Lewisite effects

Lewisite effects on the airway are similar to sulfm and nitrogen mustard, except that Lewisite is extremely irritating to the mucus membranes. The immediate, profound irritation of the mucus membranes may drive victims away from the dispersal site, thus helping to limit exposme (8). Exposme to high concentrations of Lewisite results in pulmonary edema (8). 

In its stndy of mnstard and Lewisite effects, the Institute of Medicine concluded that, following mustard exposure ... 

One such decontaminant is supertropical bleach (STB). STB is a mixture of chlorinated lime and calcium oxide containing about 30% available chlorine. It can be used either as a dry mix or as a slurry to decontaminate some equipment surfaces and terrain. The dry mix is prepared with two parts bleach to three parts earth by volume. A slurry typically consists of 40 parts STB to 60 parts by weight of water. This material is then sprayed or swabbed on the contaminated surface (see Bleaching agents). STB is an effective decontaminant for mustard, lewisite, and VX. It is less effective against nerve agents other than VX. 

Rapid hydrolysis aids in lowering the duration of effectiveness of toxic chemical agents. For example, in the presence of water or water vapor, lewisite (L) rapidly hydrolyzes. Therefore, it has a shorter duration of effectiveness than distilled mustard (HD). 

The rate of action of a chemical agent is the rate at which the body reacts to or is affected by that agent. The rate varies widely, even to those of similar tactical or physiological classification. For example, blister agent HD causes no immediate sensation on the skin. Skin effects usually occur several hours later (some cases result in delays of 10-12 days before symptoms appear). In contrast, lewisite produces an immediate burning sensation on the skin upon contact and blistering in about 13 h. Decontamination immediately (within 4-5 min) will prevent serious blister agent effects. 

Tissue damage occurs within minutes of exposure to vesicants, but clinical effects may not appear for up to 24 hours. Mixtures such as HL (C03-A010) contain lewisite (C04-A002) and will produce an immediate burning sensation on contact with the skin or eyes. Some agents are rapidly absorbed through the skin and extensive skin contamination may cause systemic damage. 

Antidotes British Anti-Lewisite (BAL) can be given by intramuscular injection as an antidote for systemic effects but has no effect on the local lesions of the skin, eyes, or airways. Treatment consists primarily of supportive care. 

Treatment—Patients should be decontaminated immediately prior to treatment using the decontamination method presented in Section 7.3.2. British Anti-Lewisite (BAL) dimercaprol antidote will alleviate some effects. It is available as a solution in oil for intramuscular administration to counteract systemic effects. It is not manufactured currently in the forms of skin and eye ointments.2... 

British Anti-Lewisite dimercaprol alleviates some effects (Ellison 2000)... 

Dimercaprol (BAL, British Anti-Lewisite) was developed in World War 11 as an antidote against vesicant organic arsenicals (B). It is able to chelate various metal ions. Dimercaprol forms a liquid, rapidly decomposing substance that is given intramuscularly in an oily vehicle. A related compound, both in terms of structure and activity, is di-mercaptopropanesulfonic acid, whose sodium salt is suitable for oral administration. Shivering, fever, and skin reactions are potential adverse effects. 

Arsine derivs used by the Germans were not as effective as Lewisite. They included a) Dic ,US designation EDt ethyldicbloroarsine... 

CDC (Centers for Disease Control and Prevention). 1988. Final Recommendations for Protecting Health and Safety Against Potential Adverse Effects of Long-Term Exposure to Low Doses of Agents GA, GB, VX Mustard Agent (H, HD, T) and Lewisite (L). Federal Register, Vol. 53, No. 50, March 15. 

IOM (Institute of Medicine). 1993. Veterans at Risk The Health Effects of Mustard and Lewisite. Washington, D.C. National Academy Press. 

Lewisite 1 was used for spiking in the sixth and in the ninth proficiency test. The participants that failed to identify lewisite 1 did not describe an effective lewisite 1 sample preparation procedure (12) in their analysis report, which could indicate that no such procedure had been employed. The participants performances in the identification of lewisite 1 are summarized in Table 3. 

M. Goldman and J.C. Dacre, Lewisite its chemistry, toxicology, and biological effects, Rev. Environ. Contam. Toxicol., 110, 75-115 (1989). 

Arsine derivs used by the Germans were not as effective as Lewisite. They included a) Dick,US designation ED, ethyldichloroOrsine C,H, -AsCl, (Ref, p 194) b)C/ar / (US designation DA) biphenylchloroarsine,... 

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