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A hazardous material (hazmat) can be any xenobiotic (solid, liquid, or gas) with the potential to harm. Typically, we are most concerned about xenobiotics that can harm people, although a hazmat may only harm other living organisms, the environment, or property. Outside of the United States, hazardous materials are often referred to as dangerous goods.

A "hazmat incident" implies that there was an unplanned or uncontrolled release of or exposure to a hazardous material. Although there are no specific requirements for an event to be considered a hazmat incident, typically there will be the potential for many people or a large area to be affected; otherwise, all toxicologic exposures would fall into this category. Therefore, a hazmat incident falls within the larger disaster management framework within a community.

Hazardous materials include chemical, biologic, and radiologic xenobiotics. In fact, a single event could provide exposure to multiple xenobiotics. Complicating matters, the incident response required for chemical, biologic, or radiologic xenobiotics may differ substantially depending on many factors. For instance, an envelope containing a white powder suspicious for containing anthrax spores that is opened in an office might require decontamination of the exposed people and environment. However, the release of the same anthrax spores surreptitiously at multiple sites may not be recognized until days later because of the delayed onset of symptoms. Certainly, a very different emergency response would be required. Emergency managers and healthcare providers must consider all possibilities and adjust the incident response based on the specific xenobiotics involved. This chapter discusses the basic principles used for a confined and quickly identifiable hazmat incident.

In general, a hazmat incident response focuses on the care of patients exposed to xenobiotics in the prehospital setting, prepares for multiple casualties, and emphasizes patient decontamination while at the same time trying to prevent exposure and contamination of healthcare providers.

Disaster management has four phases: mitigation, planning, response, and recovery. Mitigation measures are plans and efforts that attempt to prevent or reduce the effects of a potential hazard from becoming a disaster or minimizing the effects of a disaster if it has already occurred. One example of a mitigation measure is to use a secure container to prevent leakage of a chemical that is to be stored. Preparedness requires the planning of actions to be taken when a disaster occurs, as well as the practicing with mock exercises of these actions. Pre-planning is critical to limit damage from an event, and numerous such hazmat incident response plans exist. The recovery phase occurs after the immediate needs and threats to human life are addressed in the response phase and entail the restoration of property, infrastructure, and the environment.

The response phase includes the mobilization of appropriate resources and the coordinated management of the incident. Hazmat incident response must include the containment of the xenobiotic followed by neutralization, removal, or both. Typically, such a response includes multiple trained ...

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