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Chemical Terrorism:Awareness
Chemicals as Weapons
• Historical attempts to poison enemy food supplies
• Scientific advances increase mass casualty potential
• Technical advancements• New delivery methods
National Institute for Occupational Safety and Health Image
Chemical Weapons on the Battlefield
• World War I use• Chlorine and mustard agent
• World War II developments:• Tabun, Sarin, and Soman by Germany• VX by Great Britain • Rocket delivery • Worldwide outcry for chemical weapon
treaties
• 1980’s: reports of seizures of chemical stockpiles and arrests of individuals in possession of CW• Covenant, Sword, and Arm of the Lord
group• Various Palestinian groups
Growing Threat of Chemical Terrorism
• 1990’s: Increasing use
• Iraq’s chemical weapons use:• Against Iranian Soldiers• Against own Kurdish population
• Aum Shinrikyo sarin attacks in Tokyo
Growing Threat of Chemical Terrorism
CW: The Terrorist Risk
• Five levels of risk for terrorist use• Threatened use, with no real capability• Unsuccessful attempts to acquire CW• Actual possession of CW• Unsuccessful attempts to use CW• The successful use of CW
CW: The Terrorist Risk
• Why haven’t we seen more use by terrorists?• Groups seeking political legitimacy may
fear severe backlash• Bombs provide greater shock value and
carnage for media coverage• Most likely reason: Uncertainty
CW: Advantages
• Advantages• Inexpensive• Easy availability• Long “shelf life”• High level of control and containment• Effect (death or disability) is immediate• Destroys infrastructure• Low risk of detection• Lack of a “signature” allows anonymity
CW: Agents
• The military defines five types of agents• Nerve Agents
• Sarin, Soman, Tabun and VX (organophosphates)
• Blister Agents• Mustard, Lewisite
• “Blood” (Cyanide) Agents• “Choking” Agents
• Chloride, Phosgene• Incapacitating Agents
• Tear Gas, Pepper Spray,
Commercial Chemicals can also be used as weapons
The FBI has a list of industrial chemicals that terrorists might use called the “Critical Agent
List”
• Ammonia• Arsine• Chlorine• Cyanides• Hydrogen Sulfide
• Methyl Isocyanate• Phosgene• Phosphine• Sulfur Dioxide• Fluorine
CW: Availability
• Nerve Agents are a chemical of choice• Formula and chemical process
declassified information• Easy to manufacture from readily
available components
• For sale on the “black market”
CW: Availability
• Commercially available pesticides easily purchased or stolen
• Military and Law Enforcement agents may be stolen under the lax security
• State Sponsorship of terrorist groups: provision of labs & production facilities
CW: Toxicity
• Falls between conventional weapons and biological or nuclear weapons
• Environmental conditions are key factor
• Goal of the terrorist • Harassment vs. death
• Determines type of agent used
CW: Toxicity
• Quantity required to produce heavy casualties within square-mile area under idealized conditions
Nerve Agents
• Are organophosphate chemicals• Many commercial pesticides are very similar in
composition• Attack the body’s ability to send messages to
the muscles• Can be lethal in small quantities• Are dangerous if inhaled or through skin
contact
Blister Agents
• Military agents designed to cause casualties by destroying the victim’s skin
• Dangerous through inhalation and skin contact• Often have symptoms that can be delayed up
to 48 hours
“Blood” Agentsand Commercial Cyanide
Compounds
• Rapidly acting chemicals that effect a body’s ability to utilize oxygen within its cells.
• Highly toxic• Many hundreds of thousands of tons of
cyanides and cyanates are produced commercially every year
• Generally most dangerous through inhalation
“Choking” Agents and Civilian Chemicals
• Chlorine was the first chemical weapon used • Chlorine is utilized in almost every community
within the United States• Millions of tons of these materials are
manufactured and transported commercially every year
• Toxic through inhalation and irritating through skin contact
Incapacitating Chemicals
• These are chemicals designed to produce non-lethal effects in victims
• They can cause mass casualty events through panic
• The nightclub event in Chicago caused over two dozen fatalities due to panic causing a stampede with dozens of club patrons being trampled and crushed.
Other Commercial Chemicals
• Produced in huge quantities throughout the United States
• Often transported in bulk in railway cars and barges
• Offer tempting targets for terrorists• A relatively small explosive charge could
rupture a huge bulk transportation or storage container and produce a huge vapor cloud
• Depending upon product the effects may vary
CW: Delivery
• Environmental conditions • Outdoor attacks vs. indoor attacks• Dissemination problems increase
logarithmically with increasing target size
CW: Delivery
• Municipal water systems attacks• 4 billion gallon reservoir, community of
20,000, and each person consuming 16 oz of water • Requires over 14 billion lethal doses to
deliver one dose per person
• Fluoroacetates • Requires 600 metric tons to achieve lethal
dose
CW: Delivery
• Delivery by terrorists• Covert contamination of selected foods
and beverages • Covert generation of volatile agent in
enclosed space • Covert dissemination of non-volatile
agent in enclosed space • Overt attack using “bursting” munitions or
thermogenerators
CW: Defense
• Increasing defensive capabilities
• Deny terrorists access to weapons and chemicals needed for production
Los Alamos National Laboratory Image
Your Role
• In the event of a mass casualty incident involving chemicals, either an accidental release or a terrorist attack everyone will be essential to successful response
• As a member of the healthcare team what will your role be in the event of a chemical emergency?
Know the Plan
• Be familiar with your facility’s emergency response plan
• Know what your job will be
• Know who to report to
• Be prepared to be flexible
Do not pass rumors
• Listen to the information provided through official sources
• Do not pass on rumors or hearsay
• If you have questions ask your supervisors
• If patients have questions seek correct information, even if it takes longer to get
Additional Training
• Many jobs will require additional training
• If your tasks during an emergency require direct patient care you will receive additional training on signs and symptoms of the various agents and on how to treat them
• If you might be exposed to agents you will be trained in the proper use of Personal Protective equipment
Summary
• Terrorist organizations have used chemical agents in the past and are seeking to gain them for use in the future
• The ability of the healthcare system in the United States to function in the event of a mass casualty event involving chemicals depends upon the everyone
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