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SARA Three Years Later: Emergency Physician's Knowledge, Beliefs, and Actions

Published online by Cambridge University Press:  28 June 2012

Linda Y. Landesman  and
Ralph B. Leonard
Linda Y. Landesman*
Affiliation:
Albert Einstein College of Medicine, Department of Pediatrics, Nurses's Residence, Pelham Parkway and Eastchester Road, Bronx, N.Y.
Ralph B. Leonard
Affiliation:
The Bowman Gray School of Medicine, Department of Emergency Medicine, Wake ForestUniversity Medical Center, Winston-Salem, N.C.
*
Albert Einstein College of Medicine, Department of Pediatrics, Nurse's Residence, Pelham Parkway and Eastchester Road, Bronx, NY 10461USA
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Abstract

Objective:

Investigate Emergency Physicians' knowledge about the Superfund Amendments and Reauthorization Act (SARA) Title III legislation, passed by the United States Congress in 1986, and to determine the factors contributing to their level of preparedness in dealing with patients exposed to toxic chemicals.

Methods:

A 115-item questionnaire was mailed to the medical directors of all emergency departments (EDs) in the State of New York. The results of the cross-sectional survey were analyzed using standard statistical methods.

Results:

One hundred and eighty-seven (72%) of the directors of EDs in New York State responded to the survey. Three years after SARA was enacted, only 33% of the directors had heard about this legislation. Only 18% had been invited to attend the meetings of the Local Emergency Planning Committees (LEPC). Sixty percent of the directors knew whether or not the LEPC had devised plans that defined a role for their EDs in responding to environmental emergencies. This knowledge about community planning mainly had an effect on preparedness of the EDs. Preparedness also was predicted by how recently the EDs had treated patients exposed to toxic chemicals, the perception that emergency physicians had a legitimate role in planning for and responding to chemical emergencies, and how often emergency physicians had attended continuing education courses about hazardous materials.

Conclusion:

Despite the finding that some emergency physicians are involved in community preparations, two main problems persist in planning a medical response to environmental emergencies. First, the ED directors generally are unaware of the legislation that mandates these preparations and are not interacting with community planners. Second, there is not full involvement by the local EDs in the LEPC planning efforts.

Recommendations:

A procedure is needed to disseminate information about legislation which affects emergency physicians, such as SARA, and about regional planning for environmental emergencies. Dissemination should include education about the professions' role in planning for and providing care for patients exposed to toxic chemicals.

Keywords

ACTchemical emergenciesemergency departmentsemergency physiciansenvironmental emergencieshazardous materialsmedical directorsplanningpreparednessSARASuperfund Amendments and Reauthorization Acttoxic chemicals
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 8 , Issue 1 , March 1993 , pp. 39 - 44
Copyright
Copyright © World Association for Disaster and Emergency Medicine 1993

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