Wednesday, August 28, 2013

28 August 2013 The horror of gas warfare

Cassi Creek:
Why is it worse to be gassed than to be shot?
American Public Health Association
THIS ARTICLE HAS BEEN CORRECTED. See Am J Public Health. 2008 July; 98(7): 1158.
“Chemical Warfare and Medical Response During World War I
Gerard J. Fitzgerald, PhD
The first large-scale use of a traditional weapon of mass destruction (chemical, biological, or nuclear) involved the successful deployment of chemical weapons during World War I (1914–1918). Historians now refer to the Great War as the chemist’s war because of the scientific and engineering mobilization efforts by the major belligerents. The development, production, and deployment of war gases such as chlorine, phosgene, and mustard created a new and complex public health threat that endangered not only soldiers and civilians on the battlefield but also chemical workers on the home front involved in the large-scale manufacturing processes. The story of chemical weapons research and development during that war provides useful insights for current public health practitioners faced with a possible chemical weapons attack against civilian or military populations.
IN THE LATE AFTERNOON OF April 22, 1915, members of a special unit of the German Army opened the valves on more than 6000 steel cylinders arrayed in trenches along their defensive perimeter at Ypres, Belgium. Within 10 minutes, 160 tons of chlorine gas drifted over the opposing French trenches, engulfing all those downwind. Filled with pressurized liquid chlorine, the cylinders had been clandestinely installed by the Germans more than 3 weeks earlier. The order to release the gas was entrusted to German military meteorologists, who had carefully studied the area’s prevailing wind patterns. Disregarding intelligence reports about the strange cylinders prior to the attack, the French troops were totally unprepared for this new and horrifying weapon.1

“Nerve agents are substances that disrupt the chemical communications through the nervous system. The disruption is caused by blocking the acetylcholinesterase, an enzyme that normally destroys and stops the activity of acetylcholine, a neurotransmitter. Poisoning by a nerve agent leads to an accumulation of acetylcholine at the nerve axon, producing a perpetual excited state (e.g., muscle contraction). The eventual exhaustion of muscles leads to respiratory failure and death.

G series

These are low volatility nerve agents that are typically used for a nonpersistent to semipersistent effect.
·         Tabun (GA)
·         Sarin (GB)
·         Soman (GD)
·         Cyclosarin (GF)

GV series[edit source | editbeta]

These agents have a volatility between the V and G agents and are typically used for a semi-persistent to persistent effect.
·         Novichok agents
·         GV (nerve agent)

V series[edit source | editbeta]

These agents have low volatility and are typically used for a persistent effect or liquid contact hazard.
·         VE
·         VG
·         VM
·         VX
WWI took early-industrialized warfare and changed it into slaughter on an assembly line basis.  It also applied a target status upon civilian populations, pointing the way to WWII.  From the onset of WWI, the rules and customs of warfare changed.  Troops came to be pitted against ever-larger artillery shells.  Horse cavalry and animal-towed guns were replaced by tanks and truck towed guns.  Much of a European generation, as well as one of Great Britain, simply ceased to exist. 
          There is a long history of individual combats in the lead up to what we declare modern warfare.  A sees B and they attack each other.  When organized armies and navies were developed, individual battles still took place as the combatants were directed by officers and/or rulers against their opponents.  The patterns of warfare were largely unchanged until the American Civil War put an end to massed fire and maneuver using single-shot rifles. 
          Still, in the mud, shells, and wire that helped define the trench warfare of WWI it was still possible to see the continuation of A and B trying to spot and kill each other.  Soldiers were still doing what soldiers have always done. 
          Gas changed pattern.  Gas was silent.  Gas could be deployed in the dark, with the right wind pattern, to spread over the trenches occupied by the other side.  In daylight, it required the at-risk army to spend time putting on protective equipment that might or might not work. Gas arrived silently but killed noisily.  Gas was, and is, poison. 
          Thousands of gas casualties survived WWI but had permanently scarred lungs, were badly blistered, and were blinded. 
          In the post war period, the Geneva Conventions declared gas warfare to be illegal and unethical to use in warfare. 
          Nerve agents, like earlier gas weaponry, originated in Germany.  It saw little use in the battles of WWII but heavy use in the death camps that carried out the Holocaust.
          During the Cold War, there was heavy investigation of nerve agents and stockpiling of such agents by both the US and USSR.  Every modern nation is supposed to have destroyed their nerve agents.  Obviously, the Middle Eastern states have not done so. 
          The horror of nerve agents includes the mechanism they use to kill.
“How sarin works
·         The extent of poisoning caused by sarin depends on the amount of sarin to which a person was exposed, how the person was exposed, and the length of time of the exposure.
·         Symptoms likely will appear within a few seconds after exposure to the vapor form of sarin and within a few minutes to hours after exposure to the liquid form.
·         All nerve agents cause their toxic effects by preventing the proper operation of an enzyme that acts as the body’s “off switch” for glands and muscles. Without an “off switch,” the glands and muscles are constantly being stimulated. Exposed people may become tired and no longer be able to keep breathing.
·         Sarin is the most volatile of the nerve agents. This means it can easily and quickly evaporate from a liquid into a vapor and spread into the environment. People can be exposed to the vapor even if they do not come in contact with the liquid form of sarin.
·         Because it evaporates so quickly, sarin presents an immediate but short-lived threat.
Immediate signs and symptoms of sarin exposure
·         People may not know that they were exposed because sarin has no odor.
·         People exposed to a low or moderate dose of sarin by breathing contaminated air, eating contaminated food, drinking contaminated water, or touching contaminated surfaces may experience some or all of the following symptoms within seconds to hours of exposure:
o    Runny nose
o    Watery eyes
o    Small, pinpoint pupils
o    Eye pain
o    Blurred vision
o    Drooling and excessive sweating
o    Cough
o    Chest tightness
o    Rapid breathing
o    Diarrhea
o     Nausea, vomiting, and/or abdominal pain
o    Increased urination
o    Confusion
o    Drowsiness
o    Weakness
o    Headache
o    Slow or fast heart rate
o    Low or high blood pressure
·         Even a small drop of sarin on the skin can cause sweating and muscle twitching where sarin touched the skin.
·         Exposure to large doses of sarin by any route may result in the following harmful health effects:
o    Loss of consciousness
o    Convulsions
o    Paralysis
o    Respiratory failure possibly leading to death
·         Showing these signs and symptoms does not necessarily mean that a person has been exposed to sarin.”

The decision to deploy nerve agents is considered to be beyond the Pale.  While protective equipment is available to soldiers, very few civilians have protective gear and almost none have atropine to use as an antidote. 
          In the end, it matters little to the dead, once they are dead, whether a single bullet or a Sarin bomblet brought them down.  But the experience of watching nerve gases work, knowing that in most cases the end result is a most undignified death should prevent any rational being from deploying any of the nerve agents.  The Assad regime has chosen wholesale slaughter to be visited upon non-combatants. There is no place in the modern world for such people.  They are not soldiers, they are not human. 

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