What’s'In'the'Field?'a'Leveraging'Partnerships'for'Public'Health'Preparedness'&'Response'
Monday, September 9, 2013 2:00 pm ET Association of Public Health Laboratories
Agenda'• Tod Companion, PhD
o Standards for State and Local CBRNE Response
• Christina Egan, PhD, CBSP o Linking Field Screening and Public Health Laboratory Testing
• Cindy Bruckner-Lea, PhD Ann Lesperance, MPH o PNNL Activities in Support of Field Biodetection and First
Responders
• Stefan Saravia, MPH, CIH, CHMM Moe Sullivan, MPH o Sample Collection and Hazard Screening
Training Program • Q&A
'
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Tod'Companion,'Program'Manager'
''DHS$S&T$$Acquisi-on$Support$and$Opera-ons$Analysis$Group''Office'of'Standards'''Standards'for'State'&'Local'CBRNE'Response''September'9'2013''
Coordination'of'CBRNE'Standards''''
4'
• Federal, State, Local and Tribal Communities • Tight budgets create collaboration opportunities
• Many agencies are funding RDT&E for CBRNE equipment (DHS, DOD, NIST and EPA)
• Other federal stakeholders provide input on standards (CDC, FBI, DOJ, USPS and USDA)
• U.S. system of standards provides for private sector & public sector input
'''''''''Standards'Development'by'DHS'• The'Homeland'Security'Act'of'2002'(Public'Law'
107U296)'directs'DHS'to'conduct'all'standards'acXviXes'in'accordance'with'the'NaXonal'Technology'Transfer'and'Advancement'Act'of'1995'(Public'Law'104U113)'and'OMB'Circular'AU119'
• OMB'AU119;'Federal'ParXcipaXon'in'the'Development'and'Use'of'Voluntary'Consensus'Standards'and'in'Conformity'Assessment'AcXviXes'– Directs'Federal'agencies'to'develop'and'use'
voluntary'consensus'standards'in'lieu'of'governmentUunique'standards'
– Two'caveats:'• When'pracXcable'• Use'in'whole'or'in'part'
5'
Goals'of'the'NaXonal'Strategy'• Establish'an'interagency$group$for$CBRNE$standards'
to'promote'the'coordinaXon'of'such'standards'among'Federal,'state,'local,'and'tribal'communiXes''
• Coordinate'and'facilitate'the'development'and'adopXon'of'CBRNE$equipment$performance$standards''
• Coordinate'and'facilitate'the'development'and'adopXon'of'CBRNE'equipment$interoperability$standards$$
• Promote'enduring'CBRNE'standard$opera-ng$procedures''
• Establish'voluntary'CBRNE'training$and$cer-fica-on$standards'and'promote'policies'that'foster'their'adopXon''
• Establish'a'comprehensive'CBRNE'equipment$tes-ng$and$evalua-on$(T&E)$infrastructure$and'capability'to'support'conformity'assessment'standards''
6'http://www.whitehouse.gov/blog/2011/08/30/path-emergency-reponse-standards
• Guide procurement decisions of end-users (e.g., First Responders, private-sector end-users, government)
• Provide First Responders with independently-validated tools for incident management
• Provide commercial sector with guidance for developing tools that meet the needs of Public Health and First Responders
Impacts
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Standards$Capability$Model$
8'
! 'Performance'Standards'
! 'Test'Methods'
! 'Conformity'Assessment'
! 'Procure'validated'tech'
! 'Standards'for'Training''Programs'
! 'CONOPS'
! 'Guides'for'standard''operaXons'
The$Case$for$Standards$
9'
Does this work? (Performance Standards)
How do I test this? (Test Methods)
Does this solve the right problem? (CONOPS/ standard operations guides)
How do I use this?
(Training)
Should I buy this?
How do I comparison
shop? (Conformity Assessment)
Will this work with my other devices?
(Test Methods)
NOW AVAILABLE! Radiation/Multi-Toxin
Detection Meter $299.99*
• Advanced Radiation and Bio-Chemical Agent Protection!
• Industry Leading Working Duration
• Completely Self-Contained
• Compact and Innovative Design
* Special GSA rates on request
Standards enable effective capability delivery
Use'Cases'
• Rather'than'drive'a'product/process/technique'into'operaXons,'how'do'we'develop'a'capability?'
• …it'depends'– Who?'When?'How?'
• Rather'than'develop'50'or'100'separate'cases,'there'must'be'some'starXng'point'
10'
Service'Oriented'Architecture'
– Principles'and'methodologies'for'designing'and'developing'interoperable'services''
• Defined'by'funcXon,'built'as'components,'with'replicable'elements'already'in'use'by'customers…'
– What'are'our'services?'What'are'communiXes'already'doing?'
– HAZMAT'– EMS'– LRN'– CST/CBRF'
11'
Mission'Capability'
12'
• ConOps1
• Training • Proficiency Testing • Sampling & Sample Handling2
• Assay " Performance Specifications3
" Testing and Certification3
1. ASTM E2270-10 Standard Guide for Operational Guidelines for Initial Response to a Suspected Biothreat Agent 2. ASTM E2458-10 Standard Practices for Bulk Sample Collection and Swab Sample Collection of Visible Powders Suspected of Being
Biothreat Agents from Nonporous Surfaces 3. Dr. Mathew Davenport, DHS Science and Technology, CBD, PSAA Project
An assay, method, or detector must be operated by a trained and proficient user and integrated into a response plan
Framework'for'a'Biothreat'Field'Response'Mission'Capability'
Develop$guidance$to$first$responders$for$the$biological$assessment$of$suspicious$powders$• Interagency'effort'involving'DHS,'CDC,'FBI,'and'
EPA'• Defines'a'Mission'Capability'(a.k.a.,'an'
AcXonable'Assay'–'the'Onion)'• Outlines'the'accomplishments'and'remaining'
gaps'
13'
https://www.rkb.us/contentdetail.cfm?content_id=270212&query=270212&overridesubtype=950
Timeline'of'BiodetecXon'Standards'and'T&E'Methods'Development'
14'
Attempts at coordination of assay performance metrics
and T&E between DoD and CDC
BioMonitoring MOU between
DHS, CDC, DoD, DoJ, USPS
National BioMonitoring
Architecture (calls for PHAA standards)
DHS S&T PHAA
program established
PHAA Standards
development begins with
AOAC contract & SPADA
Original PHAA split into PSAA (stds for 1st responders and private
sector) and PHAA (stds for federal biodetection systems)
Establishment of NSTC/
CHNS/SoS
BioMonitoring MOU expires
Publication of A National Strategy on
CBRNE Standards
Establishment of NSTC/CHNS/SoS-
CBRNE
Publication of first SPADA Standards
Publication of Framework for a Biothreat Field
Response Mission Capability
Public'Safety'and'Public'Health'AcXonable'Assay'Architecture'
15'
PHAA Sample goes to LRN
PSAA
• Evacuate(• Close(building(• Decon(exposed(• Incident(Management(• Transport(Sample(to(LRN(
• Ini>ate(Public(Health(Inves>ga>on(• Determine(need(for(supplementary(tes>ng(• Conduct(risk(assessment(for(need(of(PEP(• Risk(communica>on(
Users First Responders Private Sector
Users LRN/CDC Fed owned & operated
Public Health Action
Public Safety Action
PSAA'ObjecXves'&'History'
16'
! Original$Objec-ves$in$2007$–$PSAA$Pilot$Project$- Establish'standards'to'validate'Polymerase'Chain'ReacXon'(PCR)Ubased'
technologies'that'detect'aerosolized'Bacillus(anthracis,'Yersinia(Pes0s,'or'Francisella(tularensis(
- Pilot'the'validaXon'process'with'an'assay'that'detects'B.(anthracis((
! Objec-ves$added$in$2009'- Develop'standards'to'validate'immunoassayUbased'HandUHeld'Assays'(HHAs)'
that'detect'B.(anthracis(or'Ricin'in'suspicious'powders'- Test'commerciallyUavailable'HHAs''
! Objec-ves$added$in$2010$- Develop'standards'to'validate'PCRUbased'technologies'that'detect'aerosolized'
Burkholderia(psuedomallei(and'Burkholderia(mallei'- Develop'standards'to'validate'PCRUbased'technologies'that'detect'B.(anthracis(
in'suspicious'powders''
! Objec-ves$added$in$2011 - Develop'recommendaXons'on'controls'needed'for'fieldUbased'assays'
SPADA'Sets'the'Standards'
• A'voluntary'consensus'standards'body'established'via'a'DHS'S&T'contract'with'AOAC'InternaXonal'
• Includes'representaXon'from'DHS,'CDC,'DoD,'DoJ,'FDA,'EPA,'USPS,'NIST,'State'&'Local'Public'Health,'First'Responders,'Industry,'and'Academia'
• Establishes'method'performance'requirements'and'panels'of'reference'materials'(and'validaXon'protocols)'
17'
The$Stakeholders$Panel$on$Agent$Detec-on$Assays$(SPADA)$
*The SPADA PHAAWG did not develop strain panels and method performance requirements; rather, the WG discussed necessary elements of an actionable assay (e.g., performance standards, user training, ConOps)
# All SPADA members volunteer their time and expertise
B.(anthracis(Working(Group((PCR)(
Y.(Pes>s(Working(Group((PCR)(
F.(tularensis(Working(Group((PCR)(
Environmental(Factors(Working(Group((PCR)(
Public(Health(Ac>onable(Assay(Working(Group*((
B.(anthracis(HHA(Working(Group((
Ricin(HHA(Working(Group((
Burkholderia(Working(Group((PCR)(
Assay(Control(Working(Group((PCR)(
SPADA(
SPADA'Established'Standards'
SPADA$has$established$detec-on$performance$standards$for$eight$detec-on$missions;$standards$include$panels$of$reference$materials$and$performance$requirements'
18'
! DetecXon'of'B.(anthracis(in'visible'powders'with'an'HHA*'! DetecXon'of'ricin(in'visible'powders'with'an'HHA*'! Detection of B. anthracis in visible powders by PCR* ! DetecXon'of'B.(anthracis'in'aerosol'collecXon'samples'by'PCR(! DetecXon'of'Y.(pes0s(in aerosol collection samples by PCR(! DetecXon'of'F.(tularensis(in aerosol collection samples by PCR(! Detection of B. psuedomallei in aerosol collection samples by PCR ! Detection of B. mallei in aerosol collection samples by PCR'
* Standards are focused on testing of tools used in the field by first responders
Concept(of(Opera>ons(
How'does'tesXng'become'an'acXonable'Mission'Capability?'
19'
(((((((((((
Tes>ng(against(SPADA(Detec>on(Standards(
Method$Developer$Valida-on$
Independent$Lab$Valida-on$
Opera-onal$Spec$Tes-ng$
Laboratory(Tes>ng(
Collabora-ve$Study$
Opera-onal$$T&E$ + SOPs$
Competency$Assessment$
Training$and$Exercises$
Proficiency$Tes-ng$
SupporXng'a'Field'DetecXon'Capability'
A$mission$capability$integrates$a$number$of$essen-al$elements$
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• Performance'SpecificaXons'(AOAC'SPADA)'• TesXng'&'CerXficaXon'of'Tools'(AOAC'SPADA)'• Sampling'&'Sample'Handling'(ASTM'E2458U10)'• Training'&'Exercises'(OVS,'TESSB)'• Proficiency'TesXng'(NGB?'NFPA?)'• ConOps'(ASTM'E2770U10)'
Performance$Specifica-ons:'for'HHA'(BA'and'Ricin),'PCR'(on'a'filter),'PCR'(on'a'powder)'AOAC'SPADA'Stakeholders''Panel'on'Agent'DetecXng'Assays,'chaired'by'Maphew'Davenport,'PhD,''
Working'with'ASTM'and'AOAC'standards'development'organizaXons,'the'federal'community'including'CDC,'FBI,'DOD,'DHS,'EPA,'OSHA,'state'and'local'stakeholder'community'to'develop'and'coordinate'an'ASTM'standards'for'response'to'and'the'collecXon'and'transport'of'suspicious'powders'to'the'LRN'laboratory'by'the'first'responders.'''
Sample'CollecXon'
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Working'with'the'Department'of'Homeland'Security'to'develop'standards'for'measurement'assurance'of'detecXon'assays'in'the'hands'of'first'responders.'Working'with'a'consorXum'of'technology'developers,'federal'agencies'and'state'and'local'members'of'the'first'responder'community,'to'idenXfy'standards'and'materials'for'rouXne'measurement'assurance'in'the'field.'
Biothreat'DetecXon'Standards''
22
Operation Vigilant Sample
$ Clandestine Terrorist Lab $ RV modified for BT agent production
$ Environmental and Clinical PH LRN Response $ Biological powders $ Cutaneous anthrax specimen
$ Army National Guard 4th WMD CST $ Sample collection $ On-scene testing $ Air-mobile
$ Live Players and Props $ Recreation vehicle “biological production facility” $ Incident Command, triage, collection, transport $ On-scene and LRN analysis
$ Performed in “Real-Time”
FLETC, Glynn County GA 8/7-9/06
Full-Scale GPHL LRN-CST Exercise Brunswick, GA
GA PH Labs CDP DHS-FLETC Coastal Health District 9-1 Glynn Co. FD/HazMat FBI GEMA GA State Patrol National Guard Bureau Responders Resource Technologies Dugway Proving Ground CPT Bryon Marsh 4th CST-WMD 404-660-8917 [email protected]
Next'Steps?'''Focus$on$the$needs$of$first$responders$• IdenXfy'technology'needs'of,'and'technologies'purchased'by,'the'first'
response'community'• Categorize'those'needs'and'technologies'
• Establish'addiXonal'Standards'where'necessary'• Provide'CONOPS'and'training'
– ONLY'in'context'of'their'local/state'operaXons'• Cost'share'tesXng'of'3U5'products'in'each'technology'type'
25'
Technology$Type$ Sensi-vity$ Specificity$ Cost$
Advanced$(e.g.,$PCR)$ ++++$ ++++$ $$$$$$
Intermediate$(e.g.,$HHAs)$ ++$ ++$ $$$
Low$(e.g.,$protein$screen)$ +$ +$ $$
To(make(available(a(series(of(validated(tools(that(jurisdic>ons(can(choose(from(based(on(their(resources(
New York State Department of Health
Wadsworth Center
Linking'Field'Screening'and'Public'Health'Laboratory'TesXng'
Christina)Egan,)Ph.D.)
New)York)State)Department)of)Health)
Wadsworth)Center)
New York State Department of Health
Wadsworth Center
Field'Screening''''''''''''PHL'TesXng'! Rapid)screening)of)samples)to)generally)characterize)the)potential)threat,)without)consuming)large)quantities)of)sample,)with)appropriate)safety)considerations))
! Ensures:)1. Sufficient)sample)remains)for)confirmatory)testing)
2. Sample)can)be)safely)transferred)to)appropriate)laboratory)
! Bomb)disposal)unit)
! Radiation)laboratory)
! Chemical)analysis)laboratory)
! Biodefense)laboratory)
3. Safety)of)staff)and)laboratory)are)not)compromised)
New York State Department of Health
Wadsworth Center
Rethinking'“White”'Powders'! Environmental)threat)samples)
! Traditionally)screened)for)biological)agents)based)on)our)2001)experiences)
)
! Majority)of)“white)powders”)are:)
! Illicit)drug)compounds)
! Explosive)compounds)
! Crystalline)powders)may)present)extremely)hazardous)explosive)
conditions)
! Little)consideration)given)to:)! Chemical)Warfare)Agents)(CWA))
! Explosives)
! Radiological)threats)
)
! Laboratory)staff,)lab)infrastructure)and)emergency)response)are)at)risk)if)samples)are)only)tested)for)Biological)Agents)
New York State Department of Health
Wadsworth Center
All'Hazards'A)comprehensive)approach)to)screening)environmental)
threat)samples)for)the)presence)of:)
))
! ! !Chemical)warfare)agents)
! ! !Biological)agents)
! ! !Radiation)sources)
! ! !Explosive)compounds)
Some tools and screening protocols were available to Public Health Laboratories Many different protocols and screening tests being performed nationally
New York State Department of Health
Wadsworth Center
''All'Hazards'Screening'Laboratory'
New York State Department of Health
Wadsworth Center
ARHF'Training'for'Lab'Staff'
New York State Department of Health
Wadsworth Center
APHL'TesXng'Algorithm'for'Unknown'Environmental'Samples'Task'Force'
! Taskforce)established)in))))))October)2009)
! To)develop)and)issue)guidance))))))to)public)health)laboratories))
))))on)how)to)process)unknown))
))))environmental)samples.)
! Members)consisted)of)State))
)))representatives)from)both))
)))LRN\B)and)LRN\C)
New York State Department of Health
Wadsworth Center
New York State Department of Health
Wadsworth Center
New York State Department of Health
Wadsworth Center
Guidelines'for'the'Unknown'Algorithm'
http://www.aphl.org/AboutAPHL/publications/Documents/PHPR_2011June_ Algorithm-and-Guidelines-for-Responding-to-an-Incident-Involving-a- Suspicious-Non-Clinical-Sample.pdf
New York State Department of Health
Wadsworth Center
Unknown'Algorithm'GuidelinesU'Minimal'Recommended'Chemical'Tests'
New York State Department of Health
Wadsworth Center
Many'Efforts'related'to'Threat'Screening'and'Laboratory'TesXng'
! FBI,)HHS,)CDC,)DHS.)Guidance)on)Initial)Responses)to)a)Suspicious)Letter/Container)With)a)Potential)Biological)Threat<)2004.))
! DHS)published)the)Framework)for)Biothreat)Field)
Response)Mission)Capability\2011)
! ASTM)E2270\10)Standard)Guide)for)Operational)Guideline)for)Initial)Response)to)a)Suspected)Biothreat)Agent\2010))
! EPA)All)Hazards)Screening)Protocol\2008)
New York State Department of Health
Wadsworth Center
ConXnued'APHL'Efforts….FiRST'Subcommipee'
PNNL Activities in Support of Field Biodetection and First Responders
CINDY BRUCKNER-LEA, PH.D. [email protected]
ANN LESPERANCE, M.P.H. [email protected]
SEPTEMBER 2013
1
PNNL Outline
Northwest Regional Technology Center Overview of Ground-Up Approach to Assess and Address Biodetection Needs End-User Technology and Info Needs: Identification and Assessment PNNL Biodetection Testing Plan – Modified AOAC Approach Biodetection Instrument and Assay Testing at PNNL Testing Outcomes Path Forward
NW Regional Technology Center for Homeland Security
Identify critical technology needs and requirements to influence the Federal R&D agenda Enable testing and evaluation of technologies by regional Federal agencies, State, local, and tribal users Provide unbiased information/support on S&T to support acquisition and/or implementation Accelerate technology development and deployment
Mission: Lead collaborative efforts between technology developers and Federal, State, local, and tribal users to:
Define performance requirements with stakeholder and end-user input
Conduct interviews with end users Bring together end users and key agency reps (FBI, PH/LRN, CST, DHS, etc.) in workshops to fully understand and define key needs and gaps
Perform technology foraging (collect, validate, compile info) Establish technology test plans Conduct 3rd party independent testing
and evaluation; support and facilitate end-user testing Publish and disseminate instrument and assay testing results and summaries for instrument use, limitations, cost/benefit Facilitate adoption of approved equipment lists
Ground-Up Approach: Biodetection Technology ID, Assessment and Transition
Statistical Methodology for COTS Testing
Existing AOAC test guidance (SPADA) is extremely burdensome due to the large number of samples that must be analyzed Because biodetection technology and assays are rapidly evolving, with new versions appearing almost annually, a more efficient, but still statistically based testing approach is needed PNNL Test Plan follows AOAC inclusivity, exclusivity and 95% confidence Probability of Detection (POD) guidelines
PNNL Test Plan approach • 34 samples must be tested without
a single failed result, • 53 samples must be tested with no
more than a single failed result, or • 86 samples must be tested with no
more than two failed results.
Calculated using a one-sided confidence interval and the normal approximation to the binomial distribution
Testing of PCR-Based Instruments Using PNNL Test Plan Test Plan for PCR Hand Portable Instruments
Test plan follows AOAC/SPADA statistical guidance 5 PCR-based biodetection platforms:
FilmArray RAZOR Bio-Seeq PLUS T-COR4 POCKIT
Bacillus species only Inclusivity panel DNAs (SPADA) (n=13)
Starting test concentration: 2,000 copies/mL Each strain analyzed in triplicate Strains not containing pXO2 were omitted from inclusivity panel
Exclusivity panel DNAs (SPADA) (n=18) Starting test concentration: 20,000 copies/mL Each strain analyzed in duplicate Strains with pXO2 homologous genes were omitted from exclusivity panel
Follow on testing with Bacillus spores and environmental hoax powders (n=21) Final results will be published/disseminated
Initial Screening of A Wide Range of Biodetection Technologies for Bacillus and Ricin detection
Goal: understanding instrument performance, limitations, and cost/benefit Test samples
Bacillus anthracis spores (BSL-2 and BSL-3) Ricin toxin (4 preparations of varying purity) Environmental material and potentially interfering common powders
Screening Assays: General Protein: BioCheck and Indipro strips Biochemical: ATP/luminometer test: New Horizons and Clean-Trace tests General DNA: Prime Alert Chemical/Spectroscopic: HazMat ID 360 Immunoassays: RAID 8 and Pro Strips PCR Assays: Razor, FilmArray, T-COR4, POCKIT, and Bio-Seeq PLUS
Outcome of these tests will help to formulate additional testing, including LOD studies with white powder + Ba and ricin mixtures
Testing Outcomes and Info Dissemination
PNNL laboratory testing Establish LOD, dynamic range, potential for false positive/negative results, and impact of other substances such as common hoax powders ID technology deficiencies/limitations prior to high cost/effort field testing Develop objective information and guidance for selection and use of biodetection technology
Publish and disseminate information COTS biodetection instrument summary reports Peer-reviewed publications of COTS instrument testing Dissemination of PNNL Test Plan for future instrument testing and transition
Summaries of instrument use, limitations, cost/benefit
Evaluation of the FilmArray® system for detection of Bacillus anthracis, Francisella tularensis and Yersinia pestis
Volume 114, Issue 4, pages 992–1000, April 2013
Biodetection Technology First Responder Report: http://1.usa.gov/17RHdt8
Path Forward
Continue technology foraging and instrument testing Provide information to end-users to assist in making more informed decisions on equipment selection, improving training and better understanding of equipment use and limitations In partnership with Public Health and other Agencies (APHL, LRN, CST, FBI, NIST, Others), support first responder field biodetection exercises
Support DHS and other agencies in the implementation of key elements of the Biothreat Field Response Mission Capability Conduct additional Working Meeting with first responders in 2014 to report testing results, present instrument use/guidelines and solicit stakeholder feedback
Acknowledgments
Principle Investigator: Cindy Bruckner-Lea
Project Manager: Rachel Bartholomew
Project Team: Cheryl Baird
Heather Colburn
Janine Hutchison
Ann Lesperance
Richard Ozanich
Jessica Sandusky
Timothy Straub
Kristin Victry
Pamela Kinsey
This effort is funded by the Department of Homeland Security Science and Technology Directorate under Contract HSHQDC-08-X-00843. DHS Program Manager: Anne Hultgren, Ph.D.
SAMPLE COLLECTION AND HAZARD SCREENING TRAINING PROGRAM Stefan Saravia, MPH, CIH, CHMM Chemical Threat Preparedness Coordinator Minnesota Department of Health Public Health Laboratory Division
Overview • Minnesota response to suspicious substances
• Developing and implementing our training programs
• Lessons learned and outcomes
40
Chemical Assessment Teams
41
• Eleven teams strategically located around the state
• Responsible for responding within region
• Crew of at least 1 specialist and 2 techs
• Deployed through state Duty Officer
Chemical Assessment Teams
• Each team has specialized equipment for: • Air monitoring • Material identification • Sample collection • Decontamination
42
55th Civil Support Team
• CST provides advanced capabilities for WMD events • Mobile laboratory • Sample collection • Communications
• Takes longer to deploy than CATs
• Not required for every incident
43
MN Laboratory Testing • Accept samples from:
• Law (local/FBI) • Hazmat • Other gov. agencies
• Have an “all hazards” approach – not just bio
• Require: • Rad and explosives
screen • Proper packaging
44
Practice Sample Program • Began in 2009 • 3 samples/quarter • Scenario driven exercise
• We have stressed “characterization” over “identification”
45
Practice Sample Program • Heavy reliance on field spectroscopy
• Suggest an orthogonal approach
• Great excuse to interact with teams
46
Areas for Improvement
• Teams had moved away from basic “characterization” techniques
• If no match on IR or Raman we would often get no information
47
Pre-screening
Areas for Improvement
• Sample too big • 55-gallon drum
• No sample to test • Powder letter w/ no
powder • Inappropriate matrix
• Dead mice
48
Inappropriate sample volumes/types
Areas for Improvement
• Samples not sealed • Samples delivered in grocery store bag
• Samples not decontaminated
49
Improper Packaging
Training Goals • Hands-on training • Standardized approach • Work with individual responders
50
Sample Collection
• Provided teams with kits and procedures
• Had hands-on exercise practicing using kits
• Covered chain-of-custody procedures
• Practiced using our submission forms
51
Hazard Screening
52
• Based on DOT hazard classes
• Emphasized “assessment” not identification
• Focused on need for proper lab analysis for toxins and infectious substances
Field Spectroscopy • Explained how field spectroscopy works
• Discussed strengths and limitations
• Ensured that they could recognize the FTIR spectra for water!
53
Screening Exercise
54
• Groups had kits with chemicals and instruments
• Demonstrated MDH approach
• Minimal screening • Explosives • Radiation
• Additional screening • VOCs/CGI • FTIR/Raman • Reactives • Corrosivity (pH) • Oxidizers
Challenges
• Wide geographic area • Scheduling
• Time restrictions • Multiple shifts
• Equipment • Expensive • Large amount of supplies • Hazardous chemicals
55
Outcomes
• Some stats: • trained 15 hazmat teams
around the state • trained 303 individuals • provided 25 half day classes • driven 2,872 miles
• Teams wanted the training to be longer!
• Higher participation rate in practice sample program
• More individual interaction with members from teams
56
First Responder Standards and Technologies Subcommittee • Under guidance of APHL Public Health
Preparedness and Response Committee • Why do we need this subcommittee?
• better define the roles and responsibilities of state/local PHLs and First Responders
• Who are the First Responders? • Police • Fire • Hazmat Teams • Civil Support Teams
57
Goal of subcommittee
• To provide guidance and to establish, enhance and maintain partnerships with first responders
• Initially focus on the lab-first responder partnership and will expand to include federal partners
58
Proposed Activities
• Identify best training practices • Oversee APHL’s Algorithm and Guidance for
Responding to an Incident Involving a Suspicious Non-Clinical Sample
• Develop a database template for PHL’s to collect information on the first responders in their jurisdiction
• Compile and synthesize existing national standards
• Review Existing first responder technologies
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