Chemical Warfare Agents: Emergency Medical and Emergency Public Health Issues☆,☆☆,★,★★
Section snippets
INTRODUCTION
The threat of exposure to chemical warfare agents (CWAs) has traditionally been considered a military issue. Several recent events, however, have demonstrated that civilians may also be exposed to these agents.1, 2, 3 Potential sources of exposure for civilian populations include acts of terrorism, inadvertent releases from domestic chemical weapon stockpiles, direct military attacks, and industrial accidents. The intentional or unintentional release of a chemical warfare agent in a civilian
Terrorism
Terrorism has been defined as the use or threat of violence to sow panic in a society, to weaken or overthrow its leaders, and to bring about political change.4 Terrorists have previously used more conventional means of violence, such as bombings, assassinations, and hostage taking, to promote their causes. Several recent events have demonstrated that some terrorists now have access to weapons of greater lethality, including chemical, biological, and radiological agents.2, 3, 4, 5, 6 Terrorists
OVERVIEW OF CWA CLASSIFICATION AND CHARACTERISTICS
CWAs are broadly classified as nerve agents, vesicants, pulmonary agents, and cyanides (formerly “blood agents”). In addition to their more familiar generic names, chemical weapons are also referred to by military designator codes (Table).
Category Common Name US Military Code Nerve agents Tabun GA Sarin GB Soman GD VX Vesicants Sulfur mustard HD Lewisite L Phosgene oxime CX Pulmonary agents Phosgene CG Chlorine CL Cyanides Hydrogen cyanide AC Cyanogen chloride CK
ISSUES IN DISASTER PREPAREDNESS
It is widely acknowledged that most prehospital and emergency medical personnel in the United States are currently not well prepared, trained, or equipped to deal with incidents involving chemical, biological, or nuclear weapons.7, 27, 29, 48, 49 Recent field and tabletop exercises have exposed serious deficiencies in preparedness and major problems of coordination.11, 27 Any emergency medical or public health response to a major incident involving a CWA will require coordination and
PRINCIPLES OF EMERGENCY RESPONSE AND MEDICAL TREATMENT
Regardless of whether civilian exposure to a CWA is the result of terrorism, a release from the military stockpile, or an industrial incident, a multidisciplinary approach will be necessary to address emergency medical and emergency public health needs. Coordination among prehospital personnel, law enforcement, emergency physicians, public health specialists, toxicologists, laboratorians, environmental engineers, and security personnel will be required.
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Cited by (116)
Chemical warfare agents: An outlook on past and present technologies
2022, Sensing of Deadly Toxic Chemical Warfare Agents, Nerve Agent Simulants, and their Toxicological AspectsAdsorption of cyanogen halides (X-CN; X = F, Cl and Br) on pristine and Fe, Mn doped C<inf>60</inf>: A highly potential gas sensor
2021, Materials Today CommunicationsCitation Excerpt :Cyanide is a potential weapon of terror [1] and traditionally known poison. Historically, cyanide has been used as a chemical warfare agent [2–4] and also as a possible potential candidate for terrorist attacks [5]. The interaction of human to cyanide in day-to-day life is very common due to its board industrial applications such as rubber and plastic manufacturing, electroplating injury production, and as fumigants and pesticides [6–9].
Acute cyanide toxicity and its treatment: The body is dead and may be red but does not stay red for long
2020, Handbook of Toxicology of Chemical Warfare Agents
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From the National Center for Environmental Health, Centers for Disease Control and Prevention,* Atlanta, GA, and Center of Excellence in Disaster Management and Humanitarian Assistance, ‡Honolulu, HI; Department of Emergency Medicine, Baptist Medical Center, Menorah Medical Center, University of Missouri–Kansas City School of Medicine, Kansas City, MO§; and US Navy Medical Corps, Naval Medical Research Center Detachment, Lima, Peru.II
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Address for reprints: Richard J Brennan, MBBS, MPH, International Rescue Committee, 122 East 42nd Street, New York, NY 10168; 212-551-3000, fax 212-551-3180;E-mail [email protected].
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