NCJ Number
190520
Journal
Pediatrics Volume: 105 Issue: 3 Dated: March 2000 Pages: 662-677
Date Published
March 2000
Length
16 pages
Annotation
This document describes the impact of chemical and biological terrorism on children.
Abstract
There is an increasing threat that chemical and biological weapons will be used on a civilian population in an act of domestic terrorism. Because children would be disproportionately affected by a chemical or biological weapons release, pediatricians must assist in planning for a domestic chemical-biological incident. With aerosolized agents such as sarin, chlorine, or anthrax, the higher number of respirations per minute in children results in exposure to a relatively greater dosage. The high vapor density of gases such as sarin and chlorine places their highest concentration close to the ground in the lower breathing zone of children. The more permeable skin of newborns and children in conjunction with a larger surface-to-mass ratio results in greater exposure to transdermally absorbed toxicants. Vesicants and corrosives produce greater injury to children because of their poor keratinization. Children, because of their relatively larger body surface area, lose heat quickly when showered. Consequently, skin decontamination with water may result in hypothermia unless heating lamps and other warming equipment are used. Having less fluid reserve increases the child’s risk of rapid dehydration or frank shock after vomiting and diarrhea. Finally, children have significant developmental vulnerabilities, such as undeveloped motor and cognitive skills, in escaping from the site of a chemical-biological incident. All children are at risk of psychological injury such as posttraumatic stress disorder and both short- and long-term psychological trauma. Recommendations are that pediatricians should participate in community efforts to establish response plans regarding local schools and child care facilities. Also, pediatricians should: assist in developing protocols for health care facilities, procurement of protective gear, and creation of separate ventilation/decontamination areas; play a key role in identifying sentinel cases of illness; assist in the development of local critical incident stress management programs for children; and become educated in issues of pediatric disaster management, including medical response to chemical-biological events. 4 tables, 43 references