Pre-hospital healthcare personnel's preparedness, awareness, attitudes, and behaviors towards chemical, biological, radiological, nuclear, and explosive (CBRNE) threats: A case study of Sakarya province

This study aims to evaluate the knowledge, awareness, attitudes, and behaviors of 365 pre-hospital healthcare personnel in Sakarya province regarding CBRNE threats. In our study, 86% of the participants stated that they had heard of the term CBRNE before, and 71.2% reported receiving training on this topic. However, only 22.2% considered themselves adequately prepared for intervention. The rates of perceived competence in managing patients exposed to chemical agents, radiation burns, and biological agents were found to be low, at 29%, 24.9%, and 28.5%, respectively. The knowledge and attitude scores of master's degree graduates were statistically higher compared to high school and associate degree graduates. Significant differences were observed among different professional experience groups, with those having 0-1 year of experience differing from those with 1-5 years, 5-10 years, and over 10 years of experience. It was concluded that knowledge and attitudes significantly increased with years of professional experience. The participants' awareness and knowledge regarding CBRNE were found to be positively correlated with their awareness and knowledge levels, but additional factors and interventions were needed for the transformation of knowledge and awareness into behavior.Our study revealed that receiving training on CBRNE did not directly translate into a sense of competence, and the practical application of the training was insufficient. Considering the frequency of encounters with CBRNE incidents, it is believed that advanced simulation training, in addition to theoretical knowledge, would significantly contribute to the improvement of knowledge and skills. The success in managing CBRNE incidents during the pre-hospital period was found to be directly proportional to the effectiveness of well-equipped and prepared pre-hospital healthcare workers. Therefore, it was concluded that risk and crisis management stages should be effective and sustainable for the proper and efficient progress of CBRNE incident management exercises. Keywords: CBRNE, Pre-hospital healthcare personnel, Incident Scene Management, Preparedness