The public health problem
The release of a chemical weapon of mass destruction (WMD) could result in hundreds or thousands of casualties, and the source of the release likely would be obvious to public health officials. However, the source of an accidental chemical release, or the hidden, intentional contamination of food or drinking water, would be more difficult to identify. During the past century, chemical releases accounted for as many as 50% of the 350 WMD incidents that have occurred worldwide, according to the Monterey Institute of International Studies, which maintains an open-source database of criminal and terrorist incidents involving WMD agents.
What we are doing to address these concerns
Various programs at the Centers for Disease Control and Prevention (CDC) work to detect, respond to, and prevent human illness caused by a chemical release. CDC’s Environmental Hazards and Health Effects Program (EHHE) is involved in the following activities:
- Supporting an early warning surveillance system that monitors
and analyzes real-time data from the nation’s poison-control centers, to
detect intentional and unintentional chemical-poisoning events. The
Toxic Exposure Surveillance System (TESS), a national database
maintained by the American Association of Poison Control Centers
(AAPCC), receives data from individual poison-control centers. EHHE and
the Agency for Toxic Substances and Disease Registry are collaborating
with AAPCC in using TESS as a surveillance tool for possible chemical
events. Early detection of such events can facilitate more immediate and
appropriate response to toxin- or chemical-related public health
threats.
- Providing medical toxicological expertise and clinical guidance
to local, state, and federal agencies during national and international
chemical-terrorism events. For example, after the intentional placement
of ricin in a threatening letter found in the Greenville, South
Carolina, postal system in October 2003, medical toxicologists from EHHE
- traveled to the scene and assisted state and county officials with the epidemiologic investigation;
- assisted the National Institute for Occupational Safety and Health with environmental sampling;
- developed ricin-specific documents—including fact sheets and case definitions for public health surveillance—for the general public, clinicians, and public health officials;
- published results of the investigation (MMWR Nov. 21,
2003;52[46]:1129-31;
http://www.cdc.gov/mmwr/preview/mmwrhtml/
mm5246a5.htm); and
- posted a Web cast, titled "Recognition, Management and
Surveillance of Ricin-Associated Illness," at
http://www.phppo.cdc.gov/phtn/webcast/
ricin/default.asp.
- fact sheets, which explain what each chemical is, where it can be found, how an individual could be exposed, and possible adverse health effects resulting from exposure;
- case definitions, which combine clinical descriptions with laboratory criteria to help health care providers and public health professionals classify cases of exposure to a specific chemical;
- links to other publications, such as "Recognition of Illness
Associated with Exposure to Chemical Agents—United States 2003"
(MMWR October 3, 2003;52[39]:938-40;
http://www.cdc.gov/mmwr/preview/mmwrhtml/
mm5239a3.htm); and - clinical syndromes, which describe signs and symptoms of
agent-specific poisoning for various chemicals. Health care
providers can use clinical syndromes to help identify poisoned
patients.
- recognizing epidemiologic clues that suggest illness associated
with a covert chemical release (http://www.phppo.cdc.gov/phtn/webcast/
chemical-exp/default.asp), and - recognizing gastrointestinal illness possibly associated with
exposure to hazardous chemicals (available in March 2005 at
http://www.phppo.cdc.gov/phtn/default.asp).
For more information, please contact:
CDC/National Center for Environmental Health
Division of Environmental Hazards and Health Effects
1-800-CDC-INFO; cdcinfo@cdc.gov
Updated: October 2004
