. "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
stands alone among sections of the Department of Defense in the maintenance of files and reports, and the sharing of those files with this committee and with the affected veterans.
The levels of exposure to mustard agents or Lewisite experienced by the test human subjects may have been much higher than inferred in the summaries of the experiments and field tests. As in all chemical exposures, such exposure levels directly relate to the types and severities of exposure-induced injuries and diseases. One can infer the cumulative exposures to the skin of chamber subjects strictly on the basis that skin damage was the end point of these experiments (see Table 3-4). Therefore, if all other types of exposures were held to zero, these subjects received between 100 and 300 Ct. As has been documented, some of the subjects were hospitalized for as long as "a month or so" (Taylor et al., 1943). Thus, exposures to the skin may have been as high as 1,000-2,000 Ct. Under the hot, humid conditions in the chambers, however, lower exposure levels would have resulted in similar injuries (Papirmeister et al., 1991). The dose to the skin from such exposures would have been as high as those observed under battlefield and occupational conditions. Further, some sulfur mustard would also have been absorbed from the skin into the systemic circulation.
In the chamber experiments, unmasked subjects were required to remain in their protective clothing from 4 to 24 hours following chamber trials, allowing ample opportunity for additional contact and inhalation exposures from contaminated surfaces and clothing. Another factor that probably resulted in some inhalation exposure of subjects in the chamber tests was vomiting during the period subjects were in the chamber. This was reported by at least one of the subjects who spoke at the public hearing; this person reported conjunctivitis and laryngitis following such a vomiting incident on his seventh day of testing (Elmer Hood, public hearing statement; see also Appendix G). Vomiting presumably would result in removal of the mask while in the chamber, with a resulting inhalation exposure of unknown duration at the chamber concentration being tested.
The most important route of additional exposure in the chamber and field tests was probably gas mask leakage. From the information available to the committee, it appears that the vast majority of the human subjects in the chamber and field tests wore full-face gas masks during their exposures. In fact, the documented exposures at the Naval Research Laboratory were delivered at concentrations and for durations that would have caused lethal respiratory effects if the subjects had not been equipped with respiratory protection. Thus, exposure of the respiratory tract and eye to the agent would have depended on the