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PAPERBACK list:$83.75 Web:$75.38 add to cart PDF BOOK your price: $64.50 add to cart Rights & Permissions Free Resources PDF EXECUTIVE SUMMARY Display this book on your site! Related Titles Acute Exposure Guideline Levels for Selected Airborne Chemicals: Volume 3 Acute Exposure Guideline Levels for Selected Airborne Chemicals: Volume 4 Other Related Titles Veterans at Risk: The Health Effects of Mustard Gas and Lewisite (1993) Institute of Medicine (IOM) Web Search Builder Use this book's key terms to search within this book, across our collection, or across the Web. Skim This Chapter Skim this chapter and use this chapter's key terms to search within this book. Reference Finder Paste in your own text to find books that relate to your topic. Page 421   E-mail  Facebook  Digg  Stumble  Twitter More The following HTML text is provided to enhance online readability. Many aspects of typography translate only awkwardly to HTML. Please use the page image as the authoritative form to ensure accuracy. Index A Accidental exposure, 42, 139-140 Acute effects, dermatological, 157-167 genital injury, 39, 160, 175, 219,221 of nitrogen mustard, 77-78 ocular, 133-139 respiratory tract, 115-118, 125-126, 127, 399-412 of sulfur mustard, 22, 25, 34, 75-78, 82 Acute nonlymphocytic leukemia (ANL), 102-103, 393-395 African Americans, 36, 41-42 Alexander, Stewart, 44 Animal studies, 222-224 blood disorders, 187-188 carcinogenicity, 88-97, 171-172, 391-396 dermatological effects, 162-164, 167, 171-172 gastrointestinal disorders, 187 immunity disorders, 181-183 ocular effects, 139 reproductive toxicity, 189-190, 192-194 respiratory effects, 117, 118 Anxiety disorders, 200, 207, 211 Arm chamber tests, 40 Arsenals, 3-4, 40-43, 55, 120, see also Edgewood Arsenal; Occupational exposure Arsenic and arsenic compounds, 86-87, 172-173, 192-193 see also Lewisite Asbestos, 126, 407 Asthma, 119, 336, 409-410 B Bainbridge, MD, Navy Training Center, 372-373 Bari harbor, Italy, disaster, 4, 10, 43-44, 184-185 Basic training, see Training exercises Battlefield use, 9-10, 47-48, 142, 173 exposure levels, 33 Page 421 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)

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Veterans at Risk: The Health Effects of Mustard Gas and Lewisite Index A Accidental exposure, 42, 139-140 Acute effects, dermatological, 157-167 genital injury, 39, 160, 175, 219,221 of nitrogen mustard, 77-78 ocular, 133-139 respiratory tract, 115-118, 125-126, 127, 399-412 of sulfur mustard, 22, 25, 34, 75-78, 82 Acute nonlymphocytic leukemia (ANL), 102-103, 393-395 African Americans, 36, 41-42 Alexander, Stewart, 44 Animal studies, 222-224 blood disorders, 187-188 carcinogenicity, 88-97, 171-172, 391-396 dermatological effects, 162-164, 167, 171-172 gastrointestinal disorders, 187 immunity disorders, 181-183 ocular effects, 139 reproductive toxicity, 189-190, 192-194 respiratory effects, 117, 118 Anxiety disorders, 200, 207, 211 Arm chamber tests, 40 Arsenals, 3-4, 40-43, 55, 120, see also Edgewood Arsenal; Occupational exposure Arsenic and arsenic compounds, 86-87, 172-173, 192-193 see also Lewisite Asbestos, 126, 407 Asthma, 119, 336, 409-410 B Bainbridge, MD, Navy Training Center, 372-373 Bari harbor, Italy, disaster, 4, 10, 43-44, 184-185 Basic training, see Training exercises Battlefield use, 9-10, 47-48, 142, 173 exposure levels, 33

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Veterans at Risk: The Health Effects of Mustard Gas and Lewisite Iran-Iraq war casualties, 48, 117, 122, 170, 185, 191 WWI casualties, 9, 47, 48, 101-102, 121-122, 135, 137, 140-142, 183 -184, 203, 335-337 Beryllium, 124-125, 406-407 Birth defects, 189-195 Blindness, 140-141 Blisters, 151, 159, 167, 168 Blood counts, 68, 183-185 Blood disorders, 187-188, 220, see also Bone marrow injury; Leukemia Bone marrow injury, 77-78, 167-168, 183-186, 187, 220 Bowen's disease, 169, 171, 172-173 British Anti-Lewisite (BAL), 79, 85, 139 Bronchitis, 119-120, 121-122, 124, 127, 408-409 Bronchopneumonia, 117, 184, 335 Bureau of Mines, 26 C Camp Sibert, Alabama, 67 Cancer, 4-5, 64, 216-218 respiratory tract, 216, 396-397 skin, 168, 169-170, 171-173, 175, 216-218, 219, 396 see also Carcinogenicity; Chemotherapy; Leukemia Carcinogenicity, 81-82, 88-97, 171-172, 391-396 battlefield exposure, 101-102 of Lewisite, 171-173, 174-175, 216 occupational exposure, 97-101, 103-104, 105, 169-170, 172-173, 397 of sulfur mustard, 47, 78, 82-85, 102, 104, 105, 168-170, 216, 390 -392, 395-397 Cardiovascular diseases, 64 Causality, 4, 19 Centers for Disease Control (CDC), recommended exposure levels, 33 Chamber tests, 3, 10, 31-33, 35-40, 52-55, 120-121, 379 cancer risk, 105, 216 psychological effects, 211, 221 treatment of subjects, 65-69 Chemical Stockpile Disposal Program, 49-50 Chemical Warfare Service (CWS), 3-4, 27-29, 31 arsenals, 3-4, 40-43, 55, 120 chamber tests, 39-40 field tests, 66, 373 records, 7, 373-374, 375-377 see also Edgewood Arsenal Chemotherapy, mustard agents use in, 44-45, 77, 102-103, 122 Chlorine gas, 124, 400-402 Civilian workers, 7, 42-43, 225 Claims, see Disability claims Claustrophobia, 206 Cleft lip and palate, 191 Clothing, see Protective clothing Coercion of test subjects, 65-66, 67-68 Combat fatigue, 203 Committee on Medical Research (CMR), 17, 30, 339 Committee on the Treatment of Gas Casualties (CTGC), NRC, 30-31, 42, 339 Conjunctivitis, 144, 219, 336 Contact lenses, 144 Corneal damage, 133, 135-145 passim, 218-219 Cotton dust, 124, 403-405, 410-411

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Veterans at Risk: The Health Effects of Mustard Gas and Lewisite CWS, see Chemical Warfare Service Cytotoxicity, of Lewisite, 86 of sulfur mustard, 75-77, 85 D Department of Defense (DoD), 7, 225-226 Department of Veterans Affairs (VA), 1-2, 6, 51, 204, 224-226 Depression, 207 Dermatological effects, see Skin disorders and injury Disability claims, 1-2, 10-11, 28, 66 Diseases, listing, 4-5, 217 self-reported, 64-65, 384-385 in VA determination guidelines, 2 Disposal of chemical weapons, 33, 48-50 DNA damage, from arsenite, 86-87 from sulfur mustard, 75-77, 83-84, 163-164, 216 Documentation, classification of, 7-8, 51-52, 226 foreign sources, 18-19 long-term effects, 2, 5-6, 214-215 personnel records, 7, 11, 66-67, 225, 370-377 of tests, 17-18, 215, 371 VA guidelines, 2, 11 Drods, 35 Drop tests, see Patch tests E Edgewood Arsenal, 28, 39-40, 42, 46, 140, 376-377 Emphysema, 119-120, 121, 127, 336, 408-409 Erythema, 159 as chamber test end point, 36, 39, 40 Exposure levels, 3, 33, 34, 215 chamber tests, 39-40, 52-55 patch tests, 35 Eye disease and injury, 4-5, 131-132, 142-145, 218-219 acute effects, 133-139 battlefield exposure, 135, 137, 140-142 from Lewisite, 137, 138, 144-145, 219 occupational exposure, 139-140 from sulfur mustard, 133-144, 218-219 treatment, 143-144 F Field tests, 3, 31, 32, 40-41, 66 Follow-up of test subjects, 34, 6-8, 50-52, 224-225 roster development, 370-377 France, WWI gas casualties, 140 G Gas chamber tests, see Chamber tests Gas masks, 3, 36n, 43, 52-55, 215 Gas neurosis, 203 Gastrointestinal disorders, 64, 187, 220 Genetic damage, from Lewisite, 86-87, 104, 192-195 from sulfur mustard, 46-47, 75-77, 83-85, 104, 189-192, 216 Genital injury, 39, 160, 175, 219, 221 Germany, mustard gas use, 9-10 weapons production workers, 169

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Veterans at Risk: The Health Effects of Mustard Gas and Lewisite Gilchrist, Harry L., 28, 29 Glutathione depletion, 77 H Heat stress, 205n Hematopoietic depression, see Bone marrow injury Hodgkin's disease, 45 Hypervigilance, 210 I Immunity disorders, 179-186, 220 battlefield exposure, 183-186 from sulfur mustard, 181-186 Incineration of chemical stockpiles, 49-50 Iran-Iraq War, 48, 117, 122, 170, 185, 191 Isocyanates, 124, 405 J Japan, weapons factory workers, 97-99, 119-120, 169-170, 172, 190-191 Japanese Americans, 36 Johns Hopkins University Medical School, 42 K Keratitis, 137, 139, 140, 141-142, 144, 219 L Leukemia, 102-103, 216, 218, 393-395 Leukopenia, 184-185 Levinstein process, 71-72 Lewis, W. Lee, 25-26 Lewisite, blood effects, 187-188 carcinogenicity, 171-173, 174-175, 216 chemistry and properties, 24, 25-26, 78-79, 84 cytotoxicity, 86 dermatological effects, 153, 164-167, 171-175 gastrointestinal effects, 187 genetic damage, 86-87, 104, 192-195 neurological effects, 188 occupational exposure, 172-173 ocular effects, 137, 138, 144-145, 219 odor threshold, 53 production, 26, 41 reproductive toxicity, 192-195 respiratory effects, 117-118 stockpiles, 48 Limbal vascular damage, 142-143 Lymphosarcoma, 45 M Man-break tests, 36, 39, 65 Medical exposure, 122-123, 142, 170-171, 173, 393-395 chemotherapy, 77, 102-103, 122 Military personnel, CWS units, 4, 7, 41, 225 Mood disorders, 200 Mutagenicity, of sulfur mustard, 46-47, 84-85, 190-191 N National Defense Research Committee (NDRC), 17, 30, 339 National Personnel Record Center (NPRC), 371-372

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Veterans at Risk: The Health Effects of Mustard Gas and Lewisite National Research Council (NRC), 26, 338-339 Committee on the Treatment of Gas Casualties (CTGC), 30-31, 42, 339 Naval Research Laboratory (NRL), chamber tests, passim, 36-40, 67 -68, 371-373 records, 371-373, 374-375, 376-377 Nerve agents, 46, 206, 380 Neurasthenic conditions, 28 Neurological disorders, 65, 188, 220 Nicotinamide adenine dinucleotide (NAD) depletion, 77 Nitrogen mustard, acute effects, 77-78 carcinogenicity, 77-78, 102-103, 104-105, 216-218, 392-393, 395-396 chemistry, 24 as chemotherapy agent, 44-45, 77, 102-103, 122 dermatological effects, 156, 170 respiratory effects, 122 wartime production, 41 Nuremberg Codes of 1947, 379-381 O Occupational exposure, 3-4, 7, 42-43, 55, 120, 140, 215, 221-222, 225 carcinogenicity, 97-101, 103-104, 105, 169-170, 172-173, 397 chlorine gas, 401 dermatological effects, 168-170, 172-173 to Lewisite, 172-173 ocular effects, 139-140 reproductive toxicity, 190-191, 194 respiratory effects, 119-120 to sulfur mustard, 97-101, 119-120, 139-140, 168-170 Ocular effects, see Eye disease and injury Ocular epithelial damage, 144 Odor thresholds, 53 Office of Scientific Research and Development (OSRD), 17, 29-30, 339 Ointments and salves, 10, 35 Online databases, 14-15, 16, 17 Operation TOP HAT, 379-380 P Patch tests, 10, 31, 33, 35, 66, 171 Physical examinations, 68 Pigmentation disorders, 156-157, 168, 169, 175 Pneumonia, 119 Post-traumatic stress disorder (PTSD), 200-204, 207-208, 211 Post-WWI period (1919-1940), chemical weapons use, 9-10 research programs, 28-29 Post-WWII period, chemical weapons use, 47-48 research programs, 45-47 Production, see Arsenals; Occupational exposure Protective clothing, 10, 36-40, 52, 205n Psoriasin, 170-171 Psychoactive drug testing, 46, 378-380 Psychological disorders, 5, 65, 199-211, 221 see also Post-traumatic stress disorder Pulmonary fibrosis, 122-123

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Veterans at Risk: The Health Effects of Mustard Gas and Lewisite R Racial factors, dermatological effects, 158-159 Rapid screening of hazard (RASH) method, 395-396 Raritan Arsenal, 49 Reproductive toxicity, 189-195, 220-221 of Lewisite, 192-195 occupational exposure, 190-191, 194 of sulfur mustard, 189-192, 220-221 Respiratory tract effects, 4-5, 112-115, 117, 118, 123-127, 218, 399-412 acute, 115-118, 125-126, 127, 399-412 battlefield exposure, 117, 120-122, 335-337 cancer, 216, 396-397 Lewisite, 117-118 of nitrogen mustard, 122 occupational exposure, 119-120 sulfur mustard, 115-123, 127, 218 Reverse assembly, 49 S Scarring, 152, 160, 168, 219 Secrecy oath, 1, 7-8, 65-66, 226 Septicemia, 117 Service records, 7, 11, 66-67, 225, 371-377 Sexual dysfunction, 5, 65, 175, 219, 221 Shell shock, 203 Silicosis, 125, 407 Sister chromatid exchange (SCE) elevation, 84, 86 Skin disorders and injury, 4, 64, 148-157, 162-164, 167-168, 171-172, 174-175, 219-220 acute effects, 157-167 battlefield exposure, 170, 173 cancer, 168, 169-170, 171-173, 175, 216-218, 219, 396 from Lewisite, 153, 164-167, 171-175 from nitrogen mustard, 156, 170 occupational exposure, 168-170, 172-173 sulfur mustard, 151, 153, 154, 156-164, 167-171, 174, 175 see also Erythema Smoking, 101-102, 411 S.S. John Harvey, 43 Stockpile disposal, 33, 48-50 Stress effects, 204-211, 221 Sulfhydryl peptide depletion, 77 Sulfur dioxide, 123, 402 Sulfur mustard, acute effects, 22, 25, 34, 75-78, 82 carcinogenicity, 47, 78, 82-85, 102, 104, 105, 168-170, 216, 390-392, 395-397 chemistry and properties, 22, 24, 71-78 cytotoxicity, 75-77, 85 dermatological effects, 151, 153, 154, 156-164, 167-171, 174, 175 development, 22, 25 genetic damage, 46-47, 75-77, 83-85, 104, 189-192, 216 immunity effects, 181-186 mutagenicity, 46-47, 84-85, 190-191 occupational exposure, 97-101, 119-120, 139-140, 168-170 ocular effects, 133-144, 218-219 odor threshold, 53 production, 41 reproductive toxicity, 189-192, 220-221 respiratory effects, 115-123, 127, 218

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Veterans at Risk: The Health Effects of Mustard Gas and Lewisite stockpiles, 48-49 WWI casualties, 9, 47, 48, 101-102, 121-122, 135, 137, 140-142, 183 -184, 335-337 WWI casualty studies, 335-337 WWI use, 9 T Testing, see Animal studies; Chamber tests; Field tests; Patch tests Three-Mile Island accident, stress effects, 209-210 Training exercises, 31, 42 Treatment of test subjects, 65-69, 211 Tuberculosis, 336-337 U Uniformed Services University of the Health Sciences (USUHS), 204-205 Unitary munitions stockpiles, 49 United Kingdom, weapons factory workers, 99-101, 119, 139-140, 170 WWI veterans, 101, 121-122, 140 U.S.S. Bistera, 43-44 V VA, see Department of Veterans Affairs Vapor cup tests, 35 Vedder, E.B., 28 Vietnam War, post-traumatic stress syndrome, 204, 207 W War Department, see Chemical Warfare Service (CWS) Wear tests, 40 Women in CWS supply units, 41-43 Women's Army Auxiliary Corps, 41-42 World War I (WWI), combat stress reactions, 203 gas casualties, 9, 47, 48, 101-102, 121-122, 135, 137, 140-142, 183 -184, 335-337 research programs, 26-28

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Representative terms from entire chapter:

occupational exposure