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estimates of permissible exposure levels (CDC, 1988), the exposures actually reaching the breathing zone of chamber subjects (from the above example, 0.1 mg/m3 sulfur mustard breakthrough with a gas mask rated at 1,000 PF) may have been more than 1,000 times the general population agent control limits (0.0001 mg/m3 for sulfur mustard), and 33 times the control limits for occupational exposure (0.003 mg/m3 for sulfur mustard). In reality, some of the subjects in the chamber tests and field trials almost certainly breathed concentrations 10 or more times the 0.1 mg/m3 level for at least a part of their exposures.

The focus here on chamber and field test subjects is not meant to discount the probable exposure levels experienced by those who were involved in the production or handling of mustard agents and Lewisite. Indeed, as outlined above, the poor safety record of the Chemical Warfare Service during the peak years of production, the high rate of agent-induced injuries, and the anecdotal reports of perceptible odors of sulfur mustard in the manufacturing areas argue that workers and gas handlers were often exposed to levels of mustard agents and Lewisite sufficient to cause short- and long-term health effects. Thus, these individuals should also be considered at risk for any of the adverse health effects this report identifies.

In conclusion, the dose of sulfur mustard to the skin, eye, and respiratory tracts of the human subjects was substantial, especially in the case of the subjects involved in the chamber tests. Doses to the skin were probably equivalent to those received under combat conditions. Consideration of the probable gas mask leakage, additional exposures from contact or vapors from the clothing, accidents, and the documented signs and symptoms in the chamber test records indicate that the doses received by the human subjects were equivalent to those received in occupational exposures and, perhaps, even battlefield exposures.

REFERENCES

Adler FH. 1944. Report of consultant in ophthalmology on 6 cases of H vapor burns occurring at Bushnell Field Installation on April 20, 1944. Memo to Colonel C.P. Rhoads, dated May 1, 1944. Available at the National Archives, Suitland Reference Branch, Suitland, MD. Record Group 175, Group 4B, Folder 319.1.

Adley FE, Uhle RJ. 1969. Protection factors and self-contained compressed-air breathing apparatus. American International Hygiene Association Journal 30:355-359.

Alexander SF. 1947. Medical report of the Bari Harbor mustard casualties. Military Surgeon 101:1-17.

Andrus EC, Bronk DW, Carden GA Jr, Keefer CS, Lockwood JS, Wearn JT, Winternitz MC, eds. 1948. Advances in Military Medicine. Science in World War II: Office of Scientific Research and Development. Boston: Little, Brown and Company.


Balali-Mood M, Navaeian A. 1986. Clinical and paraclinical findings in 233 patients with sulfur mustard poisoning. In: Heyndricks B, ed. Terrorism: Analysis and Detection of



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