Lewisite health effects

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

Israeli, M., and C.B. Nelson. 1992. Distribution and expected time of residence for U.S. households. Risk Anal. 12 65-72. lOM (Institute of Medicine). 1993. Veterans at Risk The Health Effects of Mustard Gas and Lewisite. Washington, D.C. National Academy Press. 

Table 3.7 Health effects of lewisite and mustard-lewisite mixture...

Pechura, C. M., Rail, D. P. (Eds.). (1993). Veterans at risk The health effects of mustard gas and lewisite. Washington, DC National Academy Press. 

Institute of Medicine Committee to Survey the Health Effects of Mustard Gas and Lewisite. Veterans at Risk. Washington, DC National Academy Press 1993. 

Adverse health effects caused by lewisite depend on the amount people are exposed to, the route of exposure, and the length of time that people are exposed. 

Most information on the health effects of lewisite is based on animal studies. 

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. 

DHHS (US Department of Health and Human Services) (1988). Final recommendations for protecting the health and safety against potential adverse effects of long-term exposure to low doses of agents GA, GB, VX, mustard agent (H, HD, HT), and lewisite (L). US Department of Health and Human Services, Centers for Disease Control. Fed. Reg. 53(50) 8504-7. 

After sulfur and nitrogen mustards are absorbed and interact with body tissues, they are no longer intact molecules. Therefore, unlike nerve gas victims, the body fluids of decontaminated mustard-exposed patients pose no risk to health care providers or other responders (2). In contrast to the other vesicants, Lewisite does not require a cyclization reaction, so its effects are immediate. Through direct inhibition of thiol-containing enzymes. Lewisite disrupts energy pathways, causing ATP depletion, cell death, and clinical effects (15). 

An antidote is available for lewisite exposure. BAL (British-Anti-Lewisite dimercaprol) was developed by the British during World War II. The antidote is produced in oil diluent for intramuscular administration to counter the systemic effects of lewisite. There is no effect, however, on the skin lesions (eyes, skin, and respiratory system) from the antidote. Mustard agents (H), (HD), (HS), and (HT), like nerve agents, would be classihed as Class 6.1 poisons by the DOT and would have NFPA 704 designations of health 4, flammability 1, reactivity 1, and special... 

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