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Table 3 The Haddon matrix and the medical response to dirty bomb attacks in subway systems (excluding the content described in Table 2)

From: Using the Haddon matrix to explore medical response strategies for terrorist subway bombings

Phase Host Agent/vehicle Physical environment Social environment/Organizational culture
Pre-event •Standards of individuals’ training, especially for nuclear and radiological attacks
•Malicious determination and ability of terrorists
•Sources of radioactive materials •Adequacy and effectiveness of first-aid kits, instruments, and PPE
•Distribution of hospitals along the subway lines (including hospitals that treat radiation sickness)
•Adequacy of the medical evacuation equipment for radiation-contaminated casualties
•Adequacy and effectiveness of equipment in radiation the detection and decontamination
•None
Event •Protection capability from ionizing radiation •The dose and types of radioactive materials released •Construction of a decontamination station
•Water supply for decontamination
•Disposal of radioactive sewage
•None
Post-event •Health care for the staff (including radiation dose detection) •Duration of radioactive contamination •Medical evacuation equipment decontamination
•Hospital decontamination
•None
  1. PPE Personal protection equipment