Chemical Agents of Opportunity for Terrorism: TICs & TIMs

More documents

Recommendations

Info

Chemical Agents of Opportunity for Terrorism Training Support Package Participant Guide Module Six Terrorism through Fear & Uncertainty: Delayed Toxic Syndromes - Administration Page Exposure to some chemicals is characterized by a delayed onset of toxicity which may make them attractive for use as a covert weapon. This delay of onset of symptoms complicates the epidemiology of the event, making detection and identification of the chemical (figuring out the cause of the problem and source), response and clinical management significantly more difficult. More people may be exposed to delayed-onset toxins and the individual’s dose may be larger, given the relative absence of warning properties to indicate exposure. In acute-onset toxins, most people will escape when they realize that others around them are developing symptoms. If however, no one is becoming ill, no one realizes they are being poisoned…and thus, no one takes the necessary measures to limit exposure. Chemical agents with a delayed onset can be organized and separated based on route/scenario of exposure. Some are airborne (phosgene), food and waterborne (thallium, organomercurials, radionuclides/radioactive metals), and environmental/biopersistent agents (dioxin, PCBs). Treatment depends on rapid identification and intervention and strategies will vary based on the class of chemical agent used. Duration 45 minutes Scope Statement This module will introduce industrial chemical toxins which, due to their delayed onset of symptoms, may make them likely to be used as a covert weapon by terrorists. A framework is provided for organizing and separating these chemical agents based on their route of delivery and likely scenarios of exposure, as well as relevant toxidromes. Terminal Learning Objective (TLO) • Understand the unique threat posed by exposure to chemicals which are manifested by delayed onset of symptoms. Enabling Learning Objectives (ELO) Resources • Recognize that exposure to some chemical agents does not result in the immediate onset of symptoms. • Describe the major chemical agents that may cause delayed toxic syndromes. • Differentiate between clinical presentations of various delayed-onset syndromes from these chemicals. 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 December 2008 Version 2.0 Page 304
Chemical Agents of Opportunity for Terrorism Training Support Package Participant Guide presentations are included in a printed participant guide (PG) containing the modules’ overview, 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. Amin-Zaki L, Elhassani S, Majeed MA, et al. Intra-uterine methylmercury poisoning in Iraq. Pediatrics 1974;54(5):587-595. 2. Agency for Toxic Substances and Disease Registry. Medical Management Guideline for Mercury. Accessed Dec 2008 from: http://www.atsdr.cdc.gov/MHMI/mmg46.html 3. Agency for Toxic Substances and Disease Registry. ToxFAQs for Thallium. Accessed Dec 2008 from: http://www.atsdr.cdc.gov/tfacts54.html 4. Bakir F, Damluji SF, Amin-Zaki L, et al. Methylmercury poisoning in Iraq. Science 1973;181(96):230-241. 5. Bertazzi PA, Bernucci I, Brambilla G, et al. The Seveso studies on early and long-term effects of dioxin exposure: a review. Env Health Persp 1998;106 (S2):625-633. 6. Centers for Disease Control and Prevention. Third National Report on Human Exposure to Environmental Chemicals. Atlanta (GA): CDC, 2005. Accessed Dec 2008 from: http://www.cdc.gov/exposurereport/pdf/thirdreport.pdf 7. Clarkson TW, Vyas JB, Ballatori N. Mechanisms of mercury disposition in the body. Am Industrial Medicine 2007; 50(10):757-764. 8. Cavanagh JB. What have we learned from Graham Frederick Young Reflections on the mechanism of thallium neurotoxicity. Neuropath Appl Neurobio 2007;17(1):3-9. 9. Coenraads PJ, Olie K, Tang NJ. Blood lipid concentrations of dioxins and dibenzofurans causing chloracne. Br J Dermatol 1999;141(4):694-697. 10. Conradi P. “Prisoners were used to test poisons”. TimesOnLine, October 10 2004. Accessed Dec 2008 from: http://www.timesonline.co.uk/tol/news/world/article492686.ece 11. Emsley J. Elements of Murder: A History of Poisons. Oxford University Press, USA; 2005. 12. Hoque A, Sigurdson AJ, Burau KD, et al. Cancer among a Michigan cohort exposed to polybrominated biphenyls in 1973. Epidemiol 1998;9(4):373-378. 13. Houts PS, McDougall MS. Importance of evaluating the context in which notification occurs. AM J Industr Med 2007;23(1):205-210. December 2008 Version 2.0 Page 305
Page 1 and 2:
Chemical Agents of Opportunity for
Page 3 and 4:
Page 5 and 6:
Page 7 and 8:
Page 9 and 10:
Page 11 and 12:
Page 13 and 14:
Page 15 and 16:
Page 17 and 18:
Page 19 and 20:
Page 21 and 22:
Page 23 and 24:
Page 25 and 26:
Page 27 and 28:
Page 29 and 30:
Page 31 and 32:
Page 33 and 34:
Page 35 and 36:
Page 37 and 38:
Page 39 and 40:
Page 41 and 42:
Page 43 and 44:
Page 45 and 46:
Page 47 and 48:
Page 49 and 50:
Page 51 and 52:
Page 53 and 54:
Page 55 and 56:
Page 57 and 58:
Page 59 and 60:
Page 61 and 62:
Page 63 and 64:
Page 65 and 66:
Page 67 and 68:
Page 69 and 70:
Page 71 and 72:
Page 73 and 74:
Page 75 and 76:
Page 77 and 78:
Page 79 and 80:
Page 81 and 82:
Page 83 and 84:
Page 85 and 86:
Page 87 and 88:
Page 89 and 90:
Page 91 and 92:
Page 93 and 94:
Page 95 and 96:
Page 97 and 98:
Page 99 and 100:
Page 101 and 102:
Page 103 and 104:
Page 105 and 106:
Page 107 and 108:
Page 109 and 110:
Page 111 and 112:
Page 113 and 114:
Page 115 and 116:
Page 117 and 118:
Page 119 and 120:
Page 121 and 122:
Page 123 and 124:
Page 125 and 126:
Page 127 and 128:
Page 129 and 130:
Page 131 and 132:
Page 133 and 134:
Page 135 and 136:
Page 137 and 138:
Page 139 and 140:
Page 141 and 142:
Page 143 and 144:
Page 145 and 146:
Page 147 and 148:
Page 149 and 150:
Page 151 and 152:
Page 153 and 154:
Page 155 and 156:
Page 157 and 158:
Page 159 and 160:
Page 161 and 162:
Page 163 and 164:
Page 165 and 166:
Page 167 and 168:
Page 169 and 170:
Page 171 and 172:
Page 173 and 174:
Page 175 and 176:
Page 177 and 178:
Page 179 and 180:
Page 181 and 182:
Page 183 and 184:
Page 185 and 186:
Page 187 and 188:
Page 189 and 190:
Page 191 and 192:
Page 193 and 194:
Page 195 and 196:
Page 197 and 198:
Page 199 and 200:
Page 201 and 202:
Page 203 and 204:
Page 205 and 206:
Page 207 and 208:
Page 209 and 210:
Page 211 and 212:
Page 213 and 214:
Page 215 and 216:
Page 217 and 218:
Page 219 and 220:
Page 221 and 222:
Page 223 and 224:
Page 225 and 226:
Page 227 and 228:
Page 229 and 230:
Page 231 and 232:
Page 233 and 234:
Page 235 and 236:
Page 237 and 238:
Page 239 and 240:
Page 241 and 242:
Page 243 and 244:
Page 245 and 246:
Page 247 and 248:
Page 249 and 250:
Page 251 and 252:
Page 253 and 254:
Page 255 and 256:
Page 257 and 258: Chemical Agents of Opportunity for
Page 307: Chemical Agents of Opportunity for
Page 359 and 360:
Page 361 and 362:
Page 363 and 364:
Page 365 and 366:
Page 367 and 368:
Page 369 and 370:
Page 371 and 372:
Page 373 and 374:
Page 375 and 376:
Page 377 and 378:
Page 379 and 380:
Page 381 and 382:
Page 383 and 384:
Page 385 and 386:
Page 387 and 388:
Page 389 and 390:
Page 391 and 392:
Page 393 and 394:
Page 395 and 396:
Page 397 and 398:
Page 399 and 400:
Page 401 and 402:
Page 403 and 404:
Page 405 and 406:
Page 407 and 408:
Page 409 and 410:
Page 411 and 412:
Page 413 and 414:
Page 415 and 416:
Page 417 and 418:
Page 419 and 420:
Page 421 and 422:
Page 423 and 424:
Page 425 and 426:
Page 427 and 428:
Page 429 and 430:
Page 431 and 432:
Page 433 and 434:
Page 435 and 436:
Page 437 and 438:
Page 439 and 440:
Page 441 and 442:
Page 443 and 444:
Page 445 and 446:
Page 447 and 448:
Page 449 and 450:
Page 451 and 452:
Page 453 and 454:
Page 455 and 456:
Page 457 and 458:
Page 459 and 460:
Page 461 and 462:
Page 463 and 464:
Page 465 and 466:
Page 467 and 468:
Page 469 and 470:
Page 471 and 472:
Page 473:
show all

Chemical Agents of Opportunity for Terrorism: TICs & TIMs

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?