THE
EFFECTS OF CHEMİCAL WARFARE AGENTS (CWA) ON
HEALTH Konuyu
Hazırlayan: Bio. İpek Niksarlı
What is a CWA?
Chemical warfare agents are chemical materials
that have a high toxicity potential that are used
for terror and to cause panic among civilian
personnel. These materials can: kill, wound and
weaken, have an incapacitating effect and
disable, destroy food and animal resources,
contaminate food stock and impair economically
important goals, inhibit the ability of military
and civilian personnel to move by forcing them to
wear protective clothing and vehicles.
Why are CWA’s used?
There are two main reasons for their use:
- Direct effect and destruction
- Indirect destruction (through the long
term wearing of protective masks and
clothing)
What forms do they come in?
In solids, liquids, gases and aerosol forms;
spread and dispersed through: spray containers,
spray tanks carried on helicopters and airplanes,
canons, rockets, missiles, mines, hand grenades
or airplane bombs.
Classification of CWA’s:
CWA’s are classified according to their
toxic characteristics as follows:
- Nerve agents
- Vesicants
- Pulmonary Irritants
- Incapacitating Agents
- Riot Control Agents
- Vegetation Destruction Agents
Entry into the organism
The effects of CWA’s can be seen
systemically or locally. Many are absorbed in
more than one way through the skin, the eyes, the
mouth or the airways.
Penetration Strengths
Many CWA’s have an extremely high
penetration strength through various materials.
Surgical gloves are permeable. Such synthetic
materials as butyl rubber and polyester are
impermeable.
What should be done when in contact with
CWA’s
- Detection and warning: The
qualitative and quantitative detection of
CWA’s.
- Protective measures: Gas
masks, protective and secure clothing and
shelters should be used on time and when
necessary.
- Preliminary treatment, first aid
and self -treatment :This
information has been given for every
substance.
- Decontamination: Difficult,
time consuming but an obligatory
procedure.
The goals of decontamination
methods:
Chemically to destroy, remove, limit the
physical blocks and damage of the toxic agent.
To wash, rinse, dry, absorb with absorbent
material, dry the chemical agents with
decontaminating agents to remove and clean them.
Personal Decontamination
- Skin contamination:
Speed is of the utmost importance. The
contamination must take place in less
than two minutes. Rubbing the skin during
washing procedures can increase the
absorption of the toxic agent.
- Eye contamination: Rinsing
with plenty of water and sterilized
saline solution is recommended.
Area Decontamination
The surface of the earth should be removed and
lime or a layer of lime should be spread over the
area.
Belongings, Supplies, Equipment
Decontamination
Hypocloride and DS2 substances are used.
Physical decontamination (cleaning belongings
through heating, hot air and boiling)
Food Decontamination
All contaminated food and liquids should be
destroyed. As a protective measure all food
should be placed in tightly closed aluminum, tin,
or glass containers.
5. Specific and Supportive
Measures
Substances used in CWA’s
- Nerve gases Developed as an
acetyl cholinesterase inhibitor. These
lethal agents are Tabun, Sarin, Soman and
VX and possess immediate and life
threatening effects.
Symptoms
- Elevation of muscarinic activity
- Nicotinic effects
- Central Nervous System symptoms
The first observable symptoms are:
- Running eyes
- Deep pain under the eyes
- Feeling of chest pressure, coughing
- Running nose
Treatment: In treating nerve
agents, a specific antidote called atropine and
an enzyme reactivator is used.
- Atropine: Adults: 2-5 mg. atropine
sulfate (i.v.) / Children: 0.05 mg/kg
atropine sulphate(i.v.)
- Oxime: Pralidoxime: Adults: 1-2g (i.v.) /
Children: 25-50 mg/kg
OR Obidoxime: 250 mg (i.v.) (i.m.)
*Diapezem implementation: The last step of
antidotal treatment.
Adults: 5-10 mg (i.v.) / Children:
0.25-0.4-mg/kg doses
2. Vesicants: General
tissue irritants with systemic effects. These are
mustard gases, nitrogen mustard gases and
lewisite, which have lethal effects and
incapacitate.
Mustard gas: This
group of agents is the most important. Two
minutes after coming in contact with the tissue
there is damage to the tissue and later no matter
what is done this damage is permanent. For this
reason the decontamination must take place within
two minutes.
Symptoms develop in
this order:
- On first contact there is no effect.
- After 30 minutes to 3 hours, distinct
symptoms begin in the eyes.
- After 4 to 16 hours the symptoms become
more pronounced with painful tearing of
the eyes, nausea and vomiting.
Treatment: There
is no specific antidote.
- Quick decontamination and symptomatic
treatment.
- Burn treatment for blisters.
Decontamination: A
%2.5 solution of sodium thiosulphate is
recommended as specific decontamination agent for
contact through skin, eyes and inhalation.
3.Pulmonary Irritants
Substances that cause physical irritation to
the pulmonary system tissues.
Phosgene has
lethal effects.
The first observable effects are the
irritation of the eyes and the mucous membranes
of the pulmonary area. The characteristic smell
is of rotten weeds, corn silk and newly cut hay.
Treatment:
There is no antidote. Decontamination is
conducted through plenty of soap and water.
4.Blood poisons
This is a lethal CWA, which interfere with
cell breathing. These are cyanides and hydrogen
sulphur, which have sudden life threatening
effects.
Cyanides
The most important ones are: hydrogen cyanide,
cyanogenic chloride that is dispersed in gas
form. They have a bitter almond smell. An
overdose of cyanide can kill in 6-8 minutes.
Treatment:
- Immediately administer %100 O2
- Start antidotal treatment.
- Decontamination: As long as there is a
heartbeat, antidote treatment is
effective.
- Amyl Nitrite + Sodium Nitrite+ Sodium
Thiosulphate antidote.
- Dimethylaminophenol Adults: 250mg
(i.v.) / Children: 3mg/kg (i.v.)
- Dicobalt Edetate Administer: 600 mg
(i.v.)
*Do not cause vomiting. Do stomach pumping.
*Do not attempt mouth-to-mouth resuscitation!
Hydrogen Sulphur
It has the characteristic small of rotten
eggs. It is highly toxic and has direct effects
on devastating the SSS cells.
Treatment:
Same as cyanide treatment but do not use
sodium thiosulphate.
5.Incapacitating Agents
Substances, which cause disturbances that,
resemble serious mental illnesses known as
psychoses. The most frequently used substances
are BZ (3-quinuclidinylbenzilate) and LSD
(Lysergic Acid Diethyl amide).
BZ
Blocks the impulse control of the role that
acetylcholine plays in the central and peripheral
nervous systems.
Treatment
In case of inhalation:
- Remove the patient from the contaminated
area.
- Control the patient’s pulmonary
functions.
- Put the patient in a quiet and secure
area for observation.
- Administer physostimin salycilate.
Adults: 2 mg (i.v.) (10 ml %5 dextrose) /
Children: 0.02 mg/kg (i.v.)
- Symptomatic treatment.
Tachyarrhythma’s that do not respond to
physostigmine may respond to propranolel (i.v.)
In case of oral contact:
- Produce vomiting.
- Active coal.
- Cathartics
- Antidotes (physostimin salycilate)
- Symptomatic treatment
LSD
Symptoms
- Somatic
- Sensory
- Psychic
Treatment
In case of oral contact:
- Assess pulmonary and cardiovascular
functions.
- Gastric washing and inducing vomiting are
not important.
- Active coal.
- Cathartics
- Symptomatic treatment.
In case of inhalation:
Follow instructions in # 1 and 5 of oral
contact.
6.Riot control agents
Cause quick but temporary loss of capacity.
The differences between psychochemical
agents:
- The psychochemical effects start later
but last longer after contact.
- The psychochemical affect the centers
while riot control agents are sensory
irritants.
a.Tear agents
The conjunctiva is especially sensitive to
certain irritants, which increase tear
secretions.
The effects of these agents usually rapidly
disappear through escape from the contaminated
area. The main chemicals are: chloroacetophenone
(codename CN),
orto-chlorobenzylidene-malononitrile (codename
CS) and dibenz (b,f)-1,4-oxazepine (codename CR).
b.Vomiting agents
These agents irritate the nose and the mucosa
of the upper respiratory tract. The chemical most
used is diphenylaminearsine (DM)
General protective measures and treatment.
The best preventive measure is to use a mask.
Decontamination must take place. There is no
specific antidote.
6.Vegetation Killing Agents
- These agents destroy vegetation, the
enemy’s power to resist and food
stocks.
- In areas with trees, the agent causes
leaves to fall thus limiting the
possibility for the enemy to hide.
There are two groups:
- Herbicides
- Agents that sterilize the earth
Treatment:
Decontamination and symptomatic treatment.
Table
( Characteristics Of Some CWA' S )
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