Table 1.
Peer-reviewed and grey literature on CBRN health emergency preparedness in Lebanon
| Title | Location (year of publication) | Aim of study | Methodology | Key Findings | Limitations | Health System Domain/s Addressed |
|---|---|---|---|---|---|---|
| Hospital CBRN preparedness in Lebanon: a modified Delphi-based assessment tool | Lebanon (2026) | Develop a specialized assessment tool for Lebanese hospital CBRN preparedness. | A modified Delphi study to develop a context based CBRN preparedness assessment tool | The tool emphasizes key categories for CBRN preparedness, introducing elements such as specialized response teams, comprehensive pharmaceutical management, and intensive training drills. Highlights the importance of gender-sensitive considerations in Lebanon, particularly regarding the application of decontamination protocols. |
The reliance on a localized panel of Lebanese experts potentially limits the incorporation of global best practices. This tool is tailored specifically to Lebanon’s institutional and cultural environment. The lack of field validation. |
Hospitals |
| Assessment of the Preparedness Level for Chemical, Biological, Radiological, Nuclear, and Explosive Risks in Emergency Departments in Lebanon: A Cross-Sectional Survey. | Lebanon (2026) | Assess ED staff level of preparedness for CBRNe hazards two years post-Beirut blast. | Descriptive cross-sectional survey | The study reveals a critical lack of CBRNe preparedness within Lebanese ED. |
Reliance on self-reported survey data. Low institutional response rate limits the generalizability of the findings. The survey tool is adapted from European models. |
Coordination; Material Resources; Human Resources; Hospitals |
| A closer look at the international health regulations capacities in Lebanon: a mixed method study. | Lebanon (2024) | Evaluate Lebanon’s IHR capacities, challenges, and refugee crisis impact. | Mixed-methods review of IHR data and semi-structured interviews. | Lebanon outperformed neighbouring countries and established CBRN and HAZMAT teamsLebanon suffers from significant vulnerabilities (resource shortage, governance challenges) The refugee crisis strained the health system and simultaneously triggered international funding |
Incomplete milestone data. Small interview sample size (n = 9). The potential masking of specific weaknesses caused by equal indicator weighting |
International Frameworks; National Bodies, Strategies and Regulations; Coordination; EWARS and Information Management; Material Resources; Human Resources; Hospitals |
| ARZ 2021 CBRN Field Exercise - Organisation and Implementation of a CBRN Counter-Terrorism Field Exercise: A Guiding Document | Lebanon (2021) | Provide a framework for organizing and assessing national CBRN counter-terrorism drills. | Guidance manual | Provided structured frameworks for objectives, scenarios, and evaluation metrics for national drills. | N/A | International Frameworks; National Bodies, Strategies and Regulations; Coordination; Pre-Hospital EMS |
| ARZ 2025 CBRN Field Exercise: A field exercise to counter CBRN terrorism | Lebanon (2025) | Outline the purpose, design, and objectives of the ARZ 2025 exercise. | Concept note | Describes objectives, structure, and expected outputs. No post exercise results reported. | N/A | International Frameworks; National Bodies, Strategies and Regulations; Material Resources; Human Resources |
| National Report related to the Convention of Nuclear Safety March 2023 Member State: LEBANON | Lebanon (2023) | Report on Lebanon’s implementation of Convention on Nuclear Safety (CNS). | National report |
Lebanon maintains a strictly peaceful application of radiation sources, primarily in medicine, agriculture, and research, with no nuclear power installations or fuel storage on its territory. The country has established a robust regulatory framework led by the Lebanese Atomic Energy Commission (LAEC), which manages a comprehensive national register of radiation sources and performs regular inspections |
N/A | International Frameworks; National Bodies, Strategies and Regulations; Human Resources; Pre-Hospital EMS; Hospitals |
| Public Health Emergency Operations Center Handbook | Lebanon (2023) | Establish guidance for operating a Public Health Emergency Operations Centre. | Technical manual outlining SOPs, organizational structures, and activation protocols. | Details the structured coordination system for health crises, emphasizing evidence-based response. | N/A | National Bodies, Strategies and Regulations; Coordination; EWARS and Information Management; Pre-Hospital EMS |
| Multi-Hazard Scenario Planning: Ensuring Effective Response in Complex Disasters and Crises | Lebanon (2022) | Showcase multi-hazard preparedness during overlapping crises. | Descriptive case study. | The Lebanese Red Cross (LRC) demonstrated that proactive contingency planning and long-term institutional trust were essential in responding to the 2020 Beirut explosion, even as it coincided with a pandemic and economic instability. It also highlights the LRC’s ability supported by a specialized CBRN unit and mobilization of volunteers | N/A | National Bodies, Strategies and Regulations; Material Resources; Human Resources; Pre-Hospital EMS; Hospitals |
| Case Study: Chemical Explosion Beirut Port: Technological and Biological (CBRN) Hazards | Lebanon (2020) | Document the (LRC) response to the catastrophic chemical explosion at the Beirut Port on August 4, 2020. | Descriptive case study. | Identified the blast as a large-scale chemical incident; highlighted gaps in specialized CBRN response. | N/A | National Bodies, Strategies and Regulations; Material Resources; Human Resources; Pre-Hospital EMS |
| SPAR 2024 Report | Lebanon (2025) | Assess Lebanon’s IHR core capacities. | Annual self-assessment using WHO SPAR tool. | The country capacity score was reported as 70 and is ‘approved’ as an IHR status. | N/A | International Frameworks; Coordination; EWARS and Information Management; Material Resources; Human Resources |