Understanding public responses to chemical, biological, radiological and nuclear incidents — Driving factors, emerging themes and research gaps ☆ Kristian Krieger a, ⁎, Richard Amlôt b , M. Brooke Rogers a a King's College London, Department of War Studies, London, UK b Emergency Response Department, Public Health England, Porton Down, UK abstract article info Available online 20 May 2014 Keywords: CBRN Emergency response Trust Protection motivation theory Human factors risk perception and communication Behaviour This paper discusses the management of public responses to incidents involving chemical, biological, radiological and nuclear materials (CBRN). Given the extraordinary technical and operational challenges of a response to a CBRN release including, but not limited to, hazard detection and identification, casualty decontamination and multi-agency co-ordination, it is not surprising that public psychological and behavioural responses to such inci- dents have received limited attention by scholars and practitioners alike. As a result, a lack of understanding about the roleof the public in effective emergency response constitutes a major gap in research and practice. This limitation must be addressed as a CBRN release has the potential to have wide-reaching psychological and behavioural impacts which, in turn, impact upon public morbidity and mortality rates. This paper addresses a number of key issues: why public responses matter; how responses have been conceptualised by practitioners; what factors have been identified as influencing public responses to a CBRN release and similar extreme events, and what further analysis is needed in order to generate a better understanding of public responses to inform the management of public responses to a CBRN release. © 2014 Elsevier Ltd. All rights reserved. 1. Introduction On March 20th 1995, members of the Aum Shinryko cult released the chemical toxin Sarin on three different lines of the Tokyo subway. Twelve people died. 1000 people suffered adverse symptoms, such as miosis, nausea and vomiting (Ohbu et al., 1997). The Tokyo Sarin attack and the response to this incident have been analysed and discussed from a number of angles, the majority of which focus on the technical capabilities and the effectiveness, or lack, thereof, of the co-ordination of the overall response (Beaton et al., 2005; Okumura et al., 1998a,b,c, 2003). For example, the initial misiden- tification of the agent and the resultant four-hour (approximate) delay in detection and identification of the agent led to a failure to apply ap- propriate treatment within hospitals. This delay also resulted in a failure to protect medical and emergency response staff, many of whom re- moved the chemical without simple personal protective equipment (PPE) such as protective gloves. Moreover, once the chemical was iden- tified as Sarin, the receiving hospitals were not equipped to undertake the necessary decontamination (Okumura et al., 1998b). The Tokyo Sarin attacks therefore illustrate some of the technical challenges asso- ciated with CBRN releases, in this case: developing rapid hazard detec- tion capabilities, as well as problems of coordination and management between different emergency response organisation and quasi-private operators (e.g. hospitals and subway). This article adopts a unique perspective by moving away from the traditional focus on technical and organisational response capabilities, and moving towards an understanding of public responses to CBRN re- leases. Scholars, policy-makers and practitioners, alike, are increasingly recognising the fact that many of the psychological effects of CBRN re- leases on members of the public can be greater than the direct physical harm caused by levels of exposure to CBRN materials. Moreover, the po- tential of members of the public to influence the success of the overall response to CBRN releases has been acknowledged as an important fac- tor in determining the effectiveness of the response efforts (Krieger and Rogers, 2013; Lemyre et al., 2006; Wessely et al., 2003), with “…the suc- cess of government interventions before, during and after a crisis…” relying “…on the cooperation of the public” (Rogers and Pearce, 2013:66). The Tokyo case study captures many of the human and societal dy- namics that form the public response to CBRN releases. In this case, five times the number of individuals who were found to be contaminat- ed reported to hospitals for assessment and treatment (Okumura et al., 1998b). In fact, ‘…5,510 of those who flooded hospital emergency depart- ments were “psychological casualties”— that is, they experienced physical symptoms without direct exposure to nerve agent’ (Lemyre et al., 2005:2). Environment International 72 (2014) 66–74 ☆ Acknowledgements: The research for this paper was undertaken in the context of the project PRACTICE (Preparedness and Resilience against CBRN terrorism using Integrated Concepts and Equipment) funded by 7th Framework Programme of the European Union (grant number: 261728). We would like to thank the partner organisations in the PRACTICE consortium for their feedback on the research report this paper draws on. ⁎ Corresponding author at: King's College London, Department of War Studies, London WC2R 2LS, UK. Tel.: +32 489 523 470; fax: +44 20 7848 7200. E-mail address: Kristian.1.krieger@kcl.ac.uk (K. Krieger). http://dx.doi.org/10.1016/j.envint.2014.04.017 0160-4120/© 2014 Elsevier Ltd. All rights reserved. Contents lists available at ScienceDirect Environment International journal homepage: www.elsevier.com/locate/envint