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Chemical Agent Use in Terrorist Events: A Gathering Storm Requiring Enhanced Civilian Preparedness

Published online by Cambridge University Press:  08 April 2022

Derrick Tin Open the ORCID record for Derrick Tin [Opens in a new window]  and
Gregory R. Ciottone
Derrick Tin*
Affiliation:
Senior Fellow, BIDMC Disaster Medicine Fellowship, Department of Emergency Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA
Gregory R. Ciottone
Affiliation:
Director, BIDMC Disaster Medicine Fellowship, Department of Emergency Medicine, Beth Israel Deaconess Medical Center; Associate Professor, Harvard Medical School, Boston, Massachusetts, USA
*
Correspondence: Derrick Tin, MBBS, BIDMC Disaster Medicine Fellowship, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MassachusettsUSA, E-mail: dtin@bidmc.harvard.edu
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Abstract

Background:

The use of chemical weapons in terrorist attacks, though rare, remains a significant challenge and concern due to their ability to inflict mass casualties. Chemical attacks remain a topic of interest for Disaster Medicine (DM) and Counter-Terrorism Medicine (CTM) specialists and are clearly an area in need of enhanced preparedness. This study aims to provide an epidemiological description of all terrorism-related attacks using chemical agents as a primary weapon, sustained from 1970 - 2019. These data will be useful in the development of education programs in CTM and provide an insight into how best to prepare for potential attacks in the future.

Methods:

Data collection was performed using a retrospective database search through the Global Terrorism Database (GTD). The GTD was searched using the internal database search functions for all events using chemical weapons as a primary attack method from January 1, 1970 - December 31, 2019. Years 2020 and 2021 were not yet available at the time of the study. The GTD also details the specific chemical used, when known, in the summary of incidents. Results were exported into an Excel spreadsheet (Microsoft Corp.; Redmond, Washington USA) for analysis.

Results:

A total of 292 terrorist attacks involving chemical agents as a primary attack method were recorded from 1970 - 2019, registering 284 deaths and 13,267 injuries. Acid (52) was the most commonly used chemical agent, followed by “unspecified poison” (43), “unknown chemical agents” (29), “unspecified gas” (27), tear gas (27), chlorine gas (24), cyanide (21), mercury (9), pepper spray or mace (9), mustard gas (8), insecticide or 1080 (8), diphenylamine chloroarsine (7), phosphate or phosphorous (3), sodium hydroxide or corrosive liquid (3), sarin (2), “unspecified drugs” (2), VX nerve gas and other nerve gas (2), pesticides (2), cleaning chemicals/paint thinner (2), ammonia (2), anesthesia agent (1), arsenic (1), chlorine and mustard gas mix (1), phenarsazine chloride (1), rat poison (1), unknown irritative gas (1), hydrochloric acid and sodium cyanide mix (1), unknown white powder (1), antiseptic dye (1), and chlorine gas and white phosphorous mix (1).

Conclusion:

The use of chemical weapons in warfare, though prohibited by the Chemical Weapons Convention (CWC), remains a rare but concerning terrorist attack methodology. In recent years, there have been more instances where potentially deadly chemicals have been used in civilian settings. Dual use industrial chemicals, in particular, pose a significant concern. Acid was the most commonly used chemical weapon in 52 attacks. Tear gas, chlorine, and cyanide were each used in over 20 attacks. Both DM and CTM specialists advocate for better preparedness and response training for intentional events in civilian settings.

Keywords

CBRNechemical weaponscounter terrorism medicinedisaster medicineterrorism
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 37 , Issue 3 , June 2022 , pp. 327 - 332
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Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the World Association for Disaster and Emergency Medicine

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References

Tin, D, Pepper, M, Hart, A, Hertelendy, A, Ciottone, G. Chemical warfare agents in terrorist attacks. J Spec Oper Med. 2021;21(3):51–54.CrossRefGoogle ScholarPubMed
Ciottone, GR. Toxidrome recognition in chemical-weapons attacks. N Engl J Med. 2018;378(17):1611–1620.CrossRefGoogle ScholarPubMed
Tactical Emergency Casualty Care Guidelines for BLS/ALS Medical Provider Response to Chemical Warfare Agents/Events. Committee for Tactical Emergency Casualty Care. 2021:1–18.Google Scholar
Tin, D, Hart, A, Hertelendy, AJ, Kallenborn, Z, Ciottone, GR. Opioid attack and the implications for counter-terrorism medicine. Prehosp Disaster Med. 2021;36(6):661–663.CrossRefGoogle ScholarPubMed
Global Terrorism Database (GTD). START. https://www.start.umd.edu/data-tools/global-terrorism-database-gtd. Accessed July 18, 2021.Google Scholar
National Consortium for the Study of Terrorism and Responses to Terrorism. https://www.start.umd.edu/. Accessed November 28, 2021.Google Scholar
Codebook : Inclusion Criteria and Variables. College Park, Maryland USA: National Consortium for the Study of Terrorism and Responses to Terrorism; 2019.Google Scholar
OPCW. Chemical weapons convention. https://www.opcw.org/chemical-weapons-convention. Accessed December 5, 2021.Google Scholar
Annex on Chemicals. Guidelines for Schedules of Chemicals. Organization for the Prohibition of Chemical Weapons. 2021.https://www.opcw.org/chemical-weapons-convention/annexes/annex-chemicals/annex-chemicals. Accessed December 12, 2021.Google Scholar
Annex on Chemicals Schedule 1. Organization for the Prohibition of Chemical Weapons. 2021. https://www.opcw.org/chemical-weapons-convention/annexes/annex-chemicals/schedule-1. Accessed December 12, 2021.Google Scholar
Thiodiglycol. PubChem. https://pubchem.ncbi.nlm.nih.gov/compound/Thiodiglycol#section=Absorption-Distribution-and-Excretion. Accessed December 12, 2021.Google Scholar
Keyes, D, Benitez, F, Vezel-Daubon, L. CBRNE - Nerve Agents, V-series. Medscape. 2019. https://emedicine.medscape.com/article/831760-overview. Accessed December 12, 2021.Google Scholar
Annex on Chemicals Schedule 2. Organization for the Prohibition of Chemical Weapons. 2021. https://www.opcw.org/chemical-weapons-convention/annexes/annex-chemicals/schedule-2. Accessed December 12, 2021.Google Scholar
Annex on Chemicals Schedule 3. Organization for the Prohibition of Chemical Weapons. 2021. https://www.opcw.org/chemical-weapons-convention/annexes/annex-chemicals/schedule-3. Accessed December 12, 2021.Google Scholar
Zanders, JP. What is a chemical weapon? When is chlorine a chemical weapon? The Trench. 2018. https://www.the-trench.org/what-is-a-cw. Accessed December 12, 2021.Google Scholar
5 Questions About Syria and Chemical Weapons. NPR . 2018. https://www.npr.org/sections/parallels/2018/04/09/600900702/5-questions-about-syria-and-chemical-weapons. Accessed December 12, 2021.Google Scholar
Tin, D, Margus, C, Ciottone, GR. Half a century of terrorist attacks: weapons selection, casualty outcomes, and implications for counter terrorism medicine. Prehosp Disaster Med. 2021;36(5):526–530.CrossRefGoogle ScholarPubMed
Tin, D, Granholm, F, Hart, A, Ciottone, GR. Terrorism-related chemical, biological, radiation, and nuclear attacks: a historical global comparison influencing the emergence of counter-terrorism medicine. Prehosp Disaster Med. 2021;36(4):399–402.CrossRefGoogle ScholarPubMed
Sadeghi, M. Fact check: it’s true tear gas is a chemical weapon banned in war. USA Today. 2020. https://www.usatoday.com/story/news/factcheck/2020/06/06/fact-check-its-true-tear-gas-chemical-weapon-banned-war/3156448001/. Accessed December 12, 2021.Google Scholar
What is a Chemical Weapon? Organization for the Prohibition of Chemical Weapons. 2021. https://www.opcw.org/our-work/what-chemical-weapon. Accessed December 12, 2021.Google Scholar
Tin, D, Hart, A, Ciottone, GR. Hardening hospital defenses as a counter-terrorism medicine measure. Am J Emerg Med. 2021;45:667–668.CrossRefGoogle Scholar
Tin, D, Kallenborn, Z, Hart, A, Hertelendy, AJ, Ciottone, G. Rise of the unmanned aerial vehicles: an imminent public health threat mandating counter terrorism medicine preparedness for potential mass casualty attacks. Prehosp Disaster Med. 2021;36(5):636–638.CrossRefGoogle ScholarPubMed