3.3.1. FGA SIGNS/SYMPTOMS
The presentation and timing of the onset of symptoms depends on the agent, dose, and exposure route. Regardless of the exposure route, patients may demonstrate some combination of SLUDGE and DUMBBELS. Seizures, coma, and death may occur in severe exposures.
3.3.2. PHYSICAL AND CHEMICAL PROPERTIES: FGA GENERAL CHARACTERISTICS
Table B-4 provides general physical and chemical properties of FGAs for use in decision making.
Table B-4: FGA Physical and Chemical Properties
| Vapor Pressure | Extremely low vapor pressure; 5 to 10 times lower than VX |
|---|---|
| Density (vapor) | Heavier than air |
| Skin Absorption | Easily absorbed by the skin |
| Aqueous Solubility | Highly water-soluble |
| Soluble in | Acetone, benzene, ethanol, methanol, chloroform, saline |
| Flash Point | Greater than 300 degrees Fahrenheit |
| Persistence | Can remain on environmental surfaces for days or even many months, if not decontaminated |
Table B-5 describes the phases of an example response to an FGA incident. This information is provided as a template and provides general information to be used along with the information in this framework document.
Table B-5: FGA Example Response: Phases of Chemical Response
Phase 2a&b
| Phase | Health effects of concern | Activities and decisions | Criteria used for decision-making | Notes |
|---|---|---|---|---|
| Day 1 (12-24 hours) Activities include determining the chemical of concern, locations, hot area Controls to minimize further responder/public deaths/severe injury Risk communication efforts to inform the public on the progress of the response | Immediate/near- term (acute) effects: SLUDGE, DUMBBELS, cholinergic crisis, and other general concerns Dozens of concerned citizens reporting symptoms at local hospitals | Response workers: PPE levels – Initially Level A after agent identification, reduced to Level B after field screening General public: Evacuation of the four site potential contamination areas and impounding car Decontamination of people who are likely exposed to the agent | Any “positive” detection with field identification tests/equipment (e.g., screening level field equipment and military M8 paper) Reports of symptoms or health effects | Decision- makers: Local emergency and environmental health departments |
Crisis Management Characterization, Remediation, Clearance
| Phase | Health effects of concern | Activities and decisions | Criteria used for decision-making | Notes |
|---|---|---|---|---|
| Phases 2b&c (24- 72 hours) Activities include continued identification of “sources” and field data to identify contaminated areas TWG established to determine sampling strategy and clearance goals Risk communication efforts to inform the public on the progress of the response | Immediate/near- term (acute) effects: Continued reports of upper respiratory distress, breathing difficulties, SLUDGE, and general concerns | Response workers: Air monitoring encountered some challenges and was discontinued Workers continued air sampling for the hot areas during operations to control/remove contamination General public: Initial shelter-in- place areas modified based on sampling results Hospitals and critical infrastructures cleared | Air sampling at the periphery of operable units. Exposure action levels identified for the protection of workers in PPE Wipe samples and laboratory-based analytical methods. Air sampling for the protection of the general public. Site- specific exposure action levels developed based on the extent of contamination, estimates of the duration of exposure, etc. | Decision- makers: UC: Local emergency and environmental health departments together with federal agency support: primarily HHS ATSDR and EPA for sampling |
Consequence Management Recovery/Re-entry
| Phase | Health effects of concern | Activities and decisions | Criteria used for decision-making | Notes |
|---|---|---|---|---|
| Days 4 to 30+ Sampling teams using field tests/equipment followed by laboratory-based analysis Phased clearance Risk communication efforts to inform the public on the progress of the response | Immediate/near- term (acute) effects: None Permanent/chronic injury/illness: None | Response workers: PPE Levels determined by on- scene environment and cleanup phase End response work General public: Resumed use/re- occupancy (unrestricted) of site/facilities | Approach used: Surface wipes and clearance sampling to support findings/ assumption that decontamination is successful Surface wiping – Sample results would be compared with site-specific clearance goals developed for populations of concern Sampling of soil and bulk items – laboratory analysis results compared with risk-based clearance goals for FGA Waste disposal for contaminated material | Decision- makers: UC: EPA, HHS, supported by state/locals |