BACKGROUND:Chemical accidents occur often across the United States, endangering the health and safety of many people. The Superfund Amendments and Reauthorization Act of 1986 (SARA) requires that communities increase their planning for medical response to these accidents. So far, little evidence has come forth that supports the notion that environmental legislation, such as SARA, improves preparedness for such accidents. METHODS:A one-group pretest/post-test longitudinal design was used to survey the medical directors of emergency departments in all acute care hospitals in the State of New York. Data were collected by mail survey and telephone follow-up in 1986 before the passage of SARA (Time1), and in 1989 after its implementation (Time2). RESULTS:Ninety-four percent of the directors responded at Time1 and 72% at Time2. In New York State, hospital preparedness for chemical accidents improved significantly during the study interval. The longer a hospital had a plan for response to chemical accidents, the more elements of preparedness were in place. Further, as a group, the hospitals that were the least prepared were located in the areas at highest risk. CONCLUSION:Environmental legislation can influence the manner by which health care organizations prepare for environmental emergencies.

译文

背景:化学事故在美国各地经常发生,危及许多人的健康和安全。 1986年的《超级基金修正案和重新授权法》(SARA)要求社区增加对这些事故的医疗响应的计划。迄今为止,几乎没有证据支持这样的观点,即诸如SARA之类的环境立法可以提高此类事故的防范能力。
方法:采用一组前/后测试的纵向设计,对纽约州所有急诊医院急诊科的医疗主管进行调查。在SARA通过之前(1986年,Time1),在1989年实施之后(Time2),通过邮件调查和电话随访收集了数据。
结果:94%的董事在Time1做出回应,而72%的董事在Time2做出回应。在纽约州,在研究期间,医院对化学事故的防范能力显着提高。医院制定应对化学事故的计划的时间越长,准备工作的要素就越多。此外,作为一个整体,准备最少的医院位于风险最高的地区。
结论:环境立法可以影响卫生保健组织为环境紧急事件做准备的方式。

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