Medical Aspects of Chemical Warfare (2008) - The Black Vault

Introduction to the Chemical Threatfrom the war. By targeting the skin, eyes, and lungs,mustard rendered a large number of soldiers ineffectiveas part of the fighting force. The grotesque patternof injury that resulted from exposure had a majorpsychological impact, demonstrating that a chemicalweapon need not be lethal to be strategically effective.During this period, mustard agent became known as“the king of war gases.”In 1918 lewisite was produced in the United States,but large-scale production and stockpiling came toolate for it to be used in the war. However, lewisiteeventually became the primary vesicant stockpiled bythe Soviet Union. Meanwhile in France and Austria,experiments with cyanide produced mixed results.Cyanide was novel because it produced nearly instantincapacitation and was highly lethal. However, its nonpersistentproperties and low specific gravity made itunsuitable for the open field and trench environmentof the day.By World War II, Germany had made tremendousprogress with the innovation of agents toxic to the nervoussystem. The G-series nerve agents, such as tabun(North Atlantic Treaty Organization [NATO] designation:GA) and sarin (NATO designation: GB), featuredthe instant incapacitation and lethality of cyanide andwere effective at much lower concentrations. The G-series agents also had superior dispersal characteristics.These new nerve agents were not used duringthe war, though, and the Allies discovered them anddeveloped countermeasures only after the conflict.From the Cold War to DisarmamentDuring the Cold War, the United Kingdom inventedthe V-series nerve agents, which were weaponized bythe United States and Soviet Union. V-series nerveagents are toxic in even smaller doses than G agentsand are persistent in the environment. They wereconsidered an ideal area denial weapon by both thewestern powers and the Eastern Bloc.The 1960s was a period of experimentation usingincapacitating and psychedelic agents that impairedcombat performance without being lethal. During the1970s and 1980s, the Soviet Union continued to increasethe size of its chemical stockpile and initiated a massiveprogram named “Foliant” to produce newer anddeadlier agents.During the Reagan administration, the UnitedStates produced a binary chemical weapon deterrent.Binary weapons are chemically identical to traditionalnerve agents, but differ in that the final chemicalreaction occurs only after a projectile is fired, allowingsafe storage and transportation of the weapon. 1Simultaneously, during the Iran/Iraq war, mustardagent returned to the battlefield, and an incapacitatingagent similar to 3-quinuclidinyl benzilate (oftencalled “BZ,” a glycolate anticholinergic) named“Agent 15” was developed.The Current AgeThe results of the 1993 Paris Convention, knownas the “Chemical Warfare Convention,” were in effectby 1997 and resulted in a period of disarmament bynation-states. Meanwhile, terrorist organizations developedinterests in chemical weapons and had somesuccess in producing and employing them. The mostrecent public application of chemical warfare occurredin 2002 at the Nord-Ost Moscow theater. In an attemptto free 850 hostages being held by Chechen rebels, theRussian government used a supposedly opiate-basedincapacitating agent called Kolokol-1, which resultedin the deaths of 42 terrorists and at least 129 hostages.Another concerning development was noted when dissidentscientist Vladimir Mirzayanov publicly statedthat his country was circumventing the ChemicalWarfare Convention by developing a new generationof nerve agents. 2–4Readers interested in more information on the historicalaspects of chemical warfare can find the informationin chapters 2 through 4. These chapters offera thorough review of the history of chemical warfare,the medical management of chemical casualties, andthe chemical threat.THE CURRENT THREAT OF CHEMICAL PROLIFERATIONThe Chemical Warfare Convention now includes181 signatory countries. 5 Since it became effective in1997, some progress destroying large chemical arsenalshas been made.Managing the StockpileThe global declared stockpile of chemical weaponsis about 70,000 tons. Of this, the stockpile declared bythe United States is 30,599 tons of unitary agent and680 tons of binary components. 6 As of 2007, abouthalf of the US stockpile has been destroyed: two ofseven chemical demilitarization facilities have completedtheir destruction missions. 7 Russia has hada more difficult time destroying its declared 40,000tons of agent, which consists largely of nerve agentand lewisite. 8 The reportedly poor security of storagefacilities and the very slow pace of demilitarizationpose a challenge for both Russia and the internationalcommunity. 9 These conditions may present an unin-3