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Health See other Health Articles Title: Chemical Weapons Medscape: The History of Chemical Weapons Use of chemicals in warfare dates back to the trenches of World War I. In 1914, Fritz Haber, a Prussian chemist, suggested using chlorine gas to dislodge fighters on the battlefield. This culminated in a chlorine gas release at Ypres on April 15, 1915. Soon both sides of the conflict escalated their use of chemicals as a means of war. By the end of World War I, chemical warfare included the use of chlorine, mustard gas, and phosgene. The deadly results included over 1 million injuries and more than 90,000 deaths. Because of the horrendous deaths in World War I, the 1925 Geneva Protocol was created, specifically prohibiting the use of chemical weapons on the battlefield. Unfortunately, chemical weapons continued to be developed for hostile use. Gerhard Schrader, a German chemist, while working on more potent pesticides, discovered sarin, as well as tabun and soman. These chemicals were adopted by the German military for offensive use but were never used in warfare. They are referred to in the military as the "G" agents because of their origins in "Germany" (sarin's military moniker is "GB"). After World War II, the British developed the agent amiton, which was subsequently dubbed "VX." These agents are collectively known as organophosphates because of their chemical composition. They are also described as "nerve agents" because of their effect on the nervous system as a means of incapacitation. Both the US and Soviet militaries developed offensive chemical weapons stockpiles during the Cold War. However, despite the escalation in capabilities and stockpiles, the use of chemical weapons has (thankfully) been very infrequent. In 1983, during the Iran-Iraq war, Saddam Hussein, then president of Iraq, used mustard gas to repel the Iranian army, which outnumbered his own. This attack elicited a limited response from the international community, and as a result, Hussein, feeling emboldened, proceeded to use the nerve agent sarin against Iran in March 1984. Hussein's most blatant use of chemical weapons, however, was against the population of Halabja in 1988 as a means to quell the restive Kurdish enclave. Over 5000 people died in this attack and, sadly, again there was limited international response. The United States claims that there have been multiple instances of use of chemical weapons on the Syrian battlefield, with the most significant attack occurring on August 21, 2013, in a suburb of Damascus. Reports from Syria indicate that this attack was perpetrated by the regime of Bashar al-Assad, a physician by training, with the purpose of dislodging rebel fighters from entrenched positions. The United States further reports that the chemical used was sarin, the highly toxic nerve agent, and that this attack resulted in over 1400 casualties, including 400 children. A United Nations inspection team was dispatched to Damascus to retrieve samples and conduct interviews to ascertain whether chemical weapons were used. Syria is presently not a signatory to the Chemical Weapons Convention (CWC), has a well-established partnership with Russian military, and has a known offensive chemical weapons program. Recently, in order to avoid potential military strikes by the United States, Syria has offered to become a signatory nation to the CWC, surrender all of its chemical weapons, and subject itself to inspections. Whether this proposal becomes reality remains to be seen. Chemical Weapons in Brief Chemical weapons are toxic mixtures that, through their chemical action on life processes, can cause death, temporary incapacitation, or permanent harm. Chemical weapons pose challenges that are quite different from those of the other weapons included in the category of CBRNE. Military grade "G" series chemicals are colorless and odorless, making a release less obvious. Traditional nerve agents act rapidly, whereas biological weapons need incubation periods of days to weeks before victims become symptomatic. This is an important distinction because it places a much larger burden on local first responders to mitigate a chemical attack and care for the victims. In addition, the issues of decontamination and responder safety make the rescue and treatment of victims of a chemical attack much more complex than an attack involving explosives. There are several reports coming out of Syria detailing medical personnel succumbing to the effects of sarin from contact with contaminated patient clothing. Chemical attacks also present a tremendous psychological problem, as was witnessed in the sarin gas attacks by the Aum Shinrikyo cult in Japan in 1995. Scores of "worried well" flooded emergency departments fearing that they had been exposed to sarin. Sarin is the most volatile of the nerve agents and, as a result, can easily convert from liquid to gas form. Patients are exposed to nerve agents via the respiratory, dermal, or gastrointestinal route, with the respiratory route being the most lethal. Nerve agents are extremely toxic chemicals that produce effects on multiple organ systems through their inhibition of the neurotransmitter acetylcholinesterase (AChE) at nerve synapses and in ganglia. AChE normally rapidly breaks down acetylcholine following its release by nerve endings, acting as an off-switch. Without this breakdown, there is unopposed stimulation of the nerve endings at muscles, neurons, and glands, causing constant stimulation via acetylcholine. This overstimulation explains the physical signs and symptoms seen when patients are exposed. When the muscles eventually tire, breathing cannot be sustained. Respiratory exposure has rapid onset, whereas dermal exposure is delayed. Symptoms usually occur within seconds of exposure but may take several hours to develop, depending on dose and route of exposure. The clinical presentation is variable, based on the route of exposure as well as the dose. Symptoms that are apparent following different levels of exposure include the following[1]: Mild inhalational exposure. Rapid onset of papillary constriction (miosis) causing blurry vision, runny nose (rhinorrhea), chest tightness, dyspnea, and possible bronchoconstriction causing wheezing. Severe inhalational exposure. Sudden coma, seizures, flaccid paralysis with apnea, miosis, diarrhea. A victim can be described as "wet" (lacrimation, salivation, urination, sweating, copious upper and lower respiratory secretions). Mild dermal exposure. Sweating and muscle fasciculations localized to the area of exposure, nausea, vomiting, diarrhea, and possible miosis. Severe dermal exposure. Sudden coma, seizures, flaccid paralysis with apnea, miosis, diarrhea. A victim may be described as being "wet" (lacrimation, salivation, urination, sweating, copious upper and lower respiratory secretions). The onset of symptoms may be delayed by 30 minutes following exposure as the agents transit the skin.e have been reports of healthcare workers succumbing to the effects of nerve agents while treating victims because of exposure to the nerve agent that persisted on clothing. The use of proper personal protective equipment and training in treating victims of a nerve agent is essential. Guidance for Health Professionals Decontamination. Victims of a nerve agent attack need decontamination before transport to the emergency department. After following the protocol for protecting yourself, remove the victim's clothing. If you suspect that the chemical agent may be on clothing, cut the victim's clothes off instead of pulling over the head. Dispose of clothing in double plastic bags. Wash the patient's body thoroughly with soap and water or 10% hypochlorite solution, and if the agent contacts eyes, irrigate them thoroughly. If the agent is ingested, do not induce vomiting. Presentation and testing. Victims of a terrorist attack, particularly when weapons-grade chemicals have been used, usually will have both inhalational and dermal exposures. Hours after treatment/decontamination, the agent may still be in transit through the skin and will have the potential to produce sudden and severe symptoms. Victims who survive a chemical exposure may be symptomatic for up to 2 weeks after exposure, particularly with central nervous system manifestations. There is no test to definitively rule in exposure to nerve agents; treatment is dictated by the physical presentation and a high degree of suspicion. Specialized laboratories, including the Centers for Disease Control and Prevention (CDC) Laboratory Response Network for Chemical Threats, as well as the Department of Defense and the Department of Homeland Security, have capabilities to perform sophisticated testing of clinical and environmental samples to confirm that a nerve agent was used. Special considerations and resources. DuoDote® injections, or Mark 1 kits, which are widely available, contain atropine 2 mg plus pralidoxime chloride 600 mg and should be used by out-of-hospital providers at the scene. Diazepam or another benzodiazepine should be used to control seizures. These medications are available in most emergency departments. Note that massive amounts of antidote may be required to treat the victims of a chemical exposure, especially in instances of mass casualty. Many communities participate in the CHEMPACK stockpile program, which provides these antidotes to first responders. For detailed clinical guidance on medical management, see the CDC Website, Medical Management Guidelines for Nerve Agents: Tabun (GA); Sarin (GB); Soman (GD); and VX. Nerve agents are formidable weapons that have been banned by the vast majority of nations. The recent use of these weapons by Syria is alarming in both its scope and brazenness of the attack. There are significant policy decisions that will be debated by the United States and the rest of the world, including the appropriate response against the Assad regime. Permitting a regime to use these types of weapons with impunity may embolden other rogue states or terrorist organizations, such as what was seen in Iraq. There are also concerns of a broader use of these weapons or other terrorist attacks were the United States to retaliate. What is clear, however, is that these weapons are inhumane and overwhelmingly repudiated. The goal of all should be to prevent their use in any form. 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#1. To: Tatarewicz (#0)
Syria is presently not a signatory to the Chemical Weapons Convention (CWC), Syria is a signatory of the 1925 Geneva Protocol. ------- "They're on our left, they're on our right, they're in front of us, they're behind us...they can't get away this time." -- Col. Puller, USMC
I guess that we need to update an 88yo treaty...
“The most dangerous man to any government is the man who is able to think things out... without regard to the prevailing superstitions and taboos. Almost inevitably he comes to the conclusion that the government he lives under is dishonest, insane, intolerable.” ~ H. L. Mencken
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