About the Project

Introduction

Through a programme of applied research, the ORCHIDS project has delivered quantitative evidence to support the development of optimal procedures for dealing with a range of contaminants in mass casualty decontamination scenarios, for pan-European implementation. A full range of issues have been addressed, from applied toxicological research to mass casualty decontamination exercising and modelling. The efficacy of emergency decontamination procedures has been evaluated with optimised methodology. This has enabled the provision of evidence-based best practice recommendations for EU Member States' existing mass casualty decontamination facilities. Guidelines for best practice with minority and vulnerable groups in mass casualty decontamination have also been generated. Recommendations for the procurement of second generation mass decontamination response programmes have been produced; these are applicable for EU Member States and International Partners looking to establish these resources for the first time.

The ORCHIDS project received financial support from the European Commission via the Health Threats Strand of the Community Action in the Field of Public Health Work Plan for 2007.

Specific objectives

  1. Review and survey existing decontamination provision and practices in the EU and develop a database of stakeholders.
  2. Identify optimum formulation and procedures for conducting mass casualty decontamination through laboratory analysis.
  3. Quantify the efficacy of optimised decontamination techniques using human participants in a series of field-based operational research trials.
  4. Quantify the operational processes and capacities of decontamination facilities in exercises using large-scale mass casualty scenarios.
  5. Evaluate mass casualty decontamination using simulations based on data obtained during exercises, field trials and laboratory studies.
  6. Systematically review the provision for minority and vulnerable groups and generate best-practice guidelines.
  7. Disseminate the project outcomes to EU stakeholders, including guidelines for best practice and second generation equipment procurement and exercising.
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Outcomes

The ORCHIDS project has delivered a range of outcomes including:

  1. A database of core stakeholders, comprising a network of expertise with a large coverage to engage stakeholders from all EU Member States, to disseminate and sustain the project outcomes.
  2. A review of existing decontamination provision, outlining current best practice guidelines and recommendations for participating EU Member States. Additionally, a survey protocol has been generated based on this review of existing decontamination provision.
  3. A project website which provides a portal to key resources and expertise for stakeholders across the EU, and has been sustained beyond the completion of the project.
  4. Guidance for improving mass casualty decontamination response through the delivery of technical reports and publications. These reports outline:
    • Quantitative evidence on the optimum techniques for dealing with a range of potential contaminants and scenarios, addressing a full range of issues from applied toxicological research to mass decontamination exercising and modelling.
    • Best-practice guidelines and novel methodologies that can be employed to optimise mass casualty decontamination procedures, and impact on the preparedness activities of all EU Member States.
    • A review of decontamination provision for minority and vulnerable groups, providing best practice guidelines and recommendations for future provision and/or adaptations to existing protocols for these groups.
  5. Leaflets and educational tools for stakeholders and the general public focussed on pre-incident preparedness and knowledge, as well as incident-specific guidelines (e.g. an introduction to mass casualty decontamination, instructions on dis-robe / showering / re-robe procedures).
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Work Packages

The ORCHIDS project was divided into nine Work Packages (WP).

Work Packages 1-3: Coordination, Dissemination and Evaluation of the ORCHIDS project

  • The Health Protection Agency led a group of project partners who contributed to every stage of the project. The project partnership has ensured that consistency in methodological approaches and focus were maintained.
  • All project partners have played an active role in communicating the aims, results and reports of the project to national, European and International stakeholders. Dissemination activities took place at key stages of the project.
  • As anticipated, the outcomes of the project are immediately applicable to EU Member States who have provision for mass casualty decontamination. A database of key stakeholders has been generated, who receive updates on the project activities, and recommendations outlining how to incorporate the best practice guidelines into their current decontamination practices. Recommendations were also made to stakeholders looking to establish mass casualty decontamination provision for the first time.
  • Publication in peer-reviewed journals has been sought, and presentations at international conferences have been given.
  • A strategy for communicating the project outcomes to the general EU public was developed towards the end of the project, including the development of guidance on what to do in an emergency requiring decontamination. This included leaflets and educational tools which will help authorities respond to emergencies, and address questions from the media and the public.
  • The project partners and key stakeholder organisations have formed an expert database which can be consulted in the event of an emergency incident or the heightened threat of an incident requiring emergency decontamination. This expert network provides technical and strategic guidance to any EU Member State seeking this support.
  • Key stakeholders were consulted to establish the ecological validity of the project activities.
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Work Package 4: A systematic review of current mass casualty decontamination provision in EU Member States

  • The aim of this work package was for participating Partners to review their existing emergency decontamination provision and methods, and those of other EU Member States.
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Work Package 5: Laboratory-based research trials examining the efficacy of decontamination methods

  • The aim of this work package was to optimise a range of decontamination methods through laboratory analysis.
  • This programme of applied research identified optimum formulations and procedures for conducting mass casualty decontamination and quantified the effects of disrobing prior to decontamination.
  • This work was conducted in two distinct phases. The first phase identified the most effective materials and procedures required to maximise removal of chemicals from the skin surface. The second phase investigated the effects of disrobing prior to decontamination.
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Work Package 6: Operational research trials to evaluate the efficacy of decontamination techniques with human participants

  • The aim of this work package was to evaluate the optimised decontamination methods identified in work package 5, in a series of field-based operational research trials.
  • To ensure the appropriate comparison between current procedures and the novel 'ORCHIDS protocol' for optimised decontamination, emergency response teams supported and participated in the WP6 trials.
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Work Package 7: Mass casualty decontamination exercising involving optimum decontamination techniques

  • The feasibility of the optimised decontamination techniques was tested in the context of two large-scale exercises during the lifetime of the ORCHIDS project.
  • Close observations were made at each stage of the decontamination process, including the initial processing of casualties, dis-robe procedures, decontamination showering, re-robe procedures and the control of 'clean' individuals within the 'cold' zone and the maintenance of the cordons of the 'warm' and 'hot' zones.
  • Each stage of the decontamination process was repeatedly timed through the exercise, and estimates of the passage of casualties through each section and the entire decontamination process were calculated.
  • Formal assessments of the effects of a variety of 'challenges' to operational processes were undertaken to test the capacity of the decontamination systems to respond.
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Work Package 8: Mathematical modelling of emergency decontamination procedures

  • The aim of this work package was to develop virtual simulations of the operational processes involved in mass casualty decontamination in mass decontamination facilities, based on the quantitative data collected in WP5, WP6 and WP7.
  • Simulation models allowed the evaluation of existing facilities and the generation of best-practice guidelines for second generation equipment procurement and implementation.
  • Identification of consistent parameters and variables allowed the adaptation and application of these models to different EU Member States facilities.
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Work Package 9: A systematic review of the needs of vulnerable and minority groups in emergency decontamination.

  • The aim of this work package was to review the existing decontamination provision for minority and vulnerable groups.
  • This included, reviewing the extent of existing provision to address the needs of minority and vulnerable groups in emergency decontamination incidents. For example, issues associated with the decontamination of children, the elderly, non-ambulant casualties, gender and religious issues and the possible incidence of non-compliance or refusals.
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