In contemplating how to respond to potential biological attacks, authorities should base their plans on lessons from the experiences of others who have dealt with decontamination issues in the broadest sense; they should not consider their charge a completely novel task. Decision making about a facility contaminated as the result of a biological attack should be mindful of the critical policy dimensions of the biological quality of the hazard, the public nature of the building, the public’s perception of an attack, and the event’s national security implications.
If safety-related standards and protocols are devised and implemented behind closed doors, without the consent or input of affected and interested parties, those standards are likely to be questioned or rejected outright. Lack of transparency for policy decisions that directly affect public health—even in the context of a proclaimed national security interest—can severely erode public confidence. The establishment of a formal planning procedure that involves relevant stakeholders before an event should expedite the response and confer legitimacy for decisions made during and after decontamination.
Representatives of affected parties should be involved in risk management decision making, and they should participate in the technical discussions needed to make decisions. Engaging the people whose well-being is most at stake helps ensure their greater confidence in the outcome of risk-based decisions. Those who provide the technical information should be independent experts who are free of conflicts of interest, so that they can give the highest priority to protecting public health. Stakeholder involvement in risk assessment and management provides valuable returns: local knowledge that can contribute to a more robust definition of the danger, greater public confidence in scientific tools that support public policy, and more widespread acceptance of the legitimacy of the results.
People and microorganisms cohabit the world; their interactions sometimes result in human disease. Nonetheless, in settings where people risk exposure to pathogens (laboratories, hospitals), biological safety policies can protect against human disease. Decontamination is not a standalone activity, but part of a larger set of controls over dangerous microorganisms and their potential health effects. The domestic institution that routinely dealt with weaponized pathogens—the U.S. Army Biological Warfare Laboratories—developed a comprehensive set of biological safety programs to control those pathogens. Protective measures ranged from preemptive vaccination to medical monitoring and treatment for inadvertent exposures.