However, in the case of the Tokyo sarin attack, it has been reported that up to 9 percent of EMS workers and a significant number of hospital staff experienced acute symptoms of nerve agent toxicity due to exposure to casualties in unventilated areas (Okumura et al., 1998b). In fact, once casualties of a vapor CWA incident are outside the area of the attack and accessible to medical personnel, the signs and symptoms of the patients may be the only detection method available, and the threat of spread of the CWA hazard from casualties may be minimal. In the case of cyanide and phosgene, and most nerve agents, detection in the environment may not be possible by the time monitoring equipment is in place at the scene.
By the time emergency medical personnel arrive at an incident, inevitably the agent will have dispersed significantly. The highest probability of detecting the presence of CWA occurs in cases in which there is a continuing source of vapor. The type of incident seen in Tokyo, while minimized by the inefficient release of the CWA, is an excellent example of the type of incident expected as a result of terrorist use of CWA. Rather, these agents may well be dispersed in a manner that would involve a vapor hazard within a confined space. Is it the police, the fire department, the Hazmat team, or the EMS units? If the responsibility falls on medical assets, how will the use of detection equipment increase the efficiency of the health care team in preserving life and preventing further injury? Furthermore, will the absence of more sensitive equipment somehow inhibit their performance? These are important questions that must be addressed by policymakers and incident response planners.īecause of their physical properties, CWA use in a domestic terrorist incident may not be associated with a high-explosive event. When addressing the requirement for chemical agent detection at the scene of a terrorist incident, it is important to consider who really has the responsibility for detection operations. CHEMICAL WARFARE AGENTS IN THE ENVIRONMENT
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