Governor's Office of Emergency Services - California Specialized Training Institute
Decontamination Defined
Decontamination is the process of removing contaminates from people, equipment,
structures, the environment or anything that may be contaminated. Decontamination
is primarily designed to minimize exposure to hazardous substances and limit the
spread of contamination.
Methods of Decontamination
There are many decontamination methods. Which method is selected is primarily
influenced by situational circumstances. We will discuss four basic methods of
decontamination in this section. They include discarding, dilution, absorption and
neutralization.
Discarding - The process of removing and disposing of contaminated
clothing and equipment.
Dilution - The use of copious amounts of soap and water, or a specific
decontamination solution to flush off or dilute the contaminants.
Absorption - The use of an absorbing material to trap and hold
contaminants.
Neutralization - Chemically altering the contaminant to an innocuous
or less harmful state.
Generally speaking, discarding and dilution are the preferred methods of removing
contaminants. These methods are easy to implement, effective and relatively
inexpensive. Water for dilution is generally plentiful at an emergency scene.
Types of Decontamination
There are five generally recognized types of decontamination, each of which is
reviewed below.
1.
Emergency Decontamination refers to decontamination that is
urgent, field and/or site expedient. Generally, there are two sub-types of emergency
decontamination.
First Responder Emergency Decontamination refers to
decontamination that is urgent and field expedient. Most often, it is
done to civilians or response personnel who have had a direct
exposure to hazardous solids, liquids, mist, smoke and certain gases,
and who may be displaying related symptoms. This is generally
required for a few people.
Mass Decontamination also refers to decontamination that is urgent
and field expedient. It is done to civilians or response personnel who
have had a direct exposure to hazardous solids, liquids, mist, smoke
and certain gases, and who may be displaying related symptoms. This
is generally required for large groups of people.
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2.
Precautionary Decontamination generally refers to
decontamination provided to civilians who are displaying related symptoms and may
have been through emergency decontamination. It may also be appropriate for those
who may have been exposed to hazardous chemicals, but are not displaying any
related symptoms of exposure. With Precautionary Decontamination there is time to
contain runoff water and provide for modesty. This level of decontamination might
involve the use of tents, trailers, tarps, containment basins and/or showers. This
type of decontamination may be a first step if Emergency Decontamination was not
required but ensures no suspected contamination leaves the incident site.
3.
Responder Decontamination refers to that form of decontamination
that is provided to personnel working in the Exclusion Zone or the Contamination
Reduction Zone at a Hazmat or WMD event. This generally includes Hazmat Entry
and Decontamination Teams working in Level A or Level B protective clothing, but
may include Law Enforcement Force Protection Squads and EMS personnel working in
Level C chemical protective clothing.
This type of decontamination will be the primary focus of this course. This type of
decontamination has also been called primary decontamination, technical
decontamination, full decontamination, or hazmat decontamination.
4.
Respiratory Decontamination is provided to persons who have had
an exposure to a gas, which is toxic, but poses little or no risk of secondary
contamination to rescue and EMS personnel. It involves removing the victims from
the hazardous environment and relocating them to a clean and safe location. It may
include the administration of oxygen. Bulky clothing capable of trapping gas should
be removed outdoors prior to turning the victim over to medical personnel.
5.
Equipment Decontamination refers to the form of decontamination
that is utilized to clean equipment so it can be returned to service. This may refer to
the cleaning of equipment contaminated during mitigation of the incident or to
additional cleaning of PPE once back at the work assignment.
Selecting a Method of Decontamination
Individuals within the hazmat group will decide what method of responder
decontamination to use. The Hazmat Group Supervisor, Decontamination Unit Leader
and the Assistant Safety Officer will participate in this decision. They will decide
which method to use. FROs will implement this decision.
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Hazardous Materials Zones
Once the decision has been made to conduct Responder Decontamination, it should
set up as quickly as possible. Often, entry operations are delayed because the
decontamination area is not set up and ready for use. Getting a quick jump on
setting up decontamination is highly recommended, while still ensuring that the
location selected is correct as this cannot easily be changed later.
Responder Decontamination should be conducted in an isolated area that will keep
others from exposure or contamination. Typically decontamination is set up
immediately outside the area of known or suspected contamination.
The area where decontamination is conducted is referred to as the Contamination
Reduction Zone. This is one of three zones established on any hazardous materials
incident involving an entry into the hazardous area. The three zones that should be
established on a hazardous materials incident are:
Technical Term
Also Known As
Exclusion Zone
Hot Zone
Contamination Reduction Zone Warm Zone
Support Zone
Cold Zone
Identified With
Red Barrier Tape
Red Barrier Tape
Yellow Barrier Tape
Two other areas that may need to be established are the Refuge Area and the Safe
Refuge Area.
Refuge Area - An area identified within the incident for the assembly
of individuals (usually those present when the incident occurred) to
reduce the risk of further contamination or injury
Safe Refuge Area (SRA) - A safe area within the Contamination
Reduction Zone (CRZ) for the assembly of individuals who were on site
at the time of the spill. Separation of any potentially contaminated or
exposed persons from non-exposed persons should be accomplished in
the SRA.
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Decontamination Equipment
The type of equipment that may be used during responder decontamination can vary
drastically depending on the methods selected and the needs of the incident.
FROs should be familiar with the decontamination equipment that is needed to
support their hazmat team’s mission.
Below is a list of typical decontamination equipment. The list is not all encompassing
and there may be items on the list that certain hazmat responders do not need.
Brushes – various
Buckets
Decontamination pools
Decontamination showers
Disposable blankets
Ground cover (plastic sheeting or tarps)
Hoses (including garden hoses)
Modesty protection
Nozzles
Plastic bags
Red barrier tape
Small hose adapters
Soap
Sponges
Stools
Towels
Traffic cones
For a more specific detailed list by described by FIRESCOPE as part of the hazmat
team typing program, please go to
http://www.firescope.org/ics-hazmat/pos-manuals/haz-equiplist.pdf
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General Decontamination Guidance
The following are some general decontamination guidelines that FRO should follow
during a hazmat incident. Some of these apply to the entry workers but may impact
the decontamination process.
Avoid unnecessary contact with potentially hazardous substances.
Personnel should not touch or walk through areas of obvious
contamination if it can be avoided.
Protect monitoring and sampling instruments by bagging or wrapping.
Wear disposable outer garments and use disposable equipment when
possible.
Place all discarded contaminated equipment in a designated area.
Contain all rinse water until tested when possible.
Have the Contamination Reduction Zone and decontamination set up
prior to personnel entering the Exclusion Zone.
Minimize contact time with contaminants.
Stay upwind and upgrade from contaminants when possible.
Managing the Decontamination Process
Like any incident, responders shall utilize the Incident
Command System when managing an incident that
involves decontamination. It is important that the
incident commander designate an individual in charge
of the decontamination operation. In the ICS system,
the position of Decontamination Leader (ICS-HM-222-3)
was created to manage this function.
Almost every hazmat incident warrants the creation of
the Hazardous Materials Group, or Hazardous Materials Branch. More information on
this portion of the ICS can be found in the FIRESCOPE’s Fire Service Field Operations
Guide (FOG), ICS 420-1 Incident Command System Publication.
The Decontamination Leader is the ICS position that manages the
decontamination team.
The Decontamination Leader is assigned to
the Hazardous Materials Group Supervisor
(or Hazardous Materials Branch if
activated). The Decontamination Leader
reports to the Hazardous Materials Group
Supervisor. The Decontamination Leader is
responsible for all activities taking place in
the area designated as the Contamination Reduction Zone and
coordinates with the Safe Refuge Area Manager (if activated). The
Decontamination Leader is responsible for the decontamination of
persons and equipment that leave the Exclusion Zone and the
maintenance of records for the Decontamination element.
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As stated before, on rare occasions the FROs will fill the role of Decontamination
Leader. It would be best if this position was filled by a hazmat team member trained
as a minimum to the Hazmat Technician level.
The Hazardous Materials Group Supervisor supervises the Decontamination
Leader.
The Hazardous Materials Group Supervisor is assigned to the
Operations Section (or Hazardous Materials Branch if activated). The
Hazardous Materials Group Supervisor reports to the Operations
Section Chief. The Hazardous Materials Group Supervisor is
responsible for the implementation of the phases of the Incident Action
Plan dealing with the Hazardous Materials Group operations. The
Hazardous Materials Group Supervisor is responsible for the
assignment of resources within the Hazardous Materials Group,
reporting on the progress of control operations and the status of
resources within the Group. The Hazardous Materials Group Supervisor
directs the overall operations of the Hazardous Materials Group.
The Decontamination Unit (or Team)
The size of the decontamination team depends on many factors. In addition to the
Decontamination Leader there should be at least two more members. These two
members would don PPE and enter the appropriate zone to conduct decontamination.
Complex or large incidents often require more than two members. Since
decontamination workers also have to go through the decontamination process
having more decontamination members usually means having more workers that
need to be decontaminated.
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Two decontamination workers are required at a minimum due to the OSHA
HAZWOPER requirement to ensure the use of the buddy system when sending people
into hazardous areas.
The Decontamination Leader does not don PPE and does not enter the zone to assist
with decontamination but rather supervises the process from the edge of the zone.
Performing Responder Decontamination
As stated, before there are many different ways to perform Responder
Decontamination depending on the situation and the method selected. We will
describe some general principals and guidelines for conducting the most common
method of decontamination — dilution with soap and water.
Protective clothing
The level of protective clothing for the decontamination workers does not have to be
the same as for the Entry Team. OSHA policy allows “…PPE at the same level or one
level below that worn by the emergency responders they are supporting, as
appropriate to the hazards.” The question asked when determining the level of PPE
for the decontamination workers is — what is the threat of secondary contamination?
In other words, will the materials that the entry workers are contaminated with pose
a threat to the decontamination workers?
The decontamination workers are generally exposed only to diluted material that
comes off the Entry Team. Often, they don’t have direct contact with the material the
way the Entry Team does. Exceptions might arise when extremely hazardous
materials are present.
Personnel
As stated before at least two people will be needed to enter the CRZ and perform
actual decontamination. One person should do the initial washing and scrubbing. The
second person should rinse and assist with removing clothing/outer garments. Other
responders may be used to help remove SCBAs and assist as necessary.
Setting Up the Decontamination Area
Typically hazmat teams have a standard decontamination plan that allows for
deviation and flexibility depending on the situation.
For example, a standard decontamination may call for 3 pools but because of the
limited chance for contamination they would use 2 pools in certain situations (such
as when space is limited).
A basic set up includes an isolated area that has access to water. A ground cover is
put down that is large enough to allow for a work area.
Once the ground covering is in place place the pools on top of the ground covering.
Hoses, most commonly garden type hoses, and brushes are put in place at the edge
of the pools.
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Another area adjacent to the pools is an undress area. This is where entry workers
doff their PPE with assistance from the decon workers after going through the
washing and rinsing process.
Other areas that may be needed include:
A sample decon area to decon any samples that are taken
An equipment drop off area to stage equipment that may be taken
back into the exclusion zone
A waste area to discard over-boots and/or over-gloves that have been
grossly contaminated
A gross decon pool, where there is no washing just rinsing
A SCBA cylinder change area to change out cylinders for re-entry
A SCBA removal station
An area to decontaminate patients, victims and/or non-ambulatory
persons
Other – whatever area is needed based upon the situation
The Process
The exact process will vary. Essentially the contaminated worker goes from one pool
to the other getting washed and rinsed along the way. The worker is washed from
top to bottom, paying close attention to areas that may have more contamination
than others such as the feet or hands. The concept is that as the worker moves from
one pool to the other he/she becomes progressively cleaner at each step until he/she
is completely cleaned.
The worker exits the last pool and proceeds to an adjacent area for suit removal.
Decon workers will assist with this process.
Bag equipment and waste as appropriate and secure with tape. The industry
standard it to use solid colored bags for waste (hazardous) and clear bags for
equipment that is reusable.
There is no one method that will work in all situations, but as long as the process
follows a safe logical order, the decon will be effective. The contaminated worker
goes from dirty to clean, to cleaner to cleanest.
This will be demonstrated and explained in greater detail in the hands on training
following the classroom portion of this course.
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Verification of the Decontamination Process
Every effort should be made to verify the decontamination process after the workers
have been cleaned. There are many ways to validate decontamination depending on
the situation. Below are some methods to consider:
Swipe testing
Atmospheric monitors that detect in parts per billion (ppb)
Ultraviolet light
Testing of the final rinse water
The process of validating decontamination is an area of response that is expanding
and growing each day with new scientific methods that will work for specific
chemicals. Responders are encouraged to keep current on new developments in this
area.
In-Suit Emergencies
The safety of all responders is the highest priority. Still there are various in-suit
emergencies that can occur either during the decon process or during the entry.
Keep in mind that decon is still required, but may be modified depending on the
situation.
Some examples of in-suit emergencies that may occur to entry or decon workers
include:
SCBA out of air
Chemical breach of PPE
Medical emergency – various
Traumatic injury – various
Sudden panic or onset of claustrophobia of worker
Decon workers must be ready to handle in-suit emergencies should they occur.
There must be a plan in place and it should be discussed before entry is made.
While there is not one way to handle every emergency that may occur, below are
some items to consider when handling in-suit emergencies:
Entry operations are stopped and all effort are directed toward the
emergency
The back-up entry team may need to be activated for assistance
Once the SCBA is out of air, the user will not be able breath at all
Decontamination still needs to be conducted prior to transporting
patients
Workers may need to be cut off their PPE and equipment to do so
should be readily available to the decon workers
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Decontaminating Non-ambulatory Personnel
The decon team may find themselves having to decontaminate non-ambulatory
victims. There must be a plan in place prior to entry. These victims could be
conscious or unconscious. Decontaminating an unconscious victim could prove to be
very difficult and may require additional responders. Decontaminating multiple
unconscious victims may warrant the need for Mass Decontamination.
When decontaminating a victim that is unconscious follow typical medical
considerations such as ABC’s and c-spine precautions. Take extreme care to protect
the victim from further internal exposure to contaminants.
Responders should further protect the airway, mouth, nose, eyes, ears and any open
wounds from allowing contaminants to enter. It may be acceptable to flush any open
wounds with saline if this sort of action is allowed by local policy. Ensure EMS
personnel are briefed on any treatment hazmat response personnel provide.
Supplemental oxygen or breathing air may also be used to limit the victim’s
exposure to toxic chemicals.
Examples of additional equipment that may be needed in the decon area in order to
decon non-ambulatory victims are items such as backboards/stokes baskets to carry
the patients through the decon process and sawhorses or similar devices to prop the
patients up during the washing and rinsing process. Workers may also need medical
equipment to treat any obvious injuries or remove contaminated clothing.
Summary
Responder Decontamination is required whenever workers are sent into
contaminated areas. FROs can be trained to conduct Responder Decontamination
since hazmat team members may not always be available or in present in sufficient
numbers to conduct decontamination.
In selecting exactly how to conduct the Responder Decontamination it is important to
note that this course provides only guidelines not procedures. Responder
Decontamination must be a sequence of events that follow a safe and logical order to
be effective and efficient. As long as both of those goals are met the
decontamination process should be successful.
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