Maryland State Public Health Laboratory
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Maryland State Public Health Laboratory September 25, 2008 1 “On September 11, 2001, Americans and the world witnessed a new kind of war. We saw the great harm that a stateless network could inflict upon our country, killers armed with box cutters, mace, and 19 airline tickets. Those attacks raised the prospect of even worse dangers – of other weapons in the hands of other men. The greatest threat before our humanity today is the possibility of secret and sudden attack with chemical or biological or radiological or nuclear weapons.” President George W. Bush February 11, 2004 2 Acts that are intended to instill fear, coerce, intimidate, and / or get people to change their daily activities in furtherance of political or social objectives 3 ❑ Inflict mass casualties / fatalities ❑ Destruction of critical infrastructure ❑ Economic disruption in the US ❑ Change in our daily routines 4 ❑Routine testing of multi-media environmental samples ❑Routine testing of consumer products for quality and safety ❑Special / rush testing in response to emergencies ❑Human biomonitoring testing ❑Chemical terrorism/emergency preparedness testing ❑Research and development for special projects ❑Technical consultation 5 ❑ Public Health Security and Bioterrorism Preparedness and Response Act of 2002 ❑ Homeland Security Presidential Directives (charge EPA to protect nation’s critical water infrastructure and decontamination of indoor and outdoor areas after incident) HSPD 7 - defines EPA as Sector Specific Agency for drinking water and water treatment systems HSPD 9 – requires EPA to develop a comprehensive and fully coordinated water quality surveillance/monitoring system and an interconnected laboratory network HSPD 10 – requires EPA to address risks from biological agents and develop strategies, guidelines and plans to decontaminate persons, equipment and facilities HSPD 22 – Requires EPA to develop plans and protocol to decontaminate following a chemical incident including development of risk-based clean-up goals 6 We are located at …… The State Office Complex J. Mehsen Joseph Laboratory Tower O’Conor Building 201 W. Preston Street Baltimore, MD 21201 7 The professional staff possesses a broad range of experience in the performance of environmental chemical analyses in a variety of matrices. The laboratories involved in the analysis of water and wastewater are certified by the U.S EPA. The Biomonitoring and Chemical Terrorism Preparedness Laboratories maintain CLIA certification for the analysis of human physiological fluids. The Air Quality Laboratory maintains NVLAP accreditation for asbestos testing. 8 ❑ Environmental Chemistry Testing Ambient/Indoor air Building materials Drinking water Dust/wipes Fish & Shellfish Leachates Sediments Sludges Surface water Wastewater ❑ Consumer Products Testing Pharmaceuticals Drugs/consumer products Foods Beverages/bottled water ❑ Biomonitoring Testing Urine Blood ❑ Chemical Agents Testing Urine Blood White powders 9 ❑Asbestos ❑Metals ❑Base Neutrals, & Acids ❑Nerve agents metabolites ❑Blister agents metabolites ❑Nutrients ❑Carbamates pesticides ❑Organophosphate pesticides ❑Chlorinated acid herbicides ❑Particulate matter, 2.5μm ❑Chlorinated pesticides ❑Polychlorinated biphenyls ❑Chlorophyll ❑Radiologicals ❑Demands (inorganics) ❑Semi-volatile compounds ❑Non-Metallic inorganics ❑Volatile organic compounds 10 ❑ Pre-Incident Prevention Preparedness* ❑ Incident Response* ❑ Post-Incident Recovery 11 ❑ Stabilize victims ❑ Secure area ❑ Assess symptoms ❑Field testing 12 ❑ Chemicals play important roles in our everyday lives. ❑ Found in a wide range of household and commercial products that can be lifesaving as well as hazardous to our health. ❑ Accidents do happen; threat of terrorist activity may include the use of chemicals as weapons. ❑ Chemical releases and exposure have serious implications for human health and the environment. ❑ Preparing for and responding to chemical terrorism and chemical emergencies are important functions of public health. 13 ❑ Public health personnel, not "first responders“ staff, assess short and long-term impacts on human health, food, water, and sanitation, and order actions to protect the public from chemical contamination. ❑ They work with local hospitals and health care providers to assure essential medical services. ❑ They may also interview victims or provide backup to first responders and medical staff. ❑ State and federal public health agencies become involved if the event is larger than can be handled with local resources. 14 15 ❑ Type of contaminants / media ❑ Magnitude of incident - expect large numbers of affected population ❑ Develop disaster response plans based on what people will likely do rather than expected to do (i.e., anxiety, panic, chaos, fear, hysteria) ❑ Communicate pertinent information. This is paramount to quench fears and mass hysteria ❑ Know available resources and key contacts (federal, State, private, universities) 16 ❑Why do sample collection? ❑What is the regulatory driver? ❑How will the analytical data ultimately be used? ❑Will the decision by the user be risk based or technology based? ❑What information may still be needed? ❑Appropriate analytical factors to be considered. 17 Environmental sampling for chemical analysis is an attempt to take representative portion of a physical system from its surroundings so that valid scientific decisions can be made concerning the entire ecosystem. 18 ❑Monitoring ❑Regulatory activities ❑Quality control ❑Scientific studies ❑Disaster assessment ❑Idle curiosity 19 ❑Law enforcement (FBI, SS, SP, etc.) ❑Hazmat personnel ❑Environmental health (sanitarians) ❑Hospital based staff ❑Emergency medical staff ❑Laboratory staff ❑Bonded courier ❑Others?? 20 Correct Sample + Proper Sample + Prescribed Test Collection Procedure Handling Method & QCs + Multiple Reviews (effective QA Program) = Good Defensible Test Results 21 About 30% of total error associated with analytical data is contributed by sampling variability. The chemistry of the contaminants and the specifics of the collection, preservation, and handling processes must be understood so that the concentration can be measured with a high degree of accuracy. Data generated is then legally defensible. It is important we know HOW to sample, WHEN to sample, WHERE to sample, FREQUENCY of sampling, sampling requirements, etc. 22 ❑Sample collection/distribution 1,000 urine cups? 4,000 vacutainers? Ship to CDC or surge lab (LRN Level 1 or 2)? ❑Sample handling/preparation Aliquot generation Prep “all” samples for network? Sample storage? ❑Data reduction/validation ❑Results reporting 23 ❑In 1999, CDC/NCEH was tasked with analyzing clinical samples from people with suspected exposure to chemicals from: A domestic terrorist event A chemical accident An unknown chemical exposure 24 ❑Level THREE laboratories Sample collection, storage, and shipment ❑Level TWO laboratories Level One activities plus Analysis of samples for specific agents ❑Level ONE laboratories Level three and Level Two activities plus Serve as CDC’s surge capacity for the analysis of specific agents 25 TERROR Explosives 26 Primary emphasis on battlefield designated chemical agents – chemical warfare agents Less emphasis on toxic industrial materials (TIMs) or compounds (TICs) 27 They are highly toxic, poisonous chemical compounds that injure or kill exposed individuals through dermal contact, inhalation or ingestion. They are used in chemical warfare because of the impact of their chemical effects to cause incapacitation and death instead of their physical effects like a blast. 28 CHEMICALS ARE DIVERSE …. 29 Attacks involving thefts/release could impact health and safety, disrupt local/regional economy and impact other critical infrastructure (water systems, chemical plants, etc.). For example, a total failure to protect a chlorine (or ammonia) tanker or rail car could discharge contents in 10 minutes and result in plume exceeding 14 miles in length. Goal – To reduce or eliminate the hazard; not to control it. 30 ❑ Terrorist threat is a dynamic phenomenon that continues to evolve in response to social, political, and technological changes. ❑ Terrorists acts will continue to emerge and evolve with new ways to cause human death and infrastructure destruction. 31 ❑The use of chemicals to harm or alter the behavior of an adversary. Risks are more than traditional use of chemical warfare agents ❑Often, it uses existing stores of chemicals – exploiting existing stores of opportunity ❑Huge availability of stored toxic chemicals throughout the US. Close proximity of these industrial operations to large urban centers 32 ❑Chemical insecurity - across the US, thousands of industrial facilities use and store hazardous chemicals in large quantities that pose major risks to residents and their communities. More than 100 of these facilities would each put at least 1M people at risk of injury or death in the event of a chemical release. 33 ❑Think of Bhopal, India, December 1984. Accidental release of methyl isocyanate resulted in massive casualties ❑More than 800,000 US businesses use, produce, or store TICs / TIMs ❑750 plants have enough chemicals to injure or kill at least 100,000 people ❑Terrorist attack on a chemical plant in a densely populated area could result in 2.4 million casualties 34 54% - sufficient information 7% - some information 38% - very little information 30 biotoxins 9 explosives 17 radioisotopes 30 chemical warfare agents Remainder are Toxic Industrial Chemicals (~ 30% registered by EPA as components of pesticide