A new report by a disaster-planning expert confirms what others have said: In the event of many biological or chemical attacks, removal of victims' clothing is one of the most important and effective means of decontamination.
"You hold them, you strip them and you wash them," said Henry Siegelson, report author and clinical assistant professor of emergency medicine at Emory University in Atlanta.
But the reluctance of modest victims to strip naked in front of co-workers or strangers "has been one of the issues that has prevented us from moving forward and developing a scheme to manage mass casualties," he said. "Some people would rather be dead than strip in public."
The situation has occurred several times. On Christmas Eve 1998, an anthrax threat forced more than 200 at a Mervyn's store in Palm Desert, Calif., to disrobe and be hosed down in a makeshift tent in the parking lot.
"We tried to give people as much privacy as possible," said Wayde York, emergency-services coordinator for the Riverside County Fire Department.
Another anthrax decontamination in October 2001 left 24 employees of the Fifth Third Bank of Naples, Fla., wet and clad only in plastic tarps.
Michelle Balon, marketing director, said she finally ran to a store to purchase "shorts, T-shirts, anything we could get our hands on."
Both were false alarms.
But those "strip and hose down" decontamination procedures are necessary, said Siegelson, who helped create the Section of Disaster Medicine for the American College of Emergency Physicians.
"The mere removal of clothing removes the vast majority of the contaminant, then the victims can safely enter a bus or ambulance or car for transportation to a hospital," he said.
Modesty about public nudity has emergency responders rethinking procedures.
York said Riverside County now has portable showering facilities with a private changing area. "And we are not doing mass decontamination without more evidence," he said.
But Judi Ditzler said she's "just kind of floored" that this nudity would be a problem.
"It's terribly sad if that's the situation, that people would rather die than be seen without their clothes on," said Ditzler, editor of Nude and Natural, the magazine of the Naturist Society, a 27,000-member, Oshkosh, Wis.-based nudist organization.