Evaluation of the Health and Safety Risks of the New USAMRIID High-Containment Facilities at Fort Detrick, Maryland
NATIONAL RESEARCH COUNCIL
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NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.
This project was supported by Contract No. W81K04-06-D-0023 between the National Academy of Sciences and the U.S. Department of Defense. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the organizations or agencies that provided support for this project.
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COMMITTEE TO REVIEW THE HEALTH AND SAFETYRISKS OF HIGH-BIOCONTAINMENT LABORATORIES AT FORT DETRICK
Members
CHARLES N. HAAS (Chair),
Drexel University, Philadelphia, Pennsylvania
NANCY D. CONNELL,
University of Medicine and Dentistry of New Jersey, Newark, New Jersey
DONALD A. HENDERSON,
University of Pittsburgh Medical Center, Baltimore, Maryland
MARK T. HERNANDEZ,
University of Colorado at Boulder, Boulder, Colorado
BARBARA JOHNSON,
Barbara Johnson & Associates, LLC, Herndon, Virginia
HENRY M. MATHEWS, Independent Consultant,
Atlanta, Georgia
TIMOTHY C. RELUGA,
Pennsylvania State University, University Park, Pennsylvania
JONATHAN Y. RICHMOND,
Jonathan Richmond and Associates, Southport, North Carolina
LEONARD M. SIEGEL,
Center for Public Environmental Oversight, Mountain View, California
Staff
SUSAN N. J. MARTEL, Project Director
FRANCES E. SHARPLES, Director,
Board on Life Sciences
KATHI E. HANNA, Editor
MIRSADA KARALIC-LONCAREVIC, Manager,
Technical Information Center
RADIAH ROSE, Manager,
Editorial Projects
TAMARA DAWSON, Program Associate
Sponsor
U.S. DEPARTMENT OF DEFENSE
BOARD ON LIFE SCIENCES
Members
KEITH R. YAMAMOTO (Chair),
University of California, San Francisco, California
ANN M. ARVIN,
Stanford University, Stanford, California
BONNIE L. BASSLER,
Princeton University, New Jersey
VICKI L. CHANDLER,
Gordon and Betty Moore Foundation, Palo Alto, California
SEAN EDDY,
HHMI Janelia Farm Research Campus, Ashburn, Virginia
MARK D. FITZSIMMONS,
John D. and Catherine T. MacArthur Foundation, Chicago, Illinois
DAVID R. FRANZ,
Midwest Research Institute, Frederick, Maryland
LOUIS J. GROSS,
University of Tennessee, Knoxville, Tennessee
JO HANDELSMAN,
University of Wisconsin, Madison, Wisconsin
CATO T. LAURENCIN,
University of Connecticut Health Center, Farmington, Connecticut
JONATHAN D. MORENO,
University of Pennsylvania, Philadelphia, Pennsylvania
ROBERT M. NEREM,
Georgia Institute of Technology, Atlanta, Georgia
CAMILLE PARMESAN,
University of Texas, Austin, Texas
MURIEL E. POSTON,
Skidmore College, Saratoga Springs, New York
ALISON G. POWER,
Cornell University, Ithaca, New York
BRUCE W. STILLMAN,
Cold Spring Harbor Laboratory, Cold Spring Harbor, New York
CYNTHIA WOLBERGER,
Johns Hopkins University School of Medicine, Baltimore, Maryland
MARY WOOLLEY,
Research!America, Alexandria, Virginia
Staff
FRANCES E. SHARPLES, Director
JO L. HUSBANDS, Scholar/Senior Project Director
ADAM P. FAGEN, Senior Program Officer
ANN H. REID, Senior Program Officer
MARILEE K. SHELTON-DAVENPORT, Senior Program Officer
INDIA HOOK-BARNARD, Program Officer
ANNA FARRAR, Financial Associate
CARL-GUSTAV ANDERSON, Senior Program Assistant
AMANDA P. CLINE, Senior Program Assistant
AMANDA MAZZAWI, Program Assistant
Preface
There has been vocal public opposition to the expansion of the U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID) at Fort Detrick in Frederick, Maryland. The laboratory studies infectious agents that could cause serious and potentially lethal diseases by the inhalation route of exposure. Although work with such agents must be conducted in laboratories designed and operated to prevent release of agents into the environment, the public is skeptical that public health considerations have been adequately considered in the Army’s Environmental Impact Statement (EIS), which supports the construction of the new facility. To address these concerns, Congress directed the Secretary of Defense to commission a National Research Council study of the health and safety aspects of the EIS and other relevant information regarding health risks associated with work with infectious agents (PL 110-329).
The National Research Council convened the Committee to Review the Health and Safety Risks of High-Biocontainment Laboratories at Fort Detrick, which prepared this report. The members of the committee were selected for their expertise in biosafety, infectious diseases, industrial hygiene, environmental engineering, risk assessment, epidemiology, and stakeholder participation (see Appendix A for biographic information on the members).
The committee held two public meetings to gather information to address its task. At the first meeting, held September 22, 2009, in Frederick, Maryland, the committee met with USAMRIID staff (COL Roger Martin, Deputy Commander; Shawn Boesen, Chief of Safety; and LTC James Wadding, Chief of the Medicine Division) and contractors (John Beaver, BSA Environmental) to obtain background on the EIS, learn about the plans for the new biocontainment facilities, get an overview of the procedures and regulations currently in place to reduce exposure to pathogens, and learn about the history of laboratory-acquired infections at USAMRIID. The committee also heard from representatives of the Frederick County Board of Commissioners—Jan Gardner (President), David Gray (Vice President), and Kai Hagen—and from interested members of the general public. At the second meeting, held November 5, 2009, in Washington, D.C., the committee met with COL John Skvorak, Commander of USAMRIID, to learn about the institute’s biosurety plans for its facilities and personnel. Pres-
entations also were given by David Eskildsen, the Fort Detrick Fire Chief, on fire and emergency services, and by Robert VanAtta, the Fort Detrick Emergency Manager, on USAMRIID’s biological mishap and incident response program. The committee also was briefed by Carol Tobias of the Barquist Army Health Clinic about the memorandums of understanding and agreement between the clinic and Frederick Memorial Hospital. The committee also had separate meetings with the medical and security staff of Frederick Memorial Hospital, officials from Frederick County’s emergency management and health departments, and representatives from the community. In particular the committee wishes to thank the following individuals for their time and constructive comments: Frederick County representatives Jack Markey, Director of Emergency Management, and Dr. Barbara Brookmyer, Health Officer; Frederick Memorial Hospital staff Dr. Manuel Casiano, Chief of Staff, John Veltri, Director of Safety and Security, and Phil Guiliano, Security Manager; and community members Paul Gordon, Barry Kissin, Bob White, Beth Willis, and John Willis.
This report has been reviewed in draft form by persons chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the National Research Council’s Report Review Committee. The purpose of the independent review is to provide candid and critical comments that will assist the institution in making its published report as sound as possible and to ensure that the report meets institutional standards of objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the deliberative process. We wish to thank the following individuals for their review of this report: Michael S. Ascher, California Emergency Management Agency; Richard A. Berman, Manhattanville College (retired); Gerardo Chowell, Arizona State University; Margaret E. Coleman, Upstate New York Society for Risk Analysis; Robert P. Ellis, Colorado State University; Richard Frothingham, Duke University School of Medicine; Paul Langevin, Merrick Canada ULC; and Paul A. Locke, Johns Hopkins Bloomberg School of Public Health.
Although the reviewers listed above have provided many constructive comments and suggestions, they were not asked to endorse the conclusions or recommendations, nor did they see the final draft of the report before its release. The review of this report was overseen by Michael R. Ladisch, Purdue University, and Georges C. Benjamin, American Public Health Association. Appointed by the National Research Council, they were responsible for making certain that an independent examination of this report was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this report rests entirely with the authoring committee and the institution.
The committee is grateful for the assistance of National Research Council staff in preparing the report. It particularly wishes to acknowledge the support of Project Director Susan Martel, who coordinated the project and contributed to the committee’s report. Other staff members who contributed to this effort are Frances Sharples, director of the Board on Life Sciences; Joyce Wondolowski,
Christine Mirzayan Fellow; Tamara Dawson, program associate; Kathi Hanna, editor; Mirsada Karalic-Loncarevic, manager of the Technical Information Center; and Radiah Rose, manager, editorial projects.
Finally, I thank all the members of the committee for their efforts throughout the development of this report.
Charles N. Haas, Ph.D., Chair
Committee to Review the Health and Safety Risks of High-Biocontainment Laboratories at Fort Detrick
Abbreviations
ABSA American Biological Safety Association
ACGIH American Conference of Governmental Industrial Hygienists
AIHA American Industrial Hygiene Association
ANSI American National Standards Institute
APHA American Public Health Association
APHIS Animal and Plant Health Inspection Service
AR Army Regulation
ASCE American Society of Civil Engineers
ASM American Society of Microbiology
AWWA American Water Works Association
BMBL Biosafety in Microbiological and Biomedical Laboratories
BSAT biological select agents and toxins
BSC biological safety cabinet
BSL biosafety level
CDC Centers for Disease Control and Prevention
CFR Code of Federal Regulations
DA PAM Department of the Army Pamphlet
DHS U.S. Department of Homeland Security
DOD Department of Defense
DOE U.S. Department of Energy
DOJ Department of Justice
DSB Defense Science Board
DTRA Defense Threat Reduction Agency
EIS Environmental Impact Statement
FBI Federal Bureau of Investigation
GAO Government Accountability Office
GSU Georgia State University
HEPA high-efficiency particulate air
HHS U.S. Department of Health and Human Services
HPAC Hazard Prediction and Assessment Capability
IBC Institutional Biosafety Committee
LBM Laboratory Biosafety Manual
MCE maximum credible event
NADC National Animal Disease Center
NEPA National Environmental Policy Act
NIAID National Institute of Allergy and Infectious Diseases
NICD National Institute for Communicable Diseases
NIH National Institutes of Health
NRC National Research Council
PPE personal protective equipment
SIP special immunization program
SOP standard operating procedure
USAG U.S. Army Garrison
USAMRIID U.S. Army Medical Research Institute of Infectious Diseases
USAMRMC U.S. Army Medical Research and Materiel Command
USDA U.S. Department of Agriculture
UTMB University of Texas Medical Branch
VEE Venezuelan equine encephalitis
WEF Water Environment Federation
WHO World Health Organization
Potential Scenarios in the Context of Maximum Credible Events and Risks to Personnel, |
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A New Approach to Communications and Cooperation with the Public, |
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BOXES, FIGURE, AND TABLES
BOXES
1-1 |
Excerpts from DOE (2004) Recommendations for Analyzing Human Health Impacts in EISs, |
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2-1 |
Pathogenic Agents Recently Studied or Potentially Studied in the Near Future at USAMRIID, |
FIGURE
2-1 |
USAMRIID’s Biosurety Program, |
TABLES
2-1 |
Timeline of Significant Advances in Biocontainment, Biosafety, Biosurety, and Biosecurity, and Listing (by Decade) of Laboratory-Acquired Infections at USAMRIID, |