HLM Consultants helps organizations and facilities plan and prepare to respond to terrorist attacks. Comprehensive planning includes assuring that staff have been adequately trained and that needed equipment and supplies are in place. Written response plans for likely incidents are developed with security and emergency response staff. We conduct training and exercises in carrying out the response plans to assure timely and effective response when an incident occurs.

HLM Consultants also assists in the actual response to an incident. After an attack, HLM Consultants will help staff to: (1) decontaminate premises and any items or products that may be circulated to the general public, (2) screen employees for infection, effects, or carrier status in the event of biological terrorism, (3) demonstrate to the public that the measures have been implemented, and (4) verify that they were effective. HLM Consultants has extensive experience in managing hazardous waste problems and planning for reentry and restoration following chemical stockpile emergencies. This enables us to help staff to plan for needed recovery after an incident so they can return to business as usual. Because of its emphasis on toxicology and epidemiology, coupled with medical science about infectious and other diseases, Environmental and Occupational Medicine is the specialty best equipped to assess questions of hazard effects and causality. In the environmental area, we provide a rare integration of expertise in toxicology, risk assessment, exposure assessment, epidemiology, public health, clinical medicine, and basic medical science. Drs. Hutchinson and Leffingwell participated in the initial development and implementation of federal public health assessment procedures for environmental sites. Our capabilities include evaluation of the possible or current human health impacts of environmental contamination, exposure and risk assessment to define ways people may be exposed to environmental contamination and the possible health effects of exposures, risk communication to explain findings to affected people, and technical support to interpret technical findings to non-technical decision makers. Our consultations have often helped clients better understand the findings of evaluating state and federal environmental agencies, when definite public health risks exist, and how to address them most effectively.

We provide the full spectrum of Environmental and Occupational Medicine expertise, ranging from the design and implementation of needed programs to auditing existing programs and making recommendations to address problems. We have dealt with chemical hazards; physical agents--like ionizing and non-ionizing radiation, noise, laser and other light, heat, and cold; physical injury hazards, and cumulative trauma from repetitive motion. Our consultations have included audits of Workers' Compensation programs to improve efficacy, evaluation of clinical providers, determination of compliance with regulatory and good practice measures to prevent adverse effects from hazard exposures, and design and implementation of medical surveillance programs. We have evaluated the likelihood of causal relationships between workers' health complaints and known hazard exposures and whether apparent disease clusters in workplaces represent unusual occurrences that could result from hazard exposures.

The 1995 attacks on civilians in the Tokyo subway system using the chemical warfare agent sarin (GB) highlight the potential for terrorist use of lethal chemicals and the need to plan for events involving chemical warfare agents. The bombings at the World Trade Center and in Oklahoma City show that other types of terrorism are closer to us than we had thought. The aircraft attacks on the World Trade Center and Pentagon showed that a large-scale attack was much more immediate than we had imagined. A successful biological attack in Oregon and two unsuccessful biological attacks by Aum Shin Rikyo in Japan are less well-known, but recent mailings of anthrax show the need for preparedness for biological weapons incidents.