Terrorism Health Article

TERRORISM

Terrorism refers here to the public health consequences and the methods for prevention of the purposeful use of violence or threats of violence by groups or individuals in order to serve political or personal agendas. This article does not include what has been termed "state terrorism," the use of violence by a nation-state without clear necessity for self-defense and without the authorization of the United Nations.

EXAMPLES OF TERRORISM

Use or threat of use of violence has long caused concern among those responsible for public health. Examples include indiscriminate violence, such as the 1993 bombing of the World Trade Center in New York City and the 1995 bombing of the Federal Building in Oklahoma City, and targeted violence, such as attacks on facilities for the termination of pregnancy or on those who work in such facilities. The primary responsibility for response to the health consequences of such violence has resided largely in emergency medical services and the primary responsibility for prevention in agencies concerned with public order and safety, such as the police and the Federal Bureau of Investigation.

Recent instances of use or threatened use of biological or chemical agents in terrorism have raised interest in the role of public health agencies and public health personnel in primary or secondary prevention. Documented episodes, although extremely rare, have been dramatic. In Japan, the chemical warfare agent Sarin was released by the Aum Shinrikyo cult in Matsumoto in 1994 and in the Tokyo subway in 1995. In 1984, an Oregon cult allegedly contaminated salad bars with a biological agent, salmonella. These episodes, and recent hoaxes concerning anthrax release, have led to well publicized, costly responses by public health and public safety officials. Chemical terrorism could include the purposeful contamination of water and food supplies or the aerosolization of toxicants within enclosed public spaces. Biological terrorist actions could include purposeful contamination with infectious materials, as well as the purposeful release of insects or other vectors infected with a transmissible disease.