Introduction

The phrase “weapons of mass destruction” was originally a military/political term for chemical, biological, or nuclear weapons intended for use in society-wide terrorization or destruction; the original term may have been used for chemical weapons delivered by aircraft. A weapon of mass destruction (WMD) itself can harm or kill large numbers of people, and potentially damage the environment or make it hazardous for humans or animals. While the definition is somewhat flexible, in general the assumption is that referring to something as a “WMD event” means that it was a deliberate and planned use of a powerful and dangerous material or device intended to cause large numbers of casualties and significant damage [1,2].

Weapons of mass destruction were originally developed by governments and nations, in large part due to the expense and technical expertise required to research, create, and employ them. In recent decades, though, so-called “non-state actors” have acquired, created, and employed WMDs in attacks on both humans and nature. The term non-state actor is generally understood to mean a political, social, religious, or other group not declared to be acting on behalf of a national government but to further a particular cause. The methods used by such groups may range from peaceful discussion and publicity, to non-violent civil disobedience, to targeted violence, to indiscriminate terrorist attacks. Since such groups are often not publicly organized or accessible, it is difficult to affect or dissuade them from courses of action in the ways that nation-states may be influenced, such as trade actions, diplomacy, blockade or other acts of war. This, along with some organizations’ secrecy, may contribute to the apparent unpredictability of their actions. In effect, what they do may not fit with the rational worldview of many disaster planners [1,2].

One of the early uses of WMDs by such a group was the Aum Shinrikyo attacks with sarin nerve agent in Matsumoto, Japan, in 1994, and on the Tokyo mass transit system in 1995. These two events resulted in thousands of casualties, including 11 deaths. Especially concerning, EMS responders were among the injured, potentially compromising the response. In large part, the rescuer casualties were due to lack of training or understanding of the scene threats posed by a WMD attack [3,4].

In the years since then, several major attacks have been popularly accepted as WMD terrorist events. The anthrax letters mailed in the United States in 2001–2002 fit the classic definition of a WMD event in that they involved a biological weapon which caused some casualties and deaths and also compromised the environment and functioning of the US postal service. Other events such as the 9/11 New York attacks loom in the public mind as WMD terror, even though the weapons themselves were essentially explosives and incendiaries. Mass shooting events, such as the Columbine, Colorado, and Newtown, Connecticut, school shootings, and the 2011 Norway mass shooting tragedy, also share some of these characteristics.

From the planning and response view, it is fair to approach all such major terror attacks as “WMD events,” in that they share certain characteristics which directly affect the EMS planning and response to them. While the remainder of this chapter will briefly address specific agents and the response to them, the approach will be more of a description of a general planning and response mindset. Other chapters in this book, and numerous other references, provide detailed information on treatment of specific entities such as chemical weapons (improvised hazardous materials, nerve agents, blister agents, choking agents, blood agents), biological weapons (anthrax, smallpox, tularemia, hemorrhagic fevers, toxins), radiological agents (powder, gas, or other forms of radioactive contamination), blast agents (explosives, whether commercial, military, or improvised), nuclear weapons (combining blast and radiological issues), and intentional trauma (typically by gunfire in these cases).