Chemical Terrorism: Awareness

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Chemical TerrorismAwareness
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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
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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

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Growing Threat of Chemical Terrorism

• 1980s 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

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Growing Threat of Chemical Terrorism

• 1990s Increasing use
• Iraqs chemical weapons use
• Against Iranian Soldiers
• Against own Kurdish population
• Aum Shinrikyo sarin attacks in Tokyo

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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

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CW The Terrorist Risk

• Why havent 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

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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

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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,

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Commercial Chemicals can also be used as
weaponsThe 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

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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

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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

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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

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CW Toxicity

• Quantity required to produce heavy casualties
  within square-mile area under idealized
  conditions

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Nerve Agents

• Are organophosphate chemicals
• Many commercial pesticides are very similar in
  composition
• Attack the bodys ability to send messages to the
  muscles
• Can be lethal in small quantities
• Are dangerous if inhaled or through skin contact

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Blister Agents

• Military agents designed to cause casualties by
  destroying the victims skin
• Dangerous through inhalation and skin contact
• Often have symptoms that can be delayed up to 48
  hours

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Blood Agentsand Commercial Cyanide Compounds

• Rapidly acting chemicals that effect a bodys
  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

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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

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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.

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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

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CW Delivery

• Environmental conditions
• Outdoor attacks vs. indoor attacks
• Dissemination problems increase logarithmically
  with increasing target size

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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

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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

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CW Defense

• Increasing defensive capabilities
• Deny terrorists access to weapons and chemicals
  needed for production

Los Alamos National Laboratory Image
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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?

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Know the Plan

• Be familiar with your facilitys emergency
  response plan
• Know what your job will be
• Know who to report to
• Be prepared to be flexible

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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

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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

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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