Click for next page ( 24


The National Academies | 500 Fifth St. N.W. | Washington, D.C. 20001
Copyright © National Academy of Sciences. All rights reserved.
Terms of Use and Privacy Statement



Below are the first 10 and last 10 pages of uncorrected machine-read text (when available) of this chapter, followed by the top 30 algorithmically extracted key phrases from the chapter as a whole.
Intended to provide our own search engines and external engines with highly rich, chapter-representative searchable text on the opening pages of each chapter. Because it is UNCORRECTED material, please consider the following text as a useful but insufficient proxy for the authoritative book pages.

Do not use for reproduction, copying, pasting, or reading; exclusively for search engines.

OCR for page 23
2 Threat and Risk Assessment HISTORICAL PERSPECTIVE OF THE CHEMICAL/BIOLOGICAL BATTLE SPACE CB agents have been considered effective weapons for combat for more than a millennium, from the tossing of plague victims over castle walls to the poisoning of water supplies and individuals. However, lethal CB weapons were first used extensively by the military in World War I (U.S. Army Office of the Surgeon General, 1997~. Trench warfare, in which forces were deployed in fixed positions vulnerable to concentrated pock- ets of lethal fumes, provided fertile ground for the development of chemi- cal weapons that could be dispersed as fogs, mists, or dense vapors. The first chemicals used during World War I were noxious gases (chlorine [C12], hydrogen sulfide [H2S], and phosgene [COCA) and were released from upwind storage vessels along enemy lines. Local meteorological patterns were used to predict the movement of the gas clouds. However, this methodology was often ineffective because rapid changes could cause deadly clouds to settle on friendly forces, resulting in self-inflicted casual- ties. Early chemical agents were primarily inhalation threats, and effec- tive gas masks (or respirators) were quickly developed and refined to protect personnel against toxic gases. Respirators greatly diminished the tactical advantage of using toxic gases, and new chemical warfare agents had to be developed. Some of the new agents were chemical mustard agents, sulfur and nitrogen mustards, which caused serious injury and incapacitation not only when they were inhaled but also when they came into contact with the skin or mucous 23 13547--Deployed Forces 02 23 12128199, 1:33 PM

OCR for page 23
24 STRATEGES TO PROTECT THE HEALTH OF DEPLOYED U.S. FORCES membranes. Because of the percutaneous threat of these agents, gas masks alone could no longer provide adequate protection, and garments to pro- tect skin had to be developed. In addition to new agents, new delivery systems were also devel- oped. At first, artillery shells were modified to accommodate agents. Later, more sophisticated techniques evolved. Although there was still some risk that changes in local weather and climate could cause chemical agents to drift onto friendly targets, the risk was mitigated significantly as target- ing became more accurate. During the interval between World War I and World War II, new and more lethal families of chemical agents were developed. German scien- tists working to provide weapons for their military, discovered and re- fined a series of "nerve" agents tabun (GA), soman (GD), and sarin (GB) that attacked the central nervous system, could be absorbed through mucous membranes and the skin as well as inhaled, and were lethal in much smaller doses than the chemicals that had been used dur- ing World War I. At the same time, Japanese scientists were experiment- ing with agents of biological origin, such as plague and typhus. These agents were tested on human prisoners (U.S. Army Office of the Surgeon General, 1997~. Although neither chemical nor biological agents were actually used during World War II to achieve any military objectives, work continued and provided the foundation for the extensive CB research program of the Cold War powers. Led by scientists in the United States and the Soviet Union, the CB weapons programs flourished during the 1950s and 1960s. New nerve agents were developed (the family of V agents) that were not only more lethal in smaller inhaled doses but could also be absorbed directly through the skin. Existing agents were refined and mixed with additives to increase their persistence in the environment and the diffi- culty of decontamination. During this time, natural toxins produced by biological organisms were also developed as weapons. The poisons produced, for example, by castor beans (ricin), puffer fish (tetrodotoxin), bacteria (botulinum), and fungi (mycotoxins) are among the most toxic compounds known and are lethal in even smaller quantities than V-agents. Although the production of large quantities of these toxins was difficult because of their high de- gree of lethality, much smaller amounts were required. In addition to plague and typhus, other biological pathogens were studied as biological warfare agents, and weaponization techniques were researched and developed. Virtually every type of disease, condition, and means of dissemination was studied. From smallpox to cholera, from anthrax to hemorrhagic fevers, from tularemia to parasites, these agents and others were considered as possible weapons. The exposure of troops 13547--Deployed Forces 02 24 12/28/99, 1:33 PM

OCR for page 23
THREAT AND RISK ASSESSMENT 25 to pathogens or toxins through food supplies, water supplies, aerosols, and insect or animal vectors was also studied. During the post-1950s era, the means of dissemination of lethal agents became major research objectives. Airborne spray tanks, specialized artil- lery shells, CB-capable missile warheads, and an assortment of individual weapons were developed. At the same time, the threat of exposure led to the development of defenses. Protection (both individual and collective) and decontamination became high-priority issues and stimulated the de- velopment of protective equipment. Thus, gas masks, protective garments, boots, gloves, protective shelters, and decontaminating solutions and sys- tems were produced. Even as the development of more and more lethal agents continued, societal fears and the conviction that the use of weapons of mass destruc- tion was unethical resulted in treaties and international agreements that limited the proliferation, control, and testing of CB weapons. The Geneva Protocol of 1925 condemned the use in war of asphyxiating, poisonous, or other gases, as well as bacteriological warfare. The United States signed the Geneva Protocol but did not ratify it until 1975. However, the United States reserved the right not to be bound by the protocol if any enemy or state or any of its allies did not respect the protocol. In 1972, the Biological and Toxins Weapons Convention (BWC) was signed. Under the terms of the convention, the parties agreed not to de- velop, produce, stockpile, or acquire biological agents, toxins, weapons, or means of delivery. Many years later, the Chemical Weapons Conven- tion (CWC) banned the acquisition, development, production, transfer, and use of chemical weapons throughout the world. The United States signed the CWC in 1993 but did not ratify it until 1997. On June 25, 1999, the President issued an Executive Order implementing the CWC; it went into effect on June 26, 1999. Since the implementation of these treaties, both the United States and the former Soviet Union have embarked on programs to destroy residual stockpiles (U.S. Army Office of the Surgeon General, 1997~. However, CB technologies have been transferred to, and proliferated in, other coun- tries; and modern bioengineering and molecular biological capabilities have given even small nations and groups the capability of developing novel, lethal agents. Documentation of the use of chemical weapons in localized wars and credible warnings from the intelligence community confirm that many potential enemies in regions to which U.S. forces may be deployed have the capability of using CB weapons. Thus, the United States could find itself confronted with adversaries who have either chosen not to sign and ratify the CWC and/or BWC or have chosen to ignore them. Nevertheless, as a signatory of both the CWC and BWC, the United States has adopted a national policy of not using 13547--Deployed Forces 02 25 12128199, 1:33 PM

OCR for page 23
26 STRATEGIES TO PROTECT THE HEALTH OF DEPLOYED U.S. FORCES biological or chemical weapons in warfare even in retaliation for a CB attack. This asymmetrical threat has led to a national military strategy based on defense and deterrence (Chow et al., 1998; DoD, 1995; Joint Chiefs of Staff, 1995; Secretary of Defense, 1999; U.S. Army and U.S. Ma- rine Corps, 1996~. The policy is to deter the use of CB agents by enabling U.S. forces to survive, fight, and win a war under CB conditions. This policy has stimulated a continuing research program for refining military doctrine, for developing protective technologies, and for training U.S. forces against CB attack. U.S. RESPONSE The Army Chemical Corps has historically been the military organi- zation primarily responsible for dealing with CB threats. Founded in June 1918 as the Chemical Warfare Service and renamed the Army Chemical Corps in August 1946, the Army Chemical Corps has alternately enjoyed support and been threatened with elimination, depending on political and economic exigencies. Prior to 1920, the development of chemical de- fenses was not tightly structured. Various chemical warfare schools (called gas schools) existed, but no single department was responsible for coordi- nating chemical warfare activities. The Army assumed the de facto role of executive agent for CB R&D by virtue of its large and long-term invest- ment in the development of chemical equipment and its extensive experi- ence with chemical exposure on the battlefield. The Army controlled the production of chemicals, the development and production of defensive equipment, training, testing, basic research, and a new chemical war- fare unit. Although the Army was more actively involved in this area than other services, in fact each military service was free to develop its own CB defense program and materiel. Each service had a separate budget and administered the budget and its program independently, cooperating with other services as the needs of basic or developmental research dic- tated. Each service also prioritized its needs for equipment separately, on the basis of service-specific needs. As operations became more and more integrated and cooperative (joint operations), both Congress and the military departments recognized the need for joint R&D programs and integrated procedures to improve joint operations and decrease logistical support burdens. This need has become more compelling as budgets have become more constrained and the cost of duplication of equipment has become unsupportable. In the early 1990s, Congress began to encourage joint R&D programs. However, encouragement was not enough to overcome decades of inde- pendent activities (Nilo, 1999~. Therefore, Congress passed Public Law 13547--Deployed Forces 02 26 12128199, 1:33 PM

OCR for page 23
THREAT AND RISK ASSESSMENT 27 (PL) 103-160, the National Defense Authorization Act for Fiscal Year 1994 (Title XVII), which included the following stipulations (U.S. Congress, 1994~: The CB defense program would be coordinated by a single DoD office that would oversee the program through the Defense Acqui- sition Board process. The CB defense program would have a coordinatedfintegrated budget. CB defense funds would be administered from DoD-level accounts. The Army would be the executive agent for coordination and inte- gration of the CB defense program. In order to meet the requirements of PL 103-160, a new structure, the Joint NBC Defense Board, was established to provide oversight and man- agement of DoD's NBC defense program (Figure 2-1~. The NBC Defense Board's responsibilities include approval of (1) joint NBC requirements; (2) the Joint NBC Modernization Plan; (3) the consolidated NBC Defense Program Objective Memorandum (POM); (4) the Joint NBC Research, Development, and Acquisition (RDA) Plan; (5) joint training and doctrine initiatives; and (6) the Joint NBC Logistics Support Plan. The Joint NBC Defense Board Secretariat is responsible for management of program and acquisition strategies; planning, programming, budgeting, and execution of the program; and consolidation and integration of CB requirements and programs for all services. Two subordinate groups support the Joint NBC Defense Board: the Joint Service Integration Group (ISIG) and the Joint Service Materiel Group (JSMG). The JSIG is responsible for joint NBC requirements, priori- ties, training, and doctrine. Thus, the ISIG develops a prioritized list of needs, requirements, and programs, which are based on commander-in- chief (CINC) priorities, threat projections, and analyses. A list of current, integrated CINC priorities, as well as the NBC Defense Program priorities can be found in Tables 2-1 and 2-2. The priorities identified by the ISIG are inputs to the ISMG, which is responsible for the coordination, integration, planning, and programming of nonmedical RDA, science and technology, and logistics sustainment. Other responsibilities of the ISMG include preparation of the Joint Service NBC Defense RDA Plan, preparation of the Joint Service NBC Defense Logistics Support Plan, continuous review of the technology base, and reviews of developmental programs for possible NBC defense applications Although the NBC defense program addresses nuclear, as well as chemical and biologi- cal threats, the National Academies was only asked to address chemical and biological threats. Thus, this report only includes the chemical and biological aspects of CB defense. 13547--Deployed Forces 02 27 12128199, 1:33 PM

OCR for page 23
28 STRATEGES TO PROTECT THE HEALTH OF DEPLOYED U.S. FORCES USD (A&T) Joint CBD Steering Committee Joint NBC Defense Bran rri. * Voting members are the four services IAW JSA CB Directorate DATSD(CBD) JPO-BD E: Executive agent 4iE3 T | Medical | | DOE | I DARPA I l | National laboratories | Oversight Funding management -- Coordination Program management/execution Direct reporting chain FIGURE 2-1 Management structure of the DoD Chemical and Biological Defense Program Note: CBD = chemical/biological defense; DARPA = Defense Advanced Re- search Projects Agency; DATED (CBD) = Deputy Assistant to the Secretary of Defense for Chemical/Biological Defense; DDR&E = Director, Defense Research and Engineering; DOE = U.S. Department of Energy; DTRA = Defense Threat Reduction Agency; JAW USA = in accordance with the joint service agreement; JPO-BD = Joint Program Office for Biological Defense; SIG = Joint Service Inte- gration Group; SAG = Joint Service Materiel Group; USAF = United States Air Force; USD(A&T) = Undersecretary of Defense (Acquisition and Technology); USMC = U.S. Marine Corps Source: Nilo, 1999. and/or impacts. The ISMG and the ISIG jointly prepare the consolidated NBC Defense POM strategy. The services receive funding for NBC defense programs from the Office of the Secretary of Defense after having their inputs considered by the NBC Defense Board. Programmatic and other decisions are based on a formal voting process in which each member has one vote. The mem- bership of each group (the NBC Defense Board, the ISIG, and the ISMG) consists of representatives of each of the services, the joint staff, the De- fense Logistics Agency, the Joint Program Office for Biological Defense (JPO-BD), the Medical Research Materiel Command, and the Special Op- erations Command. 13547--Deployed Forces 02 28 12128199, 1:33 PM

OCR for page 23
THREAT AND RISK ASSESSMENT TABLE 2-1 Integrated CINC Priorities 29 1. 2. 3. 4. 5. 6. 7. 8. 9. 0. 11. 12. 13. 14. 15. 16. Intelligence Precision attack with no collateral damage Special operations forces counterterrorism NBC detection and warning Theater missile defense with no collateral damage Defeat underground targets Target planning and battle damage assessment Individual protection Proliferation pathway analysis Cruise missile DEF/ADA with no collateral damage Collective protection Defeat mobile target Offensive information warfare Logistics consequences capability Decontamination NBC medical treatment Source: Nilo, 1999. Execution of the RDA program under the ISMG is controlled by a group of five commodity area managers. Each service has been assigned lead responsibility for the commodity area most closely aligned with its expertise: contamination avoidance Army; individual protection- Marine Corps; collective protection Navy; decontamination Air Force; medical protection Medical Research Materiel Command. These com- modity area managers are responsible for developing materiel that is usable in the field. Discussions with personnel at the U.S. Army Chemical School, Sol- dier and Biological Chemical Command, ISMG, Deputy Chief of Staff for Operations, and outside contractors revealed general dissatisfaction with the prioritization process because service-specific projects were often given priority over projects based on multiservice needs through a pro- cess of political compromise and CINC priorities were largely ignored in the process (Blankenbiller, 1998; Nilo, 1999; U.S. Army SBCCOM, 1998~. A comparison of CINC priorities (shown in Table 2-1) and program priori- ties (shown in Table 2-2) lends some credence to these complaints. RELATIONSHIPS AMONG POLICY; DOCTRINE; RESEARCH, DEVELOPMENT AND ACQUISITION; AND THREAT The intelligence community provides data, analysis, and advice on the development of CB capabilities of threat nations. Based on informa- tion about the types, quantities, and delivery systems of CB agents, CINCs and the ISIG evaluate the ways these agents could be used against U.S. 13547--Deployed Forces 02 29 12128199, 1:33 PM

OCR for page 23
30 STRATEGES TO PROTECT THE HEALTH OF DEPLOYED U.S. FORCES TABLE 2-2 Nuclear, Biological, Chemical (NBC) Nonmedical Defense Program Priorities Priority Area Program 1 CA Joint Biological Point Detection System 2 CA Joint Biological Remote Early Warning System 3 CA Joint Service Light NBC Reconnaissance System 4 BM Joint Warning and Reporting Network 5 CA Joint Service Lightweight Standoff Chemical Agent Detector 6 CA Biological Integrated Detection Systems 7 CA Chemical/Biological Mass Spectrometer 8 CA Interim Biological Agent Detector 9 IP Joint Lightweight Integrated Suit Technology (JLIST) 10 CA Joint Chemical Agent Detector 11 IP Aircrew Mask Programs 12 CA NBC Reconnaissance System Product Improvement Program 13 CA Automatic Chemical Agent Detector and Alarm 14 RES Joint Service Fixed-Site Decontamination 15 CA Long-Range Biological Stand-off Detection System 16 IP Protection Assessment Test System 17 RES Joint Service Sensitive Equipment Decontamination 18 IP M40A1 Series Mask 19 CA Special Operations Modular Chemical/Biological Detector 20 IP Joint Service Aviation Mask 21 CA Joint Service Warning and Identification LIDAR Detector 22 IP Joint Protective Aircrew Chemical Ensemble 23 IP Chemical Environment Survivability Suit 24 RES Fixed-Site Decontamination Subitem: Joint Advanced Decontamination System 25 CP Joint Transportable Collective Protection System 26 BM Multipurpose Integrated Chemical Agent Alarm 27 CA Shipboard Automatic Agent Detector 28 CA Improved Chemical Agent Monitor 29 CP Shipboard Collective Protective Equipment 30 CA Improved Point Detection System 31 IP Joint Service General Purpose Mask 32 CP Joint Collective Protection Improvement Program 33 RES Joint Lightweight Portable Decontamination System 34 CA Joint Chemical/Biological Agent Water Monitor 35 RES Lightweight Decontamination System 36 RES Modular Decontamination System 37 RES Sorbent Decontamination System 38 IP Joint Canteen Refilling System 39 IP Chemical Environment Survivability Mask 40 CA Pocket RADIAC (Radioactivity, Detection, Indication, and Computation) 41 CP Advanced Integrated Collective Protection System 42 CA NBC Unmanned Ground Vehicle Sensor 43 CA Stand-off RADIAC 44 CA Advanced Airborne RADIAC System CA = contamination avoidance; BM = battle space management; IP = individual protection (also known as personal protection); RES = restoration (decontamination); CP = collective protection Source: Nilo, 1999. 13547--Deployed Forces 02 30 12128199, 1:33 PM

OCR for page 23
THREAT AND RISK ASSESSMENT 31 troops. Their evaluation is then used to develop policy, doctrine, training, and equipment to counter the perceived threat. As the threat changes, approaches to countering the threat should also change. The mission to protect forces from the effects of CB weapons has developed into a five-pronged approach. The thrust of current doctrine is to avoid contamination/exposure and to prevent adverse health effects. Three major elements of this approach (individual protection, collective protection, and decontamination) will be discussed in detail in subse- quent sections of this report.2 Contamination Avoidance Prior to deployment, the intelligence community provides up-to-date assessments of the potential threat of the use of CB agents to achieve military objectives. This assessment is critical to determining the types of detection equipment, protective equipment, and CB specialists that will be necessary for the deployment. State-of-the-art detector systems, both stand-off and local monitors, can identify potential threats in advance to enable commanders to avoid areas of contamination or to take protective measures to avoid exposures. Detectors can also be used to evaluate lev- els of contamination so commanders can select appropriate protection for their forces and minimize the length of time spent in protective clothing. The report of Task 2.2 assesses technologies and methods for detecting, tracking, and monitoring exposures of deployed U.S. forces to potentially harmful agents, including, chemical and biological agents and environ- mental contaminants (NRC, l999b). Individual Protection Individuals can be protected by individual protective equipment (breathing masks with high-efficiency filters that selectively remove nox- ious agents, chemically treated clothing that can prevent agents from contacting the skin, and gloves and boot covers that are impervious to noxious agents) if they have been properly trained in rapidly donning the equipment and removing contaminated equipment safely, and if they receive adequate warning. Commanders need appropriate doctrine to establish the level of protection to minimize the risk to troops while al- lowing them to complete their mission. 2Contamination avoidance and medical systems are the subjects of separate detailed re- ports (IOM, 1999a; NRC, l999b). 13547--Deployed Forces 02 31 12128199, 1:33 PM

OCR for page 23
32 STRATEGES TO PROTECT THE HEALTH OF DEPLOYED U.S. FORCES Collective Protection Collective protection provides a contamination-free area (e.g., passenger compartments of military vehicles, shelters) for eating, rest, and relief from the constraints of individual protective equipment. It also provides a safe working environment for command and control functions and can be used for medical treatment of casualties in the CB environment. Decontamination Decontamination may be necessary for equipment and personnel be- fore they can be returned to combat. Decontamination may also be neces- sary to restore mission-critical assets to operational status. Large-scale decontamination of major resources (e.g., airfields or buildings) may be necessary to support embarkation/debarkation phases of a deployment. Medical Systems Medical systems provide predeployment and postexposure treatment for CB-induced health problems and maintain records on health and ex- posures for deployed personnel. The development of antibodies, vaccines, and medical therapies is a critical part of the medical systems. CHARACTERISTICS OF CURRENT AND FUTURE CHEMICAL AND BIOLOGICAL AGENTS Effects and Tactical Utility of Chemical Agents Chemical agents can be characterized as either lethal or nonlethal (incapacitating) (see Table 2-3~; however, these distinctions have more to do with intent and use than with the composition of the agents because all agents are lethal in high concentrations. There are three classifications of lethal agents: nerve agents, choking agents, and blood agents. Nerve agents inhibit acetylcholinesterase, an enzyme involved in the transmission of nerve impulses. Inhibition of this enzyme results in con- tinuous stimulation of the nervous system. Nerve agents act more quickly and are more lethal than other chemical agents. They can be absorbed through the skin, the eyes, or the respiratory tract. Symptoms include runny nose, tightness in the chest, impaired vision, pinpointing of the pupils, difficulty in breathing, excessive salivation and drooling, nausea, vomiting, cramps, involuntary twitching, loss of bowel and bladder con- trol, headache, confusion, drowsiness, coma, and eventually death. Choking agents, which are primarily taken in via the respiratory tract, 13547--Deployed Forces 02 32 12128199, 1:33 PM

OCR for page 23
THREAT AND RISK ASSESSMENT TABLE 2-3 Categorization of Chemical Agents 33 Type Examples Lethal Chemical Agents Blood agents Choking agents Nerve agents Incapacitating Chemical Agents Blister agents (vesicants) Lacrimator agents Sternutator agents hydrogen cyanide, cyanogen chloride, arsine phos gene, diphos gene, chlorine tabun, sarin, soman, GF, VX Levinstein mustard, distilled mustard, nitrogen mustard, mustard-t mixture, lewisite, mustard- lewisite mixture, phenyldichloroarsine, ethyldichloroarsine, methyldichloroarsine, phosgene oxime bromobenzylcyanide, chloroacetophenone, CNC, o-chlorobenzylidene malononitrile, dibenz-(b,f)-1,4-oxazepine, chloropicrin dip henyl chloro ars ine , dip henylc yan o ars ine adamsite are strong irritants that attack lung tissues causing membranes to swell and become "leaky." The lung can then fill with fluid, and death can result from pulmonary edema. Acute nonlethal exposures to choking agents can result in chronic lung disease. Blood agents are primarily absorbed via the respiratory tract. They inhibit the enzyme cytochrome oxidase or combine with hemoglobin to prevent the normal transfer of oxygen from the blood to body tissues. Exposure to these agents causes seizures due to lack of oxygenation. Agents classified as nonlethal or incapacitating include vesicants, lacrimators, and sternutators. Vesicants, or blister agents, which affect the eyes and lungs and blister the skin, are often lethal if ingested or absorbed through the lungs. Lacrimators cause tearing and irritate the skin and respiratory tract. Sternutators cause coughing, nausea, and vomiting. An agent's tactical utility is partly determined by its physical proper- ties including: (1) whether the agent is effective in the short or long term (persistence of the agent in the environment); (2) whether the agent can be targeted to a specific area or is affected by wind and weather conditions; (3) whether the agent presents an inhalation or percutaneous threat, or both; (4) whether the agent is stable during dissemination; and (5) other physical and chemical factors. 13547--Deployed Forces 02 33 12128199, 1:33 PM

OCR for page 23
THREAT AND RISK ASSESSMENT 47 Effective Dose (mg-min/m3 except where otherwise noted) Rate of Action ED50 = no existing estimates ED50 = no existing estimates ED50 = no existing estimates ED50 = no existing estimates ED50 = 5 mg/70-kg mane ED50= 1 mgC ngs ID50 = 2,000 by skin; 200 by eye ED50 = no existing estimatesb ED50 = 10 TgC ID50 = 200 by eye; 9,000 by skin ID50 = very low ID50 = less than 300 by eye; more than 1,500 by skin ED50 = 15 Tg ID50 = 200 by eye; 1,500-2,000 by skin ID50 = 16 as vomiting agent; 1,800 as blister N/Aa N/Aa Very rapid Very rapid; may be lethal within 15 minutes of absorption Very rapid; may be lethal within 15 minutes of absorption Very rapid Very rapid; may be lethal within 15 minutes of absorption Effects delayed for 4 to 6 hours Effects delayed for ~12 hours Delayed action not well known Rapid acting Rapid acting skin irritation; blisters in 13 hours Rapid acting Rapid acting nose/throat irritation; blisters in 12 hours Rapid acting nose/throat irritation; blisters in several hours 13547--Deployed Forces 02 47 12128199, 1:33 PM

OCR for page 23
48 STRATEGIES TO PROTECT THE HEALTH OF DEPLOYED U.S. FORCES TABLE 2-7 Dermal Necrotic Agents Mode Agent of Delivery Effect Effective Distilled mustard Liquid Incapacitation ID50= 2,~ ED50= n ED50= 1 Nitrogen mustard Liquid Incapacitation Mustard-T mixture Liquid Incapacitation Mustard-lewisite Liquid Incapacitation mixture ID50 = 2t ID50 = Vt ID50= 2C by skin a NATO, 1996a; NRC, 1997a. bAli et al., 1997. Sources: Boyle, 1998b; U.S. Army, 1995; U.S. Army et al., 1990. TABLE 2-8 Inhalation/Respiratory Agents Mode of Agent Delivery Effect Anthrax (Bacillus anthracis) Aerosol 75% mor Plague (Yersinia Testis) Aerosol Tularemia (Francisella tularensis) Aerosol 80% mor Q fever (Coxiella burneti) Aerosol 70% mor Smallpox Aerosol 30-35% Venezuelan equine encephalitis Aerosol 90% mor Dysentery (Shigella dysenteriae) Aerosol 25% mor Cholera (Vibrio comma) Aerosol 15-90% Brucellolis (Brucella suds) Aerosol 2% fatal) Sources: All et al., 1997; Boyle, 1998a; U.S. Air Force, 1997; U.S. Army et al., 1990. 13547--Deployed Forces 02 48 12128199, 1:33 PM

OCR for page 23
THREAT AND RISK ASSESSMENT 49 Effective Dose Rate of Action ID50 = 2,000 by skin; 200 by eye ED50= no existing estimatesa ED50 = 10 gab ID50 = 200 by eye; 9,000 by skin ID50 = very low ID50 = 200 by eye; 1,500-2,000 by skin Effects delayed for 4 to 6 hours Effects delayed for ~12 hours Delayed action not well known Rapid acting skin irritation; blisters in 13 hours Onset Effect Effective Dose Time (days) 75% morbidity; 80% mortality 8,000-50,000 spores 1-5 100-500 organisms 2-3 80% morbidity; 35% mortality 10-50 organisms 2-3 70% morbidity; <1% mortality 1-10 organisms 14-21 30-35% mortality 10-100 organisms 12 90% morbidity; <5% mortality 10-100 organisms 1-5 25% mortality 10-100 organisms 1-7 15-90% mortality 1,000,000 organisms 1-5 2% fatality 10-100 organisms 5-21 13547--Deployed Forces 02 49 12128199, 1:33 PM

OCR for page 23
50 STRATEGES TO PROTECT THE HEALTH OF DEPLOYED U.S. FORCES TABLE 2-9 Ingestion Agents Mode of Agent Delivery Effect Anthrax (Bacillus anthracis) Ingestion 75% mor Cholera (Vibrio comma) Ingestion 15-90% Dysentery (Shigella dysenteriae) Ingestion 25% mor Q Fever (Coxiella burneti) Ingestion 70% mor Tularemia (Francisella tularensis) Ingestion 80% mor aInformation, if known, was not readily available during the course of the study. Sources: All et al., 1997; Boyle, 1998a; U.S. Air Force, 1997; U.S. Army et al., 1990. TABLE 2-10 Agents Absorbed via Mucous Membranes or the Skin Mode of Agent Delivery Effect Anthrax (Bacillus anthracis) Direct contact with contaminated material 25% mor Tularemia (Francisella tularensis) Inoculation of skin or mucous membranes 80% mor with blood or tissue fluids of 35% mor infected animals Brucellosis (Brucella suds) Through abraded and possibly intact skin N/Aa Ebola/Marburg Through abrasion or via N/Aa conjunctive; possibly direct contact with blood or other tissues Crimean-Congo hemorrhagic Direct contact with animal or N/Aa fever human tissues and blood aInformation, if known, was not readily available during the course of the study. Sources: All et al., 1997; Boyle, 1998a; Johnson, 1990; LeDuc, 1989; Mikolich and Boyce, 1990; U.S. Air Force, 1997; U.S. Army et al., 1990. 13547--Deployed Forces 02 50 12128199, 1:33 PM

OCR for page 23
THREAT AND RISK ASSESSMENT 5 Onset Effect Effective Dose Time (days) 75% morbidity; 80% mortality 15-90% mortality 25% mortality 70% morbidity; <1% mortality 80% morbidity; 35% mortality rate 1,000 spores >107 organisms 10-100 organisms 1-10 organisms N/Aa 1-7 1-5 1-7 14-21 2-3 1990. tom Onset Effect Effective Dose Time 25% mortality N/Aa N/Aa mbranes 80% morbidity; 10-50 organisms N/Aa 35% mortality rate tact skin N/Aa N/Aa N/Aa N/Aa N/Aa N/Aa N/Aa N/Aa N/Aa 13547--Deployed Forces 02 51 12128199, 1:33 PM

OCR for page 23
52 STRATEGIES TO PROTECT THE HEALTH OF DEPLOYED U.S. FORCES Arthropod Vectors. Several threat agents can be carried by arthropods (e.g., flies, fleas, ticks, and mosquitoes). The agent is most often delivered by the insect's "bite," but other modes of contamination are possible. The number of agent organisms that represent an effective dose delivered by an arthropod and the effects and times of onset are shown in Table 2-11. Threat Assessment Threat assessments should be made for each type of conflict and ev- ery military operation. (See NRC report [1999c] for a framework for as- sessing risks to deployed forces in hostile environments.) Each level of military conflict or operation poses different challenges in terms of poten- tial CB use and, therefore, different risks to deployed forces. Military operations range from major regional conflicts involving large numbers of personnel to policing and peacekeeping operations that involve small units. Therefore, commanders must have accurate, timely intelligence on the possible locations, quantities, and types of CB agents, as well as a knowledgeable CB advisor. TABLE 2-11 Arthropod Vectors Agent Mode of Delivery Effect Plague (Yersinia Testis) Tularemia (Francisella tularensis) Rocky Mountain spotted fever (Rickettsia rickettsi) Yellow fever Rift Valley fever Venezuelan equine encephalitis Crimean-Congo hemorrhagic fever Fleas Bites of infected deerflies, mosquitoes, or ticks Ticks Ticks Mosquitoes Variety of mosquitoes Ticks 25-100% 80% mor 35% mor 7-20% fa < 5% mo < 1%mo 90% mor <5% mor N/Aa aInformation, if known, was not readily available during the course of the study. Sources: All et al., 1997; Boyle, 1998a; LeDuc, 1989; U.S. Air Force, 1997; U.S. Army et al., 1990. 13547--Deployed Forces 02 52 12128199, 1:33 PM

OCR for page 23
THREAT AND RISK ASSESSMENT RISK MINIMIZATION/PROTECTION OF PERSONNEL 53 The most obvious way to minimize risk from exposure to CB agents is to avoid contact with these materials. The military has developed a four- part strategy for protecting deployed forces based on avoiding exposure: sensing, shaping, shielding, and sustaining. Sensing the NBC conditions throughout the joint battle space is accomplished by means of surveil- lance, detection, identification, monitoring, and reconnaissance. Shaping includes situation awareness of the battle space and managing, assessing, and recording threats (see the Task 2.2 report [NRC, l999b]~. Shielding joint and coalition forces includes medical pretreatment, personal protec- tive equipment (PPE) and collective protective equipment (CPE). Sustain- ing the force after NBC attacks includes medical treatment and decon- tamination. Avoiding contact depends on the capability and availability of detec- tion equipment. Because the lag in detection time of our present capabili- ties (10 to 15 minutes) is longer than the time it takes to don protective equipment (Table 2-12), (NRC, l999b), our current capability has been Onset Effect Effective Dose Time (days) 25-100% mortality 1-103 organisms 2-7 erflies, 80% morbidity; 1-103 organisms 1-10 s 35% mortality 7-20% fatal N/Aa 3-10 < 5% mortality N/Aa 3-6 < 1% mortality N/Aa 3-12 yes 90% morbidity; 1-103 organisms 4-20 <5% mortality N/Aa N/Aa N/Aa 13547--Deployed Forces 02 53 12128199, 1:33 PM

OCR for page 23
54 STRATEGIES TO PROTECT THE HEALTH OF DEPLOYED U.S. FORCES TABLE 2-12 Time to Achieve MOPP 4 MOPP LEVELS MOPP0 MOPP 1 MOPP 2 MOPP 3 MOPP 4 Overgarment Available Worn Worn Worn Worn Boots Available Available Worn Worn Worn Mask Carried Carried Carried Worn Worn Gloves Carried Carried Carried Carried Worn Time to MOPP 4 (min) 8 4 0.5 0.25 o called "detect to treat" (Cain, 1999~. A preventive, rather than responsive, posture would be advantageous, of course, but this will require better detection capability. In 1998, seven joint CB future operational capabilities (FOCs) (i.e., operational capabilities required to develop warfighting concepts to guide military and industrial R&D) were identified (Payne, 1998~. One FOC focuses on the need for detecting and identifying prelaunch indicators, launch signatures, flight paths, and release or impact pointy of theater missiles, including the ability to distinguish between conventional and NBC munitions. The detection system must provide early and selective warning and must be compatible with the current and future joint com- mand, control, communications, computer, and intelligence (C4I) struc- ture; warning and reporting systems; and NBC battle management sys- tems. Because the FOC is far beyond present detection technologies, personnel must be protected by the combined use of PPE, CPE, and medi- cal protective services. The military approach to individual protection is embodied in the concept called Mission Oriented Protective Posture (MOPP), an ensemble of protective garments, boots, masks, and gloves. MOPP-Ready status is defined as having protective garments available; MOPP 4 status is defined as all components of the protective ensemble being worn. The progres- sion is shown in Table 2-13. CB battlefield exigencies may require collective protection, a place for medical treatment of casualties and the removal of MOPP gear for eating and recovery periods. Therefore, protective shelters have been developed based on filtering and overpressurization technologies. If individuals or 13547--Deployed Forces 02 54 12/28/99, 1:33 PM

OCR for page 23
THREAT AND RISK ASSESSMENT TABLE 2-13 Levels of Mission-Oriented Protective Posture (MOPP) 55 MOPP Ready Soldiers carry protective masks with their load-carrying equipment. The soldier's MOPP gear is labeled and stored no further back than the battalion support area and is ready to be brought forward to the soldier when needed. The time necessary to bring the MOPP gear forward will not exceed two hours. A second set of MOPP gear is available within six hours. Units at MOPP-Ready are highly vulnerable to attacks with persistent agents and will automatically upgrade to MOPP-Zero when they determine, or are notified, that chemical weapons have been used or that the threat of chemical weapons has arisen. When a unit is at MOPP-Ready, soldiers will have field-expedient items identified for use. MOPP 0 Soldiers carry protective masks with their load-carrying equipment. The standard battledress overgarment and other individual protective equipment that make up the soldier's MOPP gear are readily available (i.e., equipment is either carried by each soldier or stored within arm's reach [e.g., within the work area, vehicle, or fighting positions. Units at MOPP Zero are highly vulnerable to attacks with persistent agents and will automatically upgrade to MOPP 1 when they determine, or are notified, that persistent chemical weapons have been used or that the threat of chemical weapons has arisen. MOPP 1 When directed to MOPP 1, soldiers immediately don battledress overgarments. In hot weather, the overgarment jacket may be unbuttoned and the battledress overgarment may be worn directly over the underwear. M9 or Me chemical detection paper is attached to the overgarment. MOPP 1 provides a great deal of protection against persistent agents. The level is automatically assumed when chemical weapons have been used in an area of operations or when directed by higher command. MOPP 2 Soldiers put on chemical protective footwear covers, green vinyl overboots, or a field-expedient item (e.g., vapor-barrier boots), and the protective helmet cover. The overgarment jacket may be left unbuttoned, but the trousers remain closed. MOPP 3 Soldiers wear protective masks and hoods. Flexibility is built into the system to allow the soldier relief at MOPP 3. Particularly in hot weather, soldiers may open the overgarment jacket and roll the protective mask hood for ventilation, but the trousers remain closed. 13547--Deployed Forces 02 55 12128199, 1:33 PM

OCR for page 23
56 STRATEGES TO PROTECT THE HEALTH OF DEPLOYED U.S. FORCES TABLE 2-13 Levels of Mission-Oriented Protective Posture (MOPP) (continued) MOPP 4 Soldiers will completely encapsulate themselves by closing their overgarments, rolling down and adjusting mask floods, and putting on the NBC rubber gloves with cotton liners. MOPP 4 provides the highest degree of chemical protection, but it also has the most negative impact on performance. Mask Only Only the protective mask is worn. The mask-only command is given in these situations: (1) when riot control agents are being employed and no chemical or biological threat exists; and (2) in a downwind vapor hazard of a nonpersistent chemical agent. The Mask-Only command is not appropriate when blister agents or persistent nerve agents are present. Source: U.S. Army Office of the Surgeon General, 1997. equipment are contaminated, however, they must be decontaminated prior to entry into a collective protection area. Medical treatments can afford additional protection both before and after exposure (IOM, 1999a). Individual protection, collective protection, and decontamination are three means of risk minimization, and each has an associated doctrinal, training, and R&D component. FINDINGS AND RECOMMENDATION The following findings are based on information provided for this study during briefings and discussions with individuals involved with the CB RDA process. Finding. Joint structure and joint service processes were developed to maximize the efficient use of funds and to reduce duplications of effort. Finding. The purpose of the joint prioritization of system needs (and, therefore, RDA needs) is to ensure that fielded systems meet joint service needs. This requires that CINC priorities and NBC community priorities be coordinated. Finding. The prioritization and selection of RDA projects are often based on compromises or political trade-offs unrelated to CINC prioritization, technical capabilities, or bona fide needs and are focused on service- specific, rather than joint service, needs. 13547--Deployed Forces 02 56 12128199, 1:33 PM

OCR for page 23
THREAT AND RISK ASSESSMENT 57 Finding. System development is sometimes based on outdated and pos- sibly inaccurate evaluations of threats and challenges. Recommendation. The Department of Defense should reevaluate and possibly revise its prioritization process for the development of equip- ment. The reevaluation should include a reassessment of the use of threat information. 13547--Deployed Forces 02 57 12128199, 1:33 PM