Veterans at Risk The Health Effects of Mustard Gas and Lewisite (1993) / Chapter Skim
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12 Summary of Findings and Recommendations
12 Summary of Findings and Recommendations
Pages 214-226
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From page 214... ...
testing programs. Thus, the lack of follow-up health assessments of the human subjects In WWII gas chamber and field tests severely diminished the amount and quality of information that could be applied in me assessment of long-term health consequences of exposure to mustard agents and Lew~site.
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From page 215... ...
The committee was forced to rely on studies done in Japan and Great Britain to assess what was known about the long-term health risks from occupational exposure to mustard agents and Lewisite. As demonstrated in Chapters 3 and 7, such occupational data are directly relevant to the assessment of the potential effects of mustard agent and Lewisite exposure in the experimental testing programs, because the levels of exposure to mustard agents or Lew~site experienced by the human subjects may have been much higher than inferred in the summaries of the gas chamber and field tests.
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From page 216... ...
She evidence indicates a causal relation between sulfur mustard exposure and the occurrence of excess respiratory and skin cancer, and possibly leukemia. This conclusion is based upon estimates of exposure to sulfur mustard during the chamber tests, which may have approximated the battlefield exposure of surviving World War I (WWI)
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From page 217... ...
asthma chronic bronchitis emphysema chronic obstructive pulmonary disease laryngitis Recurrent corneal ulcerative diseases Delayed recurrent keratitis of the eye Chronic conjunctivitis Bone marrow depression and immunosuppressionC Psychological disorders mood disorders anxiety disorders (including post-traumatic stress disorder) other traumatic stress disorder responses Sexual dysfunctions Evidence Suggeshive of Causal Relationship to Mustard Agent Exposure Leukemia (sulfur mustard)
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From page 218... ...
Further, indirect evidence, based on a review of the relationships between acute and chronic effects caused by other substances, suggests that these long-term respiratory effects may occur in the absence of an acute respiratory response. The evidence indicates a causal relation between exposure to sulfur mustard and recurrent corneal ulcerative disease (including corneal opacities)
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From page 219... ...
The evidence indicates a causal relation between acute, severe exposure to mustard agents and increased skin pigmentation and depigmentation, chronic skin ulceration, scar formation, and the development of cancer in human skin. A causal relationship also exists between chronic exposure to minimally toxic, and even subtonic, doses and skin pigmentation abnormalities and cutaneous cancer.
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From page 220... ...
There is insufficient evidence to demonstrate a causal relationship between exposure to mustard agents or Lewisite and toxicity to the reproductive system. The database is too small and uncertain to allow a clear understanding of human reproductive risk from exposure to sulfur mustards.
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From page 221... ...
Data from studies of chemical and biological warfare environments and environmental exposures to toxic chemicals or radiation support the assertion that, in certain individuals, these experiences would have been sufficient to cause adverse psychological effects, resulting in long-term dysfunction. It is likely that such effects also occurred in some production workers, gas handlers and trainers, and Bari harbor survivors as a result of traumatic episodes including explosions, accidents, personal exposure injury, or the witnessing of severe injury or death of others.
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From page 222... ...
There are also human data derived from patients previously treated in Russian and Eastern European studies of the sulfur mustard-containing agent psoriasin that may be useful in determining the delayed effect of short-term administration of sub-erythema dosages of sulfur mustard. Because these studies began 20 to 25 years ago, follow-up of the psoriasin-treated patients now, if properly done, would be of invaluable help in determining delayed effects of acute sulfur mustard exposure.
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From page 223... ...
Further studies of the mechanisms of longterm damage to the respiratory system would also be useful. Despite intensive research on the mechanisms of sulfur mustard injury to the skin in animal models, little data exist regarding the long-term consequences of such injury.
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From page 224... ...
More studies of multiple species would be helpful in understanding the potential reproductive toxicity of this compound. RECOMMENDATIONS With the immense gaps in the knowledge base about the long-term health risks associated with exposure to mustard agents and Lewisite, and after serious consideration of the historical analyses of the WWII testing programs and the likely exposure levels to the human subjects involved, this committee believes certain recommendations are necessary and justified.
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From page 225... ...
Treating these cancers with full knowledge of their likely cause should be the responsibility of the VA and may be life-saving; for example, the likelihood of survival from skin cancer is greatly increased by early diagnosis and treatment. In the case of the human subjects of the WWII testing programs, it is reasonable to assume that the secrecy surrounding the experiments may have kept individuals and entire families from successful resolution and treatment of any adverse psychological effects that may have been caused.
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From page 226... ...
For example, only one of the three major chamber test locations, the Naval Research Laboratory, freely shared technical reports and detailed summaries with the committee from the beginning of the study. For other locations, such information only arrived as the study was in its final stages, despite months of requests and inquiries to a variety of offices.
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