Nerve agents human exposure

In the approximately 70 years since the discovery of the toxic G agents and 50 years since the subsequent development of the V agents, humans have only occassionally served as test subjects in laboratory studies designed to determine threshold toxic effects associated with low-level (nonlethal) sarin and VX vapor exposures (2-10 min) (Johns, 1952 Sim, 1956 Bramwell et al., 1963). In addition, although the toxic effects of accidental exposures and nonexperimental exposures from terrorist or military attacks are documented, critical information related to the exposure conditions can only be estimated at best. Thus, estimates of human dose-responses to nerve agent vapor exposures from such sources are often associated with significant uncertainty and are of limited utility in predicting health hazard risks. 

DF and its precursor, DC are organophosphonic acids. They will react with alcohols to form crude lethal nerve agents, such as crude GB. High overexposure may cause inhibition of cholinesterase activity. Although much less toxic than GB, DF and DC are toxic and corrosive materials. Because DF and DC are relatively volatile compounds, the primary route of exposure is expected to be the respiratory system. However, ingestion also results from inhalation exposures in animals and could occur in humans. DF and DC vapors have a pungent odor and may cause severe and painful irritation of the eyes, nose, throat, and lungs. Data provided is for DF only, DC has similar properties. 

Target Organ Toxicity. -Hexane exposure is documented to cause toxicity in peripheral nerves of humans (both sensory and motor). In rats, -hexane exposure causes toxicity in the peripheral and central nervous system and in male reproductive tissues. Effects on respiratory tissue have been observed in mice and rabbits. The toxic agent in nervous system and reproductive tissues is believed to be the -hexane metabolite 2,5-hexanedione (Graham et al. 1995). 

This paper will review the known metabolic pathways of CW agents, excretion profiles where these have been measured, and methods for the analysis of metabolites in urine or blood. Examples are provided of detection in cases of human exposure. The review focuses mainly on sulfur mustard and nerve agents that represent the greatest global CW threat, and for which most analytical methods have been developed. 

Level 1 Laboratories. Ten laboratories participate in Level 1 activities. At this level, personnel are trained to detect exposure to an expanded number of chemicals in human blood or urine, including all Level 2 laboratory analyses, plus analyses for mustard agents, nerve agents, and other toxic chemicals. 

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