Terrorism Response and the Environmental Health Role: The Million-Dollar (and Some) Question

Article excerpt

Introduction

A couple of years before September 11, a needs assessment was conducted in Union County, North Carolina, to determine what resources various agencies needed for disaster preparedness. On that occasion, all the funding that was available ended up going to hazmat teams, to fire departments, to police departments. There was no money left for public health, according to Tom Ward, environmental health director.

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"They're buying fire trucks and $50,000 detection equipment and bomb robots," added Tom Butts, emergency management coordinator with the Tri-County Health Department in Thornton, Colorado, "and we're asking for a pickup truck so that we can tow a trailer .... Our stuff just doesn't look as sexy as their stuff."

September 11 and the subsequent anthrax attacks did to some extent raise the profile of public health. Lawmakers began to express concern about a decaying public health infrastructure. In 2002, Congress passed the Public Health Security and Bioterrorism Response Act, which provided money through CDC for counterterrorism planning.

But today, three years after September 11, public discourse is still dominated by images that, while they are not untrue, tell only part of the story of terrorism preparedness and response--romantic-heroic images of rescues by police and firefighters, of squads in Level A suits entering toxic zones. One sees the effect of this preoccupation in funding and budget decisions, and in the target audiences of training programs offered by federal agencies. The Department of Homeland Security (DHS) and the Federal Emergency Management Agency (FEMA), for instance, offer a myriad of valuable training opportunities for firefighters, law enforcement, and hazmat personnel. Web, satellite, and on-site courses are all available, as is funding that helps local agencies send its employees to participate. While course descriptions occasionally mention public health personnel as a "secondary" target audience, a search through the agencies' Web sites did not turn up any counter-terrorism courses specifically targeted to environmental health.

It is true that with funding from the Public Health Security and Bioterrorism Response Act, the Centers for Disease Control and Prevention (CDC) have been dispensing money for terrorism response through cooperative agreements with the states. Some local environmental health departments have received some money under that arrangement, as will be discussed later in this article. CDC also has helped fund the Louisville Metro Community Based Emergency Response Program, which provides training geared toward public health and emergency response personnel from around the country. CDC also provides a wide variety of satellite and Web courses for clinicians and lab personnel on topics such as smallpox, plague, and anthrax. (For more information on the Louisville program, go to http://health.loukymetro.org/. For links to a variety of general public health-oriented training opportunities, go to http://www.astho.org/templates/display_pub.php?pub_id=614&admin=1.)

But just as the larger public discourse on terrorism has to some extent overlooked the role of public health, public health discussions have often overlooked environmental health.

"We focused right away on the medical side," observed Ron Grimes, director/health officer with the Jackson County Health Department in Michigan, "probably because the first term to come into play was bioterrorism, and we had the anthrax situation shortly after 9/11 .... And so I think that little bit moved us away from what the real issues are." For one thing, terrorists--from the Oklahoma City bombers to the train bombers of Madrid, Spain, to those currently operating in the Middle East--often use readily available traditional explosives to create terrible destruction. Environmental health professionals with whom the Journal of Environmental Health (JEH) spoke also are keenly aware of the potential for chemical and radiological disasters, intentional or not. …