As of June 28, local police investigators had not identified the poison. Finally, on July 3, a chemical analysis conducted by the Nagano Police Science Investigation Institute identified sarin breakdown products, six days after the attack. The Aum Shinrikyo perpetrators were not identified before the attack; their activities in procuring chemical processing equipment and organophosphorus compounds used to synthesize sarin had not attracted the attention of authorities.

Four months later, a leak in Aum’s chemical processing apparatus resulted in contamination outside the building used for sarin synthesis. Chemical analysis of soil samples collected from near the building identified methyl phosphonic acid, which is a sarin degradation product. Other forensic research showed that Aum had procured significant quantities of chemicals that are precursors in the production of sarin. Despite the fact that these studies strongly implicated Aum in the attack on the apartment building, law enforcement (LE) elected not to confront Aum largely because the group was protected under the Japanese Religious Corporation Law, which prohibited investigation of registered religious groups “activities or doctrine” (Senate Government Affairs Permanent Subcommittee on Investigations, 1995). The rationale behind this decision is not known but was probably influenced by the lack of laws in Japan that prohibit the manufacture of chemical warfare agents, and perhaps an unwillingness to confront Aum, which displayed a combative and litigious response to any challenge to their activities. In retrospect, this represents a serious oversight in interdicting the threat before additional attacks occurred.

Additional chemical attacks did occur. In the fall of 1994, Aum members attempted to kill multiple individuals who opposed the cult using VX (James Martin Center for Nonproliferation Studies, 2016). In December of 1994, Aum cultists assassinated a former cult member in Osaka by applying drops of VX to his neck. He died in the hospital several days later, and the cause of death was not recognized by the Osaka police, nor, presumably, by the Osaka University Hospital staff.

The attack on the Tokyo subway occurred at about 8:00 a.m. on March 20, 1995. Plastic bags containing dilute sarin were punctured, which resulted in puddles on the floor of the subway, and subsequent evaporation of sarin. Hospitals in Tokyo were visited by 3,227 victims, and 493 of these were admitted (Tucker, 2006). Paramedics did not recognize nerve agent poisoning, and neither did emergency physicians at the hospitals.

Fifteen underground stations were affected. First responders—police, ambulance, and firefighters—entering the subway stations encountered commuters exiting the subway, and the first responders did not recognize cholinesterase poisoning in the chaos; consequently, many of the first responders were exposed to sarin. In addition to direct exposure, more than 200 ambulances and hospital staff received secondary exposure as a result of transfer from the clothing of the victims, another consequence of the inability of the emergency personnel to recognize the toxin. The cause of the incident was not immediately understood. By 11:00 a.m., the National Research Institute of Police Science identified sarin but did not inform the hospitals, who finally found out the identity of the poison via television. Dr. Nobuo Yanagisawa, who had treated victims of the

Matsumoto incident, recognized the symptoms while viewing media reports on television, and subsequently informed Tokyo hospitals (Farley, 1995). Identification of sarin by the hospitals was within hours after the first casualties arrived (Smithson, 2000).

Conclusions related to the identification stories topic:

1. First responders quickly concluded that a poison was responsible; however, they did not recognize cholinesterase poisoning and did not have training or equipment to prevent collateral exposures.
2. Hospital staff began to suspect sarin poisoning within hours of the arrival of the first casualties. However, there was no timely communication from police laboratories to the hospitals regarding the identification of sarin.
3. Timely communication to the public regarding the nature of the attack and the risk to the general public was lacking. “What brought the Tokyo hospital system under such pressure was not the truly injured, which hospitals proved more than capable of handling, but the monsoon of psychogenic patients” (Farley, 1995). If correct information could have been more rapidly disseminated then pressures on responders and hospitals may have been significantly reduced.

SKRIPAL POISONING

Sergei and Yulia Skripal were poisoned in the United Kingdom by Russian agents using Novichok agent A234 (Carroll, 2018; Peplow, 2018; Haslam et. al., 2022), which is an acetyl cholinesterase inhibitor. The compound was applied to the outside door handle of their apartment (BBC News, 2018a). Exposure occurred when the Skripals touched the door handle (BBC, 2018; The Telegraph, 2018), which resulted in contamination of their skin. The compound functions by permeating into the skin, and diffusing into the vascular system, resulting in acetyl cholinesterase inhibition. The permeation and diffusion processes are relatively slow, and so a couple of hours elapsed before symptoms were manifest, during which time the Skripals had visited The Mill pub and Zizzi restaurant in Salisbury, finally moving to a park bench where they collapsed in response to the poisoning (BBC News, 2018b).

The couple was noticed by 16-year-old Abigail McCourt, who thought Sergei had suffered a heart attack. She alerted her mother Alison McCourt, who is an army colonel and chief nursing officer of Queen Alexandra’s Royal Army Nursing Corps (The Guardian, 2019a). It is unclear whether Colonel McCourt recognized symptoms of nerve agent poisoning, and it is likely that the majority of first responder personnel were likely not trained to recognize nerve agent poisoning, particularly releases of next-generation agents like those used in the Skripals’s poisonings.

This concern is substantiated by the exposure of the first responders, who reported itching eyes and breathing difficulties (The Guardian, 2019b). A total of 21 people (including the Skripals) were checked (itvNEWS, 2018). One police officer, Nick Bailey, received an exposure serious enough to warrant treatment in the intensive care unit. Two other police officers displayed minor symptoms. Officer Bailey was poisoned

while he inspected the Skripals’s house. This indicates that the forensic first responders were not apprised nor did they recognize the possibility of a nerve agent. It is not known whether Colonel McCourt informed first responders of the possibility of nerve agents.

Subsequently, British nationals Charlie Rowley and Dawn Sturgess were poisoned (BBC News, 2018c) as a result of contact with a sample of the same Novichok agent from a perfume bottle that had been used to transport the agent by the Russian agents. The perfume bottle had been discarded in a litterbin, found by Rowley, who gave it to Sturgess. She sprayed some of the contents of the bottle on her wrist, which resulted in her death eight days later. Rowley also was poisoned.

Paramedics responded; however, the police “initially thought the two patients had been using heroin or crack cocaine from a contaminated batch of drugs” (BBC News, 2018c). Police and firefighters who responded were in hazard suits and cordoned the area off, however, police did not declare a major incident until four days later, and shortly thereafter Scotland Yard concluded that Novichok was to blame following analysis at Porton Down (BBC News, 2018c). Reports indicate that the couple displayed symptoms consistent with nerve agent poisoning, (i.e., Sturgess was foaming at the mouth, and Rowley had pinpricked eyes, accompanied by sweating, and drooling). Yet it seems that these symptoms were not recognized by first responders, treatment personnel at the hospital, or LE until what was likely a few days later, despite widespread knowledge of the Skripal poisoning.

REFERENCES

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