After the incidents in the United Kingdom in 2018 involving a fourth generation agent, the White House National Security Council convened a federal interagency working group of experts to identify and develop resources to help the emergency response community prepare for and respond to a fourth generation agent incident if one ever occurs in the U.S.  No illicit use or manufacture of a fourth generation agent or other nerve agent is known to have occurred in the U.S., and there is no known threat of nerve agent use in the U.S.

The U.S. government used an extensive, collaborative process to develop these resources.  The federal interagency working group included experts in medicine, science, public health, law enforcement, fire, EMS, HAZMAT, and occupational safety and health from the Department of Defense, Department of Health and Human Services (Office of the Assistant Secretary for Preparedness and Response, Centers for Disease Control and Prevention, and National Institute for Occupational Safety and Health), Department of Transportation (Pipeline and Hazardous Materials Safety Administration and National Highway Traffic Safety Administration's Office of Emergency Medical Services), Department of Homeland Security, Federal Bureau of Investigation, Occupational Safety and Health Administration, and Environmental Protection Agency.

The group collaborated with stakeholders representing law enforcement, fire, EMS, HAZMAT, and hospital-based first receivers to be sure the new resources meet their needs and can be incorporated into existing plans as part of ongoing preparedness for potential hazards.

The resources include the Safety Awareness for First On-Scene Responders Bulletin, a one-page document summarizing symptoms of exposure, protective actions, and decontamination procedures; a Reference Guide with greater detail for HAZMAT response teams; and Medical Management Guidelines to prepare fire, EMS, and hospital staff and guide the medical management of patients.

These resources are based on the interpretation of available data on fourth generation agents by U.S. government experts and previously developed federal guidance related to nerve agents.  They will be updated as new data becomes available that can further support any response to a potential fourth generation agent incident and help protect responders if such an incident ever occurs in the U.S.