The US Army conducts operations in areas where potential adversaries could use NBC weapons. These weapons range from a megaton nuclear weapon used to destroy an entire city to a barrel of industrial chemicals used to contaminate an important road intersection. In addition to their destructive power, NBC weapons have political, psychological, operational, and strategic impact.

The use of passive measures such as proactive NBC defense procedures is a potential tool to reduce the threat of NBC weapons. In the event of the use of NBC weapons, the medical personnel must be prepared to provide a variety of services including medical treatment, site hazard surveys, and medical hazard assessments.

Threats

1. Nuclear Weapons. Although the threat of global nuclear annihilation has diminished, Russia and China still maintain large numbers of nuclear weapons. While direct confrontation with these nations is not likely at the present time, medical units must still be prepared for such conflicts. Several potential adversaries such as North Korea, Iraq, and Iran have tried to develop nuclear weapons. These countries could use nuclear weapons either to gain a tactical advantage or as a terrorist weapon. The employment of nuclear weapons in stability and support operations such as Bosnia is not likely; however, commanders must be prepared for their use. With the advent of new technologies, it is conceivable that a terrorist or terrorist organization could obtain a small nuclear device. This device could then be used to hold a city or state at ransom. The employment of nuclear weapons could rapidly escalate a stability and support operational scenario into a major war.

2. Radiological Hazards. Adversaries and even terrorist could spread radioactive material in an effort to deny US forces access to key terrain, roads, and buildings. The use of radiation dispersal devices and destruction of local nuclear reactors by terrorists are examples of radiological threats. Other radiological hazards present during deployments may include improperly dumped waste and accidents involving radioactive commodities.

3. Biological Warfare. Biological warfare agents range in spectrum from sophisticated, specifically engineered infectious microorganisms and toxins produced in modern biotechnology laboratories, to simple expedient food contaminants employed by insurgents or terrorists. Health care personnel must be alert to any increase in infectious disease rates or disease cases not commonly found in the area of operations. Because the use of biological weapons is not always initially evident and symptoms may take days to weeks to appear, epidemiology may provide the first clue to an attack.

4. Chemical Warfare Agents. Chemical agents are relatively simple to make and employ. Since their effects are immediate and dramatic, chemical weapons are used to kill and injure and also for terrain denial for persistent agents. For example, Iraq used large quantities of blister agents in its war against Iran. Although not classed as chemical warfare agents, incendiary/flame munitions, phosphorus compounds, and irritants O-chlorobenzylidene (CS) and chloroacetophenone (CN) could be encountered by US forces in stability and support operations. Industrial chemicals, either by accidents or intentional dispersion by adversaries, also pose possible threats to US forces. In order to predict potentially hazardous situations, treat casualties, and decontaminate areas and personnel, US forces should be aware of the industrial chemical hazards in their area. Toxic industrial chemicals (TICs) and radioactive material are collectively referred to as toxic industrial materials (TIMs).

5. Lasers and Radiofrequency Hazards. The threat of laser injuries on the battlefield is both real and significant. Lasers of many types, powers, and wavelength characteristics have been integrated into and are used by most force structures of the world. While the US and many other countries prohibit the use of lasers specifically designed to cause permanent blindness, the threat from such weapons must be considered. While the main symptom of laser injury is reduction in visual acuity, they may also be used to dazzle or startle. The US and many other countries currently use lasers as range finders and target designators. These sources, as well as radiofrequency sources used in communications, target detection, and a multiple of other uses, present occupational health hazards if used improperly.