Dr. Slavko Bokan is one of our most experienced professionals working in the area of the BWC. He managed the Eastern Group of Nations for several BWC meetings in Geneva and he originally prepared this short informative presentation for the April 2009 CBMTS-Industry VI meeting in Cavtat, Croatia.

An Integrated Approach to Risk Assessment and Mitigating
the CBRN Threat

LTC, Dr. Slavko Bokan, M.D. (CMOD Ret)

          Threat mitigation for chemical, biological, radiological or nuclear (CBRN) mass casualty events is of the highest international priority, and, a scientific approach to risk assessment of the potential use CBRN weapons in terrorist actions is required. We must also have an integrated approach for mitigating the CBRN threat to include crisis management and preparedness measures for the prevention and reduction of potential consequences.

The Risk of Terrorist Use of WMD

          If we try to define scientifically the term "risk" it is a function of two variables, namely the probability of an event occurring and the magnitude of the effects of that event. Previously, terrorists wanted many people watching, and did not care how many people died. Today, terrorists want both many people watching and many people dead.

          This risk assessment relates to the probability and effects of eleven different possible uses of CBRN weapons anywhere in the world. These eleven risks were compared with each other and assigned a rating of high, medium or low probability.

          This evaluation is based on a retrospective analysis of how frequently certain weapons have been used in the last hundred years, the current perception of experts of the likelihood of use and our understanding of the interface of technical, tactical and political considerations.

Weapons and Agents Chemicals

1. Chemical warfare (low risk of use)
   
2. Limited or small-scale use (high risk of use)

• Nerve agents - Tabun, Sarin, VX
  
• Vesicant or blistering agents - Mustard gas, Lewisite
  
• Blood agents - Cyanide compounds
  
• Riot control agents

3. Industrial/other chemicals (TICs, TIMs) (medium risk of use)
   

• Chlorine, Phosgene, Anhydrous ammonia, Cyanide, Nitric acid, Pesticides

4. ''New'' chemical weapons (medium risk of use)
   

• Fentanyl derivative (Moscow theatre)
  
• Osmium Tetroxide

Toxic Industrial Chemicals (TICs) on Hazard Index List

Chemical threat

• Chemical technologies, agents, information and expertise are more available
  
• CW production also uses dual-use equipment
  
• Toxic industrial chemicals and materials: lethal, low cost and widely available
  
• Storage facilities are potential terrorist targets
  
• Possible terrorist attacks on chemical industries that use large quantities of very toxic chemicals
  
• Chemical warfare or chemical terrorism involves the use of synthetically produced chemical compounds to kill or injure humans, animals, and plants

          According to some expert calculation more than 2.5 million casualties can result from a terrorist attack on chemical industry in densely populated areas in the USA and may be higher in other countries.

Biologicals and Toxins

5. Highly infective and contagious anti-human biological agents with global implications (low risk of use)
   
6. Bacterial agents which are infective but whose effects can be treated and of which human-to-human trans-
   mission is controllable (low risk of use)
   
7. Non-contagious agents or toxins (medium risk of use)
   
8. Infective and contagious agents against animals or plants (medium risk of use)

Biological threat

          Bioterrorism is the most important under-addressed of the CBRN threats. In the future, the potential for developing recombinant biological warfare agents exists, if these have not already been developed.

          Biological technologies, agents, information and expertise are more available. Sources of biological and toxin warfare agents for terrorist use are numbered (>100,000 biotechnology facilities in operation worldwide).

          Unknown biothreats include: Emerging Diseases, Engineered Organisms, Synthesized Organisms, Dual-Use Developments

Anatomy of a Bioterrorist Attack

          Terrorism takes much time and planning. For preparations, most experts think a bioterrorist attack takes a minimum of five years. For execution, one day is enough, but it may take more than three days to diagnose. Because of that, it is crucial to have early detection of active and potential cases. Emergency measures to save lives are of high priority, as well as the prevention and management of secondary contamination.

          Also we must remember one very important group of potential terrorist agents -- bioregulators or biomodulators. Bioregulators are closely related to substances normally found in the body and regulate of biological processes. Bioregulators also play one of the main roles in the non-lethal chemical and biological weapons program. An attack using bioregulators would be difficult to detect and nearly impossible to prove by testing victims. In each case a clandestine application of bioregulators can lead to death -- "killing without a trace".

          The main representatives of this group of dangerous agents include Endorphins; Substance P (SP) (Neurokinin); Endothelins (ET-1, ET-2, ET-3) or Sarafotoxins (S6a, S6b); Bradykinin (Kinin-9, Kalidin); Vasopressin (VP); Angiothensins (I, II, III); Enkephalins (Leu- i Met-enkefalin); Somatostatin (SS, SRIF); Bombesin (BN), and neurotensin with their specific effects: opiates analgesics, vasoconstriction, vasodilatation and increasing vascular permeability.

Radiologicals and Nuclear

9. Nuclear weapons (low risk of use)
   
10. Improvised nuclear devices (low risk of use)
    
11. Radiological device "Dirty bomb" (medium risk of use)

Radiological threat

          Radiological terror weapons would disperse a radiological dust which would cause panic as well as an extremely costly clean up and boost cancer rates in the longer term.

Types of Radiological Threats:

• Radiological Dispersal Devices
  
  • Nuclear Sabotage
    
• Sources of radiological material for terrorist use:
  
  • Nuclear medicine, research, food irradiation, industry (Co-60, Cs-137 available in large quantities)
    
• Illicit trafficking, dirty bombs, orphan sources: Sr-90, Cs-137, Pu-238, Co-60, Am-241, Ir-192
  
• Availability of radiological material:
  
  • Thousands of facilities use with poor controls and record keeping
    
  • Millions of packages with radioactive materials shipped annually

CBRN Attack Potential Locations

          Potential targets are usually highly populated public areas (enclosed areas) such as:

• National Historic and Symbolic Monuments,
  
• Public assembly areas,
  
• Public buildings,
  
• Mass transit systems and other compact areas where the public may gather:
  
  • Malls
    
  • Stadiums
    
  • Subways and Trains
    
  • Amusement Parks
    
  • Restaurants
    
  • Airports and Seaports
    
  • Hospitals - and even from:
    
    • Trash Cans or Dumpsters

Public Health Emergencies

          If we compare public health emergencies, including all potential natural disasters, CBRNE terrorism and especially pandemic influenza are the most dangerous.

• Floods
  
• Fires
  
• Winter storms / summer heat
  
• Hurricanes, tornados
  
• Mine subsidence, landslides
  
• Power outages
  
• Water emergencies
  
• Hazardous materials spills
  
• Transportation accidents
  
• Industrial accidents / releases
  
• Earthquakes / Tsunami
  
• CBRNE - terrorism
  
• Pandemic Influenza

          Psychological Impact of CBRN Terrorism is very important. Panic in and of itself, is becoming the new terrorist tool. Terror involves inflicting fear and anxiety on the victims. CBRN weapons are especially effective at causing fear and horror.

          The HazMat response teams have a very important role in CBRN threat mitigation. These teams include responders who are specially trained and equipped to manage and control incidents involving different types of hazardous materials and involves a certain degree of multi-tasking, but central focus is on managing HazMat risk.

Conclusions:

          Although significant progress has been made, national security requirements for efforts to combat Weapons of Mass Destruction will be of the highest national priority in the near future. An integration of a number of approaches is essential in the risk assessment and mitigation of the CBRN treat. Preparedness measures and procedures, engineering, science and technology, policy, medical, and emergency response are essential to reduce the threat from the proliferation and use of weapons of mass destruction. Improved coordination between international, public and private security entities is also essential task that will prevent or mitigate terrorist attacks and their impacts.

References:

1. Dominique Loye and Robin Coupland, Who will assist the victims of use of nuclear, radiological, biological or chemical weapons - and how?, International Review of the Red Cross, Volume 89, Number 866, June 2007
   
2. Dr. A. D. Romig, Jr., Vice President, Nonproliferation and Assessments Sandia National Laboratories, Mitigating the Chemical, Biological, Radiological and Nuclear (CBRN) Threat, September 29, 2004

LTC, Dr. Slavko Bokan, M.D. (CMOD Ret)
Brune Busica 13, HR-10000 Zagreb, Croatia
Phone: +385 91 6637 287
Email: slavkobokan@hotmail.com

For the Professional in Government and Industry with an interest in Nuclear, Biological and Chemical Defense, Disarmament and Verification; Emergency and Disaster Medical Planning; Industrial Health and Safety; and Environmental Protection