Research
Biological Warfare

The Decontamination of Anthrax and Other Biological Agents

Testimony of Lynn R. Goldman, MD, MPH
Professor, Environmental Health Sciences
Johns Hopkins Bloomberg School of Public Health
Baltimore, MD
Thursday, November 8, 2001
2318 Rayburn House Office Building

Part 4

Major challenges that government agencies face in decontaminating civilian facilities

The federal government needs to develop a clear safety assessment and risk management plan for the protection of people in contaminated buildings. Such a plan needs to include a clear rationale for whether a building requires testing and statically based sampling protocols for buildings. Such sampling protocols are critical if we are to be certain that the results of sampling can be relied upon as a basis for the assessment of safety, before a building is decontaminated, and for the determination of clearance, post decontamination. We know a lot about the behavior of small particles and about indoor air pollution. This knowledge needs to be applied to the situation of anthrax in buildings (which is complicated by complex ventilation systems and human activities). Modeling techniques could be developed to guide such sampling efforts.

Another critical need for sampling is a set of rapid and reliable laboratory assays for anthrax and other pathogens that will be used by terrorists. Many such assays have been developed and are in use. However, I have yet to see a validation of whether these have the needed sensitivity (ability to find anthrax when it is there) and specificity (low rate of "false positive" results) to be used for final decisions.

Decontamination strategies will need to take into account the safety needs of the public and workers in buildings. In many cases there will be no appropriate facilities for storage, mixing and handling of decontamination materials on site or near to sites. Such facilities may need to be constructed. Care will need to be taken to assure that members of the public do not wander into decontamination areas (as has occurred with methyl bromide treatment of homes.) After treatment, facilities will need to be thoroughly aired out and to assure that there will not be exposure to workers to return to their offices or work places. It would be wise to provide educational briefings to employees to ensure that they understand the risks, if any and their responsibilities (e.g., regarding disposal of food items that may have been left in offices or washing dishes and cups before using them). Special care should be given for women who are pregnant (or may be pregnant) or breast-feeding. If there is the potential for residual exposure, I think it generally is prudent to double reentry times since many substances have not been tested for the developing fetus.

In the longer term, there should be a function within the federal government, perhaps in the Centers for Disease Control and Prevention, concerned with the development of public health pesticides. Prior to anthrax, we were concerned with the arrival of West Nile Virus on our shore and the difficulties in treating mosquitoes, in highly populated and sensitive areas along the northeastern seaboard. Similar difficulties have occurred with prevention of hanta virus and other emerging diseases. Now we must be concerned about bioterrorism as well. This is an area where our public health system needs to be strengthened, in this time of emerging infectious diseases and emerging threats of bioterrorism. The infrastructure for public health disinfectants and pesticides needs to be in place before the next disaster.

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