The Royal Society - 2004 - Making The Uk Safer
The Royal Society - 2004 - Making The Uk Safer
The Royal Society - 2004 - Making The Uk Safer
April 2004
1 Introduction 3
1.1 Background to project 3
1.2 Conduct of project 4
1.3 Types and properties of possible agents 4
1.4 Types of possible incident 5
9 References 43
Annex 4 Scientific uncertainty, scientific advice and decision support for risk management 50
Recent global events have given greater prominence to · Assess and disseminate protocols and procedures for
the threat of chemical and biological agents being used detection, sampling and decontamination.
malevolently against civil targets such as key landmarks,
transport hubs and postal sorting offices. Science, · Evaluate detection and decontamination equipment
engineering and technology are central to reducing this and establish agreed industrial standards.
threat and so making the United Kingdom safer.
· Ensure information is shared effectively between
The Royal Society established an independent, expert different Government Departments and agencies, the
working group to examine the science, engineering and academic community, industry and other interested
technology relevant to detecting when chemical or parties, including the public.
biological agents have been used and to decontaminating
people and buildings subjected to attack using such · Establish the maximum levels of agents below which it is
agents. We took evidence extensively from key appropriate to permit a return to normal use following
Government Departments, emergency service staff an incident.
(or ‘first responders’), emergency planners, the academic
community and industry. The evidence received forms the · Work with the academic community, industry and the
basis of this report. research councils where appropriate and seek to make
full use of developments and potential funding in the
Rapid and effective detection and decontamination of US, Europe and elsewhere.
an incident are necessary to minimise negative health
impacts and reduce disruption to civil society. The UK has · Provide a clearly identified source of expert advice
considerable scientific expertise in this area. This should regarding chemical or biological incidents for
be harnessed to strengthen the UK’s existing resilience. Government Department and agencies, first responders,
Appropriate organisation of relevant science, engineering NHS Trusts and national and local emergency planners.
and technology is crucial and forms the focus of our main
recommendation. The centre would work with existing expertise in the
Defence Science & Technology Laboratory, Health
There are many similarities in dealing with the Protection Agency, Home Office, Department for the
consequences of a malevolent and an accidental release Environment Food and Rural Affairs, Environment
of a chemical or biological agent. Therefore, many Agency, Cabinet Office, Department of Health, Office of
countermeasures will be equally applicable to either type the Deputy Prime Minister, Department for Transport,
of incident. So there is much to be gained from close Research Councils, Office of Science and Technology,
communication between staff now focused on Department of Trade and Industry, National Health
preparedness against malevolent attack and those Service, first responders, the academic community and
dealing with accidental releases. industry. It would be under independent management
and require a physical location to undertake the required
During our deliberations we became very aware that evaluation work. To increase information sharing and
there is much knowledge and expertise available in the minimise costs, expertise and specialised equipment
UK, some of which has been acquired in a military context. could be shared with existing facilities in Government,
However, no single Government Department appears to academia and industry where appropriate. The budget
have full responsibility for determining how this expertise required by the centre will depend on the timescale
can best be utilised. While the establishment of the CBRN envisaged for the work to be done and on the
(Chemical Biological Radiological Nuclear) Team in the sophistication of the appropriate equipment and
Home Office has improved coordination and awareness, materials. Based on information received from a number
considerably more organisation of the resources is required. of sources, we estimate that a reasonable figure would be
of the order of £20 million per year for an initial five year
Consequently, our major recommendation is that the UK period. After this initial period the funding should
Government should establish a new centre to improve the continue but the level would need to be reassessed.
UK’s resilience and to minimise the impact of any civilian
chemical or biological incident. The centre's main All detection systems need to be designed to take into
functions would be to: account how the information they generate will be used,
the level of training of those who will use them, and the
· Determine, commission and direct the work required on environment in which they will be used. A range of
planning, preparedness, research and development detection system requirements covering monitoring,
related to detection and decontamination. identification and quantification of potential agents will
be needed. Some potential technologies for novel
detection systems will come from academic research.
· Development of point detectors for use by first · Development and implementation of techniques for
responders at the scene of a suspected incident. avoiding secondary contamination in hospitals and
ambulances.
· Establishment of what information on background
interferences and natural variability of agent levels might We recommend that realistic exercises be undertaken
increase the reliability and sensitivity of different regularly involving first responders, emergency planners
detection systems and decision making. Where and some civilians in order to test and develop further the
appropriate the relevant data should be collected. procedures for dealing with an incident. In addition to
providing a considerable measure of reassurance to the
· Analysis of medical intelligence to enhance resilience public, such exercises would be an integral part of staff
and the effectiveness of responses. training and preparedness.
In the event of the release of a chemical or biological We also recommend greater dialogue between scientists,
agent, a rapid and effective medical response will be psychologists, politicians and the public to improve the
crucial. To help achieve this we recommend increasing communication and public understanding of hazard and
the general awareness of all healthcare staff by training, risk issues in relation to terrorist incidents, and to inform
particularly in the detection and management of chemical planning for response to chemical and biological
or biological incidents. We also recommend improved incidents.
coordination of local and national electronic health
surveillance systems to detect clusters of illness or Reducing the threat from chemical and biological
symptoms. agents requires political, economic, organisational and
technological actions. Without political will and cost-
With respect to decontamination studies, we recommend effective implementation, organisational and
the following four priorities: technological innovation cannot deliver their full potential
to make the UK safer.
· Assessment of the efficacy of decontamination
procedures and technologies.
1.1 Background to project Our report Measures for controlling the threat from
biological weapons (Royal Society 2000) concluded that
The Royal Society has a long standing commitment the scale of effectiveness of biological weapons against
to reducing the threat of biological weapons, and has human populations in war and by terrorist attack had
produced two previous reports on this subject mercifully not been proven in practice and that, while it
(Royal Society 1994 & 2000). This report concerns the would be irresponsible to be complacent about the possible
malicious use of chemical and biological agents against effects, it would also seem prudent not to overestimate
civilian targets such as key landmarks, transport hubs, them. That report also concluded that the main negative
postal sorting offices, Government offices, water and effect of a biological weapons incident might be panic
power plants, or large gatherings of people. It examines and disruption of civilian services. While the political and
how such attacks can be detected and the agent(s) security scenario has changed since the 2000 report was
identified and quantified, and how targeted people and produced, its conclusions remain valid.
infrastructure can be decontaminated after attack. It
concentrates on the implications for humans and their Detection is an increasingly demanding and rapidly
environment. developing field, with considerable effort being devoted
to new technical developments by both industry and the
We do not address all potential terrorist threats here. academic community. Detectors of various types are used
In particular, we do not deal with radiological threats throughout science and many could be adapted or
(or ‘dirty bombs’), nor infectious animal or plant diseases developed for the specific or generic detection of chemical
(Royal Society 2002). These are important issues and or biological agents. Chapter two addresses the priorities,
merit separate study. concepts of use and implementation of detection
systems. Issues relating to sampling are discussed in
For the purposes of this report, ‘detection’ will be used to chapter three and the current capabilities and future needs
cover systems and methods for early warning alarms, for of detection systems are investigated in chapter four.
monitoring and for identification and quantification.
Decontamination can be divided into the decontamination
There are many similarities in dealing with the of people and the decontamination of structures
consequences of a malevolent and an accidental release including buildings, furniture, vehicles and equipment.
of a chemical or biological agent. Consequently, many The processes required for effective decontamination
countermeasures will be equally applicable in preparing following an incident are not fully understood. This was
the country against either type of incident. clearly illustrated by the clean-up of the Senate buildings
following the US anthrax letters in Autumn 2001 and the
The report is aimed principally at three groups: national difficulties experienced in restoring them to use. How
and local Government policy-makers involved in long-term science, engineering and technology can assist in
planning to increase preparedness against a possible decontamination is discussed in chapter five.
incident; emergency service staff (or ‘first responders’)
who would be directly involved in dealing with the The consequences of either a chemical or biological
consequences of an incident; and scientists and engineers incident can be greatly reduced if the agent can be rapidly
working in areas that could be applied to extending detected, allowing appropriate countermeasures to be
existing detection and decontamination capabilities, put in place as soon as possible. Chapter six assesses how
particularly those who are currently unaware of the science, engineering and technology can determine
potential of their work. when the environment is safe enough to justify a return to
normal use following an incident.
Reducing the threat from chemical and biological agents
requires political, economic, organisational and How best to coordinate and organise research,
technological actions. A number of these issues were development and planning relating to countermeasures
addressed by the House of Commons Science & Technology against chemical and biological agents is discussed in
Select Committee in their recent report on the scientific chapter seven. Conclusions and recommendations for
response to terrorism (House of Commons 2003). A recent emergency planners, policy-makers and researchers are
review article looked at the current US situation regarding presented in chapter eight, bringing together the
technology challenges (Fitch, Raber & Imbro 2003). Our separate recommendations from the preceding chapters.
report concentrates on where science, engineering and
technology can help in diminishing the consequences of The use of mathematical modelling of chemical and
incidents by reducing vulnerabilities, improving the response biological dispersions is discussed in annex 3. Scientific
of society by consequence management, modelling and uncertainty, scientific advice and decision support for risk
the early warning of potential threats. Detection and management are covered in annex 4.
decontamination are central to all of these issues.
· Bacteria eg Bacillus anthracis · Bacterial toxins including botulinum · Chemical warfare agents, including
(anthrax), Yersinia pestis (plague) toxin nerve gases (mustard, sarin and VX),
· Viruses eg smallpox · Naturally occurring bio-regulators blister, blood and choking agents
· Rickettsiae – Coxiella burnetii · Ricin and related protein toxins · Toxic industrial chemicals such as
(Q fever) · Mycotoxins (T2), aflatoxin chlorine and phosgene
· Fungi – Histoplasma capsulatum · Palytoxin, batrachotoxin, · Highly potent pharmaceuticals and
· Modified bacteria and tetraodotoxin, saxitoxin agrochemicals
viruses · Animal, plant, marine, snake, frog,
toad, spider and scorpion toxins
· Immuno-modulators, mood
modifiers, analgesics,
psychopeptides
Determine impact of
potential litigation.
Detection Define concept of use of Determine affected area. Confirm identity of agent.
(Chapters 2, 4) detection system.
Preliminary identification of Collect evidence.
Set up real-time monitoring / agent.
sampling systems. Confirm effective
decontamination.
Establish background
interference and agent levels.
Intelligence gathering.
Sampling Decide on type and method of Adapt sampling strategy to Assess whether ‘safe’ level
(Chapter 3) sampling for different agents. locate source and distribution has been reached after
of agent. decontamination.
Identify and train personnel.
Psychological issues Inform public what to expect. Reduce impact of event using Justify return to incident
(Chapter 6) media, economic & civil tools. site.
Prepare information to be
circulated in the event of an
incident.
Avoid secondary
contamination.
Key decisions need to be taken depending on the nature on decontamination of buildings and the environment,
of the event and the extent of the affected zone. These the determination of when something is sufficiently clean
include what steps need to be taken to control people and the impact of potential litigation will have to be resolved.
entering or leaving the affected zone, what needs to be
done to decontaminate personnel and mobile infrastructure 2.2.1 Pre-event activities
(such as ambulances), and by whom. Also, the central
authorities need to use all available psychological, media, Strategies and procedures for dealing with an event need
economic and civil tools at their disposal to minimise the to be established in advance of any potential incident.
negative impact of the incident. Post-event key decisions Sensitive installations should introduce continuous
The primary objectives for sampling are that the strategy When determining the most appropriate sampling
provides representative samples, that an appropriate strategy, it is crucial to take into account different issues
number of samples are taken and that the sampling regime that apply to chemical and biological agents. However, a
is tailored to the physical properties of the likely agent as number of generic issues that should be considered in all
well as the environment being sampled, eg water, air, soil strategy planning to achieve a representative sample that
and/or clothing. The resulting samples should support are discussed below.
accurate identification and quantification of the analyte
at appropriate concentrations (related to known harmful · Sampling techniques must be compatible with the
doses) that would reflect both acute and chronic exposure detection and identification technologies used. For
dosages. example, if microbes are to be detected by culturing the
extraction technique must not contain harsh chemicals
Any sampling methodology should be robust and that will reduce viability. Polymerase chain reaction
repeatable. In addition to analytical considerations, details (PCR) amplification of nucleic acid requires careful
of the nature and location of individual samples should be sampling, storage and transportation to avoid
logged, and samples should be stored and transported to contamination and degradation of the sample.
the point of analysis in a secure manner so that their
whereabouts can be accounted for at all times (chain-of- · The frequency of sampling should be determined,
custody). Consideration should also be given to the need taking the resources available into account. Maximum
for police evidence gathering. When detection is not coverage needs to be achieved from the minimum
carried out on site, national or regional analytical number of samples.
laboratories need to be identified in advance and reporting
procedures agreed. · Sampling strategies need to be designed to locate the
sources of the agent and the scope of its effect
A chemical or biological agent might be deliberately (vulnerable sites, likely chain of infection). Visual
released through the air, with water systems being the evidence should be taken into account (eg white
next most likely target. Food and bottled beverages could powder, agent plumes) in addition to prevailing
also be contaminated deliberately and there have been conditions, such as the weather, that may affect the
criminal incidents of this kind. An example of this was the scope of the agent’s effect. Strategies must also ensure
contamination with salmonella of salad bars in ten that a range of concentrations can be detected (eg high
restaurants in 1984 in Oregon by the Rajneeshee cult, which concentration at the focus of the event and lower
resulted in 751 cases of food poisoning (Tucker 1999). concentration as the agent disperses.) If infective dose is
The quality control systems currently in place for food and very low then rapid concentration of samples will be
drink mean far fewer people might be affected than an required.
incident involving deliberate releases in air or water systems.
The existing quality control systems for food and drink · Sampling strategies need to be validated to identify any
might help identify which sampling techniques should be likely sources of contamination.
used and where work is needed to improve detection.
Examples of additional research directions that show · Integrated ‘plug-and-play’ systems that allow
promise in providing solutions to detection of chemical replacement of the sensor head for detection of
and biological agents are given below. different analytes.
· Novel chemical and biological recognition systems – · Networked systems, software, data mining and
antibodies, fragments, single chain antibody variable knowledge engineering, to generate useful knowledge
region fragments, aptamers (single stranded DNA and from the raw data provided by sensors.
RNA molecules), peptides, molecular imprinted
polymers, whole organism systems (IR, magnetic and
optical), cell and tissue based sensors, nanoreactors. 4.5 Conclusions and recommendations
· Microfabricated transducers – electrochemical/ Much scientific and technological research that may
electroluminescence sensors, thin film optical devices, contribute to meeting the demand for novel detection
magnetic systems, optical sensors based on surface systems is being carried out in diverse fields, in particular
plasmon resonance, quantum dots, photonic crystals, in cell- and tissue-based recognition elements and
reflectivity and holography, fibre optic bundles, surface lab-on-a-chip technologies, and this effort should receive
enhanced Raman spectroscopy (SERS) and surface continued support. At present much relevant research
enhanced resonance Raman spectroscopy (SERRS), and development is driven by military, medical or
optical, electrical and acoustic arrays, imaging environmental applications and there is little coordinated
techniques, instrumentation and software, acoustic effort in the UK to harness this research for applications to
sensors (rupture event scanning, Love wave, chemical and biological agent detection in the civil
magnetic-acoustic resonance). Sample presentation, environment.
miniaturisation, ruggedisation, reagent-free techniques.
Integration with force-based techniques (magnetic Considerable research is presently being undertaken on
bead, optical tweezers). fledgling technologies of potential relevance to detection,
identification and monitoring of chemical and biological
agents, by parts of the academic community that have
little or no experience of working on military or
The requirements are so completely different from the · Gaseous oxidising and chlorinating gases can be effective
military scenario, where the focus is on personal decontaminants for many chemical and biological agents,
protection equipment to prevent individuals becoming but there is a need to evaluate such procedures, especially
contaminated, that little useful extrapolation can be with regard to damage to the contents of building, such
made from the military experience. They are also such as computing equipment, and to establish the correct
that it should be possible to produce standard detergent criteria for their use.
solutions and protocols for their use and equip first
responders accordingly. It is, however, important to · Whether there is a need to decontaminate and whether
consider variants of whatever procedure might be the decontamination has been successful will depend
standardised for different types of contamination, ie on whether any toxic substance is present in sufficient
chemical warfare agents, industrial spills (where there is quantity and form to be transferred to people by
some experience already available), and biological agents. inhalation, by mouth or by contact with the skin.
Systematic experimental investigation of the options is There is a need on an agent-by-agent basis to provide
required, especially of the interaction of contaminants estimates of safe levels of contamination. It must be
and decontaminants with skin, but the difficulties of recognised that it will be difficult to design experimental
designing experimental protocols that can be protocols to provide meaningful data about realistic
extrapolated with confidence to real situations should not scenarios. The surfaces of the interiors of buildings,
be underestimated. which will mainly be paintwork, are sometimes porous
and often highly retentive of organic contaminants. At
Contaminated casualties may arrive at hospitals and safe levels for reoccupation such surfaces might retain
adequate facilities should be available at designated significant amounts of toxic agent, but factors such as
receiving hospitals for decontamination prior to slow release of the agent and its slow degradation by air,
admission. This may require a separate building for and the role of exposure length of the occupants, would
reception to ensure the treatment area is maintained free need to be thoroughly assessed. There is also the
of contamination. considerable problem of public perception and
confidence in the advice offered (see chapter 6).
5.3 Decontamination of buildings · The selection of decontaminants will depend not only
on the toxic material but also on whether it is essential
5.3.1 Interior to avoid damage to the fabric and contents of the
building. Although excessive use of water should be
Decisions about whether decontamination of the interior avoided, this need not rule out water-based cleaning,
of buildings is necessary will depend on the nature of the especially foam- and possibly also gel-based
contamination. Good ventilation over time will be all that formulations, and the use of more specific agents such
is necessary following contamination by gases and very as enzymes.
volatile liquids. Other more persistent agents will require
specific treatments that may depend on the nature of the · It is essential that the sampling and analytical procedures
building contents and the urgency of returning the used to show that a building is safe, together with the
building to its normal use. With the notable exception of appropriate toxicological data, give those who live and
anthrax, live biological agents die off rapidly on exposure work in the building the confidence that it is safe.
to sunlight.
· Cost-effective methods of making decontamination of
There are a number of important issues that need buildings easier might usefully be investigated, along
consideration and/or investigation. the lines of ensuring that new buildings are designed to
help rather than hinder decontamination procedures.
· For decontamination of buildings, time should be allowed
to identify the agent accurately and to select the most Many of these issues had to be dealt with following the
appropriate decontaminant for that agent relevant to deliberate release of anthrax spores in letters in the USA,
the interior fabric of the building. Much experimental where the clean-up requirement was for no spores to
work is needed to provide background information for remain in the environment. In the United States 23
decision-making. Inherent in determining the level of facilities were contaminated, and 20 of these have so far
contamination will be the reliability of the sampling been decontaminated at a cost of $800m, producing
strategy adopted. Experience gained from military 3000 tons of contaminated waste. Anthrax spores exist
decontamination studies might not be entirely relevant. naturally in certain environments and can be an
Other issues relate to the exterior of buildings and to To prevent (or remove) secondary contamination of
urban environments in general. One is the problem of ambulances will require rapid and efficient methods of
immediate containment. For example, a heavily decontamination of the interior of the vehicle. This is an
contaminated surface or pools of volatile liquids on the issue where military expertise from the battlefield should
ground might cause significant down-wind hazard. Good be directly useful, for decontamination and possibly for
computer models can help in the assessment of the better design, eg avoiding crevices where capillary action
hazard and decontamination protocols available for can concentrate contaminants.
dealing with liquid pools.
Surfaces often found on the exterior of buildings, such as 5.5 Current technologies and strategies
concrete, stone or brick, have an enormous effective surface
area due to their porous nature. Rain, air and sunlight will The expertise in decontamination is held by a number of
tend to degrade any organic agent on a surface over time, groups. The most obvious are the official groups, eg the
so simple washing of the exterior along the lines of Health Protection Agency (HPA), Ministry of Defence
present procedures used for cleaning old buildings should (MoD), and overseas groups, particularly in the USA. For
be satisfactory. In serious cases detergent might also be the problems that arise in the civil environment, much
used, which would have the possible benefit of applicable knowledge might be found in those industries
incorporating specific cleaning agents, such as bleach or involved in all types of industrial cleaning,
enzymes. The extent to which a given detergent might decontamination of plant (pharmaceutical and food
assist penetration of the washings through the material industries), personal care products and household
should be assessed. Although surface contamination cleaning goods.
might be removed, some agents might remain at
appreciable levels within the pores of a building material Current technologies and strategies for decontamination
and yet be safe. Rather than attempt to remove them by adopted by the HPA use water-based formulations
drastic means it might be best to leave them or to seal including detergents, bleaches and oxidizing agents. The
them in by some appropriate surface coating. The principle of decontamination they adopt is to reduce the
presence of any such agents would need to be taken into amount of pathogen to a level at which it can no longer
account if the building was to be altered or demolished in cause harm. In many cases, this can be readily achieved by
future, especially with regard to long-lived biological washing with water and surfactant, which has been
agents. demonstrated to remove up to 99.9% of organisms from
surfaces. Additional protection can be achieved by adding
The main issue is the decision about when clean-up has hypochlorite to the wash solution, which also serves to
been achieved. This is not straightforward, and involves inactivate material in the run-off water. If surfaces are
consideration of, for example, how the wide range of heavily soiled, physical cleaning is essential to ensure that
possible agents will disperse over different types of the surface is clean: disinfectants do not reliably penetrate
exterior surfaces and whether this would change encrusted material or heavy deposits of organic material.
following simple washing procedures. Given that most
contaminant would be retained on parts of the surface MoD research is focused on military needs: the emphasis
inaccessible to people, estimates should be made of the on personnel has rightly been on protection rather than
amount of agent that could be removed by a person personal decontamination and the material
coming into direct contact with the building, such as by decontamination procedures that have been developed
placing a hand on the surface. These estimates should be assume that water will be in short supply. The emphasis
used to fix the criterion of safety of access. An alternative has therefore been on formulations with a low water
based on the total amount of toxic agent on the whole content that are especially suitable for decontamination
surface of the building would be inappropriate. Any of equipment and on the development of reactive
subsequent building work on a previously contaminated formulations. Examples are:
building would have different safety criteria for the
exterior structure. · Active surfactant formulations to overcome solubility
problems - a microemulsion based formulation has been
approved for service.
5.4 Secondary contamination of vehicles
· Microemulsion formulations to cope with capillary
In some cases, casualties and equipment may trapping (self-agitating surfactant-less middle phases)
contaminate vehicles used for transport to treatment or thickened chemical agents.
The MoD has also explored active clinging foams as a · Surfactant based decontaminating solutions. The aim is
means of dealing with agents on vertical surfaces and has to incorporate peracid chemistry into surfactant based
identified a system based on a commercial pressure microemulsions to give a system that is not corrosive or
washer dispensing an active chlorine formulation for hazardous to the user or the environment. The low
cleaning of buildings. Although MoD research has been interfacial tension of microemulsions enhances their
focussed on military needs, its experience and expertise in ability to enter contaminated porous materials and
handling and removing chemical and biological agents is hence bring the reactive components into contact with
considerable, such as Gruniard Island (Manchee et al the chemical agents. Peracids break down into weak
1983), and should be fully utilised in any new research acid and water and have many forms used in the laundry
initiative. An extensive account of liquid phase cleaning industry, with a range of solubility and surface active
agents currently in use (ie ‘proven’ decontamination properties
technologies) and in development can be found in the
Counter Proliferation Program Review Committee Report (ii) Gas phase chemistry. The most promising gas phase
to Congress (CPRC 2003). agents for application to decontamination of the external
surfaces of buildings are thought to be ozone and
Current agents are based on oxidative solutions such as chlorine dioxide, both of which are very destructive of
hydrogen peroxide, peroxyacids and potassium chemical and biological agents and of much else.
peroxymonosulphate, which are well established for Aerosols fall between solution and gas methods in that
disinfecting biological warfare agents. They are attractive they are dispersions of liquid (or solid) droplets, eg
for several reasons: (i) they act on chemical and biological hydrogen peroxide fogs. Electrostatic charging might
agents; (ii) they are less toxic to individuals and the enhance decontamination as charged aerosols have the
environment than chlorine-based decontaminants; and ability to penetrate the less accessible regions of an
(iii) they form less toxic, more manageable reaction object. The aim is to produce a battery operated
products. There are, however, concerns about the toxicity backpack, UV photoactivated liquid decontamination
of some tried and tested oxidative decontaminants such system.
as formaldehyde.
Finally, the many technologies available in the range of
Formulations currently being developed are aimed at ease industries identified above, ie those involved in all types of
of distribution and application and at the treatment of industrial cleaning, decontamination of plant
chemical and biological contaminants in a single (pharmaceutical and food industries), personal care
application. The main developments are as follows. products and household cleaning goods, constitute a
considerable body of knowledge directly and immediately
(i) Solution phase chemistry. The aim is to develop organic relevant to civil decontamination and a resource of
or aqueous-based decontamination solutions to replace research techniques that would be valuable in the
aqueous bleach and to reduce logistical burdens development of really effective methods of
associated with operational decontamination of external decontamination. For example, a high proportion of the
building surfaces. One formulation could combine items from the 2002 CPRC Report to Congress, some of
existing enzyme, peroxy- and catalyst technologies. which do involve industrial input, could be rapidly
Technologies under development include the following: developed from existing industrial capability in the UK. In
addition:
· Non-toxic, non-corrosive stable foam (Sandia 2004).
This requires minimal logistics support, and a single · The development of personal care products has required
decontaminating solution can be used for both extensive research on the interaction of materials with
chemical and biological agents. It can be deployed skin using aqueous and non-aqueous methods of
rapidly, causes minimal health and collateral damage, application. Apart from contributing to the relevant
and is relatively inexpensive. Trials have indicated that knowledge base, this type of work has generated high
the foam kills anthrax spores at least to some degree throughput testing methods that could be used in
(and partially neutralises thickened soman, VX and extending this knowledge to optimise personal
distilled mustard gas) although it is not clear whether decontamination.
this is through sporostatic (preventing germination
rather than killing the spores) or sporicidal control. · Industrial cleaning of smooth surfaces (eg ceramic,
metal and others) is highly developed and includes a
· Peroxymonosulphate oxidisers applied in the form of a wide range of methods from the application of liquid
gel. Gels maximise the contact between the bacteriocidal formulations containing many different
· There should be extensive experimental investigation of · It is important that NHS Trusts and Ambulance Trusts are
decontamination procedures for a wide range of toxic aware of the risks of secondary contamination and put
chemicals. Since decontamination formulations are measures in place to avoid it in hospitals, ambulances
likely to use similar chemically reactive species, such as and among first responders. Validated decontamination
chlorine, peracids and peroxides, the programme facilities are needed for hospitals and transport vehicles.
should obtain empirical results rather than a detailed
Independent verification that decontamination has been The second psychological perspective considers risk
successful, and that safe levels have been achieved, will communication as an element of the overall decision
be required. The public is unlikely to accept reassurances process. Pointers to good practice are available, based on
from parties directly involved in the decontamination well-established research that can be adapted to
activities or who might have a vested interest in their individual circumstances: success in communication
being undertaken, eg suppliers of decontaminants. There involves much more than just the choice of words and
is a need for a separate, impartial and authoritative body numbers (UK Resilience 2004). ‘Value judgements’
or source of advice for this specific purpose. The proposed pervade both risk and benefits, especially personal rather
new centre would be an appropriate body to provide this than societal risks. Decision-makers, potential
advice. beneficiaries and victims typically have different
viewpoints, making a variety of social and political value
The difficulties of persuading the public to return judgements unavoidable. For many people, involuntary,
following decontamination were seen following the US unjust or inescapable aspects of their situation are not just
anthrax letter incidents in 2001. The technical challenges fright or dread factors, but characteristics of
associated with decontamination following these unacceptable exposure. Thus their response to risk is
incidents were discussed in chapter 5.3.1. None of the intimately bound up with wider values. Dispassionate or
postal sorting offices involved has yet re-entered service, isolated scientific facts about the objective risk in any
even though they have apparently been decontaminated particular case might have little impact on a person’s
completely: people remain unconvinced this has been views about its generic acceptability.
achieved. There are, therefore, inescapable psychological
facets to the response to any chemical or biological It is known, for instance, that having to deal with releases
contamination incident. of certain chemicals, such as dioxins, can easily cause
additional decision-making difficulties to arise: they
The whole topic of ‘how clean is safe?’ needs to be attract a high ‘dread’ factor, because of their supposed
addressed by an interdisciplinary team, including extreme carcinogenicity and because of precedent
members of the general public, representatives from notoriety. But dioxins are difficult to measure at low
national and local Government, natural scientists, concentrations, and getting people to accept assurances
psychologists and social scientists. Even with access to all about them at what might be termed normal levels of
the available information this is not a trivial problem, and safety proves to be very difficult at the best of times, let
requires adequate funding and suitable investment in alone if such chemicals have been maliciously dispersed
preparatory work. into a populated area.
· Exploit new and existing science, engineering · Assess the efficacy of decontamination
and technology for robust detection of procedures and technologies.
chemical and biological agents.
· Assess contact hazards from contaminated
· Develop point detectors for use by first surfaces.
responders at the scene of a suspected
incident. · Develop and implement techniques for
avoiding secondary contamination in
hospitals and ambulances.
Cabinet Office (2003) Dealing with disaster. Revised third House of Commons (2003) The scientific response to
edition. Cabinet Office: London terrorism. Science & Technology select committee Eighth
report of session 2002-03 HC 415. The Stationary Office:
Carlson T M, MacQueen D H & Krauter P W (2001) London
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Lawrence Livermore National Laboratory: US Department & Melling J (1983) Decontamination of Bacillus anthracis
of Energy on Gruinard Island. Nature 303, 239-240
CDC (2001) Hand-held immunoassays for detection of NRPB (2002) Technical handbook on the national
Bacillius anthracis spores. CDC Health Advisory issued 18 arrangements for incidents involving radioactivity.
October 2001. Center for Disease Control: Atlanta. National Radiological Protection Board: Didcot.
Available online at http://www.bt.cdc.gov/agent/anthrax/
environment/handheldassays.dsp NSCWIP (2004) Go in stay in tune in. National Steering
Committee on Warning and Informing the Public: London
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decontamination information systems. Integrated goinstayintunein.htm
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Review Committee: Washington Royal Society: London
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HC 415-I. The Stationary Office: London index.htm
The members of the working group involved in producing this report were as follows.
Professor Herbert Huppert FRS (Chair) Department of Applied Mathematics & Theoretical Physics,
University of Cambridge
Professor Lynn Gladden OBE FREng Department of Chemical Engineering, University of Cambridge
Professor Alastair Hay OBE Molecular Epidemiology Unit, School of Medicine, University of Leeds
Dr Thomas Inch OBE Chairman, National Advisory Committee to the National Authority for
Implementation of the Chemical Weapons Act
* Dr Lightfoot was not involved in finalising the recommendations of this report owing to his appointment during the
study as Director, Emergency Response Division, Health Protection Agency.
Secretariat: Sara Al-Bader, Dr Nick Green1, Kate O’Shea, Dr Rachel Quinn, Matthew Rigby
1
Please address any correspondence to Dr Green
We sought evidence from a variety of organisations and individuals, and also received a number of useful unsolicited
contributions. We are very grateful to all who participated.
(i) Organisations
Antec International Ltd
Acqua Lider
British Medical Association
British Psychological Society
British Transport Police
Cambridge Environmental Research Consultants Ltd
Casella Stanger on behalf of the London Fire Brigade
Cranfield University
Department for Environment Food and Rural Affairs
Department of Trade & Industry, Foresight Directorate
dstl Fort Halstead
dstl Porton Down
Foreign & Commonwealth Office
Health Protection Agency
Home Office
London Ambulance Service NHS Trust
McBride plc
Metropolitan Police, CBRN Co-ordination Unit
Ministry of Defence
National Radiological Protection Board
Office of Science & Technology
(ii) Individuals
Dr Cam Boulet, Defence R&D Canada
Dr Tina Carlsen, Lawrence Livermore National Laboratory
Dr Eric Eisenstadt, US Defense Advanced Research Projects Agency’s Defense Science Office
Dr Homme Hellinga, Department of Biochemistry, Duke University Medical Centre
Professor Paul Kaye, Science & Technology Centre, University of Hertfordshire
Dorothea Paterno, US Army
Dr Ellen Raber, Lawrence Livermore National Laboratory
Dr Mark White, Health and Safety Executive
Professor Brendan Wren, Pathogen Molecular Biology Unit, London School of Hygiene & Tropical Medicine
Models are required that are as near to real time as Britter R E & Hanna S R (2003) Flow and dispersion in urban
possible, which should be tested against on-the-ground areas. Annual Review of Fluid Mechanics 35, 469-496
measurement of chemicals and simulates to validate and
improve them. Models are needed in following four Hanna S & Britter R E (2002) Wind Flow and Vapor Cloud
areas: Dispersion at Industrial and Urban Sites. American
Institute of Chemical Engineers, New York USA
· Determining the extent of the initial contamination and
potential re-dispersion. Hunt J C R, Carruthers D J & Daish N C (2004) Dispersion
from Accidental Releases in Urban Areas. Report to the
· Predicting the dispersal of chemical plumes in built-up UK Atmospheric Dispersion Modelling Liaison
and open environments. Committee. Report No. ADMLC/2002/3. Cambridge
Environmental Research Consultants Ltd: Cambridge
· Identifying the effectiveness of alternative cleanup
strategies.
In the UK, official documents do not detail the issues and The whole subject of scientific opinion and uncertainty
challenges involved in decision-making in the face of and the relationship to decision-making is very topical,
scientific uncertainty, especially in emergency situations receiving increasing attention in many areas. A recent UK
such the deliberate release of a chemical or biological technical report on climate change (UKCIP 2003) provides
agent. Scientific uncertainty is ubiquitous and unavoidable a wide-ranging and useful review of many of the
in such circumstances, and must be fully and properly approaches, techniques and problems. This review
incorporated into decision support procedures. Enhanced includes the various forms that scientific uncertainty takes
techniques already exist for doing this but these are not and different ways to determine, quantify and express
widely used in governmental settings. scientific uncertainty.
Expert judgement will have to be used in some form as Scientific uncertainty is a complex subject and the
part of the critical decision process in an emergency. For understanding of it is still evolving. Research in the
maximum benefit to the decision-maker, the pooling of cognitive and psychological sciences has shown that
expert scientific opinion should be formalised and individuals are not good estimators of probabilities or
structured, and make use of optimal scoring rule what confidence limits should be attached to uncertain
techniques. data.
Increasing exposure to public accountability and legal The use of science in emergency situations differs from its
ramifications can significantly prevent such advice being more usual role in one crucial respect: in an emergency
given. These factors need to be considered when scientists might have to make immediate
obtaining unbiased and high quality advice when setting recommendations that affect public safety. The traditional
up a decision support framework for responding to scientific approach involves making observations,
chemical or biological incidents. conducting experiments, and developing explanatory
models. Consequently, the usual response to significant
scientific uncertainty is to undertake further research to
A4.1 Background reduce it. Progress is dependent on many factors and
often takes a considerable amount of time. This means
The Royal Society initiated public discussion of many scientists might be viewed as being ill-equipped to deal
issues connected with risk in the 1980s and continued in with urgent crisis situations, especially when these have a
the 1990s (Royal Society 1981 & 1992). A number of very strong political component.
important discussion documents and position papers on
the technical and scientific aspects of risk assessment and The available scientific data for responding to a crisis will
management have emerged from the Government and inevitably be incomplete, insufficient and uncertain. For
its agencies in the last ten years. decision support it is vital that the available information
can be used most logically and effectively for assessing
These documents do not detail the issues and challenges and stating hazard or risk levels. The application of certain
involved in decision-making in the face of scientific elementary principles for the rational treatment of
uncertainty, especially in an urgent emergency situation. uncertainty helps, especially where responsibility for
Perhaps not surprisingly, there is virtually nothing about advice might rest mainly on the subjective judgment of a
these concerns when dealing with a terrorist chemical or few scientists, or even with a single scientist. The basic
biological attack. Indeed, this particular aspect of the principles are common to decision-making in many key
decision-making problem is apparently absent from walks of life, including the law and medicine. Evidence
international academic and technical literature, even based medicine (eg Sackett et al 2000) is a recent concept
though structures, pathways and flowcharts identifying for the formalised integration of best research evidence
the key decisions involved at different stages have been with clinical expertise and patient values in medical
proposed. practice. Similar principles apply to the use of forensic
science in the courtroom (eg Robertson & Vignaux 1995),
The Government has dealt with public safety, risk and risk although there have been difficulties in using this
management, both generally (HM Treasury 1996 & 2002; approach in the UK (Balding 1996). The principles are
HSE 1999) and in relation to the specific issues of nuclear logical rather than mathematical and should be accessible
power stations (HSE 1988), bovine spongiform to the whole spectrum of scientific expertise. The basic
encephalopathy (Phillips 2000), and foot and mouth principles involved are in an emerging speciality with the
(Anderson 2002). These led to the guidelines provided by over-arching title of evidence science (Aitken 1995;
the Office of Science and Technology (OST 2001) for Jeffreys 1961).
scientific advisory committees.