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Biological weapons preparedness: the role of physicians.

The real risk posed by biological weapons was demonstrated with the distribution of anthrax spores via the USA postal service in 2001. This review outlines the central roles of physicians in optimizing biopreparedness in Australia, including maintaining awareness of the risk, promptly recognizing an event, notifying appropriate authorities upon suspicion of an event, and instituting appropriate management. Management aspects covered include appropriate diagnostic tests, infection control procedures, and empirical therapy of agents considered possible biological weapons. The critical role of physicians as public health advocates working to prevent the use of biological weapons is also outlined.

Anthrax↗

Plague: a review of its history and potential as a biological weapon.

The increased threat of terrorism has revealed the importance of various diseases as potential weapons of destruction. Among the diseases that have been identified by the Centers for Disease Control and Prevention as being caused by category A organisms is plague. An ancient disease, it has played a role in both natural disasters and war and has been used as a weapon since at least medieval times. This article provides a brief historical overview of the disease in its natural occurrence and in its use as a biological weapon, as well as its potential for future use.

Bioterrorism↗

Military laser weapons: current controversies.

Military laser weapons systems are becoming indispensable in most modern armies. These lasers have undergone many stages of development, and have outpaced research on eye protection measures, which continue to have inherent limitations. Eye injuries caused by military lasers are increasingly reported, leading to speculation that these would become an important cause of blinding in modern conflicts. As part of the effort to ban inhumane weapons, international laws have been passed to restrict the proliferation of such blinding weapons. However, there are controversies concerning the interpretation, implementation and effectiveness of these laws. The ophthalmic community can play a greater role in highlighting ocular morbidity from military lasers, and in preventing their further proliferation.

Eye Injuries↗

Weapon carrying and substance abuse among college students.

Results from administering the Core Alcohol and Drug Survey on 61 US campuses during the 1994/95 academic year were analyzed to assess weapon carrying among college students. Seven percent of the 26,225 students (11.1% of the men and 4.3% of the women) responded that they had carried weapons (gun, knife, etc) during the last 30 days. A comparison with a matched sample of nonweapon carriers revealed that a greater percentage of the armed than the unarmed students had experienced harassment, violence, and threats of violence, and that they felt less safe on their campuses. The weapon-carrying men consumed significantly more alcohol than their unarmed counterparts, and a higher percentage reported binge drinking, use of other drugs, and adverse consequences from substance abuse. Differences between armed and unarmed female students were not as clearly consistent in terms of substance abuse and consequences.

Adolescent↗

Doctors' attitudes on civil defence and nuclear weapon issues.

97 out of 219 doctors responded to a questionnaire on medical aspects of nuclear weapons. A majority of the respondents considered that the then-current civil defence planning was not a valuable use of National Health Service resources, and that an attack with nuclear weapons would cause a degree of suffering beyond the profession's capacity to treat; thought doctors should have a special voice on nuclear issues; and believed Britain should not be increasing its nuclear weapons, and that if expenditure on them were reduced, the savings should go on health. The high support for organizations like MAPW was gratifying.

Attitude of Health Personnel↗

Primary, secondary, and tertiary prevention of genocidal weapons.

For certain countries the availability of the technology and know-how has turned the nuclear weapons option, as well as the possession of chemical and bacteriological weapons, into a threatened reality of the present. Once a country embarks on a 'solution' such as this to its security problems, the countries in conflict with it are obliged to follow suit, thus accelerating the process of development and proliferation of similar weapons. Fear stimulates the creation of a spiral of false security that will inevitably result, if left to its 'natural' forces, in world-wide destruction. Nuclear war is examined here from an epidemiological viewpoint as a disease with two corresponding different possibilities: (a) the natural history of the disease, and (b) modifications produced by primary, secondary and tertiary prevention. Medical responsibility has no alternative but to work for the prevention of the incurable consequences of nuclear war.

Chemical Warfare↗

The role of computer networking in investigating unusual disease outbreaks and allegations of biological and toxin weapons use.

Computer networking can aid in the epidemiological investigation of unusual disease outbreaks and possible uses of biological weapons. Exchange of computerized data over the Internet has many advantages in facilitating the investigation of the source of a disease outbreak. It is especially useful in the investigation of suspected or alleged releases of biological weapons. Computer networking through the Internet a fosters a truly global disease outbreak early warning system in which both government and non-government sources are contributing. Such information exchange is of great potential benefit to the Biological Weapons Convention and the attempts to develop a verification protocol.

Animal Diseases↗

Integrating workplace exposure databases for occupational medicine services and epidemiologic studies at a former nuclear weapons facility.

We outline methods for integrating epidemiologic and industrial hygiene data systems for the purpose of exposure estimation, exposure surveillance, worker notification, and occupational medicine practice. We present examples of these methods from our work at the Rocky Flats Plant--a former nuclear weapons facility that fabricated plutonium triggers for nuclear weapons and is now being decontaminated and decommissioned. The weapons production processes exposed workers to plutonium, gamma photons, neutrons, beryllium, asbestos, and several hazardous chemical agents, including chlorinated hydrocarbons and heavy metals. We developed a job exposure matrix (JEM) for estimating exposures to 10 chemical agents in 20 buildings for 120 different job categories over a production history spanning 34 years. With the JEM, we estimated lifetime chemical exposures for about 12,000 of the 16,000 former production workers. We show how the JEM database is used to estimate cumulative exposures over different time periods for epidemiological studies and to provide notification and determine eligibility for a medical screening program developed for former workers. We designed an industrial hygiene data system for maintaining exposure data for current cleanup workers. We describe how this system can be used for exposure surveillance and linked with the JEM and databases on radiation doses to develop lifetime exposure histories and to determine appropriate medical monitoring tests for current cleanup workers. We also present time-line-based graphical methods for reviewing and correcting exposure estimates and reporting them to individual workers.

Colorado↗

The revolution in military affairs debate and non-lethal weapons.

This article introduces a discussion on developments in political and strategic thinking on the use of existing and emerging weapons (including Non-lethal Weapons) and their doctrinal operational implications in the context of present trends in international relations. It asserts the need to address both the strategic assumptions and the political implications of choosing military-led solutions to trends in international social conflict. The so-called Revolution in Military Affairs (RMA) must be considered in the light of the current debate on the military application of non-lethal weapons (NLWs) to present or future conflict. The issue is introduced from a politico-strategic perspective, with a critique of the RMA debate as a starting point for discussion of the role of NLWs in conflict. Questions are set out for the politicians and strategists who are asked to formulate policy based on technology to be used in new political/social conflicts. The danger of neglecting other important dimensions of politics and strategy vis-à-vis present conflict is noted.

Conflict, Psychological↗

The role of sub-lethal weapons in human rights abuse.

This article is based on two recent reports contracted by the European Parliament (EP), which assessed sub-lethal weapons as flexible tools of political control. It analyses the role and function of existing weapons systems in human rights abuses using examples from Indonesia, Israel, Kenya, Northern Ireland and Turkey. These weapons are designed to 'appear' rather than 'be' safe and, since they augment rather than replace lethal technologies, their use can distort conflicts and actually bridge the firewall between use of less-lethal and lethal technologies.

Child↗

Non-lethal weapons technologies--the case for independent scientific analysis.

Various technologies have been proposed for non-lethal weapons (NLW), some of them credible, or at least plausible, but strong claims were made for others without evidence or references. Five such technologies are examined. For the chemical and biological examples, detailed information is lacking but the diminishing number of such claims over time and general scientific knowledge suggest that fulfilment of the promises is improbable. For acoustic weapons, a detailed study found that many of the claims are plainly untrue. In this case, even wrong values for physiological thresholds were presented. Civil and military NLW programmes in the USA put their main emphasis on simple, short-term technologies rather than exotic ones. In order to avoid dangers arising from unrealistic promises, the concept of preventive arms control should be applied to NLW. Its first step is a scientific analysis, investigating the new weapons, the propagation of their effects and the effect on the targets. Such detailed studies are needed for each proposed NLW technology.

Acoustics↗

Future police operations and non-lethal weapons.

Society has entrusted the police with power and obligation to enforce law, maintain order and protect its members and the legal order of society. To be able to fulfil these obligations the police need credible means of countering threats against these values. Selecting the weapons, or rather use of force instruments, presents a multifaceted problem of balancing human considerations, judicial and societal requirements with tactical needs and technological possibilities. No matter what the incident is, a police-officer is expected to protect the innocent, him/herself, colleagues and the object persons and to cause no more harm than is justifiable and unavoidable. Unfortunately there is no safe use of force and in real life the only option available for resolving certain conflicts is some degree of force. Any weapon can be misused but most weapons have a legitimate use. Denying legitimate use, as well as allowing uncontrolled use, may lead to unnecessary suffering and loss of life. Technology is offering interesting alternative possibilities to the police and these must be considered with open eyes, bearing in mind that misuse, like torture, is not a property inherent to technology but an intentional behaviour of some people. Thorough research and fair and credible controls on police weaponry are needed to avert the possibility of misuse and to maintain trust.

Conflict, Psychological↗

Countershock: mobilizing resistance to electroshock weapons.

Electroshock, stun and restraint technologies are often used for torture and as tools of repression. There is much information available exposing the problems with such technologies, but little about how to be effective in challenging their use. The concept of political ju-jitsu--the process by which an attack on a non-violent resister can backfire on the attackers--is introduced and adapted to examine challenges to electroshock weapons. In order to make these weapons backfire, it is important to emphasize the value of potential targets, to expose secret dealings, to reveal the harm caused by the weapons and to communicate clearly to a wide audience. A longer-term goal is policy change to deny access by torturing states to such repressive tools. Countershock strategies and methodologies are introduced here as potential tools to create ever-expanding torture-technology-free zones.

Electric Injuries↗

Japan's anti-nuclear weapons policy misses its target, even in the war on terrorism.

While actively working to promote the abolition of all nuclear weapons from the world since the end of the cold war, Japan's disarmament policies are not without problems. Promoting the elimination of nuclear weapons as Japan remains under the US nuclear umbrella creates a major credibility problem for Tokyo, since this decision maintains a Japanese deterrence policy at the same time that officials push for disarmament. Tokyo also advocates a gradual approach to the abolition of nuclear weapons, a decision that has had no effect on those countries that have been conducting sub-critical nuclear testing, nor stopped India and Pakistan from carrying out nuclear tests. Consistent with Article 9 of the Constitution, the Japanese war-renouncing constitutional clause, Tokyo toughened Japan's sizeable Official Development Assistance (ODA) programme in the early 1990s. Because of the anti-military guidelines included in Japan's ODA programme, Tokyo stopped new grant and loan aid to India and Pakistan in 1998 after these countries conducted nuclear tests. However, because of the criticism Japan faced from its failure to participate in the 1991 Gulf War, Tokyo has been seeking a new Japanese role in international security during the post-cold war period. Deepening its commitment to the security alliance with the US, Tokyo has become increasingly influenced by Washington's global polices, including the American war on terrorism. After Washington decided that Pakistan would be a key player in the US war on terrorism, Tokyo restored grant and loan aid to both Islamabad and New Delhi, despite the unequivocal restrictions of Japan's ODA programme.

Humans↗

Which bio-weapons might be used by terrorists against the United Kingdom?

The properties of potential biological weapon agents for bioterrorism include a consistent effect at low dosage and short incubation period in a population of low immunity, being difficult to treat, able to be produced in bulk, stable in storage and readily disseminated. Possible agents include smallpox, haemorrhagic fever viruses, anthrax, tularaemia and plague. The example of Severe Acute Respiratory Syndrome (SARS) demonstrates the possible consequences of an act of bioterrorism, but also the necessary global response. There is scepticism about the practicability of surveillance schemes and the global elimination of biological weapons though the Biological and Toxin Weapons Convention remains urgent.

Bioterrorism↗

Bioterrorism: how should doctors respond to the threat of biological weapons?

Planning for the threat of a biological weapons attack includes preparations to recognize and identify an attack and its scale. Training is the key element of any response, but it is not possible for any health service to maintain sufficient extra capacity to deal with a massive bioterrorist threat. Training must include both first- and second-line responders. Subject to issues of confidentiality, information about plans should be as widely available as possible. Planning for prevention is also important. This should include stopping the production and dispersal of weapons under international humanitarian law and establishing the ethical basis on which doctors and scientists would not become involved in the production of biological and other weapons.

Bioterrorism↗

Acoustic anti-personnel weapons: an inhumane future?

High intensity sound is foremost among newer technologies being considered by the military for use in war weaponry and in control of civil disorder, particularly in the United States where some weapons may be nearing deployment. The various forms of acoustic energy and the weapons in which they could be applied are considered, and the adverse effects on humans described; these can be serious and persistent, and are potentially lethal. Military applications for which high energy sound has been contemplated in the past or are being considered for the future are examined, and some existing research projects reviewed. Such uses of acoustic energy in war are criticized in the light of the obligation imposed by existing international humanitarian law for weapons not to cause 'unnecessary suffering' or 'superfluous injury'. The humanitarian community must advocate greater humanitarian protection in warfare.

Acoustics↗