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However, there is evidence to suggest a causal relationship between sulfur mustard exposure and reproductive toxicity in laboratory animals. Reproductive success, however, can be adversely affected by impaired sexual function caused by scarring of penile tissue.

The studies of the reproductive toxicity of Lewisite in laboratory animals are negative. Such data, however, are not complete and thus are insufficient to support or deny a causal relationship between exposure and adverse reproductive outcomes.

The evidence indicates a causal relationship between characteristic aspects of the chamber and field experiences and the development of adverse psychological effects. These effects may be highly individual, but diagnosable, and may include long-term mood and anxiety disorders, PTSD, or other traumatic stress disorder responses. Data are insufficient, however, to associate the presence of adverse psychological disorders with any physiological disease or dysfunction.

Many elements of the gas chamber and field experiments were highly stressful. These include lack of prior knowledge about what to expect, the duration and conditions of the chamber trials, the experience of skin injury from the exposures, the threats of punishment if the experiments were revealed, and other elements. Any stress reaction from  the experiences may have well been magnified by subsequent secrecy, fears about the health risks, and institutional denials. Data from studies of chemical and biological warfare environments and environmental exposures to toxic chemicals or radiation support the assertion that, in certain individuals, these experiences would have been sufficient to cause adverse psychological effects, resulting in long-term dysfunction. It is likely that such effects also occurred in some production workers, gas handlers and trainers, and Bari harbor survivors as a result of traumatic episodes including explosions, accidents, personal exposure injury, or the witnessing of severe injury or death of others. Current investigations of the physiological concomitants of psychological disorders are compelling and of great interest for future research. However, it is not possible to predict from these studies what adverse physiological effects may be attributable to long-standing psychological problems.

GAPS IN THE LITERATURE REGARDING MUSTARD AGENTS AND LEWISITE

Human Studies

Clearly the most important gap in studies assessing the effect of agent exposure on humans is the lack of epidemiological studies of occupa-



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