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Introduction

Modern chemical warfare began in 1915 with the use of chlorine by Germany in a large-scale attack against the Allies near Ypres, Belgium. That incident during World War I led to increased efforts toward the development of more toxic chemical warfare (CW) agents (e.g., agents that are toxic following dermal absorption) as well as more effective protective gear (e.g., more effective gas masks). In July 1917, the blistering agent sulfur mustard was used by the German army for the first time as a CW agent (IOM, 1993). Almost 100,000 deaths and more than 1 million casualties were caused by the use of CW agents in World War I. The 1925 Geneva Protocol prohibited the use of chemical and biological weapons but did not address their development, production, and storage. Unfortunately, the use of CW agents continued. There is strong evidence that they were used by Italy against Ethiopia (1935-1936), by Japan against China (1939-1944), and by Iraq against Iran as well as against the Kurdish population (1983-1988). The threat of chemical warfare by Iraq was reported during the Persian Gulf War in 1991. Therefore, CW agents are considered possible contaminants of field drinking-water supplies for military personnel during military conflicts (Lawrence Livermore National Laboratory, 1990a).

CW agents that might appear in field drinking water following a military attack include 3-quinuclidinyl benzilate (BZ), organophosphorus



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Guidelines for Chemical Warfare Agents in Military Field Drinking Water 1 Introduction Modern chemical warfare began in 1915 with the use of chlorine by Germany in a large-scale attack against the Allies near Ypres, Belgium. That incident during World War I led to increased efforts toward the development of more toxic chemical warfare (CW) agents (e.g., agents that are toxic following dermal absorption) as well as more effective protective gear (e.g., more effective gas masks). In July 1917, the blistering agent sulfur mustard was used by the German army for the first time as a CW agent (IOM, 1993). Almost 100,000 deaths and more than 1 million casualties were caused by the use of CW agents in World War I. The 1925 Geneva Protocol prohibited the use of chemical and biological weapons but did not address their development, production, and storage. Unfortunately, the use of CW agents continued. There is strong evidence that they were used by Italy against Ethiopia (1935-1936), by Japan against China (1939-1944), and by Iraq against Iran as well as against the Kurdish population (1983-1988). The threat of chemical warfare by Iraq was reported during the Persian Gulf War in 1991. Therefore, CW agents are considered possible contaminants of field drinking-water supplies for military personnel during military conflicts (Lawrence Livermore National Laboratory, 1990a). CW agents that might appear in field drinking water following a military attack include 3-quinuclidinyl benzilate (BZ), organophosphorus

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Guidelines for Chemical Warfare Agents in Military Field Drinking Water nerve agents (GA, GB, GD, and VX), sulfur mustard agents, T-2 toxin (a fungal metabolite recently identified as a possible CW agent), lewisite (an arsenical vesicant), and cyanide. Other CW agents might also contaminate water supplies, but this report reviews the toxicity and drinking-water standards of only the CW agents listed above. Because of the Army's concern for the potential exposure of military personnel to CW agents, the Army requested that the National Research Council (NRC) review the toxicity of the CW agents and assess the appropriateness of the proposed field drinking-water-quality standards for these agents. Most of the standards were proposed by the Army in collaboration with the Lawrence Livermore National Laboratory (1988, 1990a,b). The Army's recommended standards for the CW agents of concern are applicable only to military personnel deployed in the field. They are meant to protect military personnel against acute adverse health effects or performance-degrading effects resulting from the ingestion of contaminated field drinking water. The Army's assumptions in deriving short-term field drinking-water standards are that military personnel consume 5-15 liters (L) of water per day, that they might be exposed for up to 7 days, and that the field drinking water contains no other toxic materials. The NRC assigned this task to the Committee on Toxicology (COT). COT's Subcommittee on Guidelines for Military Field Drinking-Water Quality reviewed and assessed (1) the potential health effects associated with ingestion of each of the CW agents of concern, and (2) the Army 's criteria for establishing revised field drinking-water standards. Based on the review, the subcommittee determined the adequacy of the field drinking-water standards for the CW agents of concern and recommended revisions, as needed, to those standards. In addition, the NRC was asked to take into consideration the Army's assumptions concerning consumption of contaminated field drinking water and duration of exposure. Neither the existence or performance of water-quality monitoring devices nor the efficiency of water-purification equipment was a consideration in the subcommittee's recommendations for field drinking-water guidelines for CW agents. Similarly, the recommended guidelines are not intended to protect against late-appearing health effects such as carcinogenesis or teratogenesis. However, the report calls attention to data on potential carcinogenicity or genotoxicity whenever it appears that such data would be useful to field commanders.

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Guidelines for Chemical Warfare Agents in Military Field Drinking Water In this report, the subcommittee's recommendations on acceptable exposure levels for CW agents in field drinking water are referred to as “guidelines” rather than “standards” for field drinking-water quality. The term “standards” implies a regulatory limit that cannot be exceeded. The subcommittee believes that the use of the term “guidelines” provides the necessary flexibility to field commanders who must weigh the application of exposure recommendations against the need for adequate hydration, combat readiness, and mission success. The subcommittee reviewed the Army's criteria for developing field drinking-water standards and generally agrees with the criteria (see Appendix A). Therefore, the subcommittee did not develop its own criteria for establishing guidelines for CW agents in military field drinking water. Field drinking-water guidelines recommended for the CW agents by the subcommittee are intended to protect essentially all military occupational specialties. The recommended guidelines are not applicable to populations of civilians and do not represent water-quality standards for drinking water treated at fixed water-purification installations. It should be noted that the intent of this report was not to review the toxicity of the CW agents in detail but to determine the adequacy of the Army's proposed field drinking-water standards. For greater detail on the toxicity of the CW agents, the reader is referred to the reports of the Lawrence Livermore National Laboratory (1988, 1990a,b) and the U.S. Army (1988, 1990a). The Army has indicated that it plans to submit the NRC's field drinking-water guidelines to a triservice (Army, Navy, and Air Force) medical review panel for formal adoption as joint service standards. The standards might then be submitted for incorporation into the North Atlantic Treaty Organization's Standardization Agreements and the Quadripartite Standardization Agreements. The report is organized as follows: 3-quinuclidinyl benzilate (BZ) is discussed in Chapter 2, organophosphorus nerve agents in Chapter 3, sulfur mustard in Chapter 4, T-2 toxin in Chapter 5, lewisite in Chapter 6, and cyanide in Chapter 7. Appendix A describes the criteria used by the Army to establish field drinking-water standards and the subcommittee's evaluation of the criteria. Appendix B contains a discussion on the current capability to detect CW agents in field drinking water.

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Guidelines for Chemical Warfare Agents in Military Field Drinking Water This page in the original is blank.