ABSTRACT
Effects of Exposure to Nerve Chemical Warfare .................................................................. 72 III. Chronic Health Effects of Acute Exposure ........................................................................... 74 IV. Chronic Health Effects of Repeated Low-Level Exposure ................................................... 81 V. Development of Improved Medical Countermeasures .......................................................... 87
A. Advanced Anticonvulsant System ................................................................................. 87 B. Improved Oxime Therapies for Nerve Agents .............................................................. 88 C. Carbamate Pretreatment ................................................................................................. 88 D. Enzymes as Scavengers ................................................................................................. 89
VI. Summary and Conclusions .................................................................................................... 89 References ....................................................................................................................................... 89
In 2000, when we wrote this chapter for our earlier work, we were influenced by two events: (1) the significant concern for the health of Persian Gulf War veterans as it might have been affected by possible exposure to low levels of chemical warfare agents and (2) an increase in research, both epidemiological and experimental, into the health effects of exposure to nerve chemical warfare agents. In fact, in a note of optimism, we closed the chapter with this statement ‘‘The authors close by expressing hope that the recent national investment into additional research will allow a more comprehensive assessment to unfold that will possibly contribute to better treatment.’’ In the intervening 6 years, a number of epidemiological and experimental studies have added to the literature regarding health effects of exposure to nerve chemical warfare agents. Additionally, Aas (2003) reviewed current medical therapy for nerve agent intoxication and discussed possible future improvement of medical therapies. Currently, several new approaches to improved treatment of nerve agent intoxication are in full-scale development in the United States. As a result of these developments, this chapter has been updated principally in two areas: (1) inclusion of recent reports on potential chronic health effects from either asymptomatic or symptomatic exposures to nerve agents and (2) discussion of developments leading to potentially improved care for such exposures.
