Dry versus wet decontamination in disaster medicine: a focused review

Background: A key component of disaster preparedness and response is efficient decontamination, especially in situations involving mass casualties and chemical, biological, radiological, and nuclear (CBRN) threats. Although wet decontamination has long been the norm, dry decontamination is becoming more and more acknowledged as a quick, scalable, and practical substitute, particularly in environments with limited resources. Objective: To review the current evidence comparing wet and dry decontamination methods in the context of disaster medicine, with an emphasis on operational advantages, limitations, and implications for Saudi Arabia. Methods: Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria, a systematic literature review was carried out from January to March 2025 using PubMed and Google Scholar. Peer-reviewed research on wet or dry decontamination in mass casualty or CBRN settings that was published between 2010 and 2025 was the main focus of the inclusion criteria. There were 28 studies in all. Results: The effectiveness and practical benefits of dry decontamination in outdoor settings are supported by the review. Research highlighted the method's quick deployment, low infrastructure requirements, and early application efficacy. In hospital settings or for specific chemical exposures, wet decontamination is still crucial, especially when utilized as part of a sequential strategy after dry decontamination. Saudi Arabia-specific studies found significant deficiencies in protocol creation, training, and readiness. Conclusion: An efficient, flexible, and forward-thinking method of mass casualty response is dry decontamination, especially in arid and resource-constrained areas like Saudi Arabia. To improve catastrophe and CBRN preparedness, dry decontamination procedures, training, and policy alignment must be integrated nationally.