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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

were also produced at the arsenals. Other personnel were involved in biological warfare research and production, in locations such as Fort Detrick, Maryland, and a civilian plant in Terre Haute, Indiana (Brophy and Fisher, 1959). Chemicals including napalm and white phosphorus were also stored and packed into bombs by CWS personnel. Even the production and testing of gas masks and filter canisters involved the use of toxic chemicals such as asbestos.4 Finally, many people, including women, were assigned duties in the preparation of impregnated clothing, the most common method of which involved the use of two extremely toxic chemicals, chloroamide and acetylene tetrachloride.

The Bari Harbor Disaster

The only combat casualties from sulfur mustard in WWII were those injured or killed following a German air raid on the harbor of Bari, Italy, on December 2, 1943 (Alexander, 1947; Cochrane, 1946; Gage, 1946; Harris and Paxman, 1982; Infield, 1976; Perera and Thomas, 1986). Under conditions of secrecy, 2,000 bombs, each of which held 60 to 70 pounds of sulfur mustard, had been loaded on the merchant marine ship S.S. John Harvey before it had sailed from Baltimore to Bari. During the raid on Bari harbor, the John Harvey was sunk and some of its load of mustard bombs was damaged, causing liquid mustard to spill out into water already heavily contaminated with an oily slick from other damaged ships. Men who abandoned their ships for the safety of the water became covered with this oily mixture that provided an ideal solvent for sulfur mustard. The casualties were pulled from the water and sent to medical facilities unaware of what they carried with them on their clothes and skin. Equally unaware were the medical personnel who treated these casualties. Before a day passed, symptoms of mustard poisoning appeared in both the casualties and the medics. This disturbing and puzzling development was further compounded by the arrival of hundreds of civilians for treatment; they had been poisoned by a cloud of sulfur mustard vapor that blew over the city from some of the bombs that had exploded when the ship sank.

As the medical crisis worsened, little information was available about what was causing these symptoms. U.S. military command did not want to reveal to the enemy its preparations to position sulfur mustard in Europe for possible use against German forces. Eventually, however, the secret could not be kept (Harris and Paxman, 1982). The destroyer

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Canisters equipped with asbestos filters included the M9A1 and the M10A2 canisters (Brophy et al., 1959). The model numbers of canisters used in gas masks employed in the chamber or field tests are not known, but M9A1 canisters were in common use prior to July 1943 (Brophy et al., 1959).

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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)