Deliberate chemical releases

The release of the nerve gas sarin by the Aum Shinrikyo cult in Matsumoto and Tokyo - in June 1994 and March 1995, respectively (see Chapter 13) - alerted the world to the very real chemical threat from terrorist groups. The determination and sophistication of subsequent terrorist attacks, the access such groups seem to have to the necessary funds, expertise and materials and their avowed intent to cause mass casualties and fatalities all emphasise that the possibility of a deliberate chemical release in a civilian setting can no longer be ignored. 

Victims of chemical contamination need prompt and effective treatment, both at the scene of the incident and in hospital. Ambulance or emergency medical services and hospital emergency rooms provide the front line health response and most will already have tried and tested contingency arrangements for accidental chemical releases - often referred to as HAZMAT or HAZCHEM (hazardous materials and hazardous chemicals) protocols. Whether for an accidental or deliberate chemical release contingency arrangements need to address the following key objectives ... 

Unless some pre-warning is given, an emergency call to a deliberate chemical release is unlikely... 

Following the Japanese nerve agent releases, substantial numbers of casualties presented to hospital over a short time period, which stretched the resources available. Hence, each country and every hospital should now have a major accident plan that covers deliberate chemical releases, including nerve agents. This plan should be tested at least annually. It should include arrangements to triage substantial numbers of non-poisoned casualties, as well as those who are severely poisoned and require urgent treatment and admission. 

In the civil setting, the deliberate release of chemicals has also occurred. The series of deliberate chemical releases in Japan in the 1990s, most notably the sarin attacks in Matsumoto in 1994 and on the Tokyo subway network in 1995, showed that even relatively small terrorist groups have the capabiUly to produce and deploy chemical weapons. In addition, the targeting of a road chlorine tanker in Iraq in 2006 by terrorists has emphasised that improvised explosive devices may be used by terrorists to disseminate toxic agents explosively and thus create casualties with both physical and toxic traimia. 

The initial medical management of a suspected accidental chemical incident or deliberate chemical release should be carried out by the following generic principles ... 

Terrorist threat heightens the risk presented by facilities that still have large vulnerability zones. However, the RMP program does not currently address the potential for a deliberate terrorist release of chemicals. Federal law does not require companies to assess readily available alternative chemicals and processes that pose fewer dangers. 

Indirect toxic trauma arises from the ingestion of contaminated food as in mass food poisoning. Many bacterial toxins act through this route. In deliberate chemical agent release, there is also a risk of ingestion of an aerosolised toxin such as botulinum toxin. 

Large-scale chemical releases are rare events around the world. Thus, direct emergency medical experience of dealing with toxic trauma is relatively limited compared with physical trauma, which occurs on a daily basis. However, the risk of both accidental and deliberate toxic releases is growing and emergency medical teams must plan, prepare and train for such events. To do this, the following are required ... 

It is very likely that deliberate or accidental chemical release incidents will be followed by an investigation. It is therefore very important that clinical records are comprehensive, contemporary and legible. Information records can be useful to ensure documentation of all actions taken and advice given or received regarding the management of the incident. An example of this is shown in Figure 4.3. 

Recognition of the features of a deliberate chemical agent release... 

The major release mechanism for many chemicals, however, is associated with use of the chemical or of chemical-containing products. Primary uses include combustion of fuels, industrial uses, commercial uses, household and other consumer uses, deliberate applications in the environment (for example,... 

Chemicals in this class include agricultural and industrial chemicals that are readily available and possess appropriate chemical and toxicological properties to create a mass impact if deliberately released. These materials were selected by the Federal Bureau of Investigation (FBI), Centers for Disease Control and Prevention (CDC), and Department of Defense. 

Another effect, "surface contamination", must also be taken into account This may arise from residual gas and small leaks in the vacuum system, but a further possible source should not be overlooked, namely the following Polymers are capable of entrapping appreciable amounts of gas in their free volume, and these molecules are released under the effect of vacuum and of particle bombardment. In the present experiments the polymers were deliberately not degassed before plasma treatment, as such a pretreatment would not likely be economical in an industrial plasma process. The released molecules, primarily air and water vapor, evidently can participate chemically during plasma treatment by intermixing with the feed gas molecules. 

The terrorist CW threat differs fundamentally from the military CW threats of the past. Essentially, it is driven by accessibility of the material. On the one hand, there has to be concern about the security of existing CW stockpiles. But it is equally important to ensure that terrorist organizations cannot get access to relevant precursor materials or toxic industrial chemicals to produce their own make-shift chemical weapons. A related concern is the presence of toxic industrial chemicals in manufacturing, storage and transport, and the danger of deliberate releases of these chemicals by attacks with conventional explosives. 

Environmental emergencies involving the release, or threatened release, of oil, radioactive materials, or hazardous chemicals potentially may affect communities and the surrounding environment. Releases may be accidental, as in the case of a spill at a chemical plant, or may be deliberate. Releases may also be caused by natural disasters. Environmental emergencies may progress to become disasters. 

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