Experts' Opinion on Decontamination and Antidote Strategies: Complementing Contemporary Expert Consensus and Evidence to Optimize Preparedness and Response to CBRN Threats in the Middle East and North Africa

ABSTRACT Chemical, biological, radiological, and nuclear (CBRN) incidents present escalating challenges, particularly in geopolitically unstable regions such as the Middle East and North Africa. Despite advances, gaps exist regarding optimal decontamination protocols and agent‐specific antidote selection algorithms, exacerbated by variable operational contexts, fragmented services and inconsistent training initiatives. This paper synthesizes recent evidence, building on an artificial intelligence‐enhanced Delphi study with 40 international experts, to assess current CBRN response strategies. Findings support immediate dry decontamination within 5–15 min, removing over 80% of contaminants and avoiding ‘wash‐in’ effects. Triple‐phase protocols achieve > 97% reduction. Medical oversight during decontamination is critical. Antidote readiness must expand beyond organophosphates to include cyanide, biological agents, radiological decorporation, and synthetic opioids. Special populations, such as paediatric, older, and pregnant individuals, as well as those with disabilities, require tailored approaches. Effective CBRN readiness demands integrated, evidence‐based strategies that emphasize rapid response, medical integration, and population‐specific adaptations within global collaboration frameworks to address evolving threats.

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Publication Details

Journal
Journal of Contingencies and Crisis Management
Published
2026-02-16
DOI
https://doi.org/10.1111/1468-5973.70128
Primary Topic
Pesticide Exposure and Toxicity
Type
article
Field-Weighted Citation Impact
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article

Experts' Opinion on Decontamination and Antidote Strategies: Complementing Contemporary Expert Consensus and Evidence to Optimize Preparedness and Response to CBRN Threats in the Middle East and North Africa

H. Farhat, Gregory R. Ciottone, Brendon Morris, Heejun Shin et al.
Journal of Contingencies and Crisis Management
Pesticide Exposure and Toxicity
article

Experts' Opinion on Decontamination and Antidote Strategies: Complementing Contemporary Expert Consensus and Evidence to Optimize Preparedness and Response to CBRN Threats in the Middle East and North Africa

H. Farhat, Gregory R. Ciottone, Brendon Morris, Heejun Shin, Derrick Tin, Daren Morchrie, Saleh Fares Al‐Ali
article en

Abstract

ABSTRACT Chemical, biological, radiological, and nuclear (CBRN) incidents present escalating challenges, particularly in geopolitically unstable regions such as the Middle East and North Africa. Despite advances, gaps exist regarding optimal decontamination protocols and agent‐specific antidote selection algorithms, exacerbated by variable operational contexts, fragmented services and inconsistent training initiatives. This paper synthesizes recent evidence, building on an artificial intelligence‐enhanced Delphi study with 40 international experts, to assess current CBRN response strategies. Findings support immediate dry decontamination within 5–15 min, removing over 80% of contaminants and avoiding ‘wash‐in’ effects. Triple‐phase protocols achieve > 97% reduction. Medical oversight during decontamination is critical. Antidote readiness must expand beyond organophosphates to include cyanide, biological agents, radiological decorporation, and synthetic opioids. Special populations, such as paediatric, older, and pregnant individuals, as well as those with disabilities, require tailored approaches. Effective CBRN readiness demands integrated, evidence‐based strategies that emphasize rapid response, medical integration, and population‐specific adaptations within global collaboration frameworks to address evolving threats.

Journal of Contingencies and Crisis ManagementVol. 34(1)
Harvard University (US), The University of Melbourne (AU), Beth Israel Deaconess Hospital (US), Zayed Military Hospital (AE), African Federation for Emergency Medicine (ZA), Hamad Medical Corporation (QA), Bucheon University (KR), University of Sousse (TN)
Openalex Percentile: Top 53%
Pesticide Exposure and Toxicity
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