An Official American Thoracic Society Workshop Report: Chemical Inhalational Disasters. Biology of Lung Injury, Development of Novel Therapeutics, and Medical Preparedness

Abstract

This report is based on the proceedings from the Inhalational Lung Injury Workshop jointly sponsored by the American Thoracic Society (ATS) and the National Institutes of Health (NIH) Countermeasures Against Chemical Threats (CounterACT) program on May 21, 2013, in Philadelphia, Pennsylvania. The CounterACT program facilitates research leading to the development of new and improved medical countermeasures for chemical threat agents. The workshop was initiated by the Terrorism and Inhalational Disasters Section of the Environmental, Occupational, and Population Health Assembly of the ATS. Participants included both domestic and international experts in the field, as well as representatives from U.S. governmental funding agencies. The meeting objectives were to (1) provide a forum to review the evidence supporting current standard medical therapies, (2) present updates on our understanding of the epidemiology and underlying pathophysiology of inhalational lung injuries, (3) discuss innovative investigative approaches to further delineating mechanisms of lung injury and identifying new specific therapeutic targets, (4) present promising novel medical countermeasures, (5) facilitate collaborative research efforts, and (6) identify challenges and future directions in the ongoing development, manufacture, and distribution of effective and specific medical countermeasures. Specific inhalational toxins discussed included irritants/pulmonary toxicants (chlorine gas, bromine, and phosgene), vesicants (sulfur mustard), chemical asphyxiants (cyanide), particulates (World Trade Center dust), and respirable nerve agents.

Figure 1.

Organizational chart for U.S. governmental agencies directing and supporting countermeasure development. Solid lines indicate agency relationships under the Department of Health and Human Services; dotted lines indicate partnerships. ASPR = Office of the Assistant Secretary for Preparedness and Response; BARDA = Biomedical Advanced Research and Development Authority; CDC = Centers for Disease Control and Prevention; CounterACT = Countermeasures Against Chemical Threats; DHS = Department of Homeland Security; DoD = Department of Defense; FDA = Food and Drug Administration; HHS = Department of Health and Human Services; NIH = National Institutes of Health; PHEMC = Public Health Emergency Medical Countermeasures Enterprise.