Labs struggle to meet chem weapons threat

Few ready for radiological attack

Though many gains have been made in chemical and radiological terrorism preparedness, significant gaps continue to pose obstacles to the nation's overall response, the Association of Public Health Laboratories (APHL) reports.1

"Inadequate funding, environmental and radiological testing gaps and laboratory work force shortages identified in this assessment provide a snapshot of the disparities that exist in present-day chemical terrorism laboratory preparedness in the states," the APHL reported in a recently published survey and analysis. "Nationwide emergency preparedness needs cannot be met by focusing solely on bioterrorism preparedness activities."

The majority of labs perform chemical terrorism testing for metals, pesticides, organic chemicals, and PCBs using validated methods and traditional environmental tests. However, far fewer test for agents specific to chemical terrorism such as vesicants, choking agents, blood agents, and incapacitating agents, the APHL reported.

"Despite the fact that standardized environmental sampling protocols and test methods are unavailable, several states are still accepting and, to a lesser degree, analyzing environmental samples for chemical warfare agents," the APHL found. "No federal agencies currently provide training to states for environmental testing of chemical warfare agents. Therefore, any minimal training for the environmental testing of chemical warfare agents is being received through industry/vendors, in-house training, and academia, among others."

In November and December of 2005, APHL conducted a survey of public health labs in the 50 states and the District of Columbia (DC). Fifty-one responses were received, representing all states and DC. The APHL survey found that only a handful of labs are equipped and have experience with analyzing clinical and environmental samples for radiochemicals and radiological contaminants.

"In the event of a large radiation exposure, monitoring the population and investigating or confirming radiation sickness or chromosomal mutations would be challenges that most [labs] are still incapable of addressing," the APHL warned.

Most states possess the most basic screening and testing instruments for detecting radiological contaminants in samples, such as Geiger counters and liquid scintillation counters, which 81% and 56% of states reported having in the laboratory, respectively. However, in terms of the more sophisticated screening and testing technologies, states are largely deficient:

  • Two states (4%) have radon counters or alpha spectrometers to be used for screening purposes.
  • Two states (4%) possess accession area radiological monitors for testing.
  • No states possess area monitors or Primalert technology for radiological testing.
  • No states have whole body counters to use for screening purposes.

Overall, the APHL reported that all 62 state, territorial, and metropolitan public health laboratories in the chemical laboratory response network (LRN) have Level 3 characterization. The responsibilities and functions of Level 3 laboratories include:

  • working with hospitals in their jurisdiction;
  • knowing how to properly collect and ship clinical (blood, urine, saliva) samples;
  • ensuring that specimens which could constitute forensic evidence are handled properly and that chain-of-custody procedures are followed;
  • familiarity with chemical agents and their associated health effects;
  • training on anticipated clinical sample flow and shipping regulations;
  • working to develop a coordinated response plan for their respective state and jurisdictions.

In addition, 37 out of the 62 labs have Level 2 ratings, which mean they are capable of detecting exposure to a limited number of toxic chemical agents in human blood or urine such as analysis of cyanide and toxic metals in human samples is an example of an activity conducted by Level 2 chemical LRN laboratories. However, only 10 laboratories in the nation are characterized as Level 1 laboratories within the chemical LRN. These laboratories are capable of detecting an expanded number of chemical agents in human blood or urine, including all Level 2 laboratory analyses plus analysis for mustard agents, nerve agents, and other toxic chemicals. The 10 Level 1 laboratories are in California, Michigan, New Mexico, New York, Virginia, Florida, Massachusetts, Minnesota, South Carolina, and Wisconsin.

"These Level 1 laboratories function to provide the CDC with much-needed surge capacity for handling samples in a chemical event," the APHL reported.

Reference

  1. Association of Public Health Laboratories. Ready, Set, Respond: Chemical Terrorism Preparedness in the Nation's State Public Health Laboratories. March 2006. On the web at https://www.aphl.org/docs/chem_t_final.pdf.