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

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. "4 Findings from the Public Hearing Process." 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

lymphatic diseases, and disturbances in immune function. There were also frequent reports of arthritis and bone disease, headaches, and muscle spasms. Finally, a few reported hair and tooth loss.

Quite frequent were reports of neurological disease and psychological difficulties. Neurological problems included multiple sclerosis and amyotrophic lateral sclerosis (degenerative diseases of the central nervous system), abnormal sensory disturbances, Alzheimer's disease, paralysis and weakness, and chronic pain, among others. Among those reporting psychological difficulties, some had been diagnosed with post-traumatic stress disorder, others experienced chronic depression or anxiety, and still others described themselves as being very nervous or tense. It should be noted that psychological problems and any sexual problems, such as those resulting from genital scars left by gas burns to the scrotum and penis, were often extremely difficult for the men to discuss, especially on the telephone or in person, and may well have been underreported.

Personal Aspects of Veteran Reports

Beyond the facts of their exposure and subsequent health problems, there were certain aspects of the veterans' experiences that are compelling and drew the attention of the committee. For example, men who participated in the chamber tests commonly reported that they had originally volunteered to ''test summer clothing" in exchange for extra leave time before being sent overseas. It was not until they arrived at the test location that they were told about the gas chamber tests and, even then, many were not told to what agent they would be exposed. Those who became sick during the "man-break" tests reported being threatened with court martial if they did not continue the test and reenter the gas chambers. Some even reported that they saw other subjects collapse in the chamber and that they never saw these men again after they were removed from the chamber. In all such cases, the men reported that they had assumed the person had died. Other men recalled that the chamber door could not be opened from the inside and that this frightened them by making them feel trapped.

In the majority of statements, experiences were related in such precise detail that a supportable conclusion could be drawn that many of these men experienced intense fear about what was happening to them during the tests. All the men in the chamber tests vividly recalled being told that they would be sent to prison if they ever revealed their participation in these tests. Some were even shown pictures of Fort Leavenworth to reinforce the threat of prosecution. They further reported that this possibility prevented them from telling their wives, parents, family doctors, or anyone else about what had happened to

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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)