Reopening Public Facilities
AFTER A BIOLOGICAL ATTACK
A Decision Making Framework
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NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.
This material is based upon work suported by The Regents of the University of California Lawrence Livermore National Laboratory under Subcontract No. B530522 as part of the Restoration and Domestic Demonstration and Application Program funded by the Department of Homeland Security through Interagency Agreement No. HSHQPB05X00123. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the authors and do not necessarily reflect the views of the Lawrence Livermore National Laboratory or the Department of Homeland Security.
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COMMITTEE ON STANDARDS AND POLICIES FOR DECONTAMINATING PUBLIC FACILITIES AFFECTED BY EXPOSURE TO HARMFUL BIOLOGICAL AGENTS: HOW CLEAN IS SAFE?
KENNETH BERNS (Chair),
University of Florida, Gainesville, Florida
RONALD M. ATLAS,
University of Louisville, Louisville, Kentucky
MANUEL S. BARBEITO,
Biosafety Consultant, Frederick, Maryland
JACQUELINE CATTANI,
University of South Florida, Tampa, Florida
LEE CLARKE,
Rutgers University, New Brunswick, New Jersey
CHRISTOPHER J. DAVIS,
CUBRC, Inc., Buffalo, New York, and Washington, DC
PATRICIA FELLOWS,
DynPort Vaccine Company, Frederick, Maryland
CHARLES N. HAAS,
Drexel University, Philadelphia, Pennsylvania
THOMAS INGLESBY,
University of Pittsburgh Medical Center, Baltimore, Maryland
HARVEY W. KO,
Johns Hopkins University, Laurel, Maryland
R. PAUL SCHAUDIES,
Science Applications International Corporation, Rockville, Maryland
MONICA SCHOCH-SPANA,
University of Pittsburgh Medical Center, Baltimore, Maryland
JOHN D. SPENGLER,
Harvard School of Public Health, Boston, Massachusetts
JAMES TUCCI,
K&J Consulting, Cantonment, Florida
JAMES WILDING,
Metropolitan Washington Airports Authority (retired), Glenwood, Maryland
Board on Life Sciences Liaison to the Committee
RANDALL MURCH,
Virginia Polytechnic Institute and State University, Alexandria, Virginia
Staff
KERRY A. BRENNER, Study Co-director
EVONNE P.Y. TANG, Study Co-director
FRANCES E. SHARPLES, Director, Board on Life Sciences
EILEEN CHOFFNES, Senior Program Officer
BRIDGET K.B. AVILA, Senior Program Assistant (until March 2004)
SETH H. STRONGIN, Senior Program Assistant
KATE KELLY, Editor
BOARD ON LIFE SCIENCES
COREY S. GOODMAN (Chair),
Renovis, Inc., South San Francisco, California
ANN M. ARVIN,
Stanford University, Stanford, California
JEFFREY L. BENNETZEN,
University of Georgia, Athens, Georgia
RUTH BERKELMAN,
Emory University, Atlanta, Georgia
R. ALTA CHARO,
University of Wisconsin, Madison, Wisconsin
DENNIS CHOI,
Merck Research Laboratories, West Point, Pennsylvania
JEFFREY L. DANGL,
University of North Carolina, Chapel Hill, North Carolina
PAUL R. EHRLICH,
Stanford University, Stanford, California
JAMES M. GENTILE,
Research Corporation, Tucson, Arizona
ED HARLOW,
Harvard Medical School, Cambridge, Massachusetts
DAVID HILLIS,
University of Texas, Austin, Texas
KENNETH H. KELLER,
University of Minnesota, Minneapolis, Minnesota
RANDALL MURCH,
Virginia Polytechnic Institute and State University, Alexandria, Virginia
GREGORY A. PETSKO,
Brandeis University, Waltham, Massachusetts
STUART L. PIMM,
Duke University, Durham, North Carolina
BARBARA A. SCHAAL,
Washington University, St. Louis, Missouri
JAMES TIEDJE,
Michigan State University, East Lansing, Michigan
KEITH YAMAMOTO,
University of California, San Francisco, San Francisco, California
Staff
FRANCES E. SHARPLES, Director
KERRY A. BRENNER, Senior Program Officer
MARILEE K. SHELTON-DAVENPORT, Senior Program Officer
ROBERT T. YUAN, Senior Program Officer
ADAM P. FAGEN, Program Officer
ANN H. REID, Program Officer
EVONNE P. Y. TANG, Program Officer
JOE C. LARSEN, Postdoctoral Research Fellow
DENISE GROSSHANS, Financial Associate
SETH H. STRONGIN, Senior Program Assistant
MATTHEW D. MCDONOUGH, Program Assistant
Preface
The impact of bioterrorism was brought home to the American public in the fall of 2001. Although there had been earlier instances of bioterrorism, as well as threats and hoaxes in recent years in Japan and the United States, the juxtaposition of the biological attacks of 2001 to the events of September 11, and the use of highly lethal preparations of anthrax, had a profound effect on the national psyche. Private and government facilities alike were affected, and considerable challenges were encountered in the process of cleaning up the affected facilities. The decontamination efforts were heavily publicized, time consuming, and very expensive. Sampling and decontamination approaches and parameters had to be decided upon very quickly. Plans had to satisfy scientific criteria to show that individuals reentering the area would not become infected and, as important, address the concerns and fears of people who used the facilities. Eventually, all of the public and private facilities were successfully decontaminated (although there was a considerable delay, caused by financial concerns, in the cleanup of one private site). However, given the urgency, and lack of preparedness with which decisions were made in 2001 and 2002, it seemed likely that the process could be improved with advance planning. This study was requested to help provide a framework for the restoration of contaminated facilities should it be necessary in the future. Specifically, the study was undertaken to consider the question of “How clean is safe?” and to address the criteria that must be satisfied to determine that the site of a biological attack is fit to use again.
The 2001 anthrax attacks revealed our vulnerabilities, and suggested that a more widespread attack could have serious consequences for the ability of the country to function. Following the 2001 attacks, alternative locations were found so that essential work could continue. However, if a major transportation terminal
for planes or trains were to be taken out of commission, it would be extremely difficult or perhaps impossible to relocate those services elsewhere. In addition to the large costs of a cleanup, the financial consequences and impact on commerce and society could be enormous. If a larger number of sites were attacked and the areas that had to be cleaned up were more extensive, the costs could rapidly escalate to a level that might prove unsupportable (depending in some part on just how essential or irreplaceable each site was deemed to be). The final costs would depend on the approach taken to decontaminate, the parameters that need to be satisfied in terms of test results, the extent of testing, and the evaluation of acceptable risk. To make recommendations about these issues, the committee considered many questions.
What are the best ways to assess the presence of the agent? What are the best tests and how should they be applied? How much and what type of sampling is enough? How sensitive do the tests need to be? How many organisms constitute an “infectious” dose? What tests are necessary to declare an area safe? Risk analysis constitutes a major component of this study. The participation and confidence of the affected stakeholders in the process of cleanup and the overall response to a bioterrorism incident are crucial.
The recommendations of this report provide guidance on scientific and social science issues because both areas are important to creating a systematic approach to developing standards for effective remediation after a biological attack.
Kenneth Berns
Chair, Committee on Standards and Policies for Decontaminating Public Facilities Affected by Exposure to Harmful Biological Agents: How Clean is Safe?
Acknowledgments
This report has been reviewed in draft form by persons chosen for their diverse perspectives and technical expertise in accordance with procedures approved by the National Research Council’s Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published report as sound as possible and to ensure that the report meets institutional standards of objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the deliberative process. We wish to thank the following individuals for their review of this report:
Roy M. Anderson, Imperial College, London, United Kingdom
Peter Biggins, Dstl Chemical and Biological Sciences, Porton Down, United Kingdom
Margaret Coleman, Syracuse Research Corporation, Syracuse, New York
Baruch Fischhoff, Carnegie Mellon University, Pittsburgh, Pennsylvania
David Franz, Midwest Research Institute, Frederick, Maryland
Terrance Leighton, Children’s Hospital Research Institute, Oakland, California
Harold Lewis, University of California, Santa Barbara, California
Richard Marchi, Airport Council International-North America, Washington, DC
Shelly Miller, University of Colorado, Boulder
Sandra Crouse Quinn, University of Pittsburgh, Pennsylvania
Although the reviewers listed above have provided constructive comments and suggestions, they were not asked to endorse the conclusions or recommendations, nor did they see the final draft of the report before its release. The review of
this report was overseen by R. Stephen Berry, James Franck Distinguished Service Professor Emeritus, The University of Chicago and Richard B. Setlow, Senior Biophysicist, Brookhaven National Laboratory. Appointed by the National Research Council, they were responsible for making certain that an independent examination of this report was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this report rests entirely with the author committee and the institution.