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Module 1: Making Sense of Toxicology

Chemical Agents of Opportunity for Terrorism: Toxic Industrial Chemicals (TICs) & Toxic Industrial Materials (TIMs)

In recent years, there has been growing concern that many of the most likely threats of chemical terrorism involve so-called “agents of opportunity.”  Both common and unusual industrial agents may pose a considerable threat as potential terrorist weapons.  While an understanding of the traditional military chemical weapons (e.g. nerve agents) remains essential, an appreciation of the myriad of other potential toxic chemicals readily available in our society is crucial if we are to optimally prepare, identify and defend against chemical threats. Many toxic industrial chemicals are easily obtainable from multiple sources in our communities and pose a serious threat to health if accidentally released or intentionally disseminated. 

Chemical Agents of Opportunity for Terrorism Complete Course Description 

Course Target Audience

The information presented will be of interest to state and local first responders, EMTs, paramedics, emergency physicians, emergency response coordinators, public health officials, industrial hygienists and others involved with chemical terrorism preparedness and response. Our topic selection for each course is intended to prepare the response community for their upcoming OHA Demonstration Project Tabletop exercise. 

Module 1: Making Sense of Toxicology

This module provides a framework to understand and apply with confidence important toxicology principles (exposure pathway, dose-response, toxidromes, association vs. causation). CHEMM-IST (, a tool to assist the medical care provider and emergency planner in identifying the chemical class responsible for a given clinical presentation is introduced.

Module Objectives

By the end of this module, participants will be able to:

  • Demonstrate familiarity with important toxicology principles, including dose-response, the importance of a completed exposure pathway, and the specificity of chemical effects (toxidromes).
  • Describe the role of decontamination and personal protective equipment (PPE) 
  • Locate and describe available resources and tools relevant to potential exposure events, including CHEMM and CHEMM-IST.

Presenter: Charles McKay, MD, FACMT

Chuck_McKay.jpgUniversity of Connecticut School of Medicine
Hartford, CT
After graduating from both Dartmouth College and Medical School, Dr. McKay completed an internship and residency in Internal Medicine at Rhode Island Hospital. He completed his residency in Emergency Medicine at Denver General Hospital, and completed practice pathway preceptorships in Medical Toxicology at the Rocky Mountain and New York Poison Control Centers. 

Dr. McKay is a medical toxicologist at Hartford Hospital and the University of Connecticut School of Medicine, where he is an Associate Professor of Emergency Medicine. He is a diplomat of the ABMT and the ABMS Toxicology Subboard. He is the Associate Medical Director of the Connecticut Poison Control Center and the Director of the Toxicology Fellowship at UConn. Dr. McKay also directs a toxicology consult service at Hartford Hospital and Connecticut Children’s Medical Center (CCMC). As Medical Director of Occupational Health Services for Hartford Hospital and CCMC, he also evaluates questions of workplace safety and toxic exposure for 9,000 employees. 

He has served on the ACMT Board of Directors since 2007 and is the Past Chair of the ACMT Practice Committee. Dr. McKay is active in biopreparedness efforts at the local and state level and has helped lead ACMT’s participation in the Department of Homeland Security’s Chemical Terrorism Risk Assessment (CTRA) process. Dr. McKay is also the National Coordinator of the ACMT-ATSDR Regional Consultation Network.
Dr. McKay seeks “to develop sustainable practice opportunities for medical toxicologists.” His interests lie in clinical patient care, occupational and environmental toxicology, biopreparedness, and training of residents and fellows. He also enjoys scuba diving and distance running. 

Module Recording and Materials

Link to Slides