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

Medical Diagnosticsof deuterated TDG was passed through the same cartridges.The purified urine was mixed with concentratedhydrogen chloride (HCl) and heated. Sulfur mustardwas purged from the solution and trapped ontoa Tenax-TA adsorption tube. Analysis was performedusing a thermodesorption cold trap injector interfacedwith GC-MS. Analysis of urine samples obtained froma control group of patients found levels of TDG at lownanogram-to-milliliter concentrations. While mostof the control levels were approximately 5 ng/mL,two individuals had levels that exceeded 20 ng/mL.These high background levels probably indicate thatthe method was also converting another analyte, inaddition to TDG, into sulfur mustard (see below).Table 22-6reports published prior to 1995 showing laboratory analysis of humanbiomedical samples following suspected exposure to sulfur mustardPatient Sample Information* Unmetabolized Sulfur Mustard Hydrolysis Product †Urine samples from 2 Iran-Iraq War casualties Patient 1: 1.0 ng/ml nmtreated at Vienna hospital; collected 7 days after Patient 2: 1.5 ng/mLincident (no date given) 1Urine samples from 5 Iranian casualties treated at nm patient C1: 90 ng/mLGhent hospital; collectedpatient C2: 45 ng/mL10 days after incident (March 9, 1984) 2 patient C3: 40 ng/mLpatient C4: 40 ng/mLpatient C5: 15 ng/mLcontrol samples: 3–55 ng/mLUrine samples from 5 Iranian casualties treated at nm patient range: 3–140 ng/mLUtrecht hospital; collected 10 days after incident C control samples: 3–55 ng/mL(March 9, 1984) 2Hair samples from 2 Iranian casualties; collected 1 Patient 1: 0.5–1.0 µg/gram nmday after incident (Feb 27, 1986) 3patient 2: not detectedAutopsy specimens (tissues and body fluids) Urine: not detected; Fat, Skin, Brain, NMfrom Iranian casualty treated at MunichKidney: 5–15 mg/kg; Muscle, Liver,hospital; collected 7 days after incident (1985) 4 Spleen, Lung: 1–2 mg/kgUrine samples from 12 Iran-Iraq War casualties 1–30 ng/mL for 6 individuals; not NM(1986); no other details provided 5 detected in 6 individualsUrine samples from 7 Iranian casualties treated at NM 5–6 days postexposure:Ghent hospital; collected 5–6 and 18–19 daysrange 7–336 ng/mL;after incident (Feb 12–13, 1986) 618–19 days postexposure:range 3–7 ng/mLUrine samples from 3 Iranian casualties treated at nm patient range: 4–8 ng/mLGhent hospital; collected 18–19 days after C control samples: 1–21 ng/mLincident (Feb 12–13, 1986) 6Urine samples from 8 Iranian casualties treated at nm patient range: 5–76 ng/mLUtrecht hospital; collected 8–9 days after C control samples: 1–21 ng/mLincident (Feb 12–13, 1986) 6*These are the known details of the incident and sample collection time after suspected exposure.† The hydrolysis product was thiodiglycol.NM: not measuredData sources: (1) Vycudilik W. Detection of mustard gas bis(2-chloroethyl)-sulfide in urine. Forensic Sci Int. 1985;28:131–136. (2) Wils ERJ,Hulst AG, de Jong AL, Verweij A, Boter HL. Analysis of thiodiglycol in urine of victims of an alleged attack with mustard gas. J AnalToxicol. 1985;9:254–257. (3) United Nations Security Council. Report of the mission dispatched by the Secretary-General to investigate allegationsof the use of chemical weapons in the conflict between the Islamic Republic of Iran and Iraq. New York, NY: UN; 1986. Report S/17911. (4) DraschG, Kretschmer E, Kauert G, von Meyer L. Concentrations of mustard gas [bis(2-chloroethyl)sulfide] in the tissues of a victim of a vesicantexposure. J Forensic Sci. 1987;32:1788–1793. (5) Vycudilik W. Detection of bis(2-chloroethyl)-sulfide (Yperite) in urine by high resolution gaschromatography-mass spectrometry. Forensic Sci Int. 1987;35:67–71. (6) Wils ERJ, Hulst AG, van Laar J. Analysis of thiodiglycol in urine ofvictims of an alleged attack with mustard gas, part II. J Anal Toxicol. 1988;12:15–19.709