Chemical Terrorism

 What is Terrorism?

-according to Bruce Hoffman, Terrorism is defined as the deliberate creation and exploitation of fear through violence or the threat of violence in the pursuit of political change.

Chemical Agents?

-Chemical agents are those chemical compounds synthesized artificially and include the many toxic chemicals that may be available to terrorists. Everything from chlorine gas to the highly potent nerve agents (i.e.,

organophosphate compounds) are considered in this category

Chemical Terrorism?

- The use of Chemical agents by individuals or groups to create fear through violence

History

Chemical Warfare is not new. In ancient times, war was not all swords and bows. Here are some examples:

•       1000 BC. Arsenic smoke used by the Chinese.

•        Dating back to at least the 1100s, there are many examples of hurling the bodies of plague or smallpox victims over city walls.

World War I

Unrestricted use of chemical agents caused 1 million of the 26 million casualties suffered by all sides in WWI. It started with the French and British use of tear gas, but soon escalated to more toxic poisons.

Some deadly landmarks:

•       October 1914: German artillery fire 3,000 shells filled with dianisidine chlorosulfate, a lung irritant, at British troops. The shells contained too much TNT and apparently destroyed the chemical.

•       In July 1917, Germany introduced mustard gas, which burned the skin as well as the lungs.

•       Chemical weapons were used in 1915, when the German military released 168 tons of chlorine gas at Ypres, Belgium, killing an estimated 5,000 Allied troops.

•       Two years later, the same battlefields saw the first deployment of sulfur mustard. Sulfur

•       mustard was the major cause of chemical casualties in World War I.

World War II

Between the two world wars, scientists from many nations came up with evermore horrible chemical weapons. The U.S. developed seven chemical agents -- but the winner in this chemical arms race was in Germany. First, in 1936, German chemist Gerhart Schrader came up with a nerve agent that came to be called tabun (later it was called German agent A or GA). Around 1938, Schrader came up with a new nerve gas several times more deadly than tabun. It came to be called sarin (later known also as GB).

CHEMIICAL WEAPON AGENTS

Nerve Agents

Vesicating or Blistering Agents

Pulmonary Agents or Lung Intoxicants

Blood Agents

Incapacitating Agents

Pesticides

Chemical Agents Used in Terrorism

1. Nerve Agents (such as sarin, soman, cyclohexylsarin, tabun, VX)

-          extremely potent organophosphorus compounds that cause biological effects by inhibiting the enzyme acetylcholinesterase

-          Accumulation of excess acetylcholine at nicotinic and muscarinic receptors

Effects of Nerve Agents:

Eyes: Miosis, tearing, conjunctival injection (pain, dim vision, blurred vision)

Nose: Rhinorrhea

Airways: Bronchoconstriction, bronchosecretions (dyspnea, cough)

Gastrointestinal : Hypermotility, secretions (nausea, vomiting, diarrhea, cramps)

Skeletal muscles: Fasciculations, twitching, paralysis (weakness)

Central nervous system: Immediate--loss of consciousness, seizures, apnea. Later--possible difficulty in thinking, impaired judgement, and other minor effects.

Other: Salivation, sweating

Principal Route of Entry:

-          Respiratory, Dermal, Ocular, Mucous Membrane, GI Tract

Question: Antidote?

                yes, Atropine and  2-PAMCl (2- Pyridine Aldoxime Methochloride) or Pralidoxime Chloride

2. Vesicating or blistering agents (such as mustards, lewisite)

-          Causes blisters; most widely used agent is mustard

-          In addition to causing blisters, mustard also damages the eyes and airways by topical contact and the gastrointestinal tract and bone marrow after absorption. Mustard evaporates at about the same rate as thin motor oil, but despite this low volatility most battlefield casualties have been from vapor.

Signs and Symptoms

Eyes: Eye damage can occur with an exposure of just 10 mg min/m3.

-mild to severe conjunctivitis

-mild to severe corneal involvement

Skin: Erythema, Blisters, Deep burning, leading to full thickness skin loss

Respiratory Tract:  rhinorrhea, burning pain in the throat and hoarseness.

Bone Marrow: A reactive leukocytosis can occur during the first three days, followed by leukopenia

Gastrointestinal Tract: ingestion can cause  nausea, vomiting, pain,

diarrhea and prostration. Vomit and feces may be bloody. Shock may occur.

Systemic Action: Systemically absorbed mustards, by any route, may cause signs similar to those of irradiation, such as headache, nausea, vomiting, leukopenia and anemia. Gastrointestinal pain commonly occurs. Absorption of high doses may result in CNS excitation and convulsions, followed by CNS depression. Cardiac irregularities, AV block and/or cardiac arrest, may occur.

Question: Antidote?

No, Management consists of keeping the skin lesions clean by frequent irrigation and application of topical antibiotics, good pulmonary care including intubation and assisted ventilation, and irrigation of the eyes followed by frequent application of topical antibiotics.

3. Pulmonary Agents or Lung Toxicants (such as chlorine, phosgene, diphosgene)

-is a chemical weapon agent designed to impede a victim's ability to breathe. They operate by causing a build-up of fluids in the lungs which then leads to suffocation.

-commonly used agent is phosgene

What is Phosgene? Phosgene is a major industrial chemical used to make plastics and pesticides.

At room temperature (70°F), phosgene is a poisonous gas.

Signs and Symptoms:

•       Coughing

•       Burning sensation in the throat and eyes

•       Watery eyes

•       Blurred vision

•       Difficulty breathing or shortness of breath

•       Nausea and vomiting

•       Skin contact can result in lesions similar to those from frostbite or burns

•       Following exposure to high concentrations of phosgene, a person may develop fluid in the lungs (pulmonary edema) within 2 to 6 hours.

Question: Antidote?

No, removing phosgene from the body as soon as possible and providing supportive medical care is the treatment.

4. Blood Agents (Cyanide)

-          a rapidly acting, potentially deadly chemical that can exist in various forms.

-          Cyanide prevents the cells of the body from using oxygen. When this happens, the cells die.

-          Cyanide is more harmful to the heart and brain than to other organs because the heart and brain use a lot of oxygen.

-          Has  2 forms: Solid salts (sodium, potassium, and calcium) and the volatile liquids (hydrogen cyanide and cyanogen chloride)

Immediate Signs and Symptoms:

People exposed to a small amount of cyanide by breathing it, absorbing it through their skin, or eating foods that contain it may have some or all of the following symptoms within minutes:

•       Rapid breathing

•       Restlessness

•       Dizziness

•       Weakness

•       Headache

•       Nausea and vomiting

•       Rapid heart rate

Exposure to a large amount of cyanide by any route may cause these other health effects as well:

•       Convulsions

•       Low blood pressure

•       Slow heart rate

•       Loss of consciousness

•       Lung injury

•       Respiratory failure leading to death

Showing these signs and symptoms does not necessarily mean that a person has been exposed to cyanide.

Long Term Effects:

Survivors of serious cyanide poisoning may develop heart and brain damage.

Question: Antidote?

                yes, Hydroxocobalamin reacts with cyanide to form cyanocobalamin, which can be safely eliminated by the kidneys.

5. Incapacitating Agents  (such as anticholinergic compounds)

-          An agent that produces temporary physiological or mental effects, or both, which will render individuals incapable of concerted effort in the performance of their assigned duties.

-          Lethal agents are primarily intended to kill, but incapacitating agents can also kill if administered in a potent enough dose, or in certain scenarios.

Signs and Symptoms:

Mental Symptoms: Hallucinations,  symptoms  often  resemble  alcoholic drunkenness, mentally confused, prevents sleep

Physical Symptoms:

Staggering gait, dizziness and blurred visions

-These agents generally do not kill, but they can make a person non-effective.  Many  of  them  do  not  produce  effects until several hours after inhalation. The effects of incapacitating agents can last from 8 hours to 4 days

6. Pesticides  (such as Thalium, arsenic, sodium flouroacetate and the anticoagulant warfarin)

-          Pesticides refer to a group of agents used to kill a number of different “pests,” such as weeds, insects, ticks, rats, and so forth.

General Management:

-          Don Personal Protective Equipment (PPE)

-          Remove from source

-          Immediate decontamination

-          Appropriate Antidote and drug therapy

Some Unique Aspects of a Chemical Terrorist Incident

-Use of Some chemical agents may not be recognized for sometime

Ex: the use of chemical agent sarin by a Japanese cult Aum Shinrikyo in 1994

-it took about a week before authorities discovered that sarin was responsible for the death of 7 people and 280 injured victims.

-2 people died in the hospital and the other 5 was found dead in their apartments

-          He intended to assassinate local magistrates in Matsumoto City, but none of those intended targets were killed.

-it can cause massive injury and poisoning

-another attack was made by Shinrikyo  in 1995 using the same agent sarin, sending 5,000 casualties to the hospitals and 12 people were found dead.

Risk of Chemical Terrorism

The terrorism at the plant level

one of the most important risk is "the terrorism at the plant level". In

the days following the September 11 terrorist attacks, chemical plant U.S. officials say they have increased security through greater plant surveillance. The chemical industry understands the risk ! Recently Greenpeace posted a map on its website showing the distance that chemicals could travel from a facility during a worst-case accident scenario. From (approximately) Baton Rouge to New Orleans, 40 to 50 miles diameters circles can be drawn, each circle representing a chemical plant along the Mississippi River !

 Last 21 sept., in Toulouse, France, 300 tons of ammonium nitrate have exploded killing 30 people; 5500 were injured and nearly 20 000 houses  or apartments were totally  or partially destroyed. At this time we don't know the reason of this explosion, but the impact of this event was very important and, it seems to me, it is a good illustration of this risk.

-Although terrorists have for the most part opted for conventional weapons, the use of chemical or biological agents by terrorists has already occurred, albeit in rather limited fashion

-scholar of modern terrorism wrote, “The true threat of superterrorism is not a Hiroshima-like disaster, but a widespread panic caused by a relatively small CBW incident involving afew dozen fatalities” (Sprinzak, 2000).

Why was chemical used as a weapon for terrorism?

Several characteristics of chemical weapon agents lend themselves to terrorist use.

•       Chemicals used in CWAs are widely available, and recipes for CWA production may be found on the Internet.

•       CWAs are transported easily and may be delivered by a variety of routes.

•       Chemical agents often are difficult to protect against and quickly incapacitate the intended targets.

•       Most civilian medical communities are inadequately prepared to deal with a chemical terrorist attack.