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

Medical Aspects of Chemical WarfareTHE CHEMICAL AGENT WORKPLACEChemical agent operations are conducted in avariety of job settings, including storage depots,demilitarization facilities, research laboratories, andtransportation units. Before a chemical agent employeecan be placed in a job, a physician must consider theoccupational and environmental health risks associatedwith the position. The physician must understandthe various workplaces in which chemical agentoperations are performed to effectively identify thecorresponding risks.The chemical agent worker uses different kinds ofpersonal protective equipment (PPE) and engineeringcontrols based on the work environment. The use ofprotective clothing itself can create significant hazards,such as heat stress, physical and psychologicalstress, and impaired vision, mobility, and communication.The physician must understand these PPEsand engineering controls in order to select the mostappropriate preplacement examination and medicalsurveillance for the initial and continued safety of theworker. DA PAM 385-61 6 defines the protection levels(A through D) for chemical agent workers and lists thepersonal protective clothing and equipment requiredfor each level. The following text and accompanyingfigures describe the various types of chemical agentworkplaces.The purpose of the US Army Chemical MaterialsAgency is to protect and safely store the nation’s agingchemical weapons. The agency works toward the effectiverecovery, treatment, and ultimate elimination ofthe nation’s chemical warfare materials, and it managesa national inventory control point and national maintenancepoint to ensure that the stockpile is maintainedsafely during its remaining storage life. Chemical depotworkers routinely check storage containers for potentialdegradation and leaks. During these inspections,the workers operate in Level A protective clothing, thedemilitarization protective ensemble, which consistsof a totally encapsulated, positive-pressurized suit(Figure 18-1). A mask (manufactured by Mine SafetyAppliances Company, Pittsburgh, Pa) and backpack,both certified by the National Institute of OccupationalSafety and Health and the Occupational Safety andHealth Administration, are contained within the suitto provide a continual air supply via an umbilical cord.The suit is also equipped with a self-contained emergencybreathing system in case the hose air supply iscompromised. The workers wear butyl rubber bootsand gloves over the ensemble as an additional layerof protection and can communicate with each otherand the control station by way of a radio internal tothe demilitarization protective ensemble.Another mission of the Chemical Materials Agencyis to manage the safe treatment and disposal of chemicalagents and weapons. To accomplish this mission,the agency uses various technological tools, many ofFig. 18-1. A team of chemical workers wears Level A protectiveclothing, the demilitarization protective ensemble,which provides the greatest level of protection against agentexposure.Photograph: Courtesy of US Army Chemical Materials Agency,Aberdeen Proving Ground, Md. Available at http://www.cma.army.mil/multimediagallery. Accessed December 2005.Fig. 18-2. Two chemical agent operators wear Level C protectiveclothing and use a glovebox as they drain mustardagent from ton containers in the neutralization process at theAberdeen Chemical and Biological Agent Disposal Facility.Photograph: Courtesy of US Army Chemical MaterialsAgency, Aberdeen Proving Ground, Md. Available at http://www.cma.army.mil/multimediagallery. Accessed December2005.596