{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,7]],"date-time":"2026-02-07T03:12:48Z","timestamp":1770433968116,"version":"3.49.0"},"reference-count":24,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2006,3,31]],"date-time":"2006-03-31T00:00:00Z","timestamp":1143763200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/3.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>The possibility of a terrorist attack employing the use of chemical or biological weapons of mass destruction (WMD) on American soil is no longer an empty threat, it has become a reality. A WMD is defined as any weapon with the capacity to inflict death and destruction on such a massive scale that its very presence in the hands of hostile forces is a grievous threat. Events of the past few years including the bombing of the World Trade Center in 1993, the Murrah Federal Building in Oklahoma City in 1995 and the use of planes as guided missiles directed into the Pentagon and New York\u2019s Twin Towers in 2001 (9\/11) and the tragic incidents involving twentythree people who were infected and five who died as a result of contact with anthrax-laced mail in the Fall of 2001, have well established that the United States can be attacked by both domestic and international terrorists without warning or provocation. In light of these actions, hospitals have been working vigorously to ensure that they would be \u201cready\u201d in the event of another terrorist attack to provide appropriate medical care to victims. However, according to a recent United States General Accounting Office (GAO) nationwide survey, our nation\u2019s hospitals still are not prepared to manage mass causalities resulting from chemical or biological WMD. Therefore, there is a clear need for information about current hospital preparedness in order to provide a foundation for systematic planning and broader discussions about relative cost, probable effectiveness, environmental impact and overall societal priorities. Hence, the aim of this research was to examine the current preparedness of hospitals in the State of Mississippi to manage victims of terrorist attacks involving chemical or biological WMD. All acute care hospitals in the State were selected for inclusion in this study. Both quantitative and qualitative methods were utilized for data collection and analysis. Six hypotheses were tested. Using a questionnaire survey, the availability of functional preparedness plans, specific preparedness education\/training, decontamination facilities, surge capacity, pharmaceutical supplies, and laboratory diagnostic capabilities of hospitals were examined. The findings revealed that a majority (89.2%) of hospitals in the State of Mississippi have documented preparedness plans, provided specific preparedness education\/training (89.2%), have dedicated facilities for decontamination (75.7%), and pharmaceutical plans and supplies (56.8%) for the treatment of victims in the event of a disaster involving chemical or biological WMD. However, over half (59.5%) of the hospitals could not increase surge capacity (supplies, equipment, staff, patient beds, etc.) and lack appropriate laboratory diagnostic services (91.9%) capable of analyzing and identifying WMD. In general, hospitals in the State of Mississippi, like a number of hospitals throughout the United States, are still not adequately prepared to manage victims of terrorist attacks involving chemical or biological WMD which consequently may result in the loss of hundreds or even thousands of lives. Therefore, hospitals continue to require substantial resources at the local, State, and national levels in order to be \u201ctruly\u201d prepared.<\/jats:p>","DOI":"10.3390\/ijerph2006030008","type":"journal-article","created":{"date-parts":[[2008,10,25]],"date-time":"2008-10-25T13:52:15Z","timestamp":1224942735000},"page":"67-75","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":49,"title":["Chemical or Biological Terrorist Attacks: An Analysis of the Preparedness of Hospitals for Managing Victims Affected by Chemical or Biological Weapons of Mass Destruction"],"prefix":"10.3390","volume":"3","author":[{"given":"Russell  L.","family":"Bennett","sequence":"first","affiliation":[{"name":"Department of Health Policy & Management, School of Public Health, College of Public Service, Jackson State University, Jackson Medical Mall, 350 W. Woodrow Wilson Ave., Suite 2301-A, Jackson, Mississippi, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2006,3,31]]},"reference":[{"key":"ref_1","unstructured":"United States General Accounting Office (2003). United States General Accounting Office."},{"key":"ref_2","unstructured":"President George Bush \u201c2005 State of the Union Address.\u201d. Available at http:\/\/www.CNN.com, February 2005."},{"key":"ref_3","unstructured":"Ashcroft warns of new terrorist threats. Available at: http:\/\/www.amw.com\/features\/feature_story, February2005."},{"key":"ref_4","unstructured":"Martin, David \u201cQaeda still top threat to US.\u201d. available at: http:\/\/www.CBSNEWS.com, February 2005."},{"key":"ref_5","unstructured":"Nartker, Mike (2005). \u201cBiological attack likely by 2020, Report warns.\u201d. Global Security Newswire."},{"key":"ref_6","unstructured":"Linzer, Dafna (2005). \u201cCould they pull it off?\u201d. The Washington Post National Weekly Edition, 12, (22)."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1001\/jama.1997.03550050022007","article-title":"\u201cNational Health and Medical Services Response to Incidences of Chemical and Biological Terrorism.\u201d","volume":"278","author":"Tucker","year":"1997","journal-title":"Journal of the American Medical Association"},{"key":"ref_8","unstructured":"Barbara, Joseph A, MacIntyre, Anthony G, and DeAtly, Craig A (2002). \u201cAmbulances to nowhere: America\u2019s critical shortfall in medical preparedness for catastrophic terrorism. Journal of Homeland Security."},{"key":"ref_9","first-page":"1","article-title":"\u201cBiological and Chemical Terrorism.\u201d","volume":"1","author":"Anderson","year":"2003","journal-title":"National Conference of State Legislatures Terrorism Preparedness, A Series of Reports About response To Public Health Threats"},{"key":"ref_10","unstructured":"United States General Accounting Office (2004). United States General Accounting Office."},{"key":"ref_11","unstructured":"The Markle Foundation (2003). Council on Foreign Relations."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1279","DOI":"10.1126\/science.283.5406.1279","article-title":"\u201cThe looming threat of bioterrorism,\u201d","volume":"283","author":"Henderson","year":"1999","journal-title":"Science"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1136\/emj.11.3.172","article-title":"\u201cContaminated casualties: Are we prepared to receive them?\u201d","volume":"11","author":"Edgell","year":"1994","journal-title":"Journal of Emergency Medicine"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1016\/S0735-6757(99)90016-5","article-title":"\u201cHospital evacuations due to hazardous materials incidents\u201d","volume":"17","author":"Burgess","year":"1999","journal-title":"American Journal of Emergency Medicine"},{"key":"ref_15","unstructured":"United States General Accounting Office (2003). United States General Accounting Office."},{"key":"ref_16","unstructured":"Fraser, Michael, and Fisher, Scott V (2001). \u201cElements of effective bioterrorism preparedness: A planning primer for local public health agencies.\u201d. National Association of County and City Health Officials."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"972","DOI":"10.1086\/339909","article-title":"\u201cShining light on dark winter.\u201d","volume":"34","author":"Mair","year":"2002","journal-title":"Clinical Infectious Disease"},{"key":"ref_18","unstructured":"Elliott, Victoria S (2003). \u201cPublic health\u2019s main fear over bioterrorism: Surge capacity.\u201d. Health & Science."},{"key":"ref_19","unstructured":"Ferazani, Larry (2004). \u201cHospitals: Will they be ready when the terrorists are?\u201d. Massachusetts Nurse, Massachusetts Nurses Association."},{"key":"ref_20","unstructured":"McGlinchey, David \u201cWatchdog group says biological defense remains insufficient.\u201d. available at: http:\/\/www.govexec.com\/dailyfed\/1204\/121404d1.htm accessed December 2004."},{"key":"ref_21","unstructured":"Sprinthall, Richard (2000). Basic Statistical Analysis, Allyn and Bacon. [6th ed]."},{"key":"ref_22","unstructured":"Guilford, JP (1977). Guidelines for Interpreting the Strength for Values or r: Fundamental Statistics in Psychology and Education, McGraw-Hill. [6th ed]."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Fricker, Ronald, Jacobson, Jerry, and Davis, Lois (2002). \u201cMeasuring and evaluating local preparedness for a chemical or biological terrorist attack.\u201d. RAND Issue Paper.","DOI":"10.7249\/IP217"},{"key":"ref_24","unstructured":"Code of Federal Regulation, 29, 1910.120."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/3\/1\/67\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T22:25:00Z","timestamp":1760221500000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/3\/1\/67"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2006,3,31]]},"references-count":24,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2006,3]]}},"alternative-id":["ijerph2006030008"],"URL":"https:\/\/doi.org\/10.3390\/ijerph2006030008","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2006,3,31]]}}}