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

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Riot Control Agentsrespiration (RD 50). 122 PS exposure in mice at the RD 50dose (8 ppm) for 5 days, 6 hours per day, results innasal lesions of the respiratory epithelium consistingof moderate exfoliation, erosion, ulceration, and necrosiscoupled with minor squamous metaplasia andinflammation. 116 Moderate ulceration and necrosis ofthe olfactory epithelium, coupled with serous exudatesand moderate lung pathology, were also observed. Collectively,the PS pathology was similar to that observedfollowing an RD 50exposure to chlorine and displayeda distinct anterior–posterior severity gradient. Thesignificant toxicity in the posterior nasal cavity followinginhalation of PS or chlorine was likely the resultof the agents’ low water solubilities, which preventedsignificant absorption in the anterior nasal cavity.The human toxicity of PS following inhalation isprimarily restricted to the small to medium bronchi,and death may result from pulmonary edema,bronchopneumonia, or bronchiolitis obliterans. 123 Aslittle as 1.3 ppm may cause respiratory irritation inhumans. 109 The NIOSH, OSHA, and ACGIH exposurelimit for PS is 0.1 ppm (time-weighted averageof 0.7 mg/m 3 ). 69 The NIOSH IDLH level of 2.0 ppm isbased partly on studies conducted in the early 1930sthat determined that a few-second exposure to 4 ppmrenders a man unfit for action. 69,112,124 Symptoms inhumans resulting from environmental or occupationalexposures to PS include pain (burning) and tightnessin the chest, shortness of breath, sore throat, dyspnea,irritation, asthma exacerbation, and cough. 111,112,125 Thelowest published toxic concentration in humans is 2mg/m 3 (unknown exposure time), which producedlacrimation and conjunctiva irritation, and the lowestreported human lethal dose is 2,000 mg/m 3 for a 10-minute exposure. 69Dermatological effects. Direct exposure of skin toPS leads to irritation, itching, rash, and blisters. 108,111,112The minimal dose required to cause these effects isunknown.Ophthalmologic effects. PS causes eye irritationbeginning at 0.3 to 0.4 ppm, which appears to be belowthe threshold of odor (approximately 1 ppm). 109,124,126Clinical symptoms of PS-induced ocular irritationinclude immediate lacrimation, pain, and burning. In1995 three dockworkers were exposed to PS that hadleaked from a shipping container. 111 All three victimscomplained of burning and stinging in the eyes. Additionally,in the 2003 Kern, California, exposures, ofthe 165 persons complaining of PS-induced reactions,99% (164) of them reported eye irritation (82% reportedlacrimation, and 54% reported pain or burning of theeyes). 112Gastrointestinal disturbances. Following ingestionof PS, a corrosive effect on the forestomach tissueis the principal lesion. 114 Rats exposed to PS (10–80mg/kg) for 10 days demonstrated corrosion of theforestomach with histopathological findings includinginflammation, necrosis, acantholysis, hyperkeratosis,and epithelial hyperplasia. In humans, acute exposureto PS in the atmosphere from environmental sourcesand occupational accidents has been associated withan unusual taste, stomach and abdominal cramping,abdominal tenderness, diarrhea, vomiting, nausea,difficulty swallowing, and in rare cases, bloodystools. 111,112Other physiological responses. Additional clinicaland toxicological observations associated with acute PSexposure in humans include neurological manifestations(headache, dizziness, and fatigue); cyanosis; generalneuromuscular tenderness; peripheral numbness;painful urination; chest wall pain; elevations in creatinephosphokinase; and low-grade rhabdomyolysis. 111,112Long-term effects and severe medical complications.Long-term or repeated exposures to PS areassociated with damage to the kidneys and heart,and may result in hypersensitivity to subsequent PSexposures. No adequate data is available to assess themutagenic, carcinogenic, teratogenic, or reproductivetoxicity of PS in humans. 60CN (1-Chloroacetophenone)CN is also known as Mace from its chemical name,methyl chloroacetephenone. The first chemical Maceproduct is widely regarded as the original tear gas. 127,128Although it is the trademarked name for CN, the term“mace” is commonly used generically to refer to anyRCA. After the United States entered the First WorldWar, American and British chemists investigated CNand found it to be one of the most effective lacrimatorsknown. Its lacrimatory effects and persistence wereequal to or slightly greater than bromobenzyl cyanide,and its chlorine was less expensive than bromine. CN isvery stable under normal conditions and does not corrodesteel. It is a crystalline solid that can be dissolvedin a solvent or delivered in thermal grenades.Physical Characteristics and DeploymentCN (CAS 532-27-4, also known as w-chloroacetophenone,a-chloroacetophenone, phenacyl chloride,2-chloro-1-phenylethanone, and phenyl chloromethylketone) is a gray solid with an apple blossom odor. Ithas a molar mass of 154.5, corresponding to a molecularformula of C 8H 7ClO (Figure 13-9). Its molar solubilityat 20ºC is 4.4 × 10 -3 mol/L (68 mg/100 mL) in water.Hydrolysis of CN is very slow in water even whenalkali is added. 71 Melting and boiling points are 54ºC457
Medical Aspects of Chemical WarfareTABLE 13-3CHARACTERISTICS OF PS, CN, DM, AND CRProperties PS CN DM CRMolecular CCl 3NO 2C 8H 7Clo c 12H 9Ascin c 13H 9NOformulaFormer/ RCA and war gas/ War gas/RCA War gas, vomiting RCA/RCACurrent use Preplant soil fumigant agent/obsolete RCAPhysical state* Colorless oily liquid Colorless to gray Light yellow to canary Pale yellow crystallinecrystalline solid green crystals solidOdor Strong, sharp, pungent Fragrant (like apple Odorless or not Pepper-likeand highly irritating blossoms) pronounced. May beodormildly irritatingFreezing and/ Melting point: -64°C Melting point: 57°C Melting point: 195°C Melting point: 72°Cor melting Freezing point: -69°c with slightpointdecompositionVapor pressure 20 mm Hg at 20°C 0.0041–0.005 mm Hg at Negligible at ambient Data not available0°C temperature. 4.5 × 10 -11Density:Vapor (relative 5.6 times heavier 5.3 times heavierto air)Liquid 1.66 g/mL 1.187 g/mL atapproximately 58°cmm Hg at 25°CSolid 1.318 g /cm 3 at Bulk: < 1g/cm 3approximately 20°C Crystal: 1.65 g/cm 3 at 20°CSolubility:In water Insoluble relatively insoluble; 0.044 g/L at 37°C, very Relatively insoluble andslow hydrolysis; slow hydrolysis not hydrolyzed1.64 g/100 mL at 25°CIn other Soluble in organic Soluble in carbon Slightly soluble in Is sometimes suspendedsolvents solvents, lipids disulfide, ether, and benzene, xylene in solutions ofbenzene acetone, alcohols. propylene glycol, butacidic solutions data on solvents notprevent hydrolysis availableHydrolysis Carbon dioxide, bicar- HCl Diphenylaminearsenious Data not availableproducts bonate, chloride, nitrate, oxide and HCland nitrite. May alsoproduce toxic vaporssuch as oxides of nitrogen,phosgene, nitrosylchloride, and chlorineDecontamination:Clothing Move to fresh air; remove Move to fresh air; Move to fresh air; Move to fresh air;clothing, do not wear remove clothing and remove clothing and remove clothing andagain until properly wash before wearing wash before wearing wash before wearinglaundered or discard again again again(Table 13-3 continues)458
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The Coat of Arms1818Medical Departm
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Textbooks of Military MedicinePubli
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MEDICAL ASPECTS o fCHEMICAL WARFARE
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ContentsContributorsForeword by The
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ContributorsMICHAEL ADLER, PhDResea
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DONALD M. MAXWELL, MSResearch Chemi
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ForewordThe US military has been co
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PrefaceA significant concern for th
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PrologueThe original edition of Med
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xxii
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Medical Aspects of Chemical Warfare
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Nerve AgentsChapter 5NERVE AGENTSFR
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Nerve AgentsAbout 10,000 to 30,000
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Nerve Agentsphorofluoridate (DFP) w
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Nerve AgentsFig. 5-2. This schemati
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Nerve AgentsExhibit 5-1 continuedis
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Nerve Agentsactivity but only 15% t
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Nerve AgentsTABLE 5-3CHEMICAL, PHYS
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Nerve AgentsTABLE 5-4EFFECTS OF EXP
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Nerve Agentsaffecting the other eye
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Nerve Agentsmay cause severe rhinor
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Nerve Agentsof jerks and tremor.Cen
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Nerve Agentsand they were decreased
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Nerve Agentsnerve agent toxicity on
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Nerve Agentspatient. Decontaminatio
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Nerve AgentsFig. 5-5. The Mark I ki
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Nerve Agentsadministered intramuscu
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Nerve Agentsthat hydroxamine reacti
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Nerve AgentsOral administration may
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Nerve AgentsTABLE 5-7RECOMMENDED TH
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Nerve Agentsimpairment such as whee
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Nerve Agentssuboptimal, manner. The
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Nerve Agentsthan those who did not.
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Nerve Agentssible for binding nerve
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Nerve Agentsfor comparison was not
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Nerve AgentsTABLE 5-11EFFECTS OF PY
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Nerve Agentstivity of smooth muscle
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Nerve Agents38. Grob D, Lilienthal
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Nerve Agents77. McDonough JH, Shih
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Nerve Agents117. McLeod CG Jr, Sing
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Nerve Agents154. Tryphonas l, Veino
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Nerve Agents193. Funckes AJ. Treatm
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Nerve Agents235. Suzuki T, Morita H
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Nerve Agents274. Pellegrini JE, Bak
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PROCESSMedical Aspects of Chemical
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Page 429 and 430: Medical Aspects of Chemical Warfare
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Triage of Chemical CasualtiesChapte
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Triage of Chemical Casualtiesreceiv
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Triage of Chemical Casualtiesentran
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Triage of Chemical Casualtiescatego
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Triage of Chemical CasualtiesIn a f
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Triage of Chemical Casualtiesnose)
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Triage of Chemical CasualtiesWith n
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Triage of Chemical Casualties14. Sa
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Decontamination of Chemical Casualt
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• Analyze using GC-MS with methan
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Abbreviations and AcronymsAbBreviat
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Abbreviations and AcronymsPADPRP: p
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