Chemical Agents of Opportunity for Terrorism: TICs & TIMs

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Chemical Agents of Opportunity for Terrorism Training Support Package Participant Guide Module Three Toxic Industrial Gases as Terrorist Threats - Administration Page Chemical compounds are produced in massive quantities as part of America's industrial complex. Many of these compounds are amenable to use as large scale terrorist weapons. These chemicals are produced, transported, and stored in communities across our nation and are easily accessible by all. These chemicals pose a significant health risk to individuals and populations should they be released either intentionally or accidentally. Exposure to toxic gases will create serious health implication for victims. Many of these irritive gases, such as chlorine, phosgene, and ammonia, exert their effects by the production of corrosive agents, such as hydrochloric acid and ammonium hydroxide. Other agents, such as hydrofluoric acid, also produce systemic effects. Individual characteristics of each gas will determine its toxicity and health effects. Quick response and appropriate clinical management will be critical to reducing morbidity and mortality. Prevention includes methods to decrease the likelihood of exposure and mitigation efforts will be important. Current legislation under the community right to know act mandates disclosure of the presence of toxic chemicals within communities. Duration 45 minutes Scope Statement This module will address a number of chemicals, such as phosgene, chlorine, and anhydrous ammonia, which might be disseminated as inhalational threats. Historical examples of the release of these gases and their impact on the community will be reviewed. Their pathophysiology, treatment, and potential sources in the community and in the transportation system will be discussed. Terminal Learning Objective (TLO) • Understand the threat posed by toxic industrial gases and the recognition, assessment and management of exposed patients. Enabling Learning Objectives (ELO) Resources • Review the history of industrial gas exposures and regulatory response • Identify major compounds of interest • Understand the varying clinical picture created by the gases, based on their physical properties and toxicity • Address methods to decrease likelihood of exposure and illness Each of the eight course modules is deployed as an interactive, instructor-lead, MS PowerPoint presentation containing didactic content, historical examples, and selected case studies. All presentations are included in a printed participant guide (PG) containing the modules’ overview, December 2008 Version 2.0 Page 120
Chemical Agents of Opportunity for Terrorism Training Support Package Participant Guide scope statement, terminal and enabling learning objectives, PowerPoint slide handouts, and a summary section. Instructor to Participant Ratio 1:8 (minimum) to 1:25 (maximum) Reference List 1. AEGL List of Chemicals: http://earth1.epa.gov/oppt/aegl/pubs/chemlist.htm 2. ATSDR ToxFAQs (choose by chemical): http://www.atsdr.cdc.gov/toxfaq.html 3. ATSDR Medical Management Guidelines: http://www.atsdr.cdc.gov/MHMI/mmg.html#bookmark03 4. Bardana EJ Jr. Reactive airways dysfunction syndrome (RADS): guidelines for diagnosis and treatment and insight into likely prognosis. Ann Allergy, Asthma, Immunol 1999; 83(6 Pt 2):583-586. 5. Belke JC. Chemical accident risks in U.S. industry -A preliminary analysis of accident risk data from U.S. hazardous chemical facilities. Last accessed Dec 2008 from: http://www.epa.gov/ceppo/pubs/stockholmpaper.pdf 6. Bosse GM. Nebulized sodium bicarbonate in the treatment of chlorine gas inhalation. J Tox Clin Tox 1994;32(3):233-241. 7. BP Facilities Lead Nation in Chemical and Refinery Accidents Since 1990, Despite Industry-Touted Safety Measures” (Report by Texas Public Interest Research Group on HF Release). Last accessed Dec 2008 from: http://www.commondreams.org/news2005/0324-09.htm 8. CDC. Public Health Consequences from Hazardous Substances Acutely Released During Rail Transit ---South Carolina, 2005; Selected States, 1999-2004. MMWR 54(3):64-67. Last accessed Dec 2008 from: http://iier.isciii.es/mmwr/preview/mmwrhtml/mm5403a2.htm 9. Chemical Safety and Hazard Investigation Board (listing of chemical company events and investigations): http://www.chemsafety.gov/ 10. Chin S-M, Hwang H-L, Peterson BE. “A Tool for Railroad Hazmat Routing Under Shipment Bans In Major Cities” [PowerPoint presentation from Oak Ridge Laboratory at Transportation Research Board 85th Annual Meeting, 2006]. Last accessed Dec 2008 from: http://projects.battelle.org/trbhazmat/Presentations/TRB2006-LH.ppt 11. Dhara VR, Dhara R. The Union Carbide disaster in Bhopal: a review of health effects. Arch Environ Health 2002;57:391-404. 12. EPA’s Acute Exposure Guideline Levels (AEGL) Definitions: http://earth1.epa.gov/oppt/aegl/pubs/define.htm 13. EPA’s High Production Volume Information System (characterizing chemicals produced or imported at > 1 million pounds): http://www.epa.gov/hpvis/ December 2008 Version 2.0 Page 121
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