In this position since 1959, has been directly involved in actual performance of disaster relief-presently involved in operation aspects of Hurricane Cecilia. Short-term training in Chemical Warfare and Civil Defense aspects thereof.

Dr. Barry D. Silverman, Medical Officer, Community Health Services, HEW Regional Office, Atlanta. Surgeon, USPHS. 1964—B.A., Ohio State; 1967—M.D., Ohio State. Residency in internal medicine at Vanderbilt 1967-69. Some case work in toxicology. Trans. of electrolytes in red cells. Pulmonary Actinomycosis. Twelve months at state and regional level in medical care. Liaison between state medical officials and PHS Regional Office, Atlanta, during this Operation CHASE.

APPENDIX 2

CONSOLIDATION OF AD HOC COMMITTEE DRAFT COMMENTS

Packaging

The proposed movement and disposal of the vaults poses no unusual hazard to public health and safety-provided the vaults remain intact. The actual risk of agent leakage during transportation appears comparatively small. The vaults can take the degree of temperature and vibrational exposures that they will be subjected to. The probability of leakage of these containers is not likely to be increased by the handling and transportation.

Recommendations.-Rigorous physical and chemical monitoring before and after each handling operation is recommended to identify existing or potential problems.

Shipment

1. The Army's plan appears to provide ample assurance that the vaults will be protected. The plan also appears to cover every imaginable contingency attending a railroad shipment of toxic material.

2. That route which presents the best rail service and possibly the shortest distance should be chosen. Any route passes through minor population centers and to evaluate the risk of the population, one would need to know the location of the tracks through town. Calculations of population densities of cities by themselves, do not give us enough information for such judgment.

3. Recommendation.—Minimum publicity should be maintained. It would appear to be in the best interest of all to limit precise information to those individuals directly involved in the planning and operational phases of the move. Recommendation.-It would seem advisable to have aerial surveillance for the whole trip in communication with both train crews. It would give a better overview of the area including appearance of the road bed, other trains, potential accidents at road crossings, and assemblies of people.

5. Recommendation.-Breakdown of railroad cars is not a likely event, but the train should contain spare cars and lifting equipment to move some of the vaults if necessary.

6. Recommendation. The pilot train must contain adequate medical and technical personnel and equipment to independently respond to any emergency. 7. Recommendation.-When there are either rivers or lakes over or near which the trains pass, it would be advisable to take extra precautions. An adequate monitoring and civilian warning procedure in case of accident involving a water supply should be available.

8. Recommendation. The plan should indicate that from the time loading is commenced on the hulk at MOT, Sunny Point until the hulk clears the Cape Fear River Entrance Buoy, any additional safety precautions required by Coast Guard Captain of the Port, Wilmington will be provided by the responsible command.

9. There are three major threats during transportation to the integrity of the shipment as relating to public health.

(a) Leakage. The possibility of leakage during transportation appears to be comparatively small.

Recommendation.-Monitoring, physical, chemical and through the use of a sufficient number of animal detectors properly situated should adequately protect against such an eventuality.

(b) Sabotage. The time factor, accessibility to railroad and relatively slow movement of the trains especially through populated centers offer opportunities for sabotage attempts. Under those conditions the Army in coordination

with law enforcement officials would know best how to prevent such a situation from arising. The most probable attempt would be made with either small arms or an explosive charge. The Department of Army testing program on simulated vaults has demonstrated that the hazard from attack by small arms is extremely minimal and if penetration of warhead did occur, the area of contamination would be localized and well within the ability of the escort to handle.

Recommendation.-In accordance with the Gross Committee recommendations, the Department of Army should determine the safe distance for vault separation during rail transport to negate propagation of explosive effects, both intrinsic and extrinsic.

The most serious threat to public health would seem to be as a result of an explosive charge of equivalent to 50 pounds or more of dynamite. Such an incident could result in destruction of 2 vaults and dissemination of their contents.

Recommendation.-Risk analysis of such an incident should be supplied and appropriate measures to safeguard the public could be planned for (see comments under HEALTH PROTECTION).

(c) Collision.

(1) Collision with a road vehicle transporting flammable liquids are a potential hazard. Sustained heating of the vaults at 150° C. for several hours could cause detonation of the explosive elements of the vaults. However, DOT tests and experience have shown that such a road vehicle under these circumstances burns only for 20-30 minutes.

Recommendation. As a further precaution, it is appropriate that fire fighting equipment be both on the pilot and the cargo train.

(2) Collision with a passing train will not occur since DOT will require a clear track on both sides at all times.

Health protection

1. Recommendation.-Personnel involved in this operation must be thoroughly trained in the medical and physical aspects of safety associated with exposure to agents involved. This includes detection, decontamination, treatment of self and casualties. This would deal with oxides of nitrogen and other hazardous gases besides the GB. It should be considered that reaction of GB in the cement may have produced a dimer which may have different properties than were anticipated. This is in analogy to an organic phosphate insecticide where such dimer was formed with very unexpected toxic properties.

2. Recommendation.—It would seem appropriate for the Department to be prepared to help allay public apprehension and even hysterical protests which might grow following public announcement. The public should be made aware that the full resources of the Department have been marshalled and stand ready to provide emergency medical backup in the remote event of an incident.

3. Recommendation.-The Surgeon General's office should brief the Medical Directors in the affected Regions (III, IV) and arrange for them to be present when Surgeon, USCONARC, briefs the appropriate State health officials (F-3). The two Regional Medical Directors should be represented at the Office of the Surgeon, USCONARC, during the operations.

The suggestions submitted in the attached appendix are essentially those which are recommended for all disasters. They were developed by the Planning and Evaluation Branch, EHS from experience gained in all types of disasters and exercises and have been tailored to fit this operation. The Department of Defense will have to assist the states with personnel and material in order to implement the attached plans.

Miscellaneous

1. Recommendation.-The Surgeon General, USPHS, should also receive information copies of Advance Repship, Final Repship, Report of Arrival and Report indicating Completion of Loading and Date of Departure.

2. Recommendation. The disposal of these vaults should terminate the usage of this type of encasement of CW material.

APPENDIX-COMMUNITY HEALTH PROTECTION

State planning should be based on concept of supplementation of military resources to assure an adequate response to emergency medical requirements of a community in the event of an incident.

This should include, but not be restricted to:

A. Plan for allerting citizenry to awareness of danger. (This need not be a part of health plan but mention of planning responsibility should be made.)

B. Plans for evacuation in the event of an incident. (This may also be the responsibility of another agency.)

C. Plans for care of evacuees. (Generally the reponsibility of American National Red Cross but mention should be made.)

D. Plans for immediate lifesaving resuscitative measures.

It is expected that this responsibility will be carried out primarily through DOD because of specialized knowledge and equipment.

E. Plans for continuing medical care.

The medical emergency victim exposed either to life-threatening or disabling toxic materials may be expected to seek assistance at the nearest known medical resource.

Casualties in the immediate area of the incident may be first seen by medical teams of the military and transportation provided for them to the nearest medical facility either by the military or by community resources. The state plan should therefore provide the DOD with:

1. Information concerning existing hospitals, and also PDH's and HDRI units along route, and the number of beds that might be made available according to the individual hospital disaster plan.

2. The number of ambulances in each community that can be made available. F. Many other individuals with real or imagined symptomatology may be expected to make their way to either hospitals or physicians offices through private transportation. To provide essential continuing medical assistance for the citizenry the State Health Plan should therefore provide for:

1. Briefing of key hospital personnel on symptomatology and treatment of exposed individuals and military resources available.

2. Assistance to hospitals, if needed, in updating hospital disaster plans including evacuation of hospitals if necessary.

3. Supplementation of resources:

(a) Drugs (Atropine).

(b) Beds (PDH's).

4. Movement of patients either to military or other less crowded community hospitals. (This would supplement, if necessary capability of military.) 5. Movement of additional resources into community as may be indicated: (a) Personnel.

(b) Drugs.

(c) Facilities and equipment.

6. Coordination with military in the release of press statements.

SUGGESTED STATE LEVEL BRiefing for GOVERNOR'S OFFICE, CONCERNED AGENCY HEADS, AND OTHERS

(a) Develop special contingency plan similar to Inter-Agency Radiological Health Assistance Plan-Incident/Accident emphasis.

(b) Utilize team concept for assessing situation, determining actions, and direction of operations.

(c) Develop plans for protection of population along routes of movement including health facilities.

As far as the Division of Emergency Health Services is concerned, we have experienced men in each of the states involved that are ready to assist in any way that we can. Should more be needed, they can be detailed from nearby states. If our services are utilized, it would be helpful to have as much advance notice as possible.

APPENDIX 3

DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE,
Washington, D.C., July 29, 1970.

Hon. J. RONALD FOX,

Assistant Secretary of the Army (Installations and Logistics),
Pentagon, Washington, D.C.

DEAR DR. Fox: The committee of scientists and other experts convened by the Department of Health, Education, and Welfare has reviewed the Army's Operation CHASE plan forwarded with your letter of June 19, 1970. The committee also reviewed the addendum to the plan forwarded with your letter of July 22, 1970, which responded positively to the committee's initial comments. I have completed my review of the particulars of the proposed transportation as required by Public Law 91-121 and have no further comments or recommendations to offer.

As discussed informally between our staffs, I concur with the desirability of the Public Health Service cooperating in a briefing session on Operation CHASE for state health personnel at our Regional Office in Atlanta. I trust that final arrangements will be expedited at the staff level.

Sincerely yours,

Mr. Cecil M. Cork, P. H. Engineer 3, 205 Huntley Drive, Montgomery, Alabama. Mr. Lyman W. Faggard, Public Health Advisor, 3243 Covered Bridge Drive, Montgomery, Alabama.

Mr. Harvey J. Roberts, Industrial Hygienist, 2036 Grant Avenue, St. Albans, West Virginia.

Mr. L. W. Frann, Director, Disease Control, 1800 Washington Street, Charleston, W. Va.

Mr. Paul D. Kates, Director, Emergency Health Services, 823-5th Avenue, St. Albans, W. Va.,

W. R. Sauthward, Jr., M.D., Director, Disaster Medical Services, State Department of Health, 109 Governor Street, Richmond, Va.

Mr. P. Schofield Bryce, Director, Bureau of Industrial Hygiene, 109 Governor Street, Richmond, Virginia.

D. H. Robinson, M.D., Chief, Preventive Health Services, Route 1, Box 73B, Irmo, South Carolina.

Mr. Robert T. Barden, Environmental Sanitarian Supervisor, J. Marion Sims. Bldg., Columbia, South Carolina.

Mr. Earl W. Mitchell, Director, Division of Emergency Health, 224 St. Andrews Road, Columbia, South Carolina.

Mr. Francis P. Jung, Director, Division of Industrial and Radiological Health, 727 Cordell Hull Building, Nashville, Tennessee.

Mr. Milliam B. Lyons, Public Health Representative, Division of Emergency Health Services, 208 Capital Towers Building, Nashville, Tennessee.

Mr. Robert H. Odom, Director, Emergency Health Care, 208 Capital Towers Building, Nashville, Tennessee.

Mr. Herbert M. Bagman, Chief, Health Mobilization Section, Route 6, Box 230M, Raleigh, North Carolina.

Mr. Joel E. Jorsaw, Assistant General Counsel, Cordell Hull Building, Tennessee Public Service Commission, Nashville, Tennessee.

Mr. Ralph C. Pickard, Director, Environmental Health, 205 Bramton Road, Louisville, Kentucky.

William P. McElwain, M.D., Commissioner of Health, 275 E. Main Street, Frankfort, Kentucky.

Dr. H. Karl Sessions, Director, Occupation Health Branch, Georgia Department of Public Health, Atlanta, Georgia.

Dr. John H. Venable, Director, Georgia Department of Public Health, Atlanta, Georgia.

APPENDIX 5

DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE,
Washington, D.C., July 29, 1970.

Hon. J. RONALD FOX,

Assistant Secretary of the Army (Installations and Logistics),

Pentagon,

Washington, D.C.

Dear Dr. Fox: Pursuant to your letter of 2 July 1970 requesting our review of the draft environmental impact statement for Operation CHASE, we submit the following comments:

1. The Operational Plan should be attached to the environmental impact statement as a reference.

2. A more definitive description of the geographical location and known ecological characteristics of the disposal site would be desirable.

3. The draft impact statement fails to mention two potentially significant factors:

a. Other munitions, explosives and chemicals previously dumped at this disposal site and the estimated condition of this material, and

b. The impact of the CHASE propellant and explosive materials on the marine environment.

It would be desirable to initiate and maintain a perpetual inventory and monitoring of the disposal site.

4. We agree in principle with one of the conclusions of the Department of Interior Working Group's Second Report, November 13, 1969; namely, there is no choice but to accept ocean disposal of these hazardous materials as a necessary, though undesirable, expediency. This conclusion was reached after considering present hazards to human safety and to terrestrial environments and the unavailability of alternate methods of disposal.

5. We concur with the recommendations of the Gross Committee and the National Academy of Sciences that alternative disposal methods for chemical munitions and agents be developed which will have a minimum impact on the environment.

I appreciate the opportunity of reviewing this statement and assure you that this office is available to assist you n the development of new approaches to disposal problems.

Sincerely yours,

Born: May 18, 1914.

ALBERT H. STEVENSON

Education: B.S. in Civil Engineering, Union College; M.S. in Engineering, Harvard University.

Experience: Since 1937, State and local environmental health work, consulting engineering in water supply design, and, since 1941, a variety of assignments in the U.S. Public Health Service including Regional Office, research administration, program management and direction, and engineer career development guidance. Currently, Assistant Surgeon General and Chief Engineer of the Public Health Service, as well as Associate Administrator, Environmental Health Service.

Specific Activities Related to Disaster Work, CBW Agents and Handling of Toxic Materials:

1. Regional Office, New York. Participated in natural disaster relief operations over a three-year period.

2. Federal Civil Defense Administration. Assigned as Chief Sanitary Engineer for a two-year period. Planned for emergency health preparedness; participated in disaster relief operations; and directed a Civil Effects Test Group program at Operation Teapot, Mercury, Nevada.

3. Headquarters. Engaged in environmental health protection as a consultant and a member of cadre at classified site-three years.

4. Currently, as Associate Administrator, Environmental Health Service, responsible for organization, planning for emergency health preparedness and disaster response.