Lessons Learned from the Tokyo Subway Sarin Attack
Department of Acute Medicine, Kawasaki Medical School Hospital, Kurashiki-City, Okayama, JAPAN
On the morning of 20 March 1995, sarin was released in the Tokyo Subway System. There had never been such a large scale act of urban terrorism using a nerve gas. There are many lessons to be learned from Tokyo Subway Sarin Attack. Two major lessons can be cited in summary:
1) Absence of decontamination - In total, 1,364 EMTs were dispatched, and among them, 135 were secondarily affected. At St. Luke's hospital, 23% of the medical staff complained of symptoms and signs of secondary exposure. Fortunately, nobody died from the secondary exposure. The religious cult used a 30% sarin solution. If they had used a 100% sarin solution, the outcome would have been much more tragic - secondarily exposed prehospital and medical staff would have been killed. This is the reason for the development of decontamination facilities and the use of personal protective equipment (PPE) in the prehospital and hospital settings; and
2) Confusion of information and lack of coordination among related organizations - Japan is a highly vertically structured society. Fire departments, police, metropolitan governments, and hospitals acted independently without coordination. After the attack, the Japanese government developed the Severe Chemical Hazard Response Team.
The Prime Minister's office created a National Security and Crisis Management Office that calls realistic desktop hazmat drills involving the concerned organizations and specialists.
Keywords: chemicals; communications; contamination; coordination; decontamination; hazardous materials (hazmat); hospitals; prehospital; sarin; subway; terrorism; Tokyo
E-mail: xj2t-okmr@asahi-net.or.jp
Return to Table of Contents, Volume 15
Return to PDM Home Page