur in this population from radiation exposure, or about 0.6% of the cancer deaths expected in this population due to other causes. Again, these numbers only provide an indication of the likely impact of the accident because of the important uncertainties listed above. Chernobyl may also cause cancers in Europe outside Belarus, the Russian Federation and Ukraine. However, according to UNSCEAR, the average dose to these populations is much lower and so the relative increase in cancer deaths is expected to be much smaller. Predicted estimates are very uncertain and it is very unlikely that any increase in these countries will be detectable using national cancer statistics .3 Cataracts The lens of the eye is very sensitive to ionizing radiation and cataracts are known to result from effective doses of about 2 Sv. The production of cataracts is directly related to the dose. The higher the dose the faster the cataract appears.

Chernobyl cataract studies suggest that radiation opacities may occur from doses as low as 250 mSv. Recent studies among other populations exposed to ionizing radiation (e.g. atomic bomb survivors, astronauts, patients who received CT-scans to the head) support this finding. Cardiovascular disease A large Russian study among emergency workers has suggested an increased risk of death from cardiovascular disease in highly exposed individuals. While this finding needs further study with longer follow-up times, it is consistent with other studies, for example, on radiotherapy patients, who received considerably higher doses to the heart. Mental health and psychological effects The Chernobyl accident led to extensive relocation of people, loss of economic stability, and long-term threats to health in current and possibly future generations. Widespread feelings of worry and confusion, as well as a lack of physical and emotional well-being were commonplace. The dissolution of the Soviet Union soon after the Chernobyl accident, and the resultant instability in health care, added further to these reactions. High levels of stress, anxiety and medically unexplained physical symptoms continue to be reported among those affected by the accident. The accident has had a serious impact on mental health and wellbeing in the general population, mainly at a sub-clinical level that has not generally resulted in medically diagnosed disorders. Designation of the affected population as victims rather than survivors has led to feelings of helplessness and lack of control over their future. This has resulted in excessive health concerns or reckless behaviour, such as the overuse of alcohol and tobacco, or the consumption of mushrooms, berries and game from areas still designated as having high levels of radioactive caesium. Reproductive and hereditary effects and children's health Given the low radiation doses received by most people exposed to the Chernobyl accident, no effects on fertility, numbers of stillbirths, adverse pregnancy outcomes or delivery complications have been demonstrated nor are there expected to be any. A modest but steady increase in reported congenital malformations in both contaminated and uncontaminated areas of Belarus appears related to improved reporting and not to radiation exposure. WHO's role The Expert Group report is a milestone in WHOs efforts to assess and mitigate the health impact of the Chernobyl accident. WHO will actively promote the research and practical recommendations given in this report. In addition WHO will ensure that the people most affected by the Chernobyl accident will be provided with scientifically factual information that will allow them to make better-informed decisions about their health and future . GROUP H: The Impact of Natural and Man-made Disasters Natural and Man-made disasters can have a life-altering impact on the individuals and families fortunate enough to survive them. But the effect of these disasters can be felt at the community, city and state level, or many times can impact an entire country. How well the impact of a disaster event is absorbed has much to do with the

intensity of the impact and the level of preparedness and resilience of the subject impacted. Significance Even before the industrialization of the modern world, natural disasters have been a fact of life. There are records of the migratory travels of Native Americans away from coastal Florida specifically to avoid seasonal hurricanes. However, with the modernization of many societies worldwide and the changes our industrial activities have brought to the environment, many weather related natural disasters have gained in both frequency and intensity. This translates to in increased global impact of natural disasters at all levels. Various disasters like earthquake, landslides, volcanic eruptions, flood and cyclones are natural hazards that kill thousands of people and destroy billions of dollars of habitat and property each year. The rapid growth of the world's population and its increased concentration often in hazardous environment has escalated both the frequency and severity of natural disasters. With the tropical climate and unstable land forms, coupled with deforestation, unplanned growth proliferation non-engineered constructions which make the disaster-prone areas more vulnerable, tardy communication, poor or no budgetary allocation for disaster prevention, developing countries suffer more or less chronically by natural disasters. Individual Impact At the individual level, the impact can often be felt physically, mentally and emotionally. Natural disasters cause destruction of property, loss of financial resources, and personal injury or illness. The loss of resources, security and access to shelter can lead to massive population migrations in lesser-developed countries. Physical impacts includes; loss of property and goods, loss of infrastructure, and loss of amenities. After experiencing natural and man-made disasters, many individuals develop severe post-traumatic stress disorders or withdraw into states of depression. Others develop negative associations with the environment, in more developed nations; this can also lead to significant population migrations. Community Impact Those communities that experience natural and man-made disasters must also absorb the impacts of these destructive events. Many local communities lose so much in economic resources that recovery becomes difficult, if not almost impossible. Some communities find opportunity in the aftermath of a disaster to rebuild better and stronger communities than before. Communities must often recognize population, demographic, and cultural shifts as a result of the impact of the natural disaster on their individual citizens. Social impacts includes; loss of lives, loss of health and well-being, damage to livelihood, psychological stress and trauma, loss of employment, law and order problems. Economic Impact In 2005, Hurricane Katrina devastated New Orleans and the Mississippi gulf coast. In New Orleans alone, more than 200,000 homes were destroyed; over 70 percent of the resident population

had to be at least temporarily relocated outside of the greater New Orleans area. In addition, huge sums of federal assistance were necessary to help jump start recovery efforts in the city and surrounding region. Estimates of over $105 to $150 billion in reduced tax revenue, loss of infrastructure, expense of reclamation efforts, and loss of normal revenue were lost to the city. Beyond the economic losses to New Orleans, it is estimated that the United States economy suffered a 2 percent loss of overall gross domestic product within one year of the disaster as a direct result of the hurricane and its impact on this important international port city. Loss of services, loss of industry/production, loss of productivity and sustainability, loss of income, insurance losses and relief costs, economic costs of physical and environmental losses, and recovery costs

Environmental Impact Just as a natural can change the landscape of our personal lives as well as aspects of our community, so too can different types of disasters drastically alter the natural environment. The cyclones that occurred in Myanmar in 2008, or the wildfires that spread throughout California in 2009 are examples of how areas of land that detail whole ecosystems can be dramatically damaged or transformed from a single disaster event. On a larger scale, the debate regarding how to address global climate change and the resulting natural impacts is further punctuated by estimates of sea level increases that will completely swamp some island nations. Furthermore, the rapid desalination of salt water oceans caused by melting glaciers could deprive the world of 30 percent or more of its edible fish supply, and the loss of coral reefs from the same cause would put numerous coastal regions in jeopardy of tidal waves and surges. Environmental impacts includes; loss of environmental reserves, loss of environmental services, loss of environmental functions, loss of resources for livelihood, loss of resources for development/ infrastructure, loss of resources for industry, and contamination of resources. CAUSES

Effects on disaster impacts on environmental components and assets

EMERGENCY & DISASTER MANAGEMENT

EMERGENCY & DISASTER MEASURES

Industry Risk Management which specifically address the potential impacts of natural hazards on their installations. Provide emergency services and medical care to victims. Activate the health alert network. Evaluate effectiveness of disaster plan. Critically evaluate all aspects of disaster plans and practice drills for speed, effectiveness, gaps and revisions. Evaluate the disaster impact on community and surrounding regions Evaluate the response of personnel involved in disaster relief efforts.

violence perpetrated by warring factions against civilian populations and vulnerable populations, the threatened extinction of minority, ethnic, and religious populations resulting in the largest migration of people in the history of humankind, and the catastrophic destruction of basic public health protections and infrastructure. The history of complex emergencies also reflects another characteristica tremendous outpouring of humanitarian assistance from a world caught up in the confusion and alarm that these events provoke. This assistance has come from donors, both public, private, and governmental, thousands of non-governmental and private voluntary organizations, and the United Nations agencies and peacekeepers that represent every social and political persuasionunified in attempts to control the increasing mortality and morbidity seen among innocent civilian populations. The world community has struggled to understand these complex events, especially as they became longer lasting and threatened to spread into neighboring countries. Causes Wars and conflicts have been the main causes of complex emergencies. But the public health issues have often been neglected. These complex emergencies cause displacement of people, whether in the millions or a few thousand; and destruction of homes and critical infrastructure such as schools, roads, bridges, water sources, and most of all, hospitals and clinics. Wars, in a wave of destruction, leave the population without access to essential services that provide for health for life. Examples Drought, Eritrea-Ethiopia, Great Lakes, Kenya, Sahel Humanitarian Crisis, Somalia, Southern Africa Humanitarian Crisis, Sudan, Uganda, West Africa, Zimbabwe; Afghanistan, Caucasus The Sri Lankan conflict After two decades of conflict, Asias longest running civil war came to an end in May 2009 when the Sri Lankan army defeated the separatist Liberation Tigers of Tamil Eelam (LTTE). The Maluku Conflict In 2002, there was a major conflict between Muslim and Christian religious groups in Malukuand North Maluku provinces in eastern Indonesia. Families, friends, communities, private andpublic workers, and those who lived and worked together on a daily basis were divided bytheir religious beliefs. Many people died in the conflict while others were injured, traumatized or displaced, and buildings and homes were damaged. The Aceh Conflict The separatist movement in Aceh, demanding the secession of the province since 1976, created a regional humanitarian crisis leading to war between central government armed forces and separatist militants. Technological Disaster Also called a Manmade disaster, it is a disaster attributed in part or entirely to human intent, error, negligence, or involving a failure of a man-made system, resulting in significant injuries or deaths.

GROUP G: Complex Emergencies A complex emergency is a humanitarian crisis ina country, region or society where there is total or considerable breakdown of authority resulting from internal or external conflict and which requires an international response that goes beyond the mandate or capacity of any single agency and/or the ongoing United Nations country program. Inter-agency Standing Committee (IASC), December 1994 Such complex emergencies are typically characterized by: Extensive violence and loss of life; massive displacements of people; widespread damage to societies and economies The need for large-scale, multi-faceted humanitarian assistance The hindrance or prevention of humanitarian assistance by political and military constraints Significant security risks for humanitarian relief workers in some areas. Complex emergencies emerged as a new type of disaster following the end of the Cold War, and have become increasingly common in recent years. Human activity including civil strife, war, and political repression often co-exist with and contribute to natural phenomena such as famine. They frequently result in high mortality, population displacement, and the disruption of civil society and its infrastructure Human populations have migrated throughout the known history of humankind. Many migrations in modern times have resulted in multitudes of persons either displaced within their own national borders or in large refugee populations that have crossed national boundaries. However, it was not until the end of the Cold War that the health problems associated with such migrations began to be appreciated by the developed world. In the early 1990s, the world began to witness a rise in internal wars among nation-states newly emerging from the Cold War. At first, these events were considered short-lived, self-contained conflicts that reflected internal political jockeying for power. In time, the developing characteristics of these events would show a pattern that was quite differentand increasingly complex. Often referred to as complex emergencies or complex political disasters, the designation of complexity reflects the multiple political, economic, social, ethnic, and religious factors that lead first to the conflict, and then, prevent its resolution. The most telling characteristics of complex emergencies are high levels of

PROPOSED STRATEGIES FOR NATECH RISK REDUCTION: Assess the community Diagnose community disaster threats Take a visible role in community disaster planning. Emergency Planning, including prevention and mitigation, and response planning for all levels of government. Implement disaster plans Standard operating procedures (SOPs) Reception area Triage a. Priority one - needing immediate resuscitation, after emergency treatment shifted to intensive care unit b. Priority two - immediate surgery, transferred immediately to operation theatre. c. Priority three - needing first aid and possible surgery- give first aid and admit if bed is available or shift to hospital d. Priority four - needing only first aiddischarge after first aid. Documentation Public relations. Essential services. Crowd management/ security arrangement Education of the public involved in emergency management, as well as decision-makers. Public participation in NaTech risk reduction planning. Conduct hazard assessments.

Manmade or technological disasters are unpredictable, can spread across geographical boundaries, may be unpreventable, and may have limited physical damage but long-term effects. Some disasters in this class are entirely manmade, such as terrorism. Other technological disasters occur because industrial sites are located in communities affected by natural disasters, equipment failures occur, or workers have inadequate training or fatigue and make errors. The threat of terrorism is categorized as a potential technological disaster and includes bioterrorism, bombings, civil and political disorders. Technological disasters include a broad range of incidents. Routes of exposure are water, food and drink, airborne releases, fires and explosions, and hazardous materials or waste (e.g., chemical, biological, or radioactive) released into the environment from a fixed facility or during transport. Fires, explosions, building or bridge collapses, transportation crashes, dam or levee failures, nuclear reactor accidents, and breaks in water, gas, or sewer lines are other examples of technological disasters. Examples of Technological Disasters The Chernobyl disaster The Chernobyl disaster was a nuclear accident that occurred on 26 April 1986 at the Chernobyl Nuclear Power Plant in Ukraine, which was under the direct jurisdiction of the central Moscow's authorities. An explosion and fire released large quantities of radioactive contamination into the atmosphere, which spread over much of Western USSR and Europe. It is considered the worst nuclear power plant accident in history. The battle to contain the contamination and avert a greater catastrophe ultimately involved over 500,000 workers and cost an estimated 18 billion rubles, crippling the Soviet economy. The disaster began during a systems test on Saturday, 26 April 1986 at reactor number four of the Chernobyl plant, which is near the city of Prypiat and within a close proximity to the administrative border with Belarus and Dnieper River. There was a sudden power output surge, and when an emergency shutdown was attempted, a more extreme spike in power output occurred, which led to a reactor vessel rupture and a series of explosions. These events exposed the graphite moderator of the reactor to air, causing it to ignite. The resulting fire sent a plume of highly radioactive smoke fallout into the atmosphere and over an extensive geographical area, including Pripyat. The plume drifted over large parts of the western Soviet Union and Europe. From 1986 to 2000, 350,400 people were evacuated and resettled from the most severely contaminated areas of Belarus, Russia, and Ukraine. According to official post-Soviet data, about 60% of the fall out landed in Belarus. Russia, Ukraine, and Belarus have been burdened with the continuing and substantial decontamination and health care costs of the Chernobyl accident. A report of the International Atomic Energy Agency, examines the environmental consequences of the accident. Estimates of the number of deaths potentially resulting from the accident vary enormously: Thirty one deaths are directly attributed to the accident, all among the reactor staff and emergency workers. A UNSCEAR report places the total confirmed deaths from radiation at 64 as of 2008. The World Health Organization (WHO) suggests it could reach 4,000 civilian deaths,

a figure which does not include military clean-up worker casualties. A 2006 report predicted 30,000 to 60,000 cancer deaths as a result of Chernobyl fallout. Greenpeace report puts this figure at 200,000 or more. A Russian publication, Chernobyl, concludes that 985,000 excess cancer deaths occurred between 1986 and 2004 as a result of radioactive contamination. The Columbine High School Massacre The Columbine High School massacre occurred on Tuesday, April 20, 1999, at Columbine High School in Columbine, an unincorporated area of Jefferson County, Colorado, United States, near Denver and Littleton. Two senior students, Eric Harris and Dylan Klebold, embarked on a massacre, killing 12 students and 1 teacher. They also injured 21 other students directly, and three people were injured while attempting to escape. The pair then committed suicide. The massacre provoked debate regarding gun control laws, the availability of firearms in the United States, and gun violence involving youths. Much discussion also centered on the nature of high school cliques, subcultures, and bullying, as well as the role of violent movies and video games in American society. The shooting resulted in an increased emphasis on school security, and a moral panic aimed atgoth culture, social outcasts, the gun culture, the use of pharmaceutical anti-depressants by teenagers, violent films and music, teenage internet use, and violent video games. The 9/11 Attack The September 11 attacks were a series of four coordinated suicide attacks against targets in New York and Washington, D.C. on September 11, 2001. On that morning, 19 al-Qaeda terrorists hijacked four passenger jets. The hijackers intentionally crashed two planes into the Twin Towers of the World Trade Center in New York City; both towers collapsed within two hours. Hijackers crashed a third plane into the Pentagon in Arlington, Virginia. When passengers attempted to take control of the fourth plane, United Airlines Flight 93, it crashed into a field near Shanksville, Pennsylvania, preventing it from reaching its intended target in Washington, D.C. Nearly 3,000 died in the attacks. The destruction caused serious damage to the economy of Lower Manhattan. Cleanup of the World Trade Center site was completed in May 2002. The National September 11 Memorial & Museum is scheduled to open on September 11, 2011. Adjacent to the memorial the 1,776 feet (541 m) One World Trade Center is estimated for completion by 2013. The Pentagon was repaired within a year, and the Pentagon Memorial opened, adjacent to the building, in 2008. Ground was broken for the Flight 93 National Memorial in November 2009, and the memorial is to be formally dedicated on September 10, 2011. Emergency and Disaster Measures (Complex and Technological Disaster) Disaster management aims to reduce, or avoid, the potential losses from hazards, assure prompt and appropriate assistance to victims of disaster, and achieve rapid and effective recovery. The Disaster management cycle illustrates the ongoing process by which governments, businesses, and civil society plan for and reduce the impact of disasters, react during and immediately following a disaster, and take steps to recover after a disaster has

occurred. Appropriate actions at all points in the cycle lead to greater preparedness, better warnings, reduced vulnerability or the prevention of disasters during the next iteration of the cycle. Republic Act No. 10121 known as the Philippine Disaster Risk Reduction and Management Act of 2010 requires the establishment of Local Disaster Risk Reduction and Management Office (LDRRMO) in every province, city, and municipality. Each LDRRMO is also required to have an LDRRM Plan which it shall implement together with local partners and stakeholders Under Republic Act No. 10121 or the DRRM Act, provinces, cities, and municipalities have a greater responsibility in building the disaster resilience of communities, and in institutionalizing disaster risk reduction within their functions and operations. LGUs need to develop the knowledge, capacity, and a system to cost effectively comply with the law What is Contingency Planning? A forward planning process, in a state of uncertainty, in which scenarios and objectives are agreed, managerial and technical actions defined, and potential response systems put in place in order to prevent, or better respond to, an emergency or critical situation. Why do contingency planning? A. To save time by: Identifying scenarios in advance Determining key policies in advance Defining objectives in advance Identifying activities in advance Assign likely responsibilities in advance Preparing a plan in advance to save lives B. To assist in: Mobilizing effective actions and resources for emergency response; Generating commitment among parties involved to act in a coordinated manner before the emergency occurs; and Designing a concrete and continuous plan until the emergency occurs and which can be discontinued when the hazard is considered to be no longer threatening. Other Events Where CP Should Be Considered Planned Events Sudden increase of displaced population Sudden shortages of funding, food or other commodities Outbreak of an epidemic or serious health problem like the SARS, Avian Influenza/Bird Flu Terrorism Disruption of work due to emergencies The complete disaster management cycle includes the shaping of public policies and plans that either modify the causes of disasters or mitigate their effects on people, property, and infrastructure. The mitigation and preparedness phases occur as disaster management improvements are made in anticipation of a disaster event. Developmental considerations play a key role in contributing to the mitigation and preparation of a community to

effectively confront a disaster. As a disaster occurs, disaster management actors, in particular humanitarian organizations, become involved in the immediate response and long-term recovery phases. The four disaster management phases illustrated here do not always, or even generally, occur in isolation or in this precise order. Often phases of the cycle overlap and the length of each phase greatly depends on the severity of the disaster. Mitigation - Minimizing the effects of disaster. Examples: building codes and zoning; vulnerability analyses; public education. Preparedness - Planning how to respond. Examples: preparedness plans; emergency exercises/training; warning systems. Response - Efforts to minimize the hazards created by a disaster. Examples: search and rescue; emergency relief . Recovery - Returning the community to normal. Examples: temporary housing; grants; medical care.

long-term and short-term strategies, public education and building early warning systems. Preparedness can also take the form of ensuring that strategic reserves of food, equipment, water, medicines and other essentials are maintained in cases of national or local catastrophes. During the preparedness phase, governments, organizations, and individuals develop plans to save lives, minimize disaster damage, and enhance disaster response operations. Preparedness measures include preparedness plans; emergency exercises/training; warning systems; emergency communications systems; evacuations plans and training; resource inventories; emergency personnel/contact lists; mutual aid agreements; and public information/education. As with mitigations efforts, preparedness actions depend on the incorporation of appropriate measures in national and regional development plans. In addition, their effectiveness depends on the availability of information on hazards, emergency risks and the countermeasures to be taken, and on the degree to which government agencies, nongovernmental organizations and the general public are able to make use of this information. Humanitarian Action During a disaster, humanitarian agencies are often called upon to deal with immediate response and recovery. To be able to respond effectively, these agencies must have experienced leaders, trained personnel, adequate transport and logistic support, appropriate communications, and guidelines for working in emergencies. If the necessary preparations have not been made, the humanitarian agencies will not be able to meet the immediate needs of the people. Response The aim of emergency response is to provide immediate assistance to maintain life, improve health and support the morale of the affected population. Such assistance may range from providing specific but limited aid, such as assisting refugees with transport, temporary shelter, and food, to establishing semipermanent settlement in camps and other locations. It also may involve initial repairs to damaged infrastructure. The focus in the response phase is on meeting the basic needs of the people until more permanent and sustainable solutions can be found. Humanitarian organizations are often strongly present in this phase of the disaster management cycle. Recovery As the emergency is brought under control, the affected population is capable of undertaking a growing number of activities aimed at restoring their lives and the infrastructure that supports them. There is no distinct point at which immediate relief changes into recovery and then into long-term sustainable development. There will be many opportunities during the recovery period to enhance prevention and increase preparedness, thus reducing vulnerability. Ideally, there should be a smooth transition from recovery to on-going development. Recovery activities continue until all systems return to normal or better. Recovery measures, both short and long term, include returning vital life-support systems to minimum operating standards; temporary housing; public information; health and safety education; reconstruction; counseling programs; and economic impact studies. Information resources and services

include data collection related to rebuilding, and documentation of lessons learned. Complex emergency/Technological disaster Nursing Management Role of the Nurse at the Disaster Site o Ensure safety o First Aid o Emergency care Disaster preparedness, including risk assessment and multidisciplinary management strategies at all system levels, is critical to the delivery of effective responses to the short, medium, and long-term health needs of a disaster-stricken population. (International Council of Nurses, 2006) MAJOR 1. 2. 3. 4. 5. ROLES OF NURSE IN DISASTERS Determine magnitude of the event Define health needs of the affected groups Establish priorities and objectives Identify actual and potential public health problems Determine resources needed to respond to the needs identified 6. Collaborate with other professional disciplines, governmental and non-governmental agencies 7. Maintain a unified chain of command 8. Communication

Sustainable Development Developmental considerations contribute to all aspects of the disaster management cycle. One of the main goals of disaster management, and one of its strongest links with development, is the promotion of sustainable livelihoods and their protection and recovery during disasters and emergencies. Where this goal is achieved, people have a greater capacity to deal with disasters and their recovery is more rapid and long lasting. In a development oriented disaster management approach, the objectives are to reduce hazards, prevent disasters, and prepare for emergencies. Therefore, developmental considerations are strongly represented in the mitigation and preparedness phases of the disaster management cycle. Inappropriate development processes can lead to increased vulnerability to disasters and loss of preparedness for emergency situations. Mitigation Mitigation activities actually eliminate or reduce the probability of disaster occurrence, or reduce the effects of unavoidable disasters. Mitigation measures include building codes; vulnerability analyses updates; zoning and land use management; building use regulations and safety codes; preventive health care; and public education. Mitigation will depend on the incorporation of appropriate measures in national and regional development planning. Its effectiveness will also depend on the availability of information on hazards, emergency risks, and the countermeasures to be taken. The mitigation phase, and indeed the whole disaster management cycle, includes the shaping of public policies and plans that either modify the causes of disasters or mitigate their effects on people, property, and infrastructure. Preparedness The goal of emergency preparedness programs is to achieve a satisfactory level of readiness to respond to any emergency situation through programs that strengthen the technical and managerial capacity of governments, organizations, and communities. These measures can be described as logistical readiness to deal with disasters and can be enhanced by having response mechanisms and procedures, rehearsals, developing

DISASTER TIMELINE ANDNURSING ACTION/ RESPONSIBILITIES

RECENT STUDIES Civil-Military Relations in Armed Conflicts: A Humanitarian Perspective Manuel Bessler and Kaoruko Seki2

This article is an excerpt from Liaison A Journal of Civil-Military Humanitarian Relief Collaborations, Vol. III No.3, 2006, pages 410. The on-line version is available at: http://coe-dmha.org/Liaison/Vol_3No_3/Dept01.htm In todays changing security environment, the military are increasingly involved in the direct delivery of relief aid, while humanitarian organisations often find themselves having no other choice but to rely on the military to ensure the safety and security of their staff and operations, and to enable access to populations in need. Whether or not this is a temporary phenomenon in a few specific cases or a wider trend that is here to stay, the situation begs for a re-examination of civil-military relations in humanitarian crises, in order to facilitate mutual understanding and search for an optimum relationship between both actors as they operate in physical proximity in dangerous situations. One such attempt has been undertaken in 2003-2004 by the humanitarian community through the Inter-Agency Standing Committee (IASC). Although little known to the military community and despite having no authority to direct or bind its members or anyone else, the IASC is an international humanitarian coordination body that enjoys a degree of legitimacy that derives from its broad-based membership as well as the universal character of its founding body, the United Nations (UN) General Assembly (GA).3 (See Box 1 for information on IASC membership.) Thus, for military personnel interacting with humanitarian actors, taking a look at IASCendorsed guidance provides a short-cut to understanding some common positions that are shared across a diverse range of humanitarian actors. The purpose of this article is to introduce the readers to one of the latest IASC instruments on civil-military relations in humanitarian action: the IASC Reference Paper on Civil-Military Relationship in Complex Emergencies4. This generic reference is worth highlighting, as it is devised as a practical tool to be used by humanitarian personnel when formulating country-specific guidelines for civil-military relations tailored to particular complex emergencies.5 Although written primarily for humanitarian practitioners, military personnel would probably find it a useful tool in understanding a widely shared humanitarian view. What is the IASC? The Inter-Agency Standing Committee (IASC) was created to strengthen coordination and effectiveness of humanitarian assistance, called for by UN General Assembly (UNGA) resolution 46/182 of 1991. Through resolution 48/57, the UNGA affirmed the IASCs role as the primary mechanism for inter-agency humanitarian coordination. It is a key vehicle to formulate common policy and guidelines amongst a broad range of humanitarian actors. The following organisations form the IASC: Full Members: Food and Agriculture Organisation (FAO) United Nations Office for the Coordination of Humanitarian Affairs (OCHA) United Nations Development Programme (UNDP) United Nations Population Fund (UNFPA)

Office of the United Nations High Commissioner for Refugees (UNHCR) United Nations Children's Fund (UNICEF) World Food Programme (WFP) World Health Organisation (WHO)

Standing Invitees: International Committee of the Red Cross (ICRC) International Council of Voluntary Agencies (ICVA) * International Federation of Red Cross and Red Crescent Societies (IFRC) InterAction * International Organization for Migration (IOM) Office of the United Nations High Commissioner for Human Rights (OHCHR) Office of the Special Representative of the Secretary General on the Human Rights of the IDPs Steering Committee for Humanitarian Response (SCHR) * The World Bank These are umbrella organisations of three different consortia of major humanitarian NGOs. What is at Stake? Definition and Background .Technological hazards involve the release of hazardous substances that impact human health and safety, the environment, and/or the local economy. Hazardous substances are chemicals, toxic substances, gasoline and oil, nuclear and radiological material, and flammable and explosive materials, in the form of gases, liquids, or solids. Because such hazards exist during production, storage, transportation, use, or disposal, the impacts to our oceans, groundwater systems, streams, rivers, agriculture, air quality, and urban areas continue to be significant. Criminal and terrorist threats to facilities that house technological hazards are additional concerns that must be considered when assessing risk and developing prevention and mitigation strategies. Failures in cyber-infrastructures, failures of upkeep, human error and accidents, and naturally occurring events such as hurricanes, floods, earthquakes, and fires also can cascade into a technological disaster. Grand Challenges for Disaster Reduction: Priority Interagency Technological Disasters Implementation Actions Grand Challenge #1: Provide hazard anddisaster information where and when it is needed. Grand Challenge #2: Understand the natural processes that produce hazards. Grand Challenge #3: Develop hazard mitigation strategies and technologies. Grand Challenge #4: Reduce the vulnerability of infrastructure. Grand Challenge #5: Assess disaster resilience. Grand Challenge #6: Promote risk-wise behavior.