Urine nerve agents analysis

Presently available methods to diagnose and biomonitor exposure to anticholinesterases, e.g., nerve agents, rely mostly on measurement of residual enzyme activity of acetylcholinesterase (AChE) and butyrylcholinesterase (BuChE) in blood. More specific methods involve analysis of the intact poison or its degradation products in blood and/or urine. These approaches have serious drawbacks. Measurement of cholinesterase inhibition in blood does not identify the anticholinesterase and does not provide reliable evidence for exposure at inhibition levels less than 20 %. The intact poison and its degradation products can only be measured shortly after exposure. Moreover, the degradation products of pesticides may enter the body as such upon ingestion of food products containing these products. 

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. 

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