Core Competencies of Truck Drivers Responding to Emergencies during Transportation of Hazardous Materials

Background. Hazardous material (HAZMAT) transportation drivers are responsible for safe delivery of consignments and face multiple challenges carrying out their duties. Drivers are also the first to respond to emergencies and accidents. Objectives. The purpose of the present study was to identify the essential competencies needed by HAZMAT transportation drivers to deal with emergencies. Methods. Three rounds of focus groups were conducted using expert panels comprised of HAZMAT specialists, health, safety and emergency representatives, security experts and transportation advisors from June to July 2019. The panel discussed competencies, gathered from a literature review, for emergency responders. Results. The panel identified six (6) core and 23 sub-competencies of HAZMAT drivers. This is the first study in low- and middle-income countries (LMIC) to identify core competencies of HAZMAT truck drivers. Conclusions. The integration of these competencies into a development and training program for drivers will better enable drivers to handle emergencies in an efficient and effective manner. Participant Consent. Obtained Ethics Approval. The Graduate Advisory Committee of Comsats University approved study protocols. Participant Consent. Obtained Competing Interests. The authors declare no competing financial interests.


Introduction
Due to its strategic location, Pakistan is an important key player in international energy routes and is continuously investing its resources in the establishment of industrial zones and sectors. Towards this end, the Gwadar Port and China-Pakistan Economic Corridor (CPEC) are critical to international trade. 1 Once completed; the Belt and Road Initiative project would be a massive industrial advancement, covering approximately two-thirds of the land mass in 65 countries. The major important segments in this project are the Bangladesh-China-India-Myanmar Economic Corridor, China-Mongolia-Russia Economic Corridor, China-Indochina Peninsula Economic Corridor, China-Central and Asia-West Asia Economic Corridor and the New Eurasian Land Bridge. 2 The land routes consist of high speed railways, highways, ports and industrial zones with a total length of 60,000 km. The result will be extensive trade and transportation of goods across the globe. The CPEC will offer a shortened route of 3,000 km compared to the existing route of 12,000 km for the oil market between the Middle East and Chinese border. The major transportation item on the CPEC is oil from the Middle Eastern Peninsula to Chinese territory for energy production.
The transportation of oil involves travel through pipelines, rail and road tankers. The transportation of liquid flammable material is labeled as Class 3 hazardous material (HAZMAT).The accidental release of these materials may have catastrophic effects for surrounding populations; the most significant effects are mortality, morbidity, environmental damage, and financial loss. Acute and immediate health effects with physical symptoms can occur during clean-up work or residential exposure and differ according to the type of material involved, for example ammonia versus hydrogen sulphide, etc. With increased transportation and handling of Class 3 HAZMAT come increasing challenges to the safe performance of these operations, as the incidence of Class 3 HAZMAT accidents is very high compared to all classes of HAZMAT. 3 Analysis of previous accidents reveals that two-thirds of HAZMAT accidents occur on roads. 4 In the United States, about 54% of HAZMAT is transported via trucks and the majority is Class 3 HAZMAT (78%). 5 Presently, 80% of Chinese import oil is shipped through the Strait of Malacca and the current shipping time is more than 45 days.

Emerging Issue Review
Following the commissioning of the CPEC, bulk quantities will be shipped through the CPEC and shipping time will be shortened to 10 days.
Extensive studies have been undertaken and various models proposed to address the issue of safe transportation of HAZMAT. 6,7 The major underlying factors which significantly contribute to HAZMAT accidents and spillage have been identified as lack of awareness, non-adherence to safety rules, poor accident reporting mechanisms and poor licensing procedures. 8,9 Human factors such as driver skill and awareness are major factors in these accidents, followed by vehicles, equipment and HAZMAT packaging. 10 Inexperienced drivers in the HAZMAT transportation industry are a significant problem, leading to road accidents and improper emergency responses due to driver error. 10,11 Driver performance is usually dependent on age, physical condition, expertise and experience. 12 Fatigue is also considered to be a contributing factor in accidents. 13 A previous study in Africa outlined some important measures to mitigate and prevent these incidents, including provision of standard driving hours with compulsory breaks, availability of intermediate stations for rest and food, and the availability of a HAZMAT emergency response team to initiate a timely response in case of accidents. 14 Unfortunately, in Pakistan, working conditions for drivers are not conducive to occupational safety. For instance, drivers do not have proper rest cycles. They often experience extended periods of driving with no replacement/standby driver, which is a major factor in driver fatigue. Often the driving duties are shared with an assistant who is new to driving and usually gets training while on the road, an illegal and unsafe practice.
The environmental consequences of HAZMAT accidents include air pollution, followed by water, soil and biological degradation. 11 In proposed HAZMAT models, population exposure to HAZMAT accidents is considered to be less significant compared to environmental pollution. 14 However, there have been disasters involving HAZMAT accidents which have resulted in the deaths of hundreds of people.
A tragic incident resulting in the death of more than 200 people in Ahmedpur East, Pakistan has called into question the effectiveness of the HAZMAT transportation safety system and follow-up management of HAZMAT incidents. 15 Pakistan does not have a national level survey regarding HAZMAT accidents; therefore the present study uses anecdotal evidence regarding the poor state of HAZMAT transportation. Many incidents have been reported in the media, both electronic and print, highlighting the issue. For example, 33 people died in a collision between an oil tanker and a bus in 2011 in Jamshoro, Pakistan; in two separate incidents, 40,000 L of oil was spilled as tankers overturned in 2018, in both cases the cause of accident was attributed to the drivers. 16- 18 In another incident, more than sixty people died through a combination of impact, and fire sparked by the HAZMAT, attributed to negligence of the HAZMAT truck driver. 19 These incidents shed light on the poor state of HAZMAT transportation in Pakistan; in the majority of the cases the driver is blamed. In addition, the literature review highlighted several HAZMAT incidents and accidents which resulted in loss of life, property damage and environmental contamination. 3,11 Similar needs in terms of driving safety, communication and handling of hazardous materials are anticipated for other countries in the region, for example Vietnam, Indonesia, India and Sri Lanka. 5 To prevent on-road HAZMAT accidents and mitigate the effects of HAZMAT release, the role of truck drivers and emergency responders is extremely critical. The role of emergency first responders is normally filled bypolice, firefighters, emergency medical nurses and HAZMAT specialists. 20 Extensive role-specific training programs are essential to the development of emergency responders to mitigate the impact of HAZMAT occurrence. 20 The degree of HAZMAT preparedness varies among various professional groups, however previous studies revealed that HAZMAT teams have a better response compared to firefighters and police. 21, 22 In the United States, police cadets are trained on HAZMAT-related issues in the police academy, and law enforcement personnel are trained to handled HAZMAT incidents. 23, 24 The necessary competencies identified for firefighters include the ability to conduct risk assessments, perform cardiopulmonary resuscitation and handle relevant equipment. Some emergency medical staff are been The fourth and most important professional group is the HAZMAT response team. A HAZMAT response team is a group of hazardous material experts who specialize in detecting, containing, and removing any release of HAZMATs in order to control an accident or incident. 28,29 Researchers recommend further studies to determine the role and responsibilities of response teams. 30 The positioning and timing of response teams at the incident site is a key factor in effective responses. 31 However, many studies have overlooked the very first response initiated by the HAZMAT driver and crew members. In the second meeting, a response video on HAZMAT transportation accidents was presented to the group members to provide information on the theme. Afterwards, each member gave a presentation on five competencies along with their justifications. The recommended competencies were compiled.
In the third meeting, the group members were divided into subunits comprised of two members in each unit and the compiled list of competencies was distributed among the subunits for discussion

Table 2 -Core and Sub-Competencies of HAZMAT Drivers Responding to Emergency Situations
Emerging Issue Review and alteration, recommendation, and approval of competencies. After thorough deliberation and discussion, only the approved competencies and sub-competencies from all subunits were included in the final list of competencies. A thematic analysis of the collected data (the list of compiled competencies and recorded observations) was performed to obtain results for core and sub-competencies.

Results
A total of six core and 23 subcompetencies were identified as a result of the thematic analysis. The detailed description of core and subcompetencies is provided in Table 2. To mitigate further loss in case of an accident, knowledge of boiling liquid expanding vapor explosions and spill control techniques are considered essential. Boiling liquid expanding vapor explosions are caused by the rupture of a container containing a pressurized liquid/liquefied gas when exposed to heat. This is directly related to the knowledge of HAZMAT types and properties. Awareness of and proficiency with firefighting techniques and equipment were identified as helpful in the mitigation phase.

Discussion
Preparedness actions include awareness of emergency response plans, participation in emergency rehearsals, availability and knowledge of the proper use of personal protection equipment (PPE), medical equipment and spillage control equipment as outlined in an emergency response plan. The availability and use of appropriate PPE are key to an effective response. 37 Face masks with designated respirators are also needed. 38,39 Preparedness actions also include awareness and knowledge of partner emergency services such as 1 122 and other emergency contact numbers. Response actions include awareness of accident reporting mechanisms, ability to use the fastest available means of communication, liaise with emergency services and incident command, act promptly wearing PPE and controlling the spill or leakage, and ability to operate firefighting equipment if required. The final key competency is the ability to help in cordoning off the area to protect people and assets.

Limitations
The first major limitation of the present study was that the research was conducted in a setting with limited industrial activities compared to more developed nations. Secondly, qualitative methods were used with a small sample size; a mixed method could yield more detailed data. The third major limitation of study is that it was conducted in the same geographic area; the diversity of Belt and Road Initiative project demands that further studies be conducted at different geographic locations to standardize the set of competencies. Finally, the identified competencies were not tested in real time emergency situations.

Conclusions
The purpose of the present study was to explore and identify core and sub-competencies of HAZMAT truck drivers dealing with emergencies in Pakistan and other LMIC. As