Hostname: page-component-74656f9884-j7cmm Total loading time: 0 Render date: 2026-11-08T06:44:27.977Z Has data issue: false hasContentIssue false
  • English
  • Français

Evaluating the Effectiveness of Dry Decontamination Methods for Hazmat Incidents: A Scoping Review

Published online by Cambridge University Press:  23 June 2025

Eman Alshaikh ,
Attila J. Hertelendy Open the ORCID record for Attila J. Hertelendy [Opens in a new window] ,
Fadi Issa ,
Terri Davis ,
David DiGregorio ,
Janice Kung ,
Jeffrey M. Franc Open the ORCID record for Jeffrey M. Franc [Opens in a new window] ,
Amalia Voskanyan  and
Greg Ciottone
Eman Alshaikh*
Affiliation:
Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA Harvard Medical School, Boston, MA, USA Emergency Department, Rashid Hospital Trauma Center, Dubai Health, Dubai, UAE
Attila J. Hertelendy
Affiliation:
Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
Fadi Issa
Affiliation:
Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA Harvard Medical School, Boston, MA, USA
Terri Davis
Affiliation:
Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA Florida State University, College of Medicine, Tallahassee, FL, USA
David DiGregorio
Affiliation:
Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
Janice Kung
Affiliation:
Geoffrey & Robyn Sperber Health Sciences Library, University of Alberta, Edmonton, Alberta, Canada
Jeffrey M. Franc
Affiliation:
Department of Emergency Medicine, University of Alberta, Edmonton, Alberta, Canada
Amalia Voskanyan
Affiliation:
Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
Greg Ciottone
Affiliation:
Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA Harvard Medical School, Boston, MA, USA
*
Corresponding author: Eman Alshaikh; Email: dr.eos@live.com
Rights & Permissions [Opens in a new window]

Abstract

Objectives

CBRN incidents require specialized hazmat decontamination protocols to prevent secondary contamination and systemic toxicity. While wet decontamination is standard, it can present challenges in cold weather or when resources are limited. Dry decontamination offers an alternative and supportive approach, though its effectiveness across different contaminants remains unclear. This scoping review evaluates the effectiveness, advantages, and limitations of dry decontamination in hazmat incidents.

Methods

A scoping review was conducted using MEDLINE, CINAHL, and other databases. Following the PRISMA-ScR approach, 9 studies were selected from 234 identified articles. The review assessed decontamination techniques, materials, and effectiveness across different contaminants.

Results

Dry decontamination is rapid, resource-efficient, and suitable for immediate use in pre-hospital and hospital settings, especially during mass casualty incidents (MCIs). Dry decontamination is highly effective for liquid contaminants, with blue roll and sterile trauma dressings removing over 80% of contaminants within minutes. However, dry decontamination is less effective for hair and particulate contaminants. Blotting and rubbing techniques significantly enhance decontamination efficiency.

Conclusions

Dry decontamination can be an effective alternative for wet decontamination, particularly for liquid contaminants, as a first-line approach for scenarios where wet decontamination is not a practical solution for logistical and environmental reasons. However, dry decontamination is less effective than wet decontamination for hair and particulate contaminants. Combining dry and wet decontamination is shown to be more effective. Identifying the need for including dry decontamination as an integral part of the CBRN response plan improves the efficacy of decontamination.

Keywords

decontaminationdry decontaminationchemical decontaminationskin decontaminationhair decontaminationCBRN

Information

Type
Systematic Review
Information
Disaster Medicine and Public Health Preparedness , Volume 19 , 2025 , e160
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of Society for Disaster Medicine and Public Health, Inc

The increased threat of a large-scale impact from chemical, biological, radiological, and nuclear (CBRN) incidents has highlighted the critical need for effective and timely decontamination strategies to prevent widespread harm and secondary contamination.Reference Tin, Granholm and Hart 1 Between 1990 and 2020, 565 documented CBRN events occurred worldwide.Reference Tin, Cheng and Shin 2

Decontamination is a critical process that involves removing or neutralizing harmful agents from a contaminated surface or individual.Reference McDonnell, Comoy and Walker 3 Its importance became evident during World War I when chemical weapons were first used on a large scale.Reference Fitzgerald 4 Additionally, during the 1995 Tokyo subway sarin attack, prompt decontamination was critical in preventing the spread of the nerve agent and reducing the risk of secondary exposure to medical personnel and others.Reference Okumura, Okumura and Ishimatsu 5 Although it is ideal to decontaminate patients at the scene before transport, this is not always possible. Therefore, every emergency department must be equipped and prepared for rapid decontamination, as contaminated patients may arrive without prior treatment.

The timing between skin exposure and decontamination is crucial. Ideally, decontamination should occur within the first several minutes of exposure to prevent the agent from penetrating the skin, as topical decontaminants are ineffective once penetration occurs, and it becomes harder to remove the contaminant.Reference Wartell and Kleinman 6 Delay in decontamination can increase the health risk and lead to systemic toxicity.

The decontamination process begins with disrobing, a simple yet highly effective method for removing external contaminants, which should be done at the earliest opportunity during an incident response.Reference Clarke, Chilcott and Wilson 7 Disrobing can remove 80-90% of external contamination from an individual.Reference Wolbarst, Wiley and Nemhauser 8 Following disrobing, (Two) primary methods of decontamination are used: wet and dry.

Traditionally, wet decontamination has been the standard approach in responding to mass contamination incidents, relying on significant amounts of water, personnel, and logistical infrastructure.Reference Chilcott, Larner and Matar 9 Wet decontamination is recommended for exposure to caustic agents or when the contaminant is in particulate form.Reference Chilcott, Larner and Matar 9 However, this method presents challenges in scenarios where resources are limited, trained personnel are unavailable, or environmental conditions, such as extreme cold, make the use of water impractical or even hazardous. Additionally, wet decontamination may not be feasible when the contaminant is water-reactive, and with some contaminants adding water may increase skin uptake by the penetration-enhancing effect of the surfactants.Reference Alexander, Feng and Merk 10 , Reference Larese, Boeniger and Maina 11 In such scenarios, dry decontamination methods become a vital alternative.

Dry decontamination involves the mechanical removal of contaminants without the use of liquids. Different types of protocols can be used in dry decontamination including vacuuming, using compressed air, scraping with a spatula or wooden tongue depressor, and using absorbent materials like FiberTect, Fuller’s earth, paper towels, and the First Applied Sorbent Treatment Against Chemical Threats (FAST-ACT). Dry decontamination is time-effective, can be performed immediately by victims themselves, can be rapidly deployed, and requires minimal resources. This makes it a potential alternative in situations where wet decontamination is not feasible.

This scoping review aims to systematically evaluate the effectiveness, advantages, and limitations of dry decontamination. Investigating the efficacy of different materials and techniques and contributes to understanding the practical applications of dry decontamination, ultimately enhancing preparedness and response strategies in hazmat incidents.

Methods

Study Design

The scoping review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines (Figure 1). Reference Tricco, Lillie and Zarin 12 The primary objective was to systematically map the existing literature on the effectiveness of dry decontamination methods in hazmat incidents.

Figure 1.

PRISMA-ScR flow diagram of study selection.

Note: The review initially identified 234 records. After removing duplicates and conducting title, abstract, and full-text screenings based on predefined inclusion/exclusion criteria, 9 studies were included in the final scoping review.

Search Strategy

A comprehensive literature search was conducted across several electronic databases, including Ovid MEDLINE, Ovid Embase, CINAHL, Scopus, Web of Science Core Collection, and the Cochrane Library (via Wiley). The search strategy was designed to capture the breadth of available research on dry decontamination utilizing a combination of controlled vocabulary (e.g., Medical Subject Headings (MeSH) terms) and relevant keywords. These included terms such as “dry decontamination,” “mass casualty incidents,” and “CBRN decontamination” (Table 1). The search was conducted on April 5, 2024, and was restricted to studies published in English within the last 10 years, starting from 2014. This period was selected following the 2014 recommendation by PRISM (Primary Response Incident Scene Management), which highlighted using dry decontamination as an effective initial decontamination method (Table 2). 13

Table 1.

Search strategies across major databases for identifying studies on dry decontamination (2014-2024)

Table 2.

Dry decontamination inclusion and exclusion criteria

Eligibility Criteria

Studies were considered eligible if they met all of the following criteria: (i) published in the English language, (ii) published between 2014 to present, (iii) evaluating dry decontamination methods applied to humans in context of CBRN incidents (iv) focused on decontamination in MCI or emergency response settings, (v) studies involving human subjects, in vitro, or ex vivo models (vii) and quantitative and/or qualitative analysis of dry decontamination effectiveness. Studies that focused only on wet decontamination without any reference to dry decontamination, examined decontamination of surface/environmental, or medical equipment decontamination, were not related to human emergency response scenarios, or lacked sufficient methodological details to assess their validity were excluded (Table 2). The inclusion and exclusion decisions were documented at each stage of screening (Figure 1).

Data Screening

All identified studies were imported into Covidence, a web-based tool for managing systematic reviews. A total of 234 studies were identified from the database searches. After removing duplicate studies (n=95), 139 studies remained for screening.

Two independent reviewers (EA & TD) screened titles and abstracts of identified studies to determine eligibility (Table 2). If both reviewers agreed, the study proceeded to a full-text review. Discrepancies were resolved through consensus with a third reviewer (FI).

At the title and abstract screening stage, 113 articles were excluded. This left 26 full-text studies for detailed review. During the full-text review, studies were assessed against inclusion and exclusion criteria. 17 studies were excluded due to not focusing on dry decontamination (n=7), examining only surface/environmental decontamination (n=3), and wrong study design or insufficient methodology details (n=7).

Ultimately, 9 studies met all inclusion criteria and were included in the final review. Any ambiguities in study relevance or methodology were resolved through discussion between the reviewers. The stepwise selection process is illustrated in the PRISMA flowchart (Figure 1) to ensure transparency in study inclusion and exclusion.

Data Extraction and Analysis

Data extraction was performed by 1 reviewer (EA) and validated by a second reviewer (TD). Extracted data were organized using Microsoft Excel 2024 into a structured table, summarizing study objectives, design, population, dry decontamination materials used, contaminants, technique, exposure to decontamination time, and key findings (Table 3). This structured approach allowed for a comparison of the efficiency of decontamination across different materials and contaminants.

Table 3.

Dry decontamination data extraction

Note: MS = Methyl Salicylate; PT = Parathion; DEM = Diethyl Malonate; PH = Phorate; KCN = Potassium Cyanide; SFA = Sodium Fluoroacetate; TMP = Trimethyl Phosphate; SAP = Superabsorbent Polymer; MOF = Metal Organic Framework; DDGel = Decontamination Gel; LPS = Ladder Pipe System; TD = Technical Decontamination.

Results

The research carried out between 2017 and 2023 focused on the significant effectiveness of dry decontamination techniques for different CBRN scenarios. Most of the studies were conducted in the UK, with several more in the US and Sweden. The methodologies were diverse, and included peer-reviewed human volunteer trials, in vitro studies, and ex vivo approaches using pig skin and human hair (Table 3). All results are structured according to the themes identified within the scoping review.

Theme 1: Effectiveness of Dry Decontamination Across Different Contaminant Types

The effectiveness of dry decontamination was found to vary significantly depending on the type of contaminant. Several studies, including those by Chilcott et al.Reference Chilcott, Mitchell and Matar 14 and Southworth et al.,Reference Southworth, James and Davidson 15 demonstrated that dry decontamination is particularly effective for liquid contaminants. Materials like blue roll and sterile trauma dressings, when used with blotting and rubbing techniques, were successful in removing a significant proportion of liquid contaminants such as methyl salicylate (MS), particularly when performed immediately post exposure. In contrast, the study by Kassouf et al.Reference Kassouf, Syed and Larner 16 highlighted that dry decontamination was less effective on particulate contaminants such as potassium cyanide. Wet decontamination methods were often necessary to eliminate these contaminants, exposing the limitations of dry methods.

Theme 2: Effectiveness of Different Materials for Dry Decontamination

The choice of material significantly influenced the effectiveness of dry decontamination. Studies by Amlôt et al.Reference Amlôt, Carter and Riddle 17 and Chilcott et al.Reference Chilcott, Mitchell and Matar 14 consistently identified blue roll and sterile trauma dressings as highly effective for dry decontamination. These materials demonstrated strong absorbent properties, making them particularly useful for removing liquid contaminants. Cao et al.Reference Cao, Hui and Maibach 18 found that superabsorbent polymers (SAP), particularly when used in combination with a metal organic frameworks (MOF) patch and decontamination gel (DDGel), were highly effective, including in delayed decontamination scenarios. This suggests that these innovative materials could offer significant advantages in certain situations. Kassouf et al.Reference Kassouf, Syed and Larner 16 showed that these materials were also effective for dry decontamination, although their effectiveness varied depending on the type of contaminant, with better results seen for liquid contaminants compared to particulates.

Theme 3: Effectiveness of Different Dry Decontamination Techniques

The effectiveness of dry decontamination is highly dependent on the technique employed. The studies by Amlôt et al.Reference Amlôt, Carter and Riddle 17 and Chilcott et al.Reference Chilcott, Mitchell and Matar 14 found that the combination of blotting and rubbing was the most effective technique for dry decontamination. These techniques ensured greater physical removal of particulate contaminants from the skin by maximizing contact of the absorbent material with the contaminant.

Theme 4: Challenges in Hair Decontamination

Decontaminating hair emerged as a particularly challenging area within the studies reviewed. Studies by Matar et al.Reference Matar, Pinhal and Amer 19 and Larner et al.Reference Larner, Durrant and Hughes 20 emphasized that dry decontamination methods were less effective at removing contaminants from hair, particularly when dealing with lipophilic substances. Hair contamination often persisted despite dry decontamination, and the risk of off-gassing of volatile chemicals remained a significant concern, which could endanger both victims and responders. To mitigate these challenges, some studies, including Chilcott et al.Reference Chilcott, Larner and Durrant 21 and Larner et al.,Reference Larner, Durrant and Hughes 20 suggested the use of combined decontamination strategies. The combination of dry decontamination with Ladder Pipe System (LPS) and Technical Decontamination (TD) methods yielded better results, decreasing hair residual contamination.

Theme 5: Importance of Timing in Decontamination

The timing of decontamination was a critical factor in determining the efficacy of dry methods.

Studies by Matar et al.Reference Matar, Pinhal and Amer 19 and Southworth et al.Reference Southworth, James and Davidson 15 strongly emphasized that dry decontamination should be initiated as soon as possible after exposure to contaminants. Rapid decontamination was essential to minimize the risk of skin absorption and systemic exposure, particularly for lipophilic agents. The effectiveness of dry decontamination decreased with delays. For example, Thors et al.Reference Thors, Wigenstam and Qvarnström 22 reported that delayed decontamination led to reduced effectiveness, especially for agents like VX, where dry methods alone were insufficient.

Theme 6: Role of Guidance and Compliance

The effectiveness of dry decontamination was also influenced by the level of guidance provided and the compliance of those performing the decontamination. Both Amlôt et al.Reference Amlôt, Carter and Riddle 17 and Chilcott et al.Reference Chilcott, Larner and Durrant 21 found that providing clear guidance on how to perform decontamination significantly improved the effectiveness. This was particularly important in ensuring comprehensive coverage and reducing the risk of cross-contamination. The study by Chilcott et al.Reference Chilcott, Larner and Durrant 21 also noted that self-decontamination can be less effective due to non-compliance or improper technique, highlighting the importance of training and guidance in emergency situations.

Discussion

The findings emphasize the potential of dry decontamination as an effective alternative to wet decontamination, especially in settings with limited access to water or other logistical support. However, the review also highlights several challenges and limitations that need to be addressed to optimize the use of dry decontamination in emergency response.

Studies show that dry decontamination is fast and effective, particularly for liquid contaminants.Reference Kassouf, Syed and Larner 16 Chilcott et al. and Kassof et al. found that using absorbent materials like blue roll and sterile trauma dressings can remove over 80% of liquid contaminants within 3 minutes.Reference Chilcott, Mitchell and Matar 14 , Reference Kassouf, Syed and Larner 16 In contrast, wet decontamination requires more resources and takes longer, approximately 4 minutes per individual.Reference Chilcott, Mitchell and Matar 14 However, if the contaminant is solid or particulate, dry decontamination is often insufficient, and the addition of wet decontamination is required.Reference Kassouf, Syed and Larner 16

Decontamination decision-making must take into account the physicochemical properties of the contaminant. Lipophilic chemicals, such as VX nerve agents, persist longer on the skin and are more resistant to removal by dry decontamination processes.Reference Thors, Wigenstam and Qvarnström 22 Water-soluble contaminants (e.g., 2-BuEtOH) can be effectively removed with immediate wet decontamination, but delayed decontamination significantly reduces efficacy.Reference Matar, Pinhal and Amer 19 Taking into consideration chemical properties can show the wash-in effect, where wet decontamination resulted in deeper absorption instead of effective removal, such as VX nerve agent.Reference Thors, Wigenstam and Qvarnström 22 This highlighted the importance of performing immediate dry decontamination before any wet decontamination.

From an operational perspective, dry decontamination is considered faster than wet decontamination, as the absorbent material commonly found in ambulances and hospitals requires less time to set up and allows immediate use by first responders or casualties.Reference Amlôt, Carter and Riddle 17 The ability for rapid deployment of dry decontamination without the need for water or specialized infrastructure makes it beneficial in the context of MCI, remote locations, and cold weather, where wet decontamination may be logistically challenging. PRISM and Initial Operational Response (IOR) guidelines in the UK recommend dry decontamination as an initial response measure prior to wet decontamination.Reference Chilcott, Larner and Matar 9 , 13 There is a decline in decontamination effectiveness with increasing delays, especially for lipophilic compounds that readily penetrate the skin.Reference Matar, Pinhal and Amer 19 , Reference Thors, Wigenstam and Qvarnström 22 Wet decontamination was initiated 15 minutes post-exposure, which led to less effective contaminant removal compared to studies with immediate or near-immediate decontamination.Reference Southworth, James and Davidson 15 , Reference Amlôt, Carter and Riddle 17 At cold temperatures (< -15°C), dry decontamination significantly reduced VX nerve agents penetration.Reference Thors, Wigenstam and Qvarnström 23 Dry decontamination could be performed in less than 5 seconds for each body area, while in the case of wet decontamination, it can reach 90 seconds per individual.Reference Kassouf, Syed and Larner 16 In cold settings, wet decontamination increases the risk of hypothermia, making dry decontamination generally preferred.Reference Southworth, James and Davidson 15

Public perception and compliance are critical factors in dry decontamination. Where public confidence in being “clean” after dry decontamination is low,Reference Amlôt, Carter and Riddle 17 having clear communication and guidance from the emergency responder can facilitate an increase in public willingness to comply with decontamination procedures, as well as improve the efficiency of dry decontamination.Reference Chilcott, Mitchell and Matar 14 , Reference Amlôt, Carter and Riddle 17 , Reference Chilcott, Larner and Durrant 21 Participants who received verbal guidance on dry decontamination performed better and achieved 99% efficiency, compared to 70% efficiency in participants without guidance.Reference Chilcott, Larner and Durrant 21

Combining dry decontamination with wet decontamination is essential for effective hair decontamination.Reference Matar, Pinhal and Amer 19 –Reference Chilcott, Larner and Durrant 21 , Reference Collins, James and Southworth 24 Dry decontamination alone is inadequate to remove hazardous chemicals from hair, especially when the contaminant is lipophilic like MS.Reference Matar, Pinhal and Amer 19 Collins et al. found that dry decontamination removed less than 2% of contaminants from hair.Reference Collins, James and Southworth 24 Hair can retain higher levels of contaminant longer than the skin and requires more thorough decontamination.Reference Larner, Durrant and Hughes 20 , Reference Chilcott, Larner and Durrant 21 , Reference Collins, James and Southworth 24 Emerging absorbent materials such as MOFs, SAPs, and DDGel have shown promising adsorption, absorption, and catalytic degradation properties that can be potentially utilized to improve dry hair decontamination. MOFs, such as UiO-66, have shown the ability to neutralize toxic compounds, while SAP-based absorbent materials may help remove liquid contaminants from hair fibers.Reference Cao, Hui and Maibach 18 Chemical off-gassing from hair can cause secondary contamination to the victims and emergency responders. DDGel, which has been used for skin decontamination, could be adapted as a protective barrier or post-exposure for hair.Reference Cao, Hui and Maibach 18

In mass casualty scenarios, sequential decontamination (dry followed by wet) remains the preferred mechanism due to the variability in the contaminant properties and exposure conditions, allowing emergency first responders to adopt a flexible, evidence-based decontamination approach, and consider dry decontamination as a first-line intervention while using wet decontamination when necessary for complete contaminant removal.Reference Southworth, James and Davidson 15 , Reference Chilcott, Larner and Durrant 21 Combined dry and wet decontamination is more efficient as triple protocol (dry decontamination, LPS, and TD), and provided near-complete efficacy against either lipophilic contaminants and hair contamination.Reference Southworth, James and Davidson 15 , Reference Larner, Durrant and Hughes 20 , Reference Chilcott, Larner and Durrant 21 Therefore, wet decontamination alone causes the spread of contaminants, which produce contaminated runoff; dry decontamination is a self-contained decontamination process that does not cause secondary environmental contamination.Reference Amlôt, Carter and Riddle 17 Combining wet and dry decontamination can decrease environmental contamination.

Study Limitations

Although this scoping review offers important insights, it is limited by several factors. First, inclusivity was low, as only 9 studies were identified due to the inclusion of only studies on humans, in vivo, and ex vivo skin and the exclusion of experimental studies. Second, only studies published from 2014 onward were included, following the release of the PRISM guidance, which marked a pivotal shift in CBRN response by formally recommending dry decontamination as a first-line intervention during hazmat incidents, making earlier research less relevant to current protocols. Third, most studies examined chemical agents, which don’t provide insights into dry decontamination for biological or radiological contaminants. Fourth, the use of a narrow keyword search strategy, specifically “dry decontamination” in titles or abstracts, may have inadvertently excluded relevant studies due to indexing limitations. Lastly, excluding non-English publications may restrict the generalizability of findings across diverse international contexts.

Conclusion

This scoping review systematically evaluated the existing literature on dry decontamination in hazmat incidents, emphasizing its role as an initial response tool when wet decontamination is impractical due to logistical, environmental, or resource constraints. Dry decontamination is highly effective for liquid contaminants, with more than 80% of the contaminant removed within minutes using blue roll and sterile trauma dressings, and the effectiveness improves with blotting with rubbing techniques. However, the effectiveness of dry decontamination depends on factors such as the type of contaminant, materials used, and the decontamination protocol followed. Challenges remain in removing particulate contaminants and decontaminating areas with hair. Future research should investigate the different hair decontamination strategies, including the new absorbent decontaminant materials such as MOFs, SAPs, and DDGels to improve dry decontamination effectiveness, particularly for hair and persistent contaminants. Additionally, future research is needed to assess dry decontamination effectiveness for biological and radiological agents, which remain underexplored. To enhance emergency preparedness, dry decontamination protocols should be integrated into standard CBRN response strategies, and emergency response agencies should stockpile the dry decontamination absorbent materials. Incorporating dry decontamination absorbent materials into the emergency response agencies’ stockpile is essential to enhance preparedness and effectiveness. With optimization of materials, techniques, and response protocols, dry decontamination can serve as an effective and scalable frontline intervention in hazmat response.

Acknowledgments

No acknowledgments.

Competing interests

The authors declare there are no potential conflicts of interest concerning the research, authorship, and/or publication of this article.

Ethical approval

No ethical approval required.

References

Tin, D, Granholm, F, Hart, A, et al. Terrorism-related chemical, biological, radiation, and nuclear attacks: a historical global comparison influencing the emergence of counter-terrorism medicine. Prehosp Disaster Med. 2021;36(4):399–402. doi:10.1017/S1049023X21000625CrossRefGoogle ScholarPubMed
Tin, D, Cheng, L, Shin, H, et al. A descriptive analysis of the use of chemical, biological, radiological, and nuclear weapons by violent non-state actors and the modern-day environment of threat. Prehosp Disaster Med. 38(3):395–400. doi:10.1017/S1049023X23000481CrossRefGoogle Scholar
McDonnell, G, Comoy, E. Decontamination of prions. In: Walker, JT, ed. Decontamination in Hospitals and Healthcare. 2nd ed. Woodhead Publishing; 2020:395–418.10.1016/B978-0-08-102565-9.00018-2CrossRefGoogle Scholar
Fitzgerald, GJ. Chemical Warfare and Medical Response During World War I. Am J Public Health. 2008;98(4):611–625. doi:10.2105/AJPH.2007.11930CrossRefGoogle ScholarPubMed
Okumura, S, Okumura, T, Ishimatsu, S, et al. Clinical review: Tokyo – protecting the health care worker during a chemical mass casualty event: an important issue of continuing relevance. Crit Care. 2005;9(4):397–400. doi:10.1186/cc3062CrossRefGoogle ScholarPubMed
Systems NRC (US) C on E and T, Wartell, MA, Kleinman, MT, et al. Decontamination. In: Strategies to Protect the Health of Deployed U.S. Forces: Force Protection and Decontamination. National Academies Press (US); 1999. Accessed June 22, 2024. https://www.ncbi.nlm.nih.gov/books/NBK225134/Google Scholar
Clarke, SFJ, Chilcott, RP, Wilson, JC, et al. Decontamination of multiple casualties who are chemically contaminated: a challenge for acute hospitals. Prehosp Disaster Med. 2008;23(2):175–181. doi:10.1017/s1049023x00005811CrossRefGoogle ScholarPubMed
Wolbarst, AB, Wiley, AL, Nemhauser, JB, et al. Medical response to a major radiologic emergency: a primer for medical and public health practitioners. Radiology. 2010;254(3):660–677. doi:10.1148/radiol.09090330CrossRefGoogle Scholar
Chilcott, RP, Larner, J, Matar, H. UK’s initial operational response and specialist operational response to CBRN and HazMat incidents: a primer on decontamination protocols for healthcare professionals. Emerg Med J EMJ. 2019;36(2):117–123. doi:10.1136/emermed-2018-207562CrossRefGoogle ScholarPubMed
Alexander, BM, Feng, HA, Merk, G. Development of a prototype dry decontamination method for particulate contamination: the DryCon system. Am J Disaster Med. 2020;15(4):261–273. doi:10.5055/ajdm.2020.0375CrossRefGoogle ScholarPubMed
Larese, F, Boeniger, M, Maina, G, et al. Skin absorption of inorganic lead (PbO) and the effect of skin cleansers. J Occup Environ Med Am Coll Occup Environ Med. 2006;48:692–699. doi:10.1097/01.jom.0000214474.61563.1cGoogle Scholar
Tricco, AC, Lillie, E, Zarin, W, et al. PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Ann Intern Med. 2018;169(7):467–473. doi:10.7326/M18-0850CrossRefGoogle ScholarPubMed
PRISM Volume 1_Strategic Guidance Second Edition.pdf. Accessed November 26, 2024. https://medicalcountermeasures.gov/BARDA/Documents/PRISM%20Volume%201_Strategic%20Guidance%20Second%20Edition.pdfGoogle Scholar
Chilcott, RP, Mitchell, H, Matar, H. Optimization of Nonambulant Mass Casualty Decontamination Protocols as Part of an Initial or Specialist Operational Response to Chemical Incidents. Prehosp Emerg Care. 2019;23(1):32–43. doi:10.1080/10903127.2018.1469705CrossRefGoogle ScholarPubMed
Southworth, F, James, T, Davidson, L, et al. A controlled cross-over study to evaluate the efficacy of improvised dry and wet emergency decontamination protocols for chemical incidents. PloS One. 2020;15(11):e0239845. doi:10.1371/journal.pone.0239845CrossRefGoogle ScholarPubMed
Kassouf, N, Syed, S, Larner, J, et al. Evaluation of absorbent materials for use as ad hoc dry decontaminants during mass casualty incidents as part of the UK’s Initial Operational Response (IOR). PLOS ONE. 2017;12(2):e0170966. doi:10.1371/journal.pone.0170966CrossRefGoogle Scholar
Amlôt, R, Carter, H, Riddle, L, et al. Volunteer trials of a novel improvised dry decontamination protocol for use during mass casualty incidents as part of the UK’S Initial Operational Response (IOR). PLOS ONE. 2017;12(6):e0179309. doi:10.1371/journal.pone.0179309CrossRefGoogle ScholarPubMed
Cao, Y, Hui, X, Maibach, HI. Effect of superabsorbent polymers (SAP) and metal organic frameworks (MOF) wiping sandwich patch on human skin decontamination and detoxification in vitro. Toxicol Lett. 2021;337:7–17. doi:10.1016/j.toxlet.2020.11.004CrossRefGoogle ScholarPubMed
Matar, H, Pinhal, A, Amer, N, et al. Decontamination and management of contaminated hair following a CBRN or HazMat Incident. Toxicol Sci. 2019;171(1):269–279. doi:10.1093/toxsci/kfz145CrossRefGoogle ScholarPubMed
Larner, J, Durrant, A, Hughes, P, et al. Efficacy of different hair and skin decontamination strategies with identification of associated hazards to first responders. Prehosp Emerg Care. 2020;24(3):355–368. doi:10.1080/10903127.2019.1636912CrossRefGoogle ScholarPubMed
Chilcott, RP, Larner, J, Durrant, A, et al. Evaluation of US Federal Guidelines (Primary Response Incident Scene Management [PRISM]) for Mass Decontamination of Casualties During the Initial Operational Response to a Chemical Incident. Ann Emerg Med. 2019;73(6):671–684. doi:10.1016/j.annemergmed.2018.06.042CrossRefGoogle ScholarPubMed
Thors, L, Wigenstam, E, Qvarnström, J, et al. Comparison of skin decontamination strategies in the initial operational response following chemical exposures. Toxicol Vitro Int J Publ Assoc BIBRA. 2023;87:105539. doi:10.1016/j.tiv.2022.105539CrossRefGoogle ScholarPubMed
Thors, L, Wigenstam, E, Qvarnström, J, et al. Immediate dry decontamination using efficient absorbent materials is beneficial following skin exposure to low-volatile toxic chemicals. J Appl Toxicol JAT. 2024;44(9):1361–1371. doi:10.1002/jat.4627CrossRefGoogle ScholarPubMed
Collins, S, James, T, Southworth, F, et al. Human volunteer study of the decontamination of chemically contaminated hair and the consequences for systemic exposure. Sci Rep. 2020;10(1):20822. doi:10.1038/s41598-020-77930-1CrossRefGoogle ScholarPubMed
Liberati, A, Altman, DG, Tetzlaff, J, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. J Clin Epidemiol. 2009;62(10):e1–e34. doi:10.1016/j.jclinepi.2009.06.006CrossRefGoogle Scholar
Figure 0

Figure 1. PRISMA-ScR flow diagram of study selection.Note: The review initially identified 234 records. After removing duplicates and conducting title, abstract, and full-text screenings based on predefined inclusion/exclusion criteria, 9 studies were included in the final scoping review.

Figure 1

Table 1. Search strategies across major databases for identifying studies on dry decontamination (2014-2024)

Figure 2

Table 2. Dry decontamination inclusion and exclusion criteria

Figure 3

Table 3. Dry decontamination data extraction