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

Indextive liner systemdescription and uses, 587Montreal Protocolmedical aerosolized nerve agent antidote and, 652MOPP. See Mission-oriented protective postureMorgenstern, P.long-term health effects of mustard, 312, 314Morphinedescription and incapacitating effects, 418MS. See Mass spectrometryMSMTESE. See 1-methylsulfinyl-2-[2-(methylthio)ethylsulfonyl]ethaneMultiservice Tactics, and Procedures for NBC Protection (FieldManual 3-11.4), 569Murray, V.2-chlorobenzylidene malononitrile research, 451–452Mustard agent. See also Nitrogen mustardaccidental exposures, 263, 717–718, 723, 725additives for, 135alkylation of deoxyribonucleic acid and, 264–265, 312, 718analysis of specimens, 706–708analytical methods used to verify exposure to sulfur mustardin biomedical samples (table), 714–715barrier skin creams for, 530, 531biochemical mechanisms of injury, 263–265, 708blister fluid analysis, 726blood sample analysis, 718–726carcinogenesis, 290, 312–314, 315–316case history: mustard gas exposure in 14 children and teenagersfrom Halabja, Iraq (exhibit), 667casualties caused by, 20, 261, 262–263, 266, 667central nervous system effects, 276, 290, 315chronic eye disease and, 314chronic pulmonary disease and, 314clinical cases of mustard exposure from Mofid Medical Centerfollowing the Halabja, Iraq, attack on March 17, 1988 (exhibit),668–669clinical effects, 266–276, 312, 356, 519, 656, 667, 669compared with phosgene oxime and lewisite, 261, 291Cushing’s impressions, 88–89day of death after exposure in World War I fatal mustardcasualties (table), 266decontamination issues, 277, 312description (exhibit), 21development and properties of, 15, 20, 83diagnosis, 276–277, 692–693disaster at Bari, 21, 53, 105, 262Edgewood Arsenal, MD, production, 119gas mask effectiveness and, 21German production statistics, 48Germany’s experimental testing on human subjects in concentrationcamps, 105hair sample analysis, 726hospitalization and, 262, 277, 281, 670hydrolysis of sulfur mustard to produce thiodiglycol, followedby oxidation reactions (figure), 708initial clinical effects from mustard exposure (table), 266Institute of Medicine study on the effects of mustard agentand lewisite exposure, 312–313, 314introduction of, 18, 261Italian-Ethiopian War use, 45–46Japan’s use of against China, 46laboratory findings, 669laboratory tests for, 277long-term health effects, 291, 312–316mechanism of action, 136, 312, 656median lethal dose, 519medical management, 83, 135metabolism, 265military use, 262–263mortality rates, 266, 276, 277, 278mutagenesis, 315–316name derivation, 261–262nerve agents compared with, 181neuropsychiatric symptoms and, 315neutralization of, 533partial-thickness injury treatment, 283pattern of injury, 3pediatric population and, 669–670pediatric signs of mustard exposure (table), 670PFC David Allen Fisher’s exposure to mustard agent duringthe Persian Gulf War, 106–107properties, 263published reports (1997-2006) of laboratory analysis of humanblood samples following suspected exposure to sulfurmustard (table), 727published reports (1995-2006) of laboratory analysis of humanurine samples for glutathione reaction products following asuspected exposure to sulfur mustard (table), 720published reports (1995-2006) of laboratory analysis of humanurine samples for hydrolysis metabolites followingsuspected exposure to sulfur mustard (table), 719putative mechanisms by which sulfur mustard causes tissuedamage (figure), 264rapidity of reaction to, 265, 514, 656reaction pathway of glutathione (figure), 712reactions with glutathione, 265recovery time after exposure to, 262, 278, 519reports published prior to 1995 showing laboratory analysis ofhuman biomedical samples following suspected exposure tosulfur mustard (table), 709reproductive toxicity, 315–316respirator effectiveness, 25–26, 83sample preparation methods for the gas chromatographicmassspectrometric analysis of sulfur mustard adducts toblood biomolecules (exhibit), 724–725sample preparation methods for the gas chromatographic/mass spectrometric/mass spectrometric analysis of the sulfurmustard urinary β-lyase metabolites (exhibit), 713sample preparation procedure for sulfur mustard adducts todeoxyribonucleic acid in blood (exhibit), 722scarring of epithelial surfaces and, 315skin effects, 267–274skin sample analysis, 726soap and water decontamination, 533, 534synthesis of, 116–117, 312teratogenesis, 315–316tissue sample analysis, 726toxicity, 667treatment of exposure to, 277–291, 670–672triage issues, 519urine sample analysis, 708–718US production of, 117US troop training and, 53Veterans Administration study on the effects of mustard agentand lewisite exposure, 312–313Vietnam War and, 57volatility of, 135weather considerations, 135–136, 263, 266World War I use, 2–3, 15, 18, 20–21, 25–26, 27, 260, 261wound decontamination and, 538Yemen Civil War and, 57, 58Mutagenic effects2-chlorobenzylidene malononitrile, 448xlix