Title Page and Notice Committee Independent Report Reviewers Preface Abbreviations EXECUTIVE SUMMARY 1   INTRODUCTION Legislative Background Charge to the Committee Data Collection Assumptions and Parameters of This Report Current Civilian Capabilities 2   PRE-INCIDENT COMMUNICATION AND INTELLIGENCE: LINKING THE INTELLIGENCE AND MEDICAL COMMUNITIES R&D Needs 3   PERSONAL PROTECTIVE EQUIPMENT Types of PPE and Regulatory Standards Access to PPE Potential Advances R&D Needs 4   DETECTION AND MEASUREMENT OF CHEMICAL AGENTS Chemical Warfare Agents in the Environment Clinical Laboratory Analysis for Exposure to Chemical Warfare Agents R&D Needs 5   RECOGNIZING COVERT EXPOSURE IN A POPULATION Surveillance and Investigation of Biological Agents Laboratory Capacity and Surveillance Chemical/Toxin Surveillance Aids for Clinical Diagnosis Based on Signs and Symptoms R&D Needs 6   DETECTION AND MEASUREMENT OF BIOLOGICAL AGENTS Detection of Biological Agents in Clinical Samples (Patient Diagnostics) Detection of Biological Agents in the Environment R&D Needs 7   PATIENT DECONTAMINATION AND MASS TRIAGE Decontamination Mass-Casualty Triage Procedures R&D Needs 8   AVAILABILITY, SAFETY, AND EFFICACY OF DRUGS AND OTHER THERAPIES Chemical Agents Biological Agents Summary of R&D Needs 9   PREVENTION, ASSESSMENT, AND TREATMENT OF PSYCHOLOGICAL EFFECTS Long-Term Effects of Terrorism (Post Traumatic Stress Disorder) Short-Term Effects of Terrorism (Acute Needs) First Responders Neurological vs. Psychological Responses Treatment Methods Training Community Effects R&D Needs 10   COMPUTER-RELATED TOOLS FOR TRAINING AND OPERATIONS Medical Vigilance and Dose Reconstruction Models Facilitating Assessment and Planning Support for Decontamination and Reoccupation Strategies R&D Needs 11   CONCLUSIONS AND RECOMMENDATIONS Recommendations for Research and Development REFERENCES APPENDIXES A   Committee and Staff Biographies B   Inventory of Chemical and Biological Defense Technology, with Gap and Overlap Analysis C   Lethal and Incapacitating Chemical Weapons D   Centers for Disease Control and Prevention List of Restricted Agents INDEX