Chemical Terrorism

Frederick R. Sidell, M.D.

 

I. Introduction

Terrorism in general will be discussed and the Tokyo subway incident in which the nerve agent sarin was used will be reviewed.

Advantages and disadvantages of chemicals as terrorist weapons will be briefly mentioned. The military chemical warfare agents along with other potential toxic chemicals that could be used for this purpose will be listed.

A detailed discussion of the military chemical agents and their effects, and management of casualties from these agents will be presented.

An overview of the response to an agent incident will be described.

II. a. Recognize the potential use of a chemical as a terrorist weapon.

b. Recognize potential chemicals that might be used by terrorists.

c. Describe the effects of the chemical warfare agents.

d. Describe the medical management of casualties from chemical warfare agents.

e. Describe the overall response to a chemical attack by terrorists.

III.. Five years ago last month terrorism used a new weapon for the first for the fist time: a chemical warfare agent. The release of the nerve agent sarin (GB) in a Tokyo subway by a religious cult killed 12 people and injured about 1100 more. About 5510 people overwhelmed medical facilities.

Chemicals are very available and even chemical warfare agents are not difficult to manufacture. Fortunately they have not been used on a large scale since the incident in Tokyo. However, the potential for use is present and medical personnel must be aware of them and prepared to deal with casualties from them.

IV. Health care providers do not want to think about a chemical attack on a large population. However, as it is often stated "it is not a question of whether if such an event will happen, but it seems to be where and when such an event will happen." Health care providers must be prepared for such an event. The best preparation is in adequate education and training.

V. References

Sidell, F.R. What to do in Case of an Unthinkable Chemical Warfare Attack or Accident. Postgrad. Med. 88:70-84 (1990)

Sidell, F. R. Management of Chemical Warfare Agent Casualties. A Handbook for Emergency Medical Services. HB Publishing. Bel Air, MD. 1995

Urbanetti, J. S., Sidell, F. R. Chemical Exposure. Pg. 48-53. In Principles and practice of medical intensive care. R. W. Carlson and M. A. Geheb, Ed. W. B. Saunders. Philadelphia, PA. 1993

Sidell, F. R. Civil Emergencies Involving Chemical Warfare Agents: Medical Considerations. In Chemical Warfare Agents. S. Somani, Ed. Pg. 341-356. Academic Press, Inc. San Diego, Calif. 1992

Sidell, F. R., Hurst, C. G. Clinical Considerations in Mustard Poisoning. Pg. 52-66. In Chemical Warfare Agents. S. Somani, Ed. Academic Press, Inc. San Diego, Calif. 1992

Sidell, F. R. Clinical Considerations in Nerve Agent Intoxication. Pg. 156-194. In Chemical Warfare Agents. S. Somani, Ed. Academic Press, Inc. San Diego, Calif. 1992