Reopening Public Facilities After a Biological Attack A Decision Making Framework (2005) / Chapter Skim
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4 Anthrax Decontamination After the 2001 Attacks: Social and Political Context
4 Anthrax Decontamination After the 2001 Attacks: Social and Political Context
Pages 56-73
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From page 56... ...
(AMI) , building in Boca Raton, Flonda; the National Broadcasting Company (NBC)
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From page 57... ...
But without all three elements, in the case of a real-world decontamination effort, the answer to "How clean is safe? " would likely be, "Cleaner than you claim." Consider, for example, the hypothetical situation of an anthrax contamination of a major metropolitan airport, San Francisco international (SFO)
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From page 58... ...
. extremely difficult to establish the health risks associated with a release of a biological agent, such as anthrax." A nalytic-Deliberative Process to Identify Health Risk A previous NRC report on risk assessment states "it is necessary to reconceive risk characterization in order to increase the likelihood of achieving sound and acceptable decisions" (NRC, 1996)
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From page 59... ...
report that "almost $1 billion [was spent] to test for, remediate, and prevent anthrax contamination." Despite the lack of solid information about the total cost, two conclusions can be made confidently: The costs were high and, in some cases, unnecessarily so because there was not enough accurate information available about the buildings themselves or about how to proceed.
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From page 60... ...
He was an employee in the AMI mailroom. October 8 The Palm Beach County Health Department began to obtain nasal swabs from those who had been in the AMI building in an attempt to define exposure groups.
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From page 61... ...
October 27—A CDC alert recommended antibiotic prophylaxis for workers in the mail facilities that supplied the CIA, the House office buildings, the Supreme Court, Walter Reed Ammy institute of Research, the White House, and the Southwest Postal Station afte r p relim ina ry envi ronm ental samp ling reve aled B anthracis contamination in these mailrooms Octobr r 31—A 61-year-old female hospital stockroom worker in New York City died from inhalational anthrax after she had become ill with malaise and myalgias on October 25.
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From page 62... ...
Stevens's care notified state health officials as soon as they suspected inhalational anthrax. Local health authorities quickly took action to mobilize a response team without waiting for confirmatory testing from CDC.
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The AMI building cost "significantly less than $5 million" to decontaminate a. Mason, Sabre Technical Services, presentation to committee, October 13, 2004)
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From page 64... ...
Mason, Sabre Technical Services, presentation to committee, October 13, 2004) that although the compressors were turned off, the air conditioning was left running at the AMI building for 2 years, and that the air inside the building was probably exchanging with the outside air "four times a day." Greater control of the building and its contaminants was instituted after a responsibility for decontamination was clearly established.
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From page 65... ...
Of course nasal swabbing is a not diagnostic tool, so its utility in the NBC case was a way to communicate to employees that the company was competent to perform during the crisis. New York City Department of Health and Mental Hygiene officials believed that NBC management went overboard (J.
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From page 66... ...
Medical staff immediately collected nasal swabs from those most likely to have been exposed, and they initiated antibiotic prophylaxis. Within 9 hours of the initial exposure, everyone
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From page 67... ...
. One report in the Journal of the American Medical Association reported that more than 7000 nasal swabs were analyzed (Weis et al., 2002)
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From page 68... ...
It was known in the fall of 2001 that, indeed, some experts argue that it is a complete waste of resources to conduct massive nasal swab testing. But the extensive sampling likely conveyed the message that the hazard that building occupants might face was being taken senously.
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From page 69... ...
All of the deaths were from inhalational anthrax. The contaminated envelopes addressed to Senators Tom Daschle and Patrick Leahy entered the mail stream at Hamilton on October 9, 2001 and B rentwood on October 11, 2001.
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From page 70... ...
The Hart Building had been closed quickly, thousands were immediately put on antibiotic prophylaxis, and nasal swabbing was used extensively. By contrast, USPS facilities were not closed until there were official diagnoses of anthrax, the recommended dosage of anubioucs was different for employees in the two places, and nasal swabbing was more limited at the postal facilities than it had been on Capitol Hill.
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From page 71... ...
, The anthrax response and subsequent decontamination experiences provide several lessons. The acceptance of risk is likely to be enhanced if trust is fostered and preserved among authonhes, subject matter experts, and affected parties; if decision making about key issues includes those who must bear the brunt of the consequences of those decisions; if affected populations see because of transparent decision making—that their health and safety are given higher priority than material considerations, such as disrupted work schedules and cleanup costs; if the complex technical dimensions of the problem are translated into terms that are meaningful to nontechnical audiences; and if constant and open communicahons is maintained between responsible officials and directly and indirectly affected parties.
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From page 72... ...
Cooperation is the key to decreasing public anxiety, and agreements, such as the one signed by the New York City Department of Health and relevant law enforcement agencies, should be in place to protect public health and safety by allowing the process of forensic evidence collection and decontaminahon to proceed unimpeded by one another. REIFEREN CES Blactunan.
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From page 73... ...
Emerging infectious Diseases 8(10)
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