On completion of operational duties, firefighters wearing gas-tight or powered respirator suits are decontaminated with water in a designated firefighters' shower facility.

In July 2004 the Government Office for the West Midlands carried out the largest CBRN exercise in the United Kingdom. The exercise took place in Birmingham, a major city that lies about half way between London and Manchester, at a number of locations including the National Exhibition Centre, Heartlands Accident and Emergency Hospital and West Midlands Police headquarters. It took six months of planning and was part of a region-wide program to further develop the West Midlands capability to respond to CBRN incidents. The exercise involved about 2,000 responders and 450 volunteers playing the part of casualties requiring decontamination. There were more than 40 fire service vehicles used, including three IRUs.

The casualties role-played effectively and their exuberance resulted in a very realistic panic and civil disturbance situation. After the police regained order, an inner and outer cordon was established, and the fire service deployed the decontamination structures. In extremely hot and realistic conditions, the casualties removed their clothes and put them in the provided packs. They were then assisted into the showers and finally dressed in the provided clothing prior to a medical assessment. Media interest was extensive with crews attending from all major U.K. television stations, Germany, France, Japan and Al Jazeera. A hot debrief was done immediately after the event with a structured debrief taking place several weeks later. Many lessons were learned from this exercise.

The exercise identified difficulties regarding the use of the disrobe pack, in particular understanding of what people needed to do, the language of instructions included and ease of use by the elderly or disabled. The recommended solution is that a full user evaluation of disrobe packs be undertaken and modifications implemented as necessary.

It is likely that many casualties will seek alternative treatment sources and they will appear as self-presenters at local accident and emergency sites. Given the size of fire service response and decontamination vehicles, emergency plans to allow them to deploy at hospitals need to be drafted. A national program of risk assessments of these sites will be undertaken to scope capacity to respond and support the fire service CBRN response.

Exercise Horizon identified differing levels and styles of personal protective clothing. These posed welfare, hydration and communication difficulties. Therefore, the current PPE provision will be reviewed nationally for all agencies and equipment modified if necessary. There needs to be a national, multi-agency standard in CBRN PPE developed.

The exercise proved invaluable in practicing the regions response to CBRN incidents and 28 recommendations in total were raised across the full spectrum of agencies involved, many of which have been acted upon. The incident response units, MDDs, MDRs and their associated equipment worked extremely efficiently. The extensive training programs ensured that contaminated casualties were effectively decontaminated and that firefighters were confident in both the equipment's design and capability.

This CBRN decontamination capability has been used many times in the United Kingdom over the last three years, although not at CBRN incidents. But major hazmat and white-powder incidents further extends the fire and rescue service capability to deal with the public in difficult and demanding environments.

Phil Causer is group manager of MIFireE and has worked with the U.K. Fire and Rescue Service for 29 years. His last operational role was Staffordshire's training and development officer. For the last four years, he has specialised in dealing with the effects of a CBRN attack on the United Kingdom and worked with Office of the Duputy Prime Minister to develop a dedicated response to public mass decontamination. He is now part of a small team that uses specialist contractors working with multiagencies to assist in recovery following a terrorist attack.