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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
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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
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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
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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
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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.
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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.
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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.
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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.
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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).
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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,
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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.
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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
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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.
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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
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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.
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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
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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.
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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
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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
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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.
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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.
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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.
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Representative terms from entire chapter:
biological agents
