Journals / Afet ve Risk Dergisi / 2026 / Sayı: 23

CBRN Preparedness Level of Emergency Health Services Personnel in Border Regions

Sınır Bölgelerinde Acil Sağlık Hizmetleri Personelinin KBRN Hazırlık Düzeyi

Mustafa Şimşek(UNIVERSITY OF HEALTH SCIENCES, ŞANLIURFA MEHMET AKİF İNAN HEALTH RESEARCH CENTER, DEPARTMENT OF INTERNAL MEDICINE, DEPARTMENT OF ACADEMIC EMERGENCY MEDICINE)0009-0007-8040-4687
Mehmet Abdülkadir Kısmet(UNIVERSITY OF HEALTH SCIENCES, ŞANLIURFA MEHMET AKİF İNAN HEALTH RESEARCH CENTER)0009-0005-1177-5623
Ahmet Celal Özsoy(UNIVERSITY OF HEALTH SCIENCES, ŞANLIURFA MEHMET AKİF İNAN HEALTH RESEARCH CENTER, DEPARTMENT OF INTERNAL MEDICINE, DEPARTMENT OF ACADEMIC EMERGENCY MEDICINE)0009-0004-5849-088X
Hüseyin Avni Demir(UNIVERSITY OF HEALTH SCIENCES, ŞANLIURFA MEHMET AKİF İNAN HEALTH RESEARCH CENTER, DEPARTMENT OF INTERNAL MEDICINE, DEPARTMENT OF ACADEMIC EMERGENCY MEDICINE)0000-0003-2891-9345
Pages
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Publication Date
2026-10-26
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Overall, 55.4% considered existing training inadequate; face-to-face delivery and 2–3-day programs were preferred.

📌 3 Key Takeaways

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Objective & Hypothesis:This study assessed self-reported knowledge, perceived preparedness, and training needs regarding chemical, biological, radiological, and nuclear (CBRN) events among emergency health services personnel in Şanlıurfa, a border province of Türkiye.
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Key Findings & Data:A descriptive cross-sectional survey was conducted between 22 October and 5 November 2025 among 314 personnel from 112 Emergency Medical Services, the National Medical Rescue Team, and hospital emergency departments.
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Conclusion & Impact:Overall, 55.4% considered existing training inadequate; face-to-face delivery and 2–3-day programs were preferred.
🔬Design:Survey & Empirical Study
📍Scope:2025 Verileri
⚙️Variables:Acil sağlık hizmetleri · Afet planlaması · Biyolojik savaş ajanları

Abstract

This study assessed self-reported knowledge, perceived preparedness, and training needs regarding chemical, biological, radiological, and nuclear (CBRN) events among emergency health services personnel in Şanlıurfa, a border province of Türkiye. A descriptive cross-sectional survey was conducted between 22 October and 5 November 2025 among 314 personnel from 112 Emergency Medical Services, the National Medical Rescue Team, and hospital emergency departments. A structured questionnaire used five-point Likert items to assess domain-specific knowledge and perceptions of preparedness, inter-institutional collaboration, and compliance with standards. Mann–Whitney U and chi-square tests were used, with statistical significance set at p<0.05. Participants’ mean age was 31.8 years, and 69.4% were male. Self-reported knowledge was predominantly moderate across domains. The nuclear domain had the lowest proportion reporting good or very good knowledge (22.3%) and the highest perceived deficiency (74.2%). Prior CBRN training was associated with higher knowledge and perceived preparedness. Participants receiving both theoretical and practical training reported greater readiness than those receiving theory alone. Overall, 55.4% considered existing training inadequate; face-to-face delivery and 2–3-day programs were preferred. These findings highlight training needs, particularly in the nuclear domain. Short, intensive, practice-oriented programs incorporating simulation, drills, and scenario-based learning may strengthen staff preparedness.

Özet

Bu çalışmada, Türkiye’nin sınır illerinden Şanlıurfa’da görev yapan acil sağlık hizmetleri personelinin kimyasal, biyolojik, radyolojik ve nükleer (KBRN) olaylara ilişkin öz-bildirimli bilgi düzeyleri, algılanan hazırlık durumları ve eğitim gereksinimleri değerlendirilmiştir. Tanımlayıcı ve kesitsel araştırma, 22 Ekim–5 Kasım 2025 tarihleri arasında 112 Acil Sağlık Hizmetleri, Ulusal Medikal Kurtarma Ekibi ve hastane acil servislerinde çalışan 314 personelin katılımıyla yürütülmüştür. Veriler, alanlara özgü bilgi, hazırlık, kurumlar arası iş birliği ve standartlara uyum algısını beşli Likert maddeleriyle değerlendiren yapılandırılmış bir anketle toplanmıştır. Analizlerde Mann–Whitney U ve ki-kare testleri kullanılmış, istatistiksel anlamlılık düzeyi p<0,05 olarak belirlenmiştir. Katılımcıların yaş ortalaması 31,8 yıl olup %69,4’ü erkektir. Öz-bildirimli bilgi tüm alanlarda ağırlıklı olarak orta düzeydedir. İyi veya çok iyi bilgi bildirenlerin oranı nükleer alanda en düşük (%22,3), yetersizlik algısı ise en yüksek (%74,2) düzeydedir. Önceden KBRN eğitimi almış olmak, daha yüksek bilgi ve algılanan hazırlık düzeyleriyle ilişkili bulunmuştur. Kuramsal ve uygulamalı eğitimi birlikte alanlar, yalnızca kuramsal eğitim alanlara göre daha yüksek hazırlık bildirmiştir. Katılımcıların %55,4’ü mevcut eğitimleri yetersiz bulmuş; en sık yüz yüze eğitim ve 2–3 günlük programlar tercih edilmiştir. Bulgular, özellikle nükleer alandaki eğitim gereksinimini ortaya koymaktadır. Simülasyon, tatbikat ve senaryo temelli öğrenmeyi içeren kısa, yoğun ve uygulamalı programlar personelin hazırlığını güçlendirebilir.

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Cite This Article

Şimşek, M., Kısmet, M. A., Özsoy, A. C., Demir, H. A. (2026). CBRN Preparedness Level of Emergency Health Services Personnel in Border Regions. Afet ve Risk Dergisi, Sayı: 23. https://doi.org/10.35341/afet.1822110

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References (26)

  1. Acil Sağlık Hizmetleri Genel Müdürlüğü. (n.d.). Ulusal Medikal Kurtarma Ekibi Birimi (UMKE). Republic of Türkiye Ministry of Health. Retrieved April 19, 2026, from https://ashgmafetacildb.saglik.gov.tr/TR-80255/ulusal-medikal-kurtarma-ekibi-birimi-umke.html
  2. AFAD. (2021). T.C. İçişleri Bakanlığı Afet ve Acil Durum Yönetimi Başkanlığı hakkında. https://www.afad.gov.tr/afadhakkinda (Son Erişim Tarihi: 29 Temmuz 2026)
  3. Alahmari, A. A., Khan, A. A. (2023). Chemical, biological, radiological, and nuclear preparedness of public hospitals in Riyadh. Disaster Medicine and Public Health Preparedness, 17, e401. https://doi.org/10.1017/dmp.2023.66
  4. Alim, S., Kawabata, M., Nakazawa, M. (2015). Evaluation of disaster preparedness training and disaster drill for nursing students. Nurse Education Today, 35(1), 25-31. https://doi.org/10.1016/j.nedt.2014.04.016
  5. Artcı Adak, F., İnal Önal, E., Kaya, E. (2025). Determining CBRN risk perceptions and preparedness levels and related factors of emergency health services personnel: Tekirdağ provincial example. Afet ve Risk Dergisi, 8(2), 630-643. https://doi.org/10.35341/afet.1526785
  6. Babacan, A. (2023). Knowledge levels and awareness of healthcare professionals on protection from chemical, biological, radiation and nuclear hazards, and emergency aid practices. Pamukkale Medical Journal, 16(4), 618-626. https://doi.org/10.31362/patd.1315923
  7. Bajow, N., Alkhalil, S., Maghraby, N., Alesa, S., Najjar, A. A., Aloraifi, S. (2022). Assessment of the effectiveness of a course in major chemical incidents for front-line health care providers: A pilot study from Saudi Arabia. BMC Medical Education, 22, 350. https://doi.org/10.1186/s12909-022-03427-2
  8. Beikmohammadi, S., Amirheidari, B., Dehesh, T., Nekoei-Moghadam, M., Yazdi-Feyzabadi, V., Hassani, E., Habibzadeh, H. (2023). Investigating the level of preparedness of Iranian hospitals against CBRN incidents: a case study of hospitals in West Azerbaijan Province. Shiraz E-Medical Journal, 24(24), e133707. https://doi.org/10.5812/semj-133707
  9. Bulut, A., Atıcı, E. (2024). The level of emergency health workers' knowledge about chemical, biological, radiological, and nuclear (CBRN) hazards: The case of Turkey. Work, 79(4), 1763-1771. https://doi.org/10.3233/WOR-230219
  10. Dağ, N., Çalışkan, C., Koçak, H., Demir, G., Çelebi, İ. (2023). Factors affecting the intervention of health-care professionals in radiological events: A systematic review. Disaster Medicine and Public Health Preparedness, 17, e348. https://doi.org/10.1017/dmp.2023.17
  11. Djalali, A., Della Corte, F., Segond, F., Metzger, M.-H., Gabilly, L., Grieger, F., Larrucea, X., Violi, C., Lopez, C., Arnod-Prin, P., Ingrassia, P. L. (2017). TIER competency-based training course for the first receivers of CBRN casualties: a European perspective. European Journal of Emergency Medicine, 24(5), 371–376. https://doi.org/10.1097/MEJ.0000000000000383
  12. Ekmekci, P. E. (2016). An assessment of coherence between early warning and response systems and serious cross-border health threats in the European Union and Turkey. Disaster Medicine and Public Health Preparedness, 10(6), 883-892. https://doi.org/10.1017/dmp.2016.63
  13. Farhat, H., Alinier, G., Chaabna, K., El Aifa, K., Abougalala, W., Laughton, J., Ben Dhiab, M. (2024). Preparedness and emergency response strategies for chemical, biological, radiological and nuclear emergencies in disaster management: a qualitative systematic review. Journal of Contingencies and Crisis Management, 32(3), e12592. https://doi.org/10.1111/1468-5973.12592
  14. Hedberg, P., Saveman, B. I., Gyllencreutz, L. (2024). Evaluation of a collaborative multidisciplinary train-the-trainer program for first responders in chemical, radiologic and nuclear emergencies-a pre- and post-test. BMC Medical Education, 24, 1027. https://doi.org/10.1186/s12909-024-06024-7
  15. Hsu, C. C., Tsai, S. H., Tsai, P. J., Chang, Y. C., Tsai, Y. D., Chen, Y. C., Lai, K. C., Wang, J. C., Yang, T. C., Liao, W. I., Chen, S. J. (2022). An Adapted Hybrid Model for Hands-On Practice on Disaster and Military Medicine Education in Undergraduate Medical Students During the COVID-19 Pandemic. Journal of Acute Medicine, 12(4), 145-157. https://doi.org/10.6705/j.jacme.202212_12(4).0003
  16. Hsu, E. B., Thomas, T. L., Bass, E. B., Whyne, D., Kelen, G. D., Green, G. B. (2006). Healthcare worker competencies for disaster training. BMC Medical Education, 6, 19. https://doi.org/10.1186/1472-6920-6-19
  17. Kako, M., Hammad, K., Mitani, S., Arbon, P. (2018). Existing approaches to chemical, biological, radiological, and nuclear (CBRN) education and training for health professionals: Findings from an integrative literature review. Prehospital and Disaster Medicine, 33(2), 182-190. https://doi.org/10.1017/S1049023X18000043
  18. Kıyak, R., Çağlar, B., Serin, S., Taşkın, G., Fındık, M. (2025). Knowledge and awareness levels of health personnel in a university hospital regarding CBRN and disasters. Journal of Health Sciences and Medicine, 8(4), 646-649. https://doi.org/10.32322/jhsm.1678785
  19. Kollek, D., Welsford, M., Wanger, K. (2009). Chemical, biological, radiological and nuclear preparedness training for emergency medical services providers. Canadian Journal of Emergency Medicine, 11(4), 337-342. https://doi.org/10.1017/S1481803500011386
  20. Kotora, J. G. (2015). An assessment of chemical, biological, radiologic, nuclear, and explosive preparedness among emergency department healthcare providers in an inner-city emergency department. American Journal of Disaster Medicine, 10(3), 189-204. https://doi.org/10.5055/AJDM.2015.0202
  21. Paton, D., Johnston, D. (2017). Disaster resilience: An integrated approach (2nd ed.). Charles C Thomas Publisher.
  22. Pandya, J., Stricklin, A., Noel, C., Hockaday, S. L., Russell, B. L., Ryan, B. J., White, J., Schwartz, D., Harris, C. A., Klein, K. R., Fowler, R., Dallas, C. E., Swienton, R. (2025). Health system preparedness for nuclear and radiological disasters: A review. Disaster Medicine and Public Health Preparedness, 19, e312. https://doi.org/10.1017/dmp.2025.8
  23. Reilly, M. J., Markenson, D., DiMaggio, C. (2007). Comfort level of emergency medical service providers in responding to weapons of mass destruction events: Impact of training and equipment. Prehospital and Disaster Medicine, 22(4), 297-303. https://doi.org/10.1017/S1049023X00004908
  24. Rossodivita, A., Spaterna, R., Folla, L., Paganoni, C., Saporito, T., Ranghieri, M., Guidotti, M. (2023). CBRN Disaster Hospital Response and Preparedness. An Italian Civilian Military Cooperation Teaching Model. Prehospital and Disaster Medicine, 38(S1), s13–s13. https://doi.org/10.1017/S1049023X23000791
  25. Stevens, G., Jones, A., Smith, G., Nelson, J., Agho, K., Taylor, M., Raphael, B. (2010). Determinants of paramedic response readiness for CBRNE threats. Biosecurity and Bioterrorism: Biodefense Strategy, Practice, and Science, 8(2), 193-202. https://doi.org/10.1089/bsp.2009.0061
  26. Subbarao, I., Lyznicki, J. M., Hsu, E. B., Gebbie, K. M., Markenson, D., Barzansky, B., … James, J. J. (2008). A Consensus-based Educational Framework and Competency Set for the Discipline of Disaster Medicine and Public Health Preparedness. Disaster Medicine and Public Health Preparedness, 2(1), 57–68. https://doi.org/10.1097/DMP.0b013e31816564af