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Veterans at Risk: The Health Effects of Mustard Gas and Lewisite (1993)
Institute of Medicine (IOM)

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. "3 History and Analysis of Mustard Agent and Lewisite Research Programs in the United States." Veterans at Risk: The Health Effects of Mustard Gas and Lewisite. Washington, DC: The National Academies Press, 1993.

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Veterans at Risk: The Health Effects of Mustard Gas and Lewisite

CWS in jobs ranging from clerks and housekeepers to chemists and toxicologists. Civilian workers numbered 7,000 at the beginning of the war and 28,000 by 1943, of whom 40 percent were female and 45 percent were African Americans. The latter percentage was lower at the Rocky Mountain Arsenal, where there were fewer African Americans available from the surrounding community (Brophy and Fisher, 1959).

Although many of the specific jobs performed by these military and civilian personnel did not involve handling of, or even proximity to, warfare gases, the number of documented injuries was quite high. CWS, in fact, had the worst safety record of any branch of the War Department in both 1942 and 1943, the peak years of production (Brophy and Fisher, 1959). According to these authors, the safety record improved considerably after that, becoming among the best in the War Department by the end of the war. Nevertheless, the dismal safety record meant that many injuries were themselves studied by those involved in the CWS research branches or in studies contracted under NRC's Committee on Treatment of Gas Casualties. For example, many of the eye injuries at Edgewood were referred to and studied at the Johns Hopkins University Medical School under CTGC contracts (Andrus et al., 1948).

One study of these accidental injuries, reported that over 1,000 cases of mustard poisoning, resulting in eye, ear, nose, and throat symptoms, occurred at Edgewood Arsenal over a two-year period (Uhde, 1946). Of these, 790 were eye injuries; these injuries occurred to both males and females. Slow leaks of mustard vapor accounted for close to 80 percent of the problems. An additional 7 percent were from short-term exposures and accidents, such as explosions and mistaken use of real mustard in training exercises designed for simulated gas exposure. While the study did not present adequate information with which to judge the overall severity of injuries, it does report one death from sulfur mustard poisoning during this period. Little information is available from other locations, but Cochrane (1946) noted that during the first two weeks of December 1941, 577 patients were treated for eye and respiratory tract injuries from exposure to chemical warfare agents, especially sulfur mustard. The CWS locations where these injuries occurred were not reported. Finally, there is anecdotal evidence that the atmospheric concentrations of sulfur mustard around manufacturing areas at Edgewood Arsenal exceeded the odor threshold concentrations and thus may have been high enough to cause physiological effects (Howard Skipper, personal communication; see also Appendix A).

It is important to note that CWS personnel were exposed to a variety of toxic materials. For example, in addition to mustard agents, gases such as phosgene (a choking agent), hydrogen cyanide and cyanogen chloride (blood poisoning agents), and chloroacetophenone (tear gas)

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Front Matter (R1-R20)
Executive Summary (1-8)
1 Introduction (9-13)
2 Methods of Literature Collection and Survey (14-20)
3 History and Analysis of Mustard Agent and Lewisite Research Programs in the United States (21-60)
4 Findings from the Public Hearing Process (61-70)
5 Chemistry of Sulfur Mustard and Lewisite (71-80)
6 Relationship of Mustard Agent and Lewisite Exposure to Carcinogenesis (81-111)
7 Nonmalignant Respiratory Effects of Mustard Agents and Lewisite (112-130)
8 Ocular Effects of Mustard Agents and Lewisite (131-147)
9 Dermatological Effects of Mustard Agents and Lewisite (148-178)
10 Other Physiological Effects of Mustard Agents and Lewisite (179-198)
11 Relationship of Mustard Agent and Lewisite Exposure to Psychological Dysfunction (199-213)
12 Summary of Findings and Recommendations (214-226)
Bibliography (227-330)
A. Scientific and Background Presentations Made to the Committee (331-334)
B. Excerpt from The Residual Effects of Warfare Gases (335-337)
C. Involvement of the National Academy of Sciences Complex in World War II Research Programs: A Summary (338-339)
D. Excerpts from Chamber Tests with Human Subjects I, II, and IX. Naval Research Laboratory Reports Nos. P-2208 and P-2579 (340-369)
E. Interim Report and Addendum: Feasibility of Developing a Cohort of Veterans Exposed to Mustard Gas During WWII Testing Programs (370-377)
F. Summary of the Department of the Army Report: Use of Volunteers in Chemical Agent Research (378-381)
G. Public Hearing Announcement (382-385)
H. Letter from Dr. Jay Katz to Dr. David P. Rall (386-389)
I. Risk Assessment Considerations for Sulfur Mustard (390-398)
J. Examination of the Effects of Certain Acute Environmental Exposures on Future Respiratory Health Consequences (399-416)
List of Acronyms and Abbreviations (417-420)
Index (421-428)