Abstract
Grouping together chemical, biological, radiological and nuclear agents as ‘weapons of mass destruction ‘ (WMD) has been rather uncritically accepted since the appearance of the CBRN classification more than 30 years ago, replacing the original military nuclear, biological and chemical (NBC) classification. Despite the apparent operational convenience of the CBRN grouping from a military and political standpoint, it remains medically unsatisfactory. In reality, there are very considerable differences between the different classes of agent, and only nuclear weapons should be truly regarded as WMD, given the degree of trauma, both physical and from radiation and material destruction they cause. There is often confusion, particularly among civil emergency responders about the real nature of CBRN injuries and the risks they pose to others. This often leads to a negation of the fact that toxic, biological and radiation trauma are inherently treatable and thus mass injury does not necessarily mean mass fatalities. Earlier chapters in this book have considered toxic trauma caused by exposure to toxic chemical agents. This chapter provides a comparison of chemical with biological agents, and with radiation injury. A detailed discussion of biological agents is outside the scope of this book, but radiation injury is covered in more detail, particularly the essential differences between radioactivity (and accompanying possible contamination) and radiation itself, which may be the result of the deliberate release of a radioactive substance or the explosion of a nuclear device. Although chemical, biological, radiological and nuclear agents produce different types of trauma they can be viewed in terms of their essential properties which have been discussed earlier for chemical agents which are as follows: (1) physical form and how the agent interfaces with the body, (2) persistency—how long the agent remains in the environment, (3) toxicity—how the agent causes trauma to the body and (4) latency—the time taken for physical signs and symptoms to appear.
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