# CBRNe CBRNe (Chemical, Biological, Radiological, Nuclear, and Explosives) in humanitarian settings. ### Description The CBRNe program sits within HHI’s Emergency Health Systems (EHS) department and is dedicated to enhancing global preparedness for Chemical, Biological, Radiological, Nuclear, and Explosive threats in conflict and humanitarian settings. By focusing on education, research, and advocacy, our team strengthens CBRNe preparedness through in-depth training, collaboration with global leaders, and close partnerships with key stakeholders. This multifaceted approach improves the capacity of front-line providers and emergency care systems to respond effectively to the unique challenges of CBRNe events. Our work is pivotal in advancing the resilience of health systems and ensuring the delivery of a comprehensive humanitarian response. ### CBRNe Projects 1. #### Trauma care Response in Ukraine As part of the [EHS](/emergency-health-systems?ct=717a46fcace8e45379d2b20a4c1ce02ab6545218348ebcc58afe07f2ed6f91ff&cb=1718301991#) trauma care training project with International Medical Corps, the CBRNe team was tasked with delivering a 2-day course to hospital staff and others. The course provides an in-depth training on CBRNe-related events, including personal safety, PPE, recognition, medical management, facility considerations, and environmental considerations. 44 courses were delivered and more than 1350 Ukrainians participated in these courses across 7 locations between August 2022 and July 2024. Lear more on our mission [here](https://www.linkedin.com/posts/harvard-humanitarian-initiative_hhi-ehs-ukraine-activity-7184598637312643072-NtLC?utm_source=share&utm_medium=member_desktop) ### CBRNe Team [### Timothy B. Erickson, MD, FACEP, FACMT, FAACT ](/people/timothy-b-erickson)Director, Humanitarian Action and the Environment Dr. Timothy B. Erickson has expertise in the areas of humanitarian health, environmental toxicology, crisis in climate change, wastewater epidemiology, chemical, biological, radiological, nuclear, and explosives (CBRNE) and acute injuries in global... ![headshot](/sites/g/files/omnuum6866/files/styles/hwp_4_5__690x865/public/humanitarianinitiative/files/timothy_b._erickson_md.jpg?itok=SpNk9Kx2) [### Donell Harvin, DrPH, MPH, MPA ](/people/donell-harvin)Visiting Scientist, Harvard T.H. Chan School of Public Health Donell Harvin is a public health emergency and weapons of mass destruction (WMD) expert from Washington, DC, who provides analysis for MSNBC/NBC News and CNN. In his capacity as a Visiting Scientist, he helps oversee the Harvard Humanitarian Initiative... ![d.harvin](/sites/g/files/omnuum6866/files/styles/hwp_4_5__690x865/public/humanitarianinitiative/files/d.harvin_headshot1_cropped.jpg?itok=byNWVs6B) [### AN Na, M.D. M.P.H. MSc ](/people/na-md-mph-msc)Practicum Student Dr. An Na is a DrPH candidate at the Harvard T.H. Chan School of Public Health. She has worked in humanitarian health for more than a decade. She started her global health journey as a Gynaecologist/Obstetrician for Médecins Sans Frontières (MSF) projects... ![picture1_01](/sites/g/files/omnuum6866/files/styles/hwp_4_5__690x865/public/humanitarianinitiative/files/picture1_01.png?itok=O1JVRpSH) ### CBRNe Videos #### [CBRNE educational videos](https://www.youtube.com/playlist?list=PLguYDaLTowCfhDMchmF40fDtJt-NYZZZq) ### CBRNe Publications Download 12 citations download- [BibTeX](/bibcite/export?pager_style=no_pager&number_of_items=12&sort_field=bibcite_year--desc&&content_filter%5B0%5D=1554501&content_filter%5B1%5D=1599971&content_filter%5B2%5D=1600001&content_filter%5B3%5D=1438253&content_filter%5B4%5D=1434141&content_filter%5B5%5D=1599986&content_filter%5B6%5D=1395230&content_filter%5B7%5D=1395222&content_filter%5B8%5D=1395228&content_filter%5B9%5D=1395217&content_filter%5B10%5D=1395218&content_filter%5B11%5D=1600031&&format=bibtex) - [EndNote X3 XML](/bibcite/export?pager_style=no_pager&number_of_items=12&sort_field=bibcite_year--desc&&content_filter%5B0%5D=1554501&content_filter%5B1%5D=1599971&content_filter%5B2%5D=1600001&content_filter%5B3%5D=1438253&content_filter%5B4%5D=1434141&content_filter%5B5%5D=1599986&content_filter%5B6%5D=1395230&content_filter%5B7%5D=1395222&content_filter%5B8%5D=1395228&content_filter%5B9%5D=1395217&content_filter%5B10%5D=1395218&content_filter%5B11%5D=1600031&&format=endnote8) - [EndNote 7 XML](/bibcite/export?pager_style=no_pager&number_of_items=12&sort_field=bibcite_year--desc&&content_filter%5B0%5D=1554501&content_filter%5B1%5D=1599971&content_filter%5B2%5D=1600001&content_filter%5B3%5D=1438253&content_filter%5B4%5D=1434141&content_filter%5B5%5D=1599986&content_filter%5B6%5D=1395230&content_filter%5B7%5D=1395222&content_filter%5B8%5D=1395228&content_filter%5B9%5D=1395217&content_filter%5B10%5D=1395218&content_filter%5B11%5D=1600031&&format=endnote7) - [Endnote tagged](/bibcite/export?pager_style=no_pager&number_of_items=12&sort_field=bibcite_year--desc&&content_filter%5B0%5D=1554501&content_filter%5B1%5D=1599971&content_filter%5B2%5D=1600001&content_filter%5B3%5D=1438253&content_filter%5B4%5D=1434141&content_filter%5B5%5D=1599986&content_filter%5B6%5D=1395230&content_filter%5B7%5D=1395222&content_filter%5B8%5D=1395228&content_filter%5B9%5D=1395217&content_filter%5B10%5D=1395218&content_filter%5B11%5D=1600031&&format=tagged) - [Marc](/bibcite/export?pager_style=no_pager&number_of_items=12&sort_field=bibcite_year--desc&&content_filter%5B0%5D=1554501&content_filter%5B1%5D=1599971&content_filter%5B2%5D=1600001&content_filter%5B3%5D=1438253&content_filter%5B4%5D=1434141&content_filter%5B5%5D=1599986&content_filter%5B6%5D=1395230&content_filter%5B7%5D=1395222&content_filter%5B8%5D=1395228&content_filter%5B9%5D=1395217&content_filter%5B10%5D=1395218&content_filter%5B11%5D=1600031&&format=marc) - [PubMedId](/bibcite/export?pager_style=no_pager&number_of_items=12&sort_field=bibcite_year--desc&&content_filter%5B0%5D=1554501&content_filter%5B1%5D=1599971&content_filter%5B2%5D=1600001&content_filter%5B3%5D=1438253&content_filter%5B4%5D=1434141&content_filter%5B5%5D=1599986&content_filter%5B6%5D=1395230&content_filter%5B7%5D=1395222&content_filter%5B8%5D=1395228&content_filter%5B9%5D=1395217&content_filter%5B10%5D=1395218&content_filter%5B11%5D=1600031&&format=pubmed_id) - [RIS](/bibcite/export?pager_style=no_pager&number_of_items=12&sort_field=bibcite_year--desc&&content_filter%5B0%5D=1554501&content_filter%5B1%5D=1599971&content_filter%5B2%5D=1600001&content_filter%5B3%5D=1438253&content_filter%5B4%5D=1434141&content_filter%5B5%5D=1599986&content_filter%5B6%5D=1395230&content_filter%5B7%5D=1395222&content_filter%5B8%5D=1395228&content_filter%5B9%5D=1395217&content_filter%5B10%5D=1395218&content_filter%5B11%5D=1600031&&format=ris) ### 2024 Daniel Hryhorczuk, Barry Levy, Mykola Prodanchuk, Oleksandr Kravchuk, Nataliia Bubalo, Alex Hryhorczuk, and Timothy B. Erickson. 2024. “[The Environmental Health Impacts of Russia’s War on Ukraine](/publications/environmental-health-impacts-russia%E2%80%99s-war-ukraine)”. Journal of Occupational Medicine and Toxicology, 19, 1 Daniel Hryhorczuk, Barry Levy, Mykola Prodanchuk, Oleksandr Kravchuk, Nataliia Bubalo, Alex Hryhorczuk, and Timothy B. Erickson. 2024. “[The Environmental Health Impacts of Russia’s War on Ukraine](/publications/environmental-health-impacts-russia%E2%80%99s-war-ukraine)”. Journal of Occupational Medicine and Toxicology, 19, 1 - [ descriptionPublisher's Version](https://occup-med.biomedcentral.com/articles/10.1186/s12995-023-00398-y) - [ descriptionPublisher's Version](https://occup-med.biomedcentral.com/articles/10.1186/s12995-023-00398-y) ### 2023 Timothy B. Erickson, Donell Harvin, Alexis Schmid, Gideon Loevinsohn, Anna Poriechna, Oleg Martyshyn, Kryrylo Kliukach, Meaghan Sydlowski, Jonathan Strong, and Sean M. Kivlehan. 2023. “[Evaluation of Chemical, Biological, Radiological, Nuclear Explosive (CBRNE) Knowledge Change and Skills Confidence Among Front-Line Providers During the Russia-Ukraine War](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10171778/)”. Disaster Medicine and Public Health Preparedness Timothy B. Erickson, Donell Harvin, Alexis Schmid, Gideon Loevinsohn, Anna Poriechna, Oleg Martyshyn, Kryrylo Kliukach, Meaghan Sydlowski, Jonathan Strong, and Sean M. Kivlehan. 2023. “[Evaluation of Chemical, Biological, Radiological, Nuclear Explosive (CBRNE) Knowledge Change and Skills Confidence Among Front-Line Providers During the Russia-Ukraine War](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10171778/)”. Disaster Medicine and Public Health Preparedness - add\_circle do\_not\_disturb\_on Abstract ### Objective: To evaluate the change in knowledge and skill confidence after implementation of a CBRNE training course during the Russia-Ukraine War. ### Methods: Pre/post-test study in the Ukrainian cities of Kyiv, Dnipro, Zaporizhzhia, and Odesa. Fifteen... ### 2022 Eric Goralnick, Peter Chai, and . 2022. “[Health and Safety Threats to UkraineFrom NonconventionalWeaponsA Clear and Present Danger](https://jamanetwork.com/journals/jama/article-abstract/2799368)”. Journal of American Medical Association, 328 , 23 Eric Goralnick, Peter Chai, and . 2022. “[Health and Safety Threats to UkraineFrom NonconventionalWeaponsA Clear and Present Danger](https://jamanetwork.com/journals/jama/article-abstract/2799368)”. Journal of American Medical Association, 328 , 23 - add\_circle do\_not\_disturb\_on Abstract This Viewpoint discusses the potential for use of nonconventional warfare threats (chemical, biological, radiological, nuclear, and explosives) in the conflict in Ukraine and how health care professionals need to recognize and respond to these threats. Sean Kivlehan, Amy Allen, Olha Viun, Dmitry Makarov, Daniel Schnorr, Sonny Patel, Sergii Ryzhenko, Phuong Pham, and Timothy Erickson. 2022. “[Evaluation of Change in Emergency Care Knowledge and Skills Among Front-Line Healthcare Providers in Ukraine With the Basic Emergency Care Course: a Pretest Post-Test Study](/publications/evaluation-change-emergency-care-knowledge-and-skills-among)”. BMJ Open Sean Kivlehan, Amy Allen, Olha Viun, Dmitry Makarov, Daniel Schnorr, Sonny Patel, Sergii Ryzhenko, Phuong Pham, and Timothy Erickson. 2022. “[Evaluation of Change in Emergency Care Knowledge and Skills Among Front-Line Healthcare Providers in Ukraine With the Basic Emergency Care Course: a Pretest Post-Test Study](/publications/evaluation-change-emergency-care-knowledge-and-skills-among)”. BMJ Open - add\_circle do\_not\_disturb\_on Abstract - [ descriptionPublisher's Version](https://bmjopen.bmj.com/content/12/6/e050871) **Objective:** Evaluate the change in participant emergency care knowledge and skill confidence after implementation of the WHO-International Committee of the Red Cross (ICRC) Basic Emergency Care (BEC) course. **Design:** Pretest/post-test quasi-experimental... - [ descriptionPublisher's Version](https://bmjopen.bmj.com/content/12/6/e050871) Valerie A. Dobiesz, Madeline Schwid, Roger D. Dias, Benjamin Aiwonodagbon, Baraa Tayeb, Adrienne Fricke, Phuong Pham, and Timothy B. Erickson. 2022. “[Maintaining Health Professional Education During War: A Scoping Review](/publications/maintaining-health-professional-education-during-war-scoping)”. Medical Education Valerie A. Dobiesz, Madeline Schwid, Roger D. Dias, Benjamin Aiwonodagbon, Baraa Tayeb, Adrienne Fricke, Phuong Pham, and Timothy B. Erickson. 2022. “[Maintaining Health Professional Education During War: A Scoping Review](/publications/maintaining-health-professional-education-during-war-scoping)”. Medical Education - add\_circle do\_not\_disturb\_on Abstract - [ descriptionPublisher's Version](https://pubmed.ncbi.nlm.nih.gov/35388529/) **Purpose:** War negatively impacts health professional education when healthcare is needed most. The aims of this scoping review are to describe the scope of barriers and targeted interventions to maintaining health professional education during war and... - [ descriptionPublisher's Version](https://pubmed.ncbi.nlm.nih.gov/35388529/) Sonny S. Patel, Julian H. Neylan, Katerina Bavaro, Peter Chai, Eric Goralnick, and Timothy B. Erickson. 2022. “[Chemical, Biological, Radiological, Nuclear, and Explosives (CBRNEs) Preparedness for Sporting Event Mass Gatherings: A Systematic Review of the Literature](https://wmpllc.org/ojs/index.php/ajdm/article/view/3268)”. American Journal of Disaster Medicine, 17, 1, Pp. 57-74 Sonny S. Patel, Julian H. Neylan, Katerina Bavaro, Peter Chai, Eric Goralnick, and Timothy B. Erickson. 2022. “[Chemical, Biological, Radiological, Nuclear, and Explosives (CBRNEs) Preparedness for Sporting Event Mass Gatherings: A Systematic Review of the Literature](https://wmpllc.org/ojs/index.php/ajdm/article/view/3268)”. American Journal of Disaster Medicine, 17, 1, Pp. 57-74 - add\_circle do\_not\_disturb\_on Abstract ***Objective:*** *Sporting events often constitute mass gatherings (MGs) featuring large crowds of spectators and participants. Our objective is to understand the current state of emergency preparedness for sporting events by examining past MG sporting events*... ### 2021 Chai, Ferro, Kirshenbaum, Hayes, Culbreth, Boyer, and Erickson. 2021. “[In Reply to ‘Hydroxychloroquine Overdose: What Are the Exact Roles of Diazepam and Potassium Infusion?’](/publications/reply-hydroxychloroquine-overdose-what-are-exact-roles-diazepam)”. J Med Toxicol, 17, 1, Pp. 85-86. doi:10.1007/s13181-020-00812-5 Chai, Ferro, Kirshenbaum, Hayes, Culbreth, Boyer, and Erickson. 2021. “[In Reply to ‘Hydroxychloroquine Overdose: What Are the Exact Roles of Diazepam and Potassium Infusion?’](/publications/reply-hydroxychloroquine-overdose-what-are-exact-roles-diazepam)”. J Med Toxicol, 17, 1, Pp. 85-86. doi:10.1007/s13181-020-00812-5 ### 2020 Michael DeLuca, Peter Chai, Eric Goralnick, and Timothy Erickson. 2020. “[Five Decades of Global Chemical Terror Attacks: Data Analysis to Inform Training and Preparedness](/publications/five-decades-global-chemical-terror-attacks-data-analysis-inform)”. Disaster Med Public Health Prep, Pp. 1-12. doi:10.1017/dmp.2020.176 Michael DeLuca, Peter Chai, Eric Goralnick, and Timothy Erickson. 2020. “[Five Decades of Global Chemical Terror Attacks: Data Analysis to Inform Training and Preparedness](/publications/five-decades-global-chemical-terror-attacks-data-analysis-inform)”. Disaster Med Public Health Prep, Pp. 1-12. doi:10.1017/dmp.2020.176 - add\_circle do\_not\_disturb\_on Abstract BACKGROUND: Chemical weapons attacks during the recent conflict in Syria and Iraq highlight the need to better understand the changing epidemiology of chemical weapons use, especially among non-state actors. Public health professionals and policy-makers... Sonny Patel, Robert Grace, Patrick Chellew, Mykola Prodanchuk, Olha Romaniuk, Yuriy Skrebets, Sergii Ryzhenko, and Timothy Erickson. 2020. “[‘Emerging Technologies and Medical Countermeasures to Chemical, Biological, Radiological, and Nuclear (CBRN) Agents in East Ukraine’](/publications/emerging-technologies-and-medical-countermeasures-chemical)”. Conflict and Health, 14, Pp. 24. doi:10.1186/s13031-020-00279-9 Sonny Patel, Robert Grace, Patrick Chellew, Mykola Prodanchuk, Olha Romaniuk, Yuriy Skrebets, Sergii Ryzhenko, and Timothy Erickson. 2020. “[‘Emerging Technologies and Medical Countermeasures to Chemical, Biological, Radiological, and Nuclear (CBRN) Agents in East Ukraine’](/publications/emerging-technologies-and-medical-countermeasures-chemical)”. Conflict and Health, 14, Pp. 24. doi:10.1186/s13031-020-00279-9 - add\_circle do\_not\_disturb\_on Abstract Since 2014, Ukraine has been beset by an armed conflict with international and internal dimensions. The nature of this conflict is multidimensional, and disaster preparedness and response in this context must be as well. Health experts from Ukraine, the... ### 2018 Peter Chai, Bryan Hayes, Timothy Erickson, and Edward Boyer. 2018. “[Novichok Agents: A Historical, Current, and Toxicological Perspective](/publications/novichok-agents-historical-current-and-toxicological-perspective)”. Toxicol Commun, 2, 1, Pp. 45-48. doi:10.1080/24734306.2018.1475151 Peter Chai, Bryan Hayes, Timothy Erickson, and Edward Boyer. 2018. “[Novichok Agents: A Historical, Current, and Toxicological Perspective](/publications/novichok-agents-historical-current-and-toxicological-perspective)”. Toxicol Commun, 2, 1, Pp. 45-48. doi:10.1080/24734306.2018.1475151 - add\_circle do\_not\_disturb\_on Abstract The , or "newcomer" class of nerve agents are lesser characterized, weaponized organophosphate agents. The use of known agents in warfare is banned under the Chemical Weapons Convention of 1997. agents are considered more potent than VX gas and can be... Julia Brooks, Timothy Erickson, Stephanie Kayden, Raul Ruiz, Stephen Wilkinson, and Frederick Burkle. 2018. “[Responding to Chemical Weapons Violations in Syria: Legal, Health, and Humanitarian Recommendations](/publications/responding-chemical-weapons-violations-syria-legal-health-and)”. Confl Health, 12, Pp. 12. doi:10.1186/s13031-018-0143-3 Julia Brooks, Timothy Erickson, Stephanie Kayden, Raul Ruiz, Stephen Wilkinson, and Frederick Burkle. 2018. “[Responding to Chemical Weapons Violations in Syria: Legal, Health, and Humanitarian Recommendations](/publications/responding-chemical-weapons-violations-syria-legal-health-and)”. Confl Health, 12, Pp. 12. doi:10.1186/s13031-018-0143-3 - add\_circle do\_not\_disturb\_on Abstract Background: The repeated use of prohibited chemical weapons in the Syrian conflict poses serious health, humanitarian, and security threats to civilians, healthcare personnel, and first responders. Moreover, the use of chemical weapons constitutes a clear... ### 2017 Peter Chai, Edward Boyer, Houssam Al-Nahhas, and Timothy B. Erickson. 2017. “[Toxic Chemical Weapons of Assassination and Warfare: Nerve Agents VX and Sarin](https://www.tandfonline.com/doi/full/10.1080/24734306.2017.1373503)”. Toxicology Communications , 1, 1, Pp. 21-23 Peter Chai, Edward Boyer, Houssam Al-Nahhas, and Timothy B. Erickson. 2017. “[Toxic Chemical Weapons of Assassination and Warfare: Nerve Agents VX and Sarin](https://www.tandfonline.com/doi/full/10.1080/24734306.2017.1373503)”. Toxicology Communications , 1, 1, Pp. 21-23 - add\_circle do\_not\_disturb\_on Abstract The use of VX and sarin as weapons of assassination and warfare raises important considerations for healthcare professionals who may encounter victims, bystanders, and responders who require prompt assessment and treatment. Chemical warfare agents such as... ## Features Helping Ukrainians Help Themselves on International Medical Corps' [website](https://internationalmedicalcorps.org/story/helping-ukrainians-help-themselves/) ## Events #### November 2024 - *Ukraine CBRNe preparedness for healthcare and public health: CBRNe implications in humanitarian and conflict settings* Webinar on zoom. Register [here](https://harvard.zoom.us/webinar/register/WN_ipv4UDazTPWrfd7l3xe5oA#/registration). #### August 2024 - *Traveled to Krakow, Poland along with MGH Center for Disaster Medicine to participate in a workshop hosted by the US Department of State Bureau of International Security & Nonproliferation working alongside Ukrainian officials to develop policies that support Ukraine's medical and public health response in the event of a nuclear detonation or chemical incident*. - [X post](https://x.com/HHI/status/1833563248513126629) #### August 2023 - *Building a CBRNE and Disaster Response Capability in Ukraine* Accelerator Workshop at the Harvard [Radcliffe Institue](/sites.harvard.edu/building-disaster-response-capability-in-ukraine/) - [LinkedIn post](https:/www.linkedin.com/posts/harvard-humanitarian-initiative_ukraine-activity-7103036380741554176-Avi1?utm_source=share&utm_medium=member_desktop) #### June 2023 - On the eve of CBRNe World's High Intensity CBRN 2023 in Warsaw, Poland, Harvard Humanitarian Initiative co-hosted a workshop 'Strengthening CBRNE Disaster Response Capacity in Ukraine' alongside Akademia Pożarnicza." - [LinkedIn post](https:/www.linkedin.com/posts/harvard-humanitarian-initiative_on-the-eve-of-cbrne-worlds-high-intensity-activity-7094339038261764096-0Mt2?utm_source=share&utm_medium=member_desktop)