title: Developing a consensus framework and risk profile for agents of opportunity in academic medical centers: implications for public health preparedness.
abstract: Agents of opportunity (AO) in academic medical centers (AMC) are defined as unregulated or lightly regulated substances used for medical research or patient care that can be used as "dual purpose" substances by terrorists to inflict damage upon populations. Most of these agents are used routinely throughout AMC either during research or for general clinical practice. To date, the lack of careful regulations for AOs creates uncertain security conditions and increased malicious potential. Using a consensus-based approach, we collected information and opinions from staff working in an AMC and 4 AMC-affiliated hospitals concerning identification of AO, AO attributes, and AMC risk and preparedness, focusing on AO security and dissemination mechanisms and likely hospital response. The goal was to develop a risk profile and framework for AO in the institution. Agents of opportunity in 4 classes were identified and an AO profile was developed, comprising 16 attributes denoting information critical to preparedness for AO misuse. Agents of opportunity found in AMC present a unique and vital gap in public health preparedness. Findings of this project may provide a foundation for a discussion and consensus efforts to determine a nationally accepted risk profile framework for AO. This foundation may further lead to the implementation of appropriate regulatory policies to improve public health preparedness. Agents of opportunity modeling of dissemination properties should be developed to better predict AO risk.
authors.affiliation: New York Presbyterian Hospital/Weill-Cornell Medical Center, NY 10065, USA. brennafarmer@gmail.com
authors.forename: Brenna M
authors.initials: BM
authors.lastname: Farmer
authors.forename: Lewis S
authors.initials: LS
authors.lastname: Nelson
authors.forename: Margaret E
authors.initials: ME
authors.lastname: Graham
authors.forename: Carly
authors.initials: C
authors.lastname: Bendzans
authors.forename: Aileen M
authors.initials: AM
authors.lastname: McCrillis
authors.forename: Ian
authors.initials: I
authors.lastname: Portelli
authors.forename: Meng
authors.initials: M
authors.lastname: Zhang
authors.forename: Judith
authors.initials: J
authors.lastname: Goldberg
authors.forename: Sheldon D
authors.initials: SD
authors.lastname: Rosenberg
authors.forename: Lewis R
authors.initials: LR
authors.lastname: Goldfrank
authors.forename: Michael
authors.initials: M
authors.lastname: Tunik
mesh_terms: D000046:Academic Medical Centers; D023482:Bioterrorism / Q000517:prevention & control*; D032921:Consensus; D004189:Disaster Planning / Q000379:methods*; D006801:Humans; D011634:Public Health; D015980:Public Health Practice; D018570:Risk Assessment / Q000379:methods*; D012637:Security Measures; D014481:United States