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Appendixes



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Page 213 Appendixes

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214 CHEMICAL AND BIOLOGICAL TERRORISM Personal Protective Equipment There are 63 entries in the personal protective equipment database. Of these, the vast majority (86%) of these products are designed to protect against both chemical and biological agents (eight are for chemicals only and one is for biological agents only). Many of the products are commercially available (44%), but 3 items are unique to the military. Also represented is equipment from ~ ~ other countries. The U.S. Department of Defense (] 7 entries) and the multi- agency Technical Support Working Group (6 entries) sponsor laboratory research or field testing in this area. The type of equipment is evenly divided between protective clothing and breathing apparatus (both at 41%), with ~ ~ entries that offer both types of protection. Decontamination Seventy-eight percent of the 33 products in this database involve strictly chemical decontamination. The remaining products are designed to decontaminate either biological agents alone (13%), or both biological and chemical agents together (9%~. Only ten (31%) are commercially available. Three of these ~ 0 items are focused on decontamination of people, 4 on equipment or materiel decon, and 3 might be used for decon of either people or inanimate objects. Twenty two entries (69%) are currently in research and development, which is largely funded by government agencies. The Department of Defense furies 50%, the Department of Energy 32%, and the multiagency Technical Services Working Group 9% of the decontamination products listed as in research or field testing. Only four of the 22 R&D items in the inventory are focused on biological agent decontamination; two items pertain to both chemical and biological agents; and 13 focus on chemical agents. Thirty-six percent of the products being researched are potentially applicable to human decontamination; the remainder focus solely on decon of inanimate objects. Treatment Of the 128 treatment products in the inventory, 88 (69%) are intended for biological agents, leaving 40 (32%) for the treatment of chemical agents. Funding for treatment research is provided largely by DOD (43%) and commercial institutions (34%~. NTH accounts for IS% of the funding, leaving only 5% of the funding from the Public Health Service. Biological Agents The biological agents for which at least one treatment is being tested or is already available are: anthrax, brucelIa, c. botulinum, dengue, Ebola, EKE, Lassa, plague, Q-fever, ricin, SEB, smallpox, T-2 mycotoxin, tularemia, VEE, and WEE. Other entries involve broader treatments of more than one bacteria, virus, or toxin. Treatments for viruses, c. botulinum, and T- 2 mycotoxin account for 35% of the treatment entries in the inventory (13%, 12%, and 10%, respectively)

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Page 215 Appendix A Committee and Staff Biographies Committee Biographies Peter Rosen, M.D., FACS, FACEP (Chair), is Director of Emergency Medicine Residency Program at the University of California, San Diego. Dr. Rosen previously served as chair of the IOM Committee on Treatment of Near-Drowning Victims. He has authored or edited a dozen textbooks on aspects of emergency medicine and since 1983 has served as Editor-in-Chief of the Journal of Emergency Medicine. He is a Fellow of the American College of Surgeons, the American College of Emergency Physicians, and the American Burn Association. Dr. Rosen is an IOM member. Leo G. Abood, Ph.D., was Professor of Pharmacology, Department of Pharmacology and Physiology, University of Rochester Medical Center until his death in January 1998. Dr. Abood was an expert on the biochemistry and physiology of the nervous system whose research focused on the isolation and characterization of neurotransmitter receptors from the mammalian brain, specifically nicotine, vasopressin, and opioid receptors. He previously served on the NRC Committee on Toxicology's Panel on Anticholinergic Compounds and the Chemical Weapons Stockpile Assessment Panel. Georges C. Benjamin, M.D., FACP, is Deputy Secretary for Public Health Services for the State of Maryland. Dr. Benjamin was formally Commissioner of Health for the District of Columbia and, a former Chairman,

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Page 216 Ambulatory Care, D.C. General Hospital. From 1983 to 1987 he was Chief of Emergency Medicine at the Walter Reed Army Medical Center. He is a fellow of the American College of Physicians. Rosemarie Bowler, Ph.D., is Assistant Professor and Fieldwork Coordinator, Department of Psychology, San Francisco State University. Dr. Bowler has done extensive research on individual and community reactions to toxic chemical spills and has chaired a recent symposium on the topic for the Agency for Toxic Substances and Disease Registry. Her clinical experience at SFSU includes assessing patients and groups of workers exposed to neurotoxins. Jeffrey I. Daniels, D.Env., is Risk Sciences Group Leader, Health and Ecological Assessment Division, Earth and Environmental Sciences Directorate, Lawrence Livermore National Laboratory. His expertise is risk assessment and his research involves the potential human health risks from contaminated environmental media, including air, water, soil, vegetation, and the development of a coupled chemical/biological system to degrade high explosives in demilitarization waste water. He is Past-President of the Northern California Chapter of the Society for Risk Analysis. Craig A. DeAtley, B.S., P.A., is Director of the Emergency Medical Services Program, Associate Professor, Department of Emergency Medicine and Health Care Sciences Program, and CoDirector for Hazmat Medical Services, George Washington University. He is also Deputy Medical Director, Flight Medic and SWAT Medic, Fairfax County Police; Medical Specialist, Metropolitan Medical Strike Team DC-1 (PHS-sponsored NBC responders in Washington, D.C., area); and EMS Captain, Fairfax Fire and Rescue. He serves on the editorial boards of Rescue EMS News and Prehospital and Disaster Medicine. Lewis Goldfrank, M.D., FACMT, FACP, FACEP, is Director of Emergency Medicine, New York University School of Medicine, Bellevue Medical Center. He is the medical director of the New York City Poison Control Center. Dr. Goldfrank served as president of the Society of Academic Emergency Medicine and chairs the American Board of Emergency Medicine's Subboard on Medical Toxicology. He is coeditor of the Agency for Toxic Substances Disease Registry's Medical Guidelines for Managing Hazmat Incidents, and senior editor of Goldfrank's Toxicologic Emergencies, a standard text in medical toxicology. Dr. Goldfrank is an IOM member. Jerome M. Hauer, M.H.S., is Director, Office of Emergency Management, City of New York. He previously was Director of Emergency Medical

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Page 217 Services and Emergency Management for the State of Indiana. He also directed Hazmat response, crisis management, and fire safety for IBM. He is a former Army Captain assigned to the Walter Reed Army Institute of Research and past Chair of the U.S. Earthquake Consortium. Hauer also served on the U.S. Geological Survey ad hoc working group on earth-quake-related casualties. He currently serves on the FBI Scientific Advisory Council on Hazardous Materials Response. Karen Larson, Ph.D., is a Toxicologist, Office of Toxic Substances, Washington (State) Department of Health. A molecular biologist, Dr. Larson is the Washington Health Department's liaison with the state emergency planning agency, advising on methods of detection, protection, and treatment in real and hypothetical chemical or biological disasters. Matthew S. Meselson, Ph.D., is Thomas Dudley Cabot Professor of the Natural Sciences, Department of Molecular and Cellular Biology, Harvard University. Dr. Meselson is a member of the NAS Committee on International Security and Arms Control and the Working Group on Biological Weapons Control. He served on the NAE Committee on Alternative Chemical Demilitarization Technologies and the Advisory Panel on the Chemical Research, Development and Engineering Center. Dr. Meselson is a member of both IOM and NAS. David H. Moore, D.V.M., Ph.D., is Director, Medical Toxicology Programs for Battelle Memorial Institute's National Security Division since January, 1998. This position follows a distinguished career of more than 20 years as a scientist in Army medical research and development, culminating in his service as Deputy Director of the U.S. Army Medical Research Institute of Chemical Defense. Dr. Moore also served as the Army Surgeon General's Advisor on Toxicology and Consultant on Comparative Medicine. Dr. Moore graduated with honors from the University of Georgia College of veterinary medicine in 1977, and earned his Ph.D. in Physiology at Emory University in 1984. Dennis M. Perrotta, Ph.D., is Chief, Bureau of Epidemiology, Texas Department of Health. Dr. Perrotta administers the Texas Poison Center Network, serves on the Armed Forces Epidemiology Board (AFEB), and recently prepared a report for the AFEB on mustard gas and sarin. In addition, he has served on review sections at NIH and ATSDR and served as a reviewer for the IOM report on Emerging Infectious Diseases. Linda Powers, Ph.D., is Director, National Center for the Design of Molecular Function, Professor of Electrical and Biological Engineering, and

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Page 218 Adjunct Professor of Physics at Utah State University. After completing her M.A. in Physics and Ph.D. in Biophysics at Harvard University, she became a member of the technical staff at AT&T Bell Laboratories. She joined the USU faculty in 1988. She has a broad scope of expertise from biochemistry to electrical engineering, and has considerable experience in heme protein catalysis, structural biology, and the design and construction of optical and X-ray instrumentation. She was a pioneer the use of X-ray absorption spectroscopy for the investigation of biological problems and has authored more than 100 technical publications in refereed journals and books. Philip K. Russell, M.D., is Professor of International Health, School of Hygiene and Public Health, Johns Hopkins University. He is former Commander of Army Medical Research and Development. An infectious disease specialist with particular expertise in vaccines, he serves on the Scientific Advisory Board of the National Center on Infectious Disease at the Centers for Disease Control and Prevention. Jerome Schultz, Ph.D., is Director, Center for Biotechnology and Bioengineering, University of Pittsburgh. Dr. Schultz is a biochemical engineer with expertise in biochemistry. His research is focused on using bio-molecules with recognition capability for biosensor probe devices. He is a past president of the American Institute for Medical and Biological Engineering, and is currently Vice-Chair, Board on Army Science and Technology's (BAST) Committee for the Review of Army Chemical and Biological Defense Command. Dr. Schultz is an NAE member. Robert E. Shope, M.D., is Professor of Pathology in the WHO Center for Tropical Diseases at the University of Texas Medical Branch at Galveston. The Center serves as the repository for a major collection of arboviruses and rodent-associated viruses. He is a virologist/epidemiologist and former Director of the Yale Arbovirus Research Unit. He was involved as a member of the teams that investigated outbreaks of Rift Valley fever, Lassa fever, Venezuelan hemorrhagic fever, and other often fatal hemorrhagic diseases caused by viruses that have bioterrorism potential. He also has expertise in diagnosis and rapid identification of human-pathogenic viruses carried by arthropods and rodents, and he cochaired in 1992 the Institute of Medicine's study on emerging infections. Robert S. Tharratt, M.D., FACP, FCCP, FACMT, is Associate Professor of Medicine and Chief, Section of Clinical Pharmacology and Medical Toxicology, Division of Pulmonary and Critical Care Medicine, University of California Davis. Dr. Tharratt is also Associate Regional Medical Director

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Page 219 of the Davis Division of the California Poison Control System, Medical Director of Sacramento County Emergency Medical Services, and Medical Director of the Sacramento City and County Fire Agencies. He is a hazardous materials specialist and a Medical Manager for FEMA Urban Search and Rescue Team CA-7. Staff Biographies Frederick J. Manning, Ph.D., is a Senior Program Officer in IOM's Health Science Policy Program and Study Director. In 5 years at IOM, he has served as Study Director for projects addressing a variety of topics from medical isotopes to potential hepatitis drugs, blood safety and availability, rheumatic disease, and resource sharing in biomedical research. Prior to joining IOM, Dr. Manning spent 25 years in the U.S. Army Medical Research and Development Command, serving in positions that included Director of Neuropsychiatry at the Walter Reed Army Institute of Research and Chief Research Psychologist for the Army Medical Department. Dr. Manning earned his Ph.D. in Psychology from Harvard University in 1970, following undergraduate education at the College of the Holy Cross. C. Elaine Lawson, M.S., is a Program Officer in the Institute of Medicine's Health Sciences Section. Ms. Lawson obtained her B.S. in Physical and Health Education from James Madison University, and her M.S. in Exercise Science and Health from George Mason University. She has written chapters for IOM reports on genetic risks and stalking behavior, and was coeditor of IOM reports on healthcare in schools and on gender differences in susceptibility to environmental factors. She recently codirected the Institute of Medicine and Smithsonian Institution joint venture for a leadership institute on K–6 science education. Carol A. Maczka, Ph.D., is the Director of Toxicology and Risk Assessment in the NAS Board on Environmental Studies and Toxicology (BEST). She obtained her Ph.D. in pharmacology from the George Washington University, with a minor concentration in the metabolism of xenobiotics. She has written a chapter for the IOM report Veterans and Agent Orange and participated in numerous BEST studies. Other current projects involve: drinking water contaminants, hormonally active agents in the environment, developmental toxicology, and strategies to protect the health of deployed U.S. forces. Prior to joining the NRC, Dr. Maczka was Senior Vice President of Clement International, a health and environmental consulting firm.

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220 CHEMICAL AND BIOLOGICAL TERRORISM CoxielIa burnetii Rickettsia prowozekii Rickettsia rickettsii Cocciclioicles immitis Abrin Aflatoxins BotuTinum toxins Clostridium perfringens epsilon toxin Conotoxins DiacetoxyscirpenoT Ricin Saxitoxin Shigatoxin Staphylococcal enterotoxins Tekodotoxin T-2 toxin FUNGI TOXINS