Department of Health and Human Services

North Carolina Suspicious Substance Response Guidelines (SSRG)

Purpose and Scope

This document contains response guidelines to incidents where the presence or release of suspicious substances, including powders and liquids, presents the threat of human exposure to harmful agents. These guidelines cover the response from the discovery of a suspicious substance to the delivery of samples to the laboratory. It is for use by public health, emergency response, and law enforcement personnel. While these guidelines are directed at biological and chemical substances, suspicious packages should also be considered for explosives and radioactivity as well.

Discovery of Suspicious Packages or Substances

Individuals who discover suspicious packages, powders or liquids should take the following steps:

• Do not shake or empty the contents of a suspicious package or envelope.
• Do not carry a package or envelope.
• Do not show a suspicious substance or package to others, or allow others to examine them.
• Do not sniff, touch, taste, or look closely at the package or suspicious substance.
• Put the package or envelope on a stable surface.
• Wash hands with soap and water to prevent spreading potentially infectious material to face or skin.
• Alert others in the area about the suspicious package or envelope. Leave the area, close any doors, and take actions to prevent others from entering the area.
• Call 911 and describe the situation.
• Isolate, in a safe area, individuals who may have been exposed until they are cleared to leave by law enforcement, public health, or emergency response personnel.
• Create a list of persons who may have been exposed to the substance.

Threat Assessment

Assess both health and criminal threats in a suspicious package or material event. The assessments can be made simultaneously and jointly by the responders on the scene. Critical decisions are made based on these assessments and further response activities are based on these initial assessments.

Health and Safety Threat Assessment

Determine if there is a threat to human health and safety. Information about the event may be gathered as follows:

• Was anyone exposed to the powder by inhaling a “puff” of powder or noticing an odor?
• Is there visible powder or substance on surfaces indicating an aerosolized
  release?
• Is anyone in the immediate area having symptoms indicating an immediate exposure to a chemical substance? The immediate area can be estimated as 6- 10 feet indoors. Outdoors, it is difficult to quantify because of air movement, temperature and humidity.
• In some cases it may be necessary to secure the scene, take samples and submit to the SLPH for analysis to rule out a health threat.

Note: The US Centers for Disease Control and Prevention (CDC), and the NC Division of Public Health do not recommend the use of handheld assays (HHA’s) for the detection of biological agents. If first responders choose to utilize HHA’s, the results they provide should not be used as the only means of determining threat credibility.

Criminal Threat Assessment

Law enforcement professionals have primary responsibility for determining the credibility of a criminal threat that may pose a health and/or safety risk to the public because of exposure to a suspicious package or material. Law Enforcement professionals (LE) should make a credibility assessment with the cooperation and participation of the Local Public Health Department (LHD), the Public Health Regional Surveillance Team (PHRST), and/or the local or Regional Hazardous Materials Response Team (RRT) as needed. Notification of the Federal Bureau of Investigation (FBI) is required if a credible criminal threat is identified or suspected. If there is uncertainty about threat credibility or a need for consultation, contact the FBI WMD Coordinator at 704-377-9200. Information about the substance may be gathered as follows:

• While maintaining the safety of the personnel, determine the presence or absence of an implied or explicit threat.
• If there is a return address on a package or envelope, try to contact and interview the sender.
• Determine if the explanation for the presence of a powder or suspicious substance leads to the conclusion that the substance is or is not harmless.
• Determine whether the package has any of the “characteristics of suspicious packages” outlined in attachment A.

Post Assessment Actions

No Criminal and No Health Threat Identified

If it is determined that the substance or package does not present a threat the following steps should be followed:

• Potentially exposed individuals that have been isolated should be released.
• Provide individuals that may have been exposed to the suspicious substance with 24/7 contact information for the PHRST and or LHD.
• Do not send the sample for laboratory testing.
• No further response is necessary.

Credible Criminal and\or Health Threat Identified

If the criminal and\or health threat is determined to be credible proceed with the following response to protect the health and safety of the public and to preserve the possible criminal evidence. Use the matrix below to guide actions.

Response

Notification

If not already on scene, notification should be made to the following agencies according to local notification procedures:

• Emergency Management
• Local Law enforcement agencies (police, sheriff) 911.
• NC State Bureau of Investigation (919-662-4500).
• Federal Bureau of Investigation (WMD Coordinator at 704-377-9200).
• Hazardous Materials Team (HAZMAT).
• PHRST and Local Health Department. PHRST will notify the local health director or designee and the NC Office of Public Health and Preparedness (PHPR) (888-820-0520) if they have not been notified.

Exposed Individuals

• Decisions regarding immediate transport of potentially exposed individuals to emergency medical care will be made based on the symptoms or the finding of potential immediately life threatening substances. Consultation with Public Health can assist in these decisions.
  
  Those with direct hand and face exposure should wash their exposed areas with soap and water as soon as possible if readily available. This action should not contaminate areas or other people. Those with heavier contamination or those who do not have soap and water readily available will require appropriate decontamination. Ensure that exposed individuals remain in the building in an isolated or safe location. If it is not clear who or how to decontaminate, decontamination decisions should be made by public health personnel with cooperation and participation of the hazmat team and others as needed.
• Law enforcement and public health officials should obtain contact information for the list of individuals that may have been exposed to the suspicious substance or powder.
• All incidents involving suspicious substances are unique and should be handled on an individual basis. However, to assist in determining whether or not to provide prophylactic therapy to exposed persons and to submit samples for laboratory testing the following decision matrices in tables 1 through 4 may be helpful.

Note: Consult with a physician for decisions about treatment or prophylaxis of exposed persons and the PHRST Industrial Hygienist for guidance on sampling procedures.

Area Isolation

• Shut down ventilation systems serving the affected areas, if necessary. Keep all windows and doors closed.
• Maintain isolation of areas suspected of being contaminated until a decision is made by public health and law enforcement to release the area. It may not be possible to make the decision to allow re-entry until laboratory results are available (24-48 hours).
• Law enforcement personnel should be responsible for ensuring that the affected area remains isolated and guarded until release of the area.

Sample Collection

• Restrict entry into the isolated area for collection of samples to properly trained hazardous materials personnel using appropriate personal protective equipment as specified in OSHA standard 29 CFR 1910.120, Appendix B.
• Screen suspicious substances for volatile organic compounds and ionizing radiation as deemed necessary by on-scene officials.
• Notify the appropriate lab for sample submittal and consultation (State Laboratory of Public Health (SLPH) at 919-807-8600 or (pager) 919-310-4243, the NC Department of Agriculture and Consumer Services Lab (919) 270-2544, or the SBI Lab by law enforcement ). If it is unclear where to submit the sample, it may be necessary to consult with responders and the laboratory contacts for a decision on sample submittal.
• For sample submission to the SLPH complete environmental sample submittal form (attachment B (PDF)). For sample submission to other labs, consult with lab contact for appropriate lab submittal procedures.
• Collect sample according to sampling instructions (attachment C (PDF))

NOTE: Law enforcement personnel must be consulted about sample collection to ensure that forensic integrity of the site and samples is maintained during the site entry and sampling process.

Sample Transportation

• Samples may be transported to the SLPH by Law enforcement (preferred) or public health personnel.
• Chain of Custody must be maintained from sample collection until the sample reaches the lab.
• Either the Public Health chain of custody form (Attachment D (PDF)) or a Law Enforcement chain of custody form should accompany the samples.

Laboratory Testing

As much information about the event needs to be communicated to the lab so that the appropriate tests are preformed and evidentiary procedures are followed. Results will be reported to the individual requesting the tests, PHP&R and the FBI. Follow-up with individuals who may have been exposed will be the responsibility of Public Health. It will be agreed upon when the sample is submitted who will be the person or agency responsible for communicating these results.

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