Emergency Health Care Workers' Preparedness and Willingness to Respond to a Dirty Bomb-related Disaster in Pakistan

Our study examined the association between willingness-to-respond (WTR) and behavioral factors, demographics, and work-related characteristics among emergency department healthcare workers (HCWs) toward a radiological dispersal device (RDD) ("dirty bomb") blast scenario in Pakistan.

A cross-sectional survey was conducted in August to September 2022 among emergency department HCWs from 2 hospitals in Karachi, Pakistan. Nonprobability purposive sampling was used to recruit participants. Multivariate logistic regression analyses were performed to examine the association between WTR and key attitudes/beliefs, including perceived norms, preparedness, and safety, as well as the EPPM variables.

Among behavioral factors, perceived likelihood that colleagues will report to work duty, perceived importance of one's role, and psychological preparedness showed particularly significant associations with WTR; 53.6% of participants indicated low perceived threat, while 46.43% showed high perceived threat, toward an RDD disaster scenario.

Our findings point to the need to improve WTR toward an RDD event by shifting behavioral factors among HCWs through efficacy-focused training; enhancing WTR through such training strategies is imperative beyond mere delivery of information. Changing norms around response, along with institutional support, may further boost WTR during RDD emergencies.