2. Introduction

Book Authors

Kathy L. Lehman-Huskamp, MD | William J. Keenan, MD | Anthony J. Scalzo, MD | George Sam Wang, MD | Shan Yin, MD 

Introduction

The first large-scale production of chemical and biological weapons occurred during the 20th century. World War I introduced the use of toxic gases such as chlorine, cyanide, and sulfur mustard as a means of chemical warfare. With terrorist events, such as the airplane attacks on the World Trade Center in New York City, use of nerve gases in Tokyo subway terrorist attack and the Syrian conflict, people have become increasingly fearful of potential large-scale terrorist attacks. Consequently, there has been a heightened interest in disaster preparedness especially involving chemical and biological agents. The U.S. Federal Emergency Management Agency (FEMA) recommends an “all-hazards” approach to emergency planning. This means creating a simultaneous plan for intentional terrorist events as well as for the more likely unintentional public health emergencies, such as earthquakes, floods, hazardous chemical spills, and infectious outbreaks. Most large-scale hazardous exposures are determined by the type of major industries that exist and/or the susceptibility to different types of natural disasters in a given area. For example, in 1984 one of the greatest man-made disasters of all times occurred in Bhopal, India, when a Union Carbide pesticide plant released tons of methylisocyanate gas over a populated area, killing scores of thousands and injuring well over 250,000 individuals. The 2011 earthquake and tsunami in Japan demonstrated the vulnerability of nuclear power stations to natural disasters and the need to prepare for possible widespread nuclear contamination and radiation exposure. This module provides universal guidelines for interventions during toxicological disasters.