Veterans at Risk : the health effects of mustard gas and Lewisite / Constance M. Pechura and David P. Rall, editors.

Format:

Book

Author/Creator:

Institute of Medicine (U.S.). Committee to Survey the Health Effects of Mustard Gas and Lewisite.

Contributor:

Pechura, Constance M.

Rall, David P.

Language:

English

Subjects (All):

Mustard gas--Toxicology.

Mustard gas.

Lewisite (Poison gas)--Toxicology.

Lewisite (Poison gas).

Physical Description:

xviii, 427 p. : ill.

Edition:

1st ed.

Place of Publication:

Washington, D.C. : National Academy Press, 1993.

Language Note:

English

Summary:

Recently, World War II veterans have come forward to claim compensation for health effects they say were caused by their participation in chemical warfare experiments. In response, the Veterans Administration asked the Institute of Medicine to study the issue. Based on a literature review and personal testimony from more than 250 affected veterans, this new volume discusses in detail the development and chemistry of mustard agents and Lewisite followed by interesting and informative discussions about these substances and their possible connection to a range of health problems, from cancer to reproductive disorders. The volume also offers an often chilling historical examination of the use of volunteers in chemical warfare experiments by the U.S. military--what the then-young soldiers were told prior to the experiments, how they were "encouraged" to remain in the program, and how they were treated afterward. This comprehensive and controversial book will be of importance to policymakers and legislators, military and civilian planners, officials at the Department of Veterans Affairs, military historians, and researchers.

Contents:

Veterans at Risk

Copyright

Preface

Acknowledgments

Contents

Executive Summary

BACKGROUND

GENERAL CONCLUSIONS

SPECIFIC FINDINGS

RECOMMENDATIONS

1 Introduction

REFERENCES

2 Methods of Literature Collection and Survey

ONLINE DATABASES

OTHER SOURCES

SUPPLEMENTAL WORLD WAR II MILITARY REPORTS

LITERATURE TRANSLATION, DISSEMINATION, AND ANALYSIS

3 History and Analysis of Mustard Agentand Lewisite Research Programsin the United States

INTRODUCTION

Sulfur Mustard

Lewisite

RESEARCH PROGRAMS OF WORLD WAR I AND THE POSTWAR PERIOD

TESTING PROGRAMS AND CHEMICAL WARFARE PRODUCTION IN WORLD WAR II

Patch or Drop Tests

Chamber Tests

Field Tests

Gas Production, Gas Handling, and Chemical Warfare Production

The Bari Harbor Disaster

Medical Applications of Chemical Warfare Research

RESEARCH, USE, AND DISPOSAL OF CHEMICAL WEAPONS AFTER WORLD WAR II

Postwar Research Programs

Continuing Use of Sulfur Mustard and Other Chemical Weapons in International Conflicts

U.S. Chemical Stockpile Disposal Program

CONCLUSIONS AND FURTHER ANALYSIS

4 Findings from the Public Hearing Process

RESULTS AND FINDINGS

Types of Veteran Exposures

Health Problems Reported

Personal Aspects of Veteran Reports

TREATMENT OF HUMAN SUBJECTS

CONCLUSIONS AND ACTIONS TAKEN

5 Chemistry of Sulfur Mustard and Lewisite

SULFUR MUSTARD

Reaction of Sulfur Mustard with Various Nucleophiles

Reactions of Biologic Importance

LEWISITE

6 Relationship of Mustard Agent and Lewisite Exposure to Carcinogenesis

ACUTE EFFECTS AND BIOLOGICAL MECHANISMS

Biologic Fate and Mechanisms of Action

Nucleic Acid and Protein Conjugation

Cytogenetic and Mutagenic Effects

Summary

Lewisite.

Biologic Fate and Mechanism of Action

EVIDENCE OF LONG-TERM HEALTH EFFECTS

Animal Studies

Early Studies in Mice and Rats

Heston's Studies in Mice

Later Studies of Mustard Agents and Other Alkylating Agents

Summary of Animal Studies

Human Studies

Occupational Exposure

Battlefield Exposure

Medical Therapeutic Exposure

SUMMARY

Gaps in the Literature

Conclusions

7 Nonmalignant Respiratory Effects of Mustard Agents and Lewisite

PHYSIOLOGY AND ANATOMY

RELATIONSHIP BETWEEN ACUTE AND CHRONIC EFFECTS CAUSED BY EXPOSURES TO OTHER RESPIRATORY HAZARDS

Gaps

8 Ocular Effects of Mustard Agents and Lewisite

PHYSIOLOGY AND ANATOMY OF THE EYE

Dose-Related Considerations

Clinical Observations

Physiology and Histopathology of Injury

Animal Data and Cellular Bioassay

Chronic Course

Gaps in Knowledge

Limbal Vascular Damage

Ocular Epithelial Damage

Protection of the Corneal Epithelium with a Contact Lens

Sulfur Mustard Compared to Alkali Injury: The Stromal Component

CONCLUSIONS

9 Dermatological Effects of Mustard Agents and Lewisite

ANATOMY AND PHYSIOLOGY OF SKIN

Epidermis

Dermis

Eccrine Sweat Glands

Apocrine Glands

Melanocyte System

Clinical and Microscopic Observations

Mechanisms of Skin Injury.

Lewisite

EVIDENCE OF LONG-TERM HEALTH EFFECTS OF MUSTARD AGENTS

Animal Studies and Cellular Bioassays

Experimental Exposure

EVIDENCE OF LONG-TERM HEALTH EFFECTS OF LEWISITE

10 Other Physiological Effects of Mustard Agents and Lewisite

EFFECTS ON THE IMMUNE SYSTEM

Anatomy and Physiology

EFFECTS ON SYSTEMS OTHER THAN THE IMMUNE SYSTEM

Gastrointestinal Effects

Hematological Effects

Neurological Effects

REPRODUCTIVE RISKS

Sulfur Mustards

Summary and Conclusions

Introduction

11 Relationship of Mustard Agent and Lewisite Exposure to Psychological Dysfunction

HISTORICAL DEVELOPMENT OF THE CONCEPT OF PTSD

CURRENT RESEARCH IN PTSD

EVIDENCE FROM STUDIES OF MILITARY PERSONNEL AND VETERANS

Chemical and Biological Warfare Environments

Studies of PTSD in Veteran Populations

EVIDENCE FROM STUDIES OF THE PSYCHOLOGICAL EFFECTS OF ENVIRONMENTAL CONTAMINATIONS

12 Summary of Findings and Recommendations

CONCLUSIONS REGARDING THE CAUSAL RELATIONSHIPS OF EXPOSURE TO THE DEVELOPMENT OF SPECIFIC DISEASES

GAPS IN THE LITERATURE REGARDING MUSTARD AGENTS AND LEWISITE

Bibliography

PUBLISHED LITERATURE

MILITARY REPORTS UNITED STATES

U.S. Army Reports

1923-1946

1947-1992.

U.S. Navy Reports

Other U.S. Military Reports

UNITED KINGDOM

Chemical Defence Experimental Station, Porton Down

Other British Military Reports

AUSTRALIA

CANADA

Experimental Station, Suffield, Alberta

Chemical Warfare Laboratories, Ottawa

INDIA

OTHER MILITARY REPORTS

TECHNICAL REPORTS

Office of Scientific Research and Development

1947-1992

AVAILABILITY INFORMATION

OFFICE OF SCIENTIFIC AND RESEARCH DEVELOPMENT (OSRD) REPORTS:

COMMITTEE ON TREATMENT OF GAS CASUALTIES (CTGC) REPORTS:

NATIONAL TECHNICAL INFORMATION SERVICE (NTIS):

NAVAL RESEARCH LABORATORY REPORTS:

BRITISH REPORTS:

APPENDIXES

A Scientific and Background Presentations Made to the Committee

January 6, 1992

April 15-16, 1992

JUNE 11-12, 1992

B Excerpt from The Residual Effects of Warfare Gases (1933)

SUMMARY AND CONCLUSIONS

C Involvement of the National Academy of Sciences Complex in World War II Research Programs: A Summary

D Excerpts from Chamber Tests with Human Subjects I, II, and IX. Naval Research Laboratory Reports Nos. P-2208…

E Interim Report and Addendum Han K. Kang, Dr. P.H.

Feasibility of Developing a Cohort of Veterans Exposed to Mustard Gas During WWII Testing Programs

I. Background

II. Naval Research Laboratory (NRL) Tests

A. NRL Lab Log

B. Suitland Federal Records Center

C. National Personnel Record Center (NPRC), St. Louis, MO

D. Bainbridge, MD, Navy Training Center

E. Conclusions

III. The U.S. Army Chemical Warfare Service Tests

A. Special Orders No. 152

B. Conclusions

IV. Summary

ADDENDUM

I. Naval Research Laboratory (NRL) Test Participants

II. U.S. Army Chemical Warfare Service Test Participants

III. Conclusions

F Summary of the Department of the Army Report by James R. Taylor and William Johnson.

USE OF VOLUNTEERS IN CHEMICAL AGENT RESEARCH (1975)

KEY ELEMENTS OF THE NUREMBERG CODE OF 1947

G Public Hearing Announcement

PUBLIC HEARING ANNOUNCEMENT

COMMITTEE TO SURVEY THE HEALTH EFFECTS OF MUSTARD GAS AND LEWISITE

VETERANS WHO APPEARED AT THE PUBLIC HEARING

SUMMARY OF HEALTH PROBLEMS REPORTED BY VETERANS

H Yale Law School

I Risk Assessment Considerations for Sulfur Mustard

NITROGEN MUSTARD

CANCER RISKS FROM SIMILAR COMPOUNDS

RAPID SCREENING OF HAZARD (RASH) APPROACH

RELEVANCE OF EXPERIMENTAL RESULTS TO HUMAN RISKS

HUMAN EXPOSURES

J Examination of the Effects of Certain Acute Environmental Exposures on Future Respiratory Health Consequences

REVIEW OF AGENTS CAUSING ACUTE AND CHRONIC RESPIRATORY EFFECTS

Chlorine

Sulfur Dioxide

Miscellaneous Irritants

Cotton Dust

Isocyanates

Notes on Selected Inorganic Agents

THE FUNDAMENTAL QUESTION

Narrowly Structured

Alternative Broadly Structured

THE RESPIRATORY END POINTS

Simple Chronic Bronchitis

Chronic Obstructive Bronchitis and Emphysema

Allergic Bronchoconstriction

Inflammatory Bronchoconstriction

Pharmacologic Bronchoconstriction

HOST FACTORS

LITERATURE CITED

List of Acronyms and Abbreviations

Index.

Notes:

"Committee to Survey the Health Effects of Mustard Gas and Lewisite, Division of Health Promotion and Disease Prevention, Institute of Medicine, National Academy of Sciences."

Includes bibliographical references (p. 227-329) and index.

ISBN:

9786610196647

9781280196645

1280196645

9780309557368

0309557364

9780585027258

0585027250

OCLC:

814272447