Varney Shawn, Hirshon Jon Mark, Dischinger Patricia, Mackenzie Colin
Coalition for the Sustainment of Trauma and Readiness Skills, Baltimore, MD, USA.
Am J Disaster Med. 2006 Nov-Dec;1(1):18-27.
The Haddon Matrix offers a classic epidemiological model for studying injury prevention. This methodology places the public health concepts of agent, host, and environment within the three sequential phases of an injury-producing incident-pre-event, event, and postevent. This study uses this methodology to illustrate how it could be applied in systematically preparing for a mass casualty disaster such as an unconventional sarin attack in a major urban setting. Nineteen city, state, federal, and military agencies responded to the Haddon Matrix chemical terrorism preparedness exercise and offered feedback in the data review session. Four injury prevention strategies (education, engineering, enforcement, and economics) were applied to the individual factors and event phases of the Haddon Matrix. The majority of factors identified in all phases were modifiable, primarily through educational interventions focused on individual healthcare providers and first responders. The Haddon Matrix provides a viable means of studying an unconventional problem, allowing for the identification of modifiable factors to decrease the type and severity of injuries following a mass casualty disaster such as a sarin release. This strategy could be successfully incorporated into disaster planning for other weapons attacks that could potentially cause mass casualties.
哈顿矩阵提供了一个用于研究伤害预防的经典流行病学模型。这种方法将致病因子、宿主和环境等公共卫生概念置于伤害发生事件的三个连续阶段——事前、事中及事后。本研究运用此方法来说明如何将其系统地应用于为大规模伤亡灾难（如在主要城市环境中发生的非常规沙林袭击）做准备。19个城市、州、联邦和军事机构参与了哈顿矩阵化学恐怖主义防范演习，并在数据审查会议上提供了反馈。四种伤害预防策略（教育、工程、执法和经济）被应用于哈顿矩阵的各个因素和事件阶段。在所有阶段确定的大多数因素都是可改变的，主要通过针对个体医疗服务提供者和急救人员的教育干预措施来实现。哈顿矩阵提供了一种研究非常规问题的可行方法，能够识别可改变的因素，以减少诸如沙林泄漏等大规模伤亡灾难后伤害的类型和严重程度。这一策略可以成功地纳入针对其他可能导致大规模伤亡的武器袭击的灾难规划中。
