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