Chemical Agents of Opportunity for Terrorism: TICs & TIMs

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Chemical Agents of Opportunity for Terrorism Training Support Package Participant Guide Slide 12 Chemical Agents of Opportunity for Terrorism: TICs & TIMs Treatment • Multi-dose activated charcoal – Prevents absorption – Enterohepatic circulation • Prussian Blue ( Radiogardase ) – Prevents absorption from GI tract – Undefined efficacy • Unclear role for chelators once thallium is absorbed Module One - Terrorism by Fear and Uncertainty: Delayed Toxic Syndromes 12 Treatment for thallium poisoning involves efforts to prevent its absorption or hasten elimination. Thallium can be bound to either activated charcoal or Prussian Blue preventing its absorption through the GI tract. In addition, there is some recycling of thallium back into the gastrointestinal tract via the bile, where it can be bound to these therapeutic agents, if they are present in the duodenum, preventing reabsorption. Once thallium has been distributed to the rest of the body, it is unclear if any chelating agents would play a role in hastening elimination. December 2008 Version 2.0 Page 320
Chemical Agents of Opportunity for Terrorism Training Support Package Participant Guide Slide 13 Chemical Agents of Opportunity for Terrorism: TICs & TIMs Three forms of Mercury Elemental (Hg 0 ; quicksilver) Liquid: essentially nontoxic by ingestion Vapor: brain and lung toxicity Inorganic salt (Hg 2+ ) Organic (Methyl-Hg) Typically rapid onset of GI effects when ingested Aryl (cyclic): behave like inorganic Alkyl (short -chain): methylmercury , ethylmercury , dimethylmercury Module One - Terrorism by Fear and Uncertainty: Delayed Toxic Syndromes 13 Mercury provides an example of an agent to use to raise fear and concern. Mercury exists in several forms. The particular physical state of mercury determines its toxicity and how the body handles it. Elemental mercury is of minimal toxicity in liquid form, but when inhaled following volatilization it can produce lung damage and neurotoxicity. Although low level exposure to a vapor over a long period of time can produce neurotoxicity without pulmonary abnormalities, this would not be as useful to a terrorist as would organic mercury (see below). Mercury salts produce corrosive gastrointestinal effects when ingested. There are no other realistic routes of poisoning than the oral route for mercury salts. Although this has been used in individual cases, it would not be effective in a large scale release. Organic mercury is the most concerning form of mercury, from a terrorism perspective. The neurotoxicity that it causes is similar to that of inhaled elemental mercury, but the ability of the short chain organic mercury compounds to be absorbed orally, to be inhaled, and to cross the dermal barrier raise concerns for its nefarious use. December 2008 Version 2.0 Page 321
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Chemical Agents of Opportunity for Terrorism: TICs & TIMs

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