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1. Ellison: 1434_c000 2007/7/4 20:25 page i #1
2. Ellison: 1434_c000 2007/7/4 20:25 page ii #2
3. Ellison: 1434_c000 2007/7/4 20:25 page iii #3
4. Ellison: 1434_c000 2007/7/4 20:25 page iv #4
5. Ellison: 1434_c000 2007/7/4 20:25 page v #5 Contents
Preface...............................................................................................
xxiii Acknowledgments
................................................................................
xxv
Author...............................................................................................
xxvii Explanatory
Notes.................................................................................
xxix Section I Nerve Agents 1 1 Organophosphorus Nerve Agents
....................................................... 3 1.1
General Information
................................................................. 3
1.1.1 G-Series Nerve
Agents....................................................... 3
1.1.2 V-Series Nerve Agents
....................................................... 3 1.1.3
GV-Series Nerve
Agents..................................................... 4 1.1.4
Novichok-Series Nerve
Agents............................................. 4 1.1.5
Comments
.....................................................................
4 1.2 Toxicology
.............................................................................
5 1.2.1 Effects
..........................................................................
5 1.2.2 Pathways and Routes of
Exposure......................................... 5 1.2.3 General
Exposure Hazards .................................................
5 1.2.3.1 G-Series
.............................................................. 5
1.2.3.2
V-Series...............................................................
5 1.2.3.3 GV-Series
............................................................ 6
1.2.3.4 Novichok
Series..................................................... 6 1.2.4
Latency Period
................................................................ 6
1.2.4.1 Vapor/Aerosols (Mists or Dusts)
................................. 6 1.2.4.2 Liquids
............................................................... 6
1.2.4.3 Solids (Nonaerosol)
................................................ 6 1.3
Characteristics
........................................................................
6 1.3.1 Physical
Appearance/Odor................................................. 6
1.3.1.1 Laboratory
Grade................................................... 6 1.3.1.2
Munition Grade.....................................................
6 1.3.1.3 Binary Agents
....................................................... 7 1.3.1.4
Modied Agents.................................................... 7
1.3.2 Stability
........................................................................
7 1.3.3
Persistency.....................................................................
8 1.3.4 Environmental Fate
.......................................................... 8 1.4
Additional Hazards
..................................................................
9 1.4.1 Exposure
.......................................................................
9 1.4.2 Livestock/Pets
................................................................
9
6. Ellison: 1434_c000 2007/7/4 20:25 page vi #6 vi Contents
1.4.3
Fire..............................................................................
9 1.4.4 Reactivity
......................................................................
10 1.4.5 Hazardous Decomposition Products
...................................... 10 1.4.5.1 Hydrolysis
........................................................... 10
1.4.5.2 Combustion
......................................................... 10 1.5
Protection
..............................................................................
10 1.5.1 Evacuation Recommendations
............................................. 10 1.5.2 Personal
Protective Requirements .........................................
11 1.5.2.1 Structural Fireghters Gear
...................................... 11 1.5.2.2 Respiratory
Protection ............................................. 12 1.5.2.3
Chemical Protective Clothing ....................................
12 1.6 Decontamination
.....................................................................
12 1.6.1 General
.........................................................................
12 1.6.1.1 G-Series Nerve
Agents............................................. 12 1.6.1.2
V-Series Nerve Agents .............................................
13 1.6.1.3 GV-Series Nerve
Agents........................................... 13 1.6.1.4
Novichok Agents ...................................................
14 1.6.1.5 Vapors
................................................................ 14
1.6.1.6 Liquids, Solutions, or Liquid Aerosols
.......................... 15 1.6.1.7 Solids, Dusty Agents, or
Particulate Aerosols.................. 15 1.7
Medical.................................................................................
16 1.7.1 CDC Case
Denition.........................................................
16 1.7.2 Differential
Diagnosis........................................................
16 1.7.3 Signs and
Symptoms.........................................................
16 1.7.3.1 Vapors/Aerosols
.................................................... 16 1.7.3.2
Liquids/Solids
...................................................... 16 1.7.4
Mass-Casualty Triage
Recommendations................................. 17 1.7.4.1
Priority 1
............................................................. 17
1.7.4.2 Priority 2
............................................................. 17
1.7.4.3 Priority 3
............................................................. 17
1.7.4.4 Priority 4
............................................................. 17
1.7.5 Casualty
Management.......................................................
17 1.8 Fatality Management
................................................................ 17
References....................................................................................
101 2 Carbamate Nerve
Agents..................................................................
105 2.1 General Information
.................................................................
105 2.2 Toxicology
.............................................................................
105 2.2.1 Effects
..........................................................................
105 2.2.2 Pathways and Routes of
Exposure......................................... 105 2.2.3 General
Exposure Hazards .................................................
106 2.2.4 Latency Period
................................................................
106 2.2.4.1 Aerosols (Mists or Dusts)
......................................... 106 2.2.4.2
Solids/Solutions (Nonaerosol) ...................................
106 2.3 Characteristics
........................................................................
106 2.3.1 Physical
Appearance/Odor.................................................
106 2.3.1.1 Laboratory
Grade................................................... 106
2.3.1.2 Modied
Agents.................................................... 106
2.3.2 Stability
........................................................................
106 2.3.3
Persistency.....................................................................
107 2.3.4 Environmental Fate
.......................................................... 107
7. Ellison: 1434_c000 2007/7/4 20:25 page vii #7 Contents vii
2.4 Additional Hazards
..................................................................
107 2.4.1 Exposure
.......................................................................
107 2.4.2 Livestock/Pets
................................................................
107 2.4.2.1
Fire....................................................................
108 2.4.2.2 Reactivity
............................................................ 108
2.4.3 Hazardous Decomposition Products
...................................... 108 2.4.3.1 Hydrolysis
........................................................... 108
2.4.3.2 Combustion
......................................................... 108 2.5
Protection
..............................................................................
108 2.5.1 Evacuation Recommendations
............................................. 108 2.5.2 Personal
Protective Requirements .........................................
108 2.5.2.1 Structural Fireghters Gear
...................................... 108 2.5.2.2 Respiratory
Protection ............................................. 109
2.5.2.3 Chemical Protective Clothing
.................................... 109 2.5.3 Decontamination
............................................................. 109
2.5.3.1 General
............................................................... 109
2.5.3.2 Solutions or Liquid Aerosols
..................................... 109 2.5.3.3 Solids or
Particulate Aerosols .................................... 110 2.6
Medical.................................................................................
110 2.6.1 CDC Case
Denition.........................................................
110 2.6.2 Differential
Diagnosis........................................................
110 2.6.3 Signs and
Symptoms.........................................................
111 2.6.3.1
Aerosols..............................................................
111 2.6.3.2 Solutions/Solids
.................................................... 111 2.6.4
Mass-Casualty Triage
Recommendations................................. 111 2.6.4.1
Priority 1
............................................................. 111
2.6.4.2 Priority 2
............................................................. 111
2.6.4.3 Priority 3
............................................................. 111
2.6.4.4 Priority 4
............................................................. 111
2.6.5 Casualty
Management.......................................................
111 2.7 Fatality Management
................................................................
112
References....................................................................................
139 Section II Vesicant/Urticant Agents 141 3 Sulfur and Nitrogen
Vesicants
............................................................ 143
3.1 General Information
.................................................................
143 3.2 Toxicology
.............................................................................
144 3.2.1 Effects
..........................................................................
144 3.2.2 Pathways and Routes of
Exposure......................................... 144 3.2.3 General
Exposure Hazards .................................................
144 3.2.3.1 Sulfur Series
......................................................... 144
3.2.3.2 Nitrogen
Series...................................................... 145
3.2.4 Latency Period
................................................................
145 3.2.4.1 Vapor/Aerosols (Mists or Dusts)
................................. 145 3.2.4.2 Liquids
............................................................... 145
3.2.4.3 Solids (Nonaerosol)
................................................ 145 3.3
Characteristics
........................................................................
146 3.3.1 Physical
Appearance/Odor.................................................
146 3.3.1.1 Laboratory
Grade................................................... 146
3.3.1.2 Munition
Grade..................................................... 146
8. Ellison: 1434_c000 2007/7/4 20:25 page viii #8 viii Contents
3.3.1.3 Modied
Agents.................................................... 146
3.3.1.4 Mixtures with Other Agents
...................................... 146 3.3.2 Stability
........................................................................
147 3.3.3
Persistency.....................................................................
147 3.3.4 Environmental Fate
.......................................................... 147 3.4
Additional Hazards
..................................................................
147 3.4.1 Exposure
.......................................................................
147 3.4.2 Livestock/Pets
................................................................
148 3.4.3
Fire..............................................................................
148 3.4.4 Reactivity
......................................................................
148 3.4.5 Hazardous Decomposition Products
...................................... 148 3.4.5.1 Hydrolysis
........................................................... 148
3.4.5.2 Combustion
......................................................... 149 3.5
Protection
..............................................................................
149 3.5.1 Evacuation Recommendations
............................................. 149 3.5.2 Personal
Protective Requirements .........................................
150 3.5.2.1 Structural Fireghters Gear
...................................... 150 3.5.2.2 Respiratory
Protection ............................................. 150
3.5.2.3 Chemical Protective Clothing
.................................... 150 3.5.3 Decontamination
............................................................. 150
3.5.3.1 General
............................................................... 150
3.5.3.2 Vapors
................................................................
151 3.5.3.3 Liquids, Solutions, or Liquid Aerosols
.......................... 152 3.5.3.4 Solids, Dusty Agents, or
Particulate Aerosols.................. 152 3.6
Medical.................................................................................
153 3.6.1 CDC Case
Denition.........................................................
153 3.6.2 Differential
Diagnosis........................................................
153 3.6.3 Signs and
Symptoms.........................................................
153 3.6.3.1 Vapors/Aerosols
.................................................... 153 3.6.3.2
Liquids/Solids
...................................................... 154 3.6.4
Mass-Casualty Triage
Recommendations................................. 154 3.6.4.1
Priority 1
............................................................. 154
3.6.4.2 Priority 2 (Majority of Cases)
..................................... 154 3.6.4.3 Priority 3
............................................................. 154
3.6.4.4 Priority 4
............................................................. 154
3.6.5 Casualty
Management.......................................................
154 3.7 Fatality Management
................................................................
155
References....................................................................................
187 4 Arsenic Vesicants
...........................................................................
191 4.1 General Information
.................................................................
191 4.2 Toxicology
.............................................................................
191 4.2.1 Effects
..........................................................................
191 4.2.2 Pathways and Routes of
Exposure......................................... 191 4.2.3 General
Exposure Hazards .................................................
192 4.2.4 Latency Period
................................................................
192 4.2.4.1 Vapor/Aerosols (Mists or Dusts)
................................. 192 4.2.4.2 Liquids
............................................................... 192
4.3 Characteristics
........................................................................
192 4.3.1 Physical
Appearance/Odor.................................................
192 4.3.1.1 Laboratory
Grade................................................... 192
9. Ellison: 1434_c000 2007/7/4 20:25 page ix #9 Contents ix
4.3.1.2 Munition
Grade..................................................... 193
4.3.1.3 Modied
Agents.................................................... 193
4.3.1.4 Mixtures with Other Agents
...................................... 193 4.3.2 Stability
........................................................................
193 4.3.3
Persistency.....................................................................
193 4.3.4 Environmental Fate
.......................................................... 193 4.4
Additional Hazards
..................................................................
194 4.4.1 Exposure
.......................................................................
194 4.4.2 Livestock/Pets
................................................................
194 4.4.3
Fire..............................................................................
194 4.4.4 Reactivity
......................................................................
194 4.4.5 Hazardous Decomposition Products
...................................... 194 4.4.5.1 Hydrolysis
........................................................... 194
4.4.5.2 Combustion
......................................................... 195 4.5
Protection
..............................................................................
195 4.5.1 Evacuation Recommendations
............................................. 195 4.5.2 Personal
Protective Requirements .........................................
195 4.5.2.1 Structural Fireghters Gear
...................................... 195 4.5.2.2 Respiratory
Protection ............................................. 196
4.5.2.3 Chemical Protective Clothing
.................................... 196 4.5.3 Decontamination
............................................................. 196
4.5.3.1 General
............................................................... 196
4.5.3.2 Vapors
................................................................
197 4.5.3.3 Liquids, Solutions, or Liquid Aerosols
.......................... 197 4.6
Medical.................................................................................
198 4.6.1 CDC Case
Denition.........................................................
198 4.6.2 Differential
Diagnosis........................................................
198 4.6.3 Signs and
Symptoms.........................................................
198 4.6.3.1 Vapors/Aerosols
.................................................... 198 4.6.3.2
Liquids
............................................................... 198
4.6.4 Mass-Casualty Triage
Recommendations................................. 198 4.6.4.1
Priority 1
............................................................. 198
4.6.4.2 Priority 2 (Majority of Cases)
..................................... 199 4.6.4.3 Priority 3
............................................................. 199
4.6.4.4 Priority 4
............................................................. 199
4.6.5 Casualty
Management.......................................................
199 4.7 Fatality Management
................................................................
199
References....................................................................................
205 5
Urticants......................................................................................
207 5.1 General Information
.................................................................
207 5.2 Toxicology
.............................................................................
207 5.2.1 Effects
..........................................................................
207 5.2.2 Pathways and Routes of
Exposure......................................... 208 5.2.3 General
Exposure Hazards .................................................
208 5.2.4 Latency Period
................................................................
208 5.3 Characteristics
........................................................................
208 5.3.1 Physical
Appearance/Odor.................................................
208 5.3.1.1 Laboratory
Grade................................................... 208
5.3.1.2 Munition
Grade..................................................... 208
5.3.2 Stability
........................................................................
209
10. Ellison: 1434_c000 2007/7/4 20:25 page x #10 x Contents
5.3.3
Persistency.....................................................................
209 5.3.4 Environmental Fate
.......................................................... 209 5.4
Additional Hazards
..................................................................
209 5.4.1 Exposure
.......................................................................
209 5.4.2 Livestock/Pets
................................................................
209 5.4.3
Fire..............................................................................
210 5.4.4 Reactivity
......................................................................
210 5.4.5 Hazardous Decomposition Products
...................................... 210 5.4.5.1 Hydrolysis
........................................................... 210
5.4.5.2 Combustion
......................................................... 210 5.5
Protection
..............................................................................
210 5.5.1 Evacuation Recommendations
............................................. 210 5.5.2 Personal
Protective Requirements .........................................
211 5.5.2.1 Structural Fireghters Gear
...................................... 211 5.5.2.2 Respiratory
Protection ............................................. 211
5.5.2.3 Chemical Protective Clothing
.................................... 211 5.5.3 Decontamination
............................................................. 211
5.5.3.1 General
............................................................... 211
5.5.3.2 Vapors
................................................................
212 5.5.3.3 Liquids, Solutions, or Liquid Aerosols
.......................... 212 5.5.3.4 Solids or Particulate
Aerosols .................................... 212 5.6
Medical.................................................................................
213 5.6.1 CDC Case
Denition.........................................................
213 5.6.2 Differential
Diagnosis........................................................
213 5.6.3 Signs and
Symptoms.........................................................
213 5.6.3.1 Vapors/Aerosols
.................................................... 213 5.6.3.2
Liquids/Solids
...................................................... 214 5.6.4
Mass-Casualty Triage
Recommendations................................. 214 5.6.4.1
Priority 1
............................................................. 214
5.6.4.2 Priority 2 (Majority of Cases)
..................................... 214 5.6.4.3 Priority 3
............................................................. 214
5.6.4.4 Priority 4
............................................................. 214
5.6.5 Casualty
Management.......................................................
214 5.7 Fatality Management
................................................................
214
References....................................................................................
217 Section III Toxic Agents 219 6 Bicyclophosphate Convulsants
........................................................... 221 6.1
General Information
.................................................................
221 6.2 Toxicology
.............................................................................
221 6.2.1 Effects
..........................................................................
221 6.2.2 Pathways and Routes of
Exposure......................................... 221 6.2.3 General
Exposure Hazards .................................................
222 6.2.4 Latency Period
................................................................
222 6.3 Characteristics
........................................................................
222 6.3.1 Physical
Appearance/Odor.................................................
222 6.3.1.1 Laboratory
Grade................................................... 222
6.3.1.2 Modied
Agents.................................................... 222
6.3.2 Stability
........................................................................
222 6.3.3
Persistency.....................................................................
222 6.3.4 Environmental Fate
.......................................................... 222
11. Ellison: 1434_c000 2007/7/4 20:25 page xi #11 Contents xi
6.4 Additional Hazards
..................................................................
223 6.4.1 Exposure
.......................................................................
223 6.4.2 Livestock/Pets
................................................................
223 6.4.3
Fire..............................................................................
223 6.4.4 Reactivity
......................................................................
224 6.4.5 Hazardous Decomposition Products
...................................... 224 6.5 Protection
..............................................................................
224 6.5.1 Evacuation Recommendations
............................................. 224 6.5.2 Personal
Protective Requirements .........................................
224 6.5.2.1 Structural Fireghters Gear
...................................... 224 6.5.2.2 Respiratory
Protection ............................................. 224
6.5.2.3 Chemical Protective Clothing
.................................... 224 6.5.3 Decontamination
............................................................. 225
6.5.3.1 General
............................................................... 225
6.5.3.2 Solutions or Liquid Aerosols
..................................... 225 6.5.3.3 Solids or
Particulate Aerosols .................................... 225 6.6
Medical.................................................................................
226 6.6.1 CDC Case
Denition.........................................................
226 6.6.2 Differential
Diagnosis........................................................
226 6.6.3 Signs and
Symptoms.........................................................
226 6.6.4 Mass-Casualty Triage
Recommendations................................. 226 6.6.5 Casualty
Management.......................................................
226 6.7 Fatality Management
................................................................
227
References....................................................................................
229 7 COX Inhibiting Blood
Agents.............................................................
231 7.1 General Information
.................................................................
231 7.2 Toxicology
.............................................................................
231 7.2.1 Effects
..........................................................................
231 7.2.2 Pathways and Routes of
Exposure......................................... 231 7.2.3 General
Exposure Hazards .................................................
232 7.2.4 Latency Period
................................................................
232 7.2.4.1 Vapor
.................................................................
232 7.2.4.2 Liquid
................................................................
232 7.3 Characteristics
........................................................................
232 7.3.1 Physical
Appearance/Odor.................................................
232 7.3.1.1 Laboratory
Grade................................................... 232
7.3.1.2 Munition
Grade..................................................... 232
7.3.1.3 Binary/Reactive Agents
........................................... 233 7.3.1.4 Modied
Agents.................................................... 233
7.3.1.5 Mixtures with Other Agents
...................................... 233 7.3.2 Stability
........................................................................
233 7.3.3
Persistency.....................................................................
233 7.3.4 Environmental Fate
.......................................................... 233 7.4
Additional Hazards
..................................................................
234 7.4.1 Exposure
.......................................................................
234 7.4.2 Livestock/Pets
................................................................
234 7.4.3
Fire..............................................................................
234 7.4.4 Reactivity
......................................................................
234 7.4.5 Hazardous Decomposition Products
...................................... 235 7.4.5.1 Hydrolysis
........................................................... 235
7.4.5.2 Combustion
......................................................... 235
12. Ellison: 1434_c000 2007/7/4 20:25 page xii #12 xii Contents
7.5 Protection
..............................................................................
235 7.5.1 Evacuation Recommendations
............................................. 235 7.5.2 Personal
Protective Requirements .........................................
236 7.5.2.1 Structural Fireghters Gear
...................................... 236 7.5.2.2 Respiratory
Protection ............................................. 236
7.5.2.3 Chemical Protective Clothing
.................................... 236 7.5.3 Decontamination
............................................................. 236
7.5.3.1 General
............................................................... 236
7.5.3.2 Vapors
................................................................
236 7.5.3.3 Liquids, Solutions, or Liquid Aerosols
.......................... 237 7.5.3.4 Solids or Particulate
Aerosols .................................... 237 7.6
Medical.................................................................................
237 7.6.1 CDC Case Denition (for Cyanides)
...................................... 237 7.6.2 Differential
Diagnosis........................................................
238 7.6.3 Signs and
Symptoms.........................................................
238 7.6.3.1 Vapors/Aerosols
.................................................... 238 7.6.3.2
Liquids/Solids
...................................................... 238 7.6.4
Mass-Casualty Triage
Recommendations................................. 238 7.6.4.1
Priority 1
............................................................. 238
7.6.4.2 Priority 2
............................................................. 238
7.6.4.3 Priority 3
............................................................. 238
7.6.4.4 Priority 4
............................................................. 238
7.6.5 Casualty
Management.......................................................
239 7.7 Fatality Management
................................................................
239
References....................................................................................
245 8 Arsine Blood Agents
.......................................................................
247 8.1 General Information
.................................................................
247 8.2 Toxicology
.............................................................................
247 8.2.1 Effects
..........................................................................
247 8.2.2 Pathways and Routes of
Exposure......................................... 247 8.2.3 General
Exposure Hazards .................................................
247 8.2.4 Latency Period
................................................................
248 8.3 Characteristics
........................................................................
248 8.3.1 Physical
Appearance/Odor.................................................
248 8.3.1.1 Laboratory
Grade................................................... 248 8.3.2
Stability
........................................................................
248 8.3.3
Persistency.....................................................................
248 8.3.4 Environmental Fate
.......................................................... 248 8.4
Additional Hazards
..................................................................
248 8.4.1 Exposure
.......................................................................
248 8.4.2 Livestock/Pets
................................................................
249 8.4.3
Fire..............................................................................
249 8.4.4 Reactivity
......................................................................
249 8.4.5 Hazardous Decomposition Products
...................................... 249 8.4.5.1 Hydrolysis
........................................................... 249
8.4.5.2 Combustion
......................................................... 249 8.5
Protection
..............................................................................
249 8.5.1 Evacuation Recommendations
............................................. 249 8.5.2 Personal
Protective Requirements .........................................
250 8.5.2.1 Structural Fireghters Gear
...................................... 250
13. Ellison: 1434_c000 2007/7/4 20:25 page xiii #13 Contents
xiii 8.5.2.2 Respiratory Protection
............................................. 250 8.5.2.3 Chemical
Protective Clothing .................................... 250 8.5.3
Decontamination
............................................................. 250
8.5.3.1 General
............................................................... 250
8.5.3.2 Vapors
................................................................
250 8.5.3.3 Reactive Solids
...................................................... 251 8.6
Medical.................................................................................
251 8.6.1 CDC Case
Denition.........................................................
251 8.6.2 Differential
Diagnosis........................................................
251 8.6.3 Signs and
Symptoms.........................................................
251 8.6.4 Mass-Casualty Triage
Recommendations................................. 252 8.6.4.1
Priority 1
............................................................. 252
8.6.4.2 Priority 2
............................................................. 252
8.6.4.3 Priority 3
............................................................. 252
8.6.4.4 Priority 4
............................................................. 252
8.6.5 Casualty
Management.......................................................
252 8.7 Fatality Management
................................................................
252
References....................................................................................
253 9 Carbon Monoxide Blood Agents
......................................................... 255 9.1
General Information
.................................................................
255 9.2 Toxicology
.............................................................................
255 9.2.1 Effects
..........................................................................
255 9.2.2 Pathways and Routes of
Exposure......................................... 255 9.2.3 General
Exposure Hazards .................................................
255 9.2.4 Latency Period
................................................................
256 9.2.4.1 Vapor/Aerosols (Mists)
............................................ 256 9.2.4.2 Liquid
................................................................
256 9.3 Characteristics
........................................................................
256 9.3.1 Physical
Appearance/Odor.................................................
256 9.3.1.1 Laboratory
Grade................................................... 256
9.3.1.2 Munition
Grade..................................................... 256
9.3.1.3 Mixtures with Other Agents
...................................... 256 9.3.2 Stability
........................................................................
256 9.3.3
Persistency.....................................................................
256 9.3.4 Environmental Fate
.......................................................... 257 9.4
Additional Hazards
..................................................................
257 9.4.1 Exposure
.......................................................................
257 9.4.2 Livestock/Pets
................................................................
257 9.4.3
Fire..............................................................................
258 9.4.4 Reactivity
......................................................................
258 9.4.5 Hazardous Decomposition Products
...................................... 258 9.4.5.1 Hydrolysis
........................................................... 258
9.4.5.2 Combustion
......................................................... 258 9.5
Protection
..............................................................................
258 9.5.1 Evacuation Recommendations
............................................. 258 9.5.2 Personal
Protective Requirements .........................................
258 9.5.2.1 Structural Fireghters Gear
...................................... 258 9.5.2.2 Respiratory
Protection ............................................. 258
9.5.2.3 Chemical Protective Clothing
.................................... 259 9.5.3 Decontamination
.............................................................
259
14. Ellison: 1434_c000 2007/7/4 20:25 page xiv #14 xiv Contents
9.5.3.1 General
............................................................... 259
9.5.3.2 Vapors
................................................................
259 9.5.3.3 Liquids or Solutions (Metal
Carbonyls)......................... 259 9.6
Medical.................................................................................
259 9.6.1 CDC Case
Denition.........................................................
259 9.6.2 Differential
Diagnosis........................................................
260 9.6.3 Signs and
Symptoms.........................................................
260 9.6.3.1 Vapors/Aerosols
.................................................... 260 9.6.3.2
Liquids
............................................................... 260
9.6.4 Mass-Casualty Triage
Recommendations................................. 260 9.6.4.1
Priority 1
............................................................. 260
9.6.4.2 Priority 2
............................................................. 260
9.6.4.3 Priority 3
............................................................. 260
9.6.4.4 Priority 4
............................................................. 260
9.6.5 Casualty
Management.......................................................
261 9.7 Fatality Management
................................................................
261
References....................................................................................
263 10 Pulmonary
Agents..........................................................................
265 10.1 General Information
.................................................................
265 10.2 Toxicology
.............................................................................
265 10.2.1 Effects
..........................................................................
265 10.2.2 Pathways and Routes of
Exposure......................................... 265 10.2.3
General Exposure Hazards
................................................. 266 10.2.4
Latency Period
................................................................
266 10.2.4.1
Vapor/Aerosols.....................................................
266 10.3 Characteristics
........................................................................
266 10.3.1 Physical
Appearance/Odor.................................................
266 10.3.1.1 Laboratory
Grade................................................... 266
10.3.1.2 Modied
Agents.................................................... 266
10.3.1.3 Mixtures with Other Agents
...................................... 266 10.3.2 Stability
........................................................................
266 10.3.3
Persistency.....................................................................
267 10.3.4 Environmental Fate
.......................................................... 267 10.4
Additional Hazards
..................................................................
267 10.4.1 Exposure
.......................................................................
267 10.4.2 Livestock/Pets
................................................................
267 10.4.3
Fire..............................................................................
267 10.4.4 Reactivity
......................................................................
268 10.4.5 Hazardous Decomposition Products
...................................... 268 10.4.5.1 Hydrolysis
........................................................... 268
10.4.5.2 Combustion
......................................................... 268 10.5
Protection
..............................................................................
268 10.5.1 Evacuation Recommendations
............................................. 268 10.5.2 Personal
Protective Requirements .........................................
269 10.5.2.1 Structural Fireghters Gear
...................................... 269 10.5.2.2 Respiratory
Protection ............................................. 269
10.5.2.3 Chemical Protective Clothing
.................................... 269 10.5.3 Decontamination
............................................................. 269
10.5.3.1 General
............................................................... 269
10.5.3.2 Vapors
................................................................
269
15. Ellison: 1434_c000 2007/7/4 20:25 page xv #15 Contents xv
10.5.3.3 Liquids, Solutions, or Liquid Aerosols
.......................... 269 10.5.3.4 Solids or Particulate
Aerosols .................................... 270 10.6
Medical.................................................................................
270 10.6.1 CDC Case
Denition.........................................................
270 10.6.2 Differential
Diagnosis........................................................
270 10.6.3 Signs and
Symptoms.........................................................
271 10.6.3.1 Vapors
................................................................
271 10.6.3.2 Liquids
............................................................... 271
10.6.4 Mass-Casualty Triage
Recommendations................................. 271 10.6.4.1
Priority 1
............................................................. 271
10.6.4.2 Priority 2
............................................................. 271
10.6.4.3 Priority 3
............................................................. 271
10.6.4.4 Priority 4
............................................................. 271
10.6.5 Casualty
Management.......................................................
271 10.7 Fatality Management
................................................................
272
References....................................................................................
282 11 Toxic Industrial Agents
....................................................................
285 11.1 General Information
.................................................................
285 11.2 Toxicology
.............................................................................
285 11.2.1 Effects
..........................................................................
285 11.2.2 Pathways and Routes of
Exposure......................................... 285 11.3
Protection
..............................................................................
286 11.3.1 Evacuation Recommendations
............................................. 286 11.3.2 Personal
Protective Requirements .........................................
287 11.3.2.1 Structural Fireghters Gear
...................................... 287 11.3.2.2 Respiratory
Protection ............................................. 287
11.3.2.3 Chemical Protective Clothing
.................................... 287 11.3.3 Decontamination
............................................................. 287
11.3.3.1 General
............................................................... 287
11.3.3.2 Vapors
................................................................
287 11.3.3.3 Liquids, Solutions, or Liquid Aerosols
.......................... 288 11.3.3.4 Solids or Particulate
Aerosols .................................... 288 11.4
Medical.................................................................................
288 11.4.1 CDC Case
Denition.........................................................
288 11.4.2 Signs and
Symptoms.........................................................
289 11.4.2.1 Vapors
................................................................
289 11.4.2.2 Liquids/Solids
...................................................... 289 11.4.3
Mass-Casualty Triage
Recommendations................................. 289 11.4.4
Casualty
Management.......................................................
289 11.5 Fatality Management
................................................................
290
References....................................................................................
374 Section IV Incapacitation and Riot Control Agents 377 12
Incapacitating Agents
......................................................................
379 12.1 General Information
.................................................................
379 12.2 Toxicology
.............................................................................
380 12.2.1 Effects
..........................................................................
380 12.2.2 Pathways and Routes of
Exposure......................................... 380 12.2.3
General Exposure Hazards
................................................. 380
16. Ellison: 1434_c000 2007/7/4 20:25 page xvi #16 xvi Contents
12.2.4 Latency Period
................................................................
380 12.2.4.1 Vapors/Aerosols (Mists or
Dusts)................................ 380 12.2.4.2 Liquids
............................................................... 380
12.2.4.3 Solids (Nonaerosol)
................................................ 381 12.3
Characteristics
........................................................................
381 12.3.1 Physical
Appearance/Odor.................................................
381 12.3.1.1 Laboratory
Grade................................................... 381
12.3.1.2 Munition
Grade..................................................... 381
12.3.1.3 Modied
Agents.................................................... 381
12.3.2 Stability
........................................................................
381 12.3.3
Persistency.....................................................................
381 12.3.4 Environmental Fate
.......................................................... 382 12.4
Additional Hazards
..................................................................
382 12.4.1 Exposure
.......................................................................
382 12.4.2 Livestock/Pets
................................................................
382 12.4.3
Fire..............................................................................
382 12.4.4 Reactivity
......................................................................
382 12.4.5 Hazardous Decomposition Products
...................................... 383 12.4.5.1 Hydrolysis
........................................................... 383
12.4.5.2 Combustion
......................................................... 383 12.5
Protection
..............................................................................
383 12.5.1 Evacuation Recommendations
............................................. 383 12.5.2 Personal
Protective Requirements .........................................
383 12.5.2.1 Structural Fireghters Gear
...................................... 383 12.5.2.2 Respiratory
Protection ............................................. 383
12.5.2.3 Chemical Protective Clothing
.................................... 384 12.5.3 Decontamination
............................................................. 384
12.5.3.1 General
............................................................... 384
12.5.3.2 Vapors
................................................................
384 12.5.3.3 Liquids/Solutions or Liquid Aerosols
.......................... 384 12.5.3.4 Solids or Particulate
Aerosols .................................... 385 12.6
Medical.................................................................................
385 12.6.1 CDC Case
Denition.........................................................
385 12.6.2 Differential
Diagnosis........................................................
385 12.6.3 Signs and
Symptoms.........................................................
385 12.6.4 Mass-Casualty Triage
Recommendations................................. 386 12.6.4.1
Priority 1
............................................................. 386
12.6.4.2 Priority 2
............................................................. 386
12.6.4.3 Priority 3
............................................................. 386
12.6.4.4 Priority 4
............................................................. 386
12.6.5 Casualty
Management.......................................................
386 12.7 Fatality Management
................................................................
387
References....................................................................................
402 13 Irritating and Lachrymatory Agents
..................................................... 403 13.1
General Information
.................................................................
403 13.2 Toxicology
.............................................................................
403 13.2.1 Effects
..........................................................................
403 13.2.2 Pathways and Routes of
Exposure......................................... 403 13.2.3
General Exposure Hazards
................................................. 404 13.2.4
Latency Period
................................................................
404
17. Ellison: 1434_c000 2007/7/4 20:25 page xvii #17 Contents
xvii 13.3 Characteristics
........................................................................
404 13.3.1 Physical
Appearance/Odor.................................................
404 13.3.1.1 Laboratory
Grade................................................... 404
13.3.1.2 Munition
Grade..................................................... 404
13.3.1.3 Modied
Agents.................................................... 404
13.3.2 Stability
........................................................................
404 13.3.3
Persistency.....................................................................
405 13.3.4 Environmental Fate
.......................................................... 405 13.4
Additional Hazards
..................................................................
405 13.4.1 Exposure
.......................................................................
405 13.4.2 Livestock/Pets
................................................................
405 13.4.3
Fire..............................................................................
405 13.4.4 Reactivity
......................................................................
406 13.4.5 Hazardous Decomposition Products
...................................... 406 13.4.5.1 Hydrolysis
........................................................... 406
13.4.5.2 Combustion
......................................................... 406 13.5
Protection
..............................................................................
406 13.5.1 Evacuation Recommendations
............................................. 406 13.5.2 Personal
Protective Requirements .........................................
407 13.5.2.1 Structural Fireghters Gear
...................................... 407 13.5.2.2 Respiratory
Protection ............................................. 407
13.5.2.3 Chemical Protective Clothing
.................................... 407 13.5.3 Decontamination
............................................................. 407
13.5.3.1 General
............................................................... 407
13.5.3.2 Vapors
................................................................
408 13.5.3.3 Liquids, Solutions, or Liquid Aerosols
.......................... 408 13.5.3.4 Solids or Particulate
Aerosols .................................... 408 13.6
Medical.................................................................................
409 13.6.1 CDC Case
Denition.........................................................
409 13.6.2 Differential
Diagnosis........................................................
409 13.6.3 Signs and
Symptoms.........................................................
409 13.6.3.1 Vapors/Aerosols
.................................................... 409 13.6.3.2
Solids/Solutions
.................................................... 409 13.6.4
Mass-Casualty Triage
Recommendations................................. 409 13.6.5
Casualty
Management.......................................................
410 13.7 Fatality Management
................................................................
410
References....................................................................................
425 14 Vomiting/Sternatory
Agents..............................................................
427 14.1 General Information
.................................................................
427 14.2 Toxicology
.............................................................................
427 14.2.1 Effects
..........................................................................
427 14.2.2 Pathways and Routes of
Exposure......................................... 428 14.2.3
General Exposure Hazards
................................................. 428 14.2.4
Latency Period
................................................................
428 14.2.4.1
Aerosols..............................................................
428 14.3 Characteristics
........................................................................
428 14.3.1 Physical
Appearance/Odor.................................................
428 14.3.1.1 Laboratory
Grade................................................... 428
14.3.1.2 Munition
Grade..................................................... 428
14.3.1.3 Modied
Agents.................................................... 428
18. Ellison: 1434_c000 2007/7/4 20:25 page xviii #18 xviii
Contents 14.3.1.4 Mixtures with Other Agents
...................................... 429 14.3.2 Stability
........................................................................
429 14.3.3
Persistency.....................................................................
429 14.3.4 Environmental Fate
.......................................................... 429 14.4
Additional Hazards
..................................................................
429 14.4.1 Exposure
.......................................................................
429 14.4.2 Livestock/Pets
................................................................
430 14.4.3
Fire..............................................................................
430 14.4.4 Reactivity
......................................................................
430 14.4.5 Hazardous Decomposition Products
...................................... 430 14.4.5.1 Hydrolysis
........................................................... 430
14.4.5.2 Combustion
......................................................... 430 14.5
Protection
..............................................................................
430 14.5.1 Evacuation Recommendations
............................................. 430 14.5.2 Personal
Protective Requirements .........................................
431 14.5.2.1 Structural Fireghters Gear
...................................... 431 14.5.2.2 Respiratory
Protection ............................................. 431
14.5.2.3 Chemical Protective Clothing
.................................... 431 14.5.3 Decontamination
............................................................. 431
14.5.3.1 General
............................................................... 431
14.5.3.2 Solutions or Liquid Aerosols
..................................... 432 14.5.3.3 Solids or
Particulate Aerosols .................................... 432 14.6
Medical.................................................................................
432 14.6.1 CDC Case
Denition.........................................................
432 14.6.2 Differential
Diagnosis........................................................
433 14.6.3 Signs and
Symptoms.........................................................
433 14.6.4 Mass-Casualty Triage
Recommendations................................. 433 14.6.5
Casualty
Management.......................................................
433 14.7 Fatality Management
................................................................
433
References....................................................................................
437 15 Malodorants
.................................................................................
439 15.1 General Information
.................................................................
439 15.2 Toxicology
.............................................................................
439 15.2.1 Effects
..........................................................................
439 15.2.2 Pathways and Routes of
Exposure......................................... 440 15.2.3
General Exposure Hazards
................................................. 440 15.2.4
Latency Period
................................................................
440 15.3 Characteristics
........................................................................
440 15.3.1 Physical
Appearance/Odor.................................................
440 15.3.1.1 Laboratory
Grade................................................... 440
15.3.1.2 Munition
Grade..................................................... 440
15.3.1.3 Modied
Agents.................................................... 440
15.3.2 Stability
........................................................................
440 15.3.3
Persistency.....................................................................
441 15.3.4 Environmental Fate
.......................................................... 441 15.4
Additional Hazards
..................................................................
441 15.4.1 Exposure
.......................................................................
441 15.4.2 Livestock/Pets
................................................................
441 15.4.3
Fire..............................................................................
441 15.4.4 Reactivity
......................................................................
441
19. Ellison: 1434_c000 2007/7/4 20:25 page xix #19 Contents xix
15.4.5 Hazardous Decomposition Products
...................................... 442 15.4.5.1 Hydrolysis
........................................................... 442
15.4.5.2 Combustion
......................................................... 442 15.5
Protection
..............................................................................
442 15.5.1 Evacuation Recommendations
............................................. 442 15.5.2 Personal
Protective Requirements .........................................
442 15.5.2.1 Structural Fireghters Gear
...................................... 442 15.5.2.2 Respiratory
Protection ............................................. 442
15.5.2.3 Chemical Protective Clothing
.................................... 442 15.5.3 Decontamination
............................................................. 443
15.5.3.1 General
............................................................... 443
15.5.3.2 Vapors
................................................................
443 15.5.3.3 Liquids, Solutions, or Liquid Aerosols
.......................... 443 15.6
Medical.................................................................................
444 15.6.1 CDC Case
Denition.........................................................
444 15.6.2 Differential
Diagnosis........................................................
444 15.6.3 Signs and
Symptoms.........................................................
444 15.6.3.1 Vapors
................................................................
444 15.6.3.2 Liquids
............................................................... 444
15.6.4 Mass-Casualty Triage
Recommendations................................. 444 15.6.5
Casualty
Management.......................................................
444 15.7 Fatality Management
................................................................
444
References....................................................................................
457 Section V Biological Agents 459 16 Toxins
.........................................................................................
461 16.1 General Information
.................................................................
461 16.2 Toxicology
.............................................................................
461 16.2.1 Effects
..........................................................................
461 16.2.2 Pathways and Routes of
Exposure......................................... 462 16.2.3
General Exposure Hazards
................................................. 462 16.2.4
Latency Period
................................................................
462 16.3 Characteristics
........................................................................
462 16.3.1 Physical
Appearance/Odor.................................................
462 16.3.1.1 Laboratory
Grade................................................... 462
16.3.1.2 Modied
Agents.................................................... 462
16.3.2 Stability
........................................................................
462 16.3.3
Persistency.....................................................................
463 16.3.4 Environmental Fate
.......................................................... 463 16.4
Additional Hazards
..................................................................
463 16.4.1 Exposure
.......................................................................
463 16.4.2 Livestock/Pets
................................................................
463 16.4.3
Fire..............................................................................
463 16.4.4 Reactivity
......................................................................
463 16.5 Protection
..............................................................................
464 16.5.1 Evacuation Recommendations
............................................. 464 16.5.2 Personal
Protective Requirements .........................................
464 16.5.2.1 Structural Fireghters Gear
...................................... 464 16.5.2.2 Respiratory
Protection ............................................. 464
16.5.2.3 Chemical Protective Clothing
.................................... 464
20. Ellison: 1434_c000 2007/7/4 20:25 page xx #20 xx Contents
16.5.3 Decontamination
............................................................. 465
16.5.3.1 General
............................................................... 465
16.5.3.2 Liquids, Solutions, or Liquid Aerosols
.......................... 465 16.5.3.3 Solids or Particulate
Aerosols .................................... 465 16.6
Medical.................................................................................
466 16.6.1 CDC Case
Denition.........................................................
466 16.6.2 Differential
Diagnosis........................................................
466 16.6.3 Signs and
Symptoms.........................................................
466 16.6.4 Mass-Casualty Triage
Recommendations................................. 466 16.6.5
Casualty
Management.......................................................
467 16.7 Fatality Management
................................................................
467
References....................................................................................
488 17 Bacterial Pathogens
.........................................................................
493 17.1 General Information
.................................................................
493 17.2 Response
...............................................................................
494 17.2.1 Personal Protective Requirements
......................................... 494 17.2.1.1 Responding
to the Scene of a Release ........................... 494 17.2.1.2
Working with Infected Individuals ..............................
495 17.2.2 Decontamination
............................................................. 496
17.2.2.1 Food
..................................................................
496 17.2.2.2 Casualties/Personnel
.............................................. 496 17.2.2.3 Animals
.............................................................. 496
17.2.2.4 Plants
.................................................................
496 17.2.2.5
Property..............................................................
496 17.3 Fatality Management
................................................................
497
References....................................................................................
522 18 Viral Pathogens
.............................................................................
527 18.1 General Information
.................................................................
527 18.2 Response
...............................................................................
528 18.2.1 Personal Protective Requirements
......................................... 528 18.2.1.1 Working with
Infected Individuals .............................. 529 18.2.2
Decontamination
............................................................. 530
18.2.2.1 Food
..................................................................
530 18.2.2.2 Casualties/Personnel
.............................................. 530 18.2.2.3 Animals
.............................................................. 530
18.2.2.4 Plants
.................................................................
531 18.2.2.5
Property..............................................................
531 18.3 Fatality Management
................................................................
531
References....................................................................................
589 19 Rickettsial
Pathogens.......................................................................
593 19.1 General Information
.................................................................
593 19.2 Response
...............................................................................
594 19.2.1 Personal Protective Requirements
......................................... 594 19.2.1.1 Responding
to the Scene of a Release ........................... 594 19.2.1.2
Working with Infected Individuals ..............................
594 19.2.2 Decontamination
............................................................. 594
19.2.2.1 Food
..................................................................
594 19.2.2.2 Casualties/Personnel
.............................................. 595 19.2.2.3 Animals
..............................................................
595
21. Ellison: 1434_c000 2007/7/4 20:25 page xxi #21 Contents xxi
19.2.2.4
Property..............................................................
595 19.3 Fatality Management
................................................................
595
References....................................................................................
601 20 Fungal Pathogens
...........................................................................
603 20.1 General Information
.................................................................
603 20.2 Response
...............................................................................
604 20.2.1 Personal Protective Requirements
......................................... 604 20.2.1.1 Responding
to the Scene of a Release ........................... 604 20.2.1.2
Working with Infected Individuals ..............................
604 20.2.2 Decontamination
............................................................. 604
20.2.2.1 Food
..................................................................
604 20.2.2.2 Casualties/Personnel
.............................................. 604 20.2.2.3 Animals
.............................................................. 605
20.2.2.4 Plants
.................................................................
605 20.2.2.5
Property..............................................................
605 20.3 Fatality Management
................................................................
605
References....................................................................................
613 Section VI Additional Information 615 21 Alphanumeric
Indices......................................................................
617 Additional References
............................................................................
731
Index.................................................................................................
735
22. Ellison: 1434_c000 2007/7/4 20:25 page xxii #22
23. Ellison: 1434_c000 2007/7/4 20:25 page xxiii #23 Preface
The rst edition of this handbook was written primarily as an aid to
rst responders and meant to help bridge the gap between what was
known about responding to industrial hazardous materials and
responding to military chemical and biological agents. At the time
it was written, it was one of only a few readily available
resources that addressed the topic. This is no longer the case.
There are numerous books that have been written on virtually every
aspect of a potential response; some are specialized and directed
toward a specic audience while others are written for the average
citizen. However, the world of military agents goes well beyond the
dirty thirty that are usually discussed and there are still only a
limited number of references that provide rapid access to technical
data on a wider range of agents. On the basis of this assessment of
the current literature and on comments received on the rst edition
of this book, this volume has been written to focus on these
details. With this new information, additional classes of agents
have been added. Where it provided clarity, multiple classes have
been consolidated into a single class. The information in existing
classes has been updated and expanded. There is a signicant
increase in the number of agents described, as well as in the
number of components, precursors, and decomposition products. There
is more information on health effects and on the chemical,
physical, and biological properties of these materials. As in the
rst edition, all materials listed in this handbook have been used
on the bat- tleeld, stockpiled as weapons, received signicant
interest by research programs, used or threatened to be used by
terrorists, or have been assessed by qualied law enforcement and
response organizations as agents of signicant concern. To assure
accuracy, all data have been cross-checked over the widest variety
of military, scientic, and medical sources available. Finally, in
presenting this broad spectrum, I do not offer an evaluation of the
efcacy or viability of the agent classes or any of the individual
agents. I have included agents classied by the military as obsolete
along with those that are still considered a major threat. It is
important to remember that while an agent may have been a failure
on the battleeld, it could still be a very successful weapon in the
hands of a terrorist.
24. Ellison: 1434_c000 2007/7/4 20:25 page xxiv #24
25. Ellison: 1434_c000 2007/7/4 20:25 page xxv #25
Acknowledgments I would like to once again thank Pam Ellison, DVM,
for her assistance on the biological sections of this book. She was
a wealth of information on both the technical and practical aspects
of response to biological agents. She spent a great deal of time
challenging my ideas, providing guidance, and correcting my drafts.
Without her, the quality and content of this handbook would have
suffered greatly. There are numerous others out there who have
provided comments, insights, and sug- gestions, both on the rst
edition and on the manuscript for this one. I appreciate them all.
I have tried to address each of them, and incorporated changes that
I believe have improved this edition. Any failures or omissions are
mine and not due to a lack of vigilance or effort on the part of
others. Finally, I would like to thank my wife and children for
their patience as I worked on this project. They have endured not
only my mental absences during family events, but also my attempts
to sneak off and get back on the computer. This second edition took
far longer than I had anticipated and they have suffered the brunt
of it.
26. Ellison: 1434_c000 2007/7/4 20:25 page xxvi #26
27. Ellison: 1434_c000 2007/7/4 20:25 page xxvii #27 Author D.
Hank Ellison served in the United States Army as a chemical ofcer
and has worked for the U.S. Environmental Protection Agency as both
a remedial project manager and federal on-scene coordinator under
the Superfund Program. He currently is president of Cerberus &
Associates, Inc., a consulting rm that specializes in response to
technological disasters. As a private consultant, Ellison has
responded to hazardous material incidents involving highly
poisonous materials, chemical res, water reactive substances, and
shock-sensitive materials throughout the state of Michigan. He has
provided chemical and biological coun- terterrorism training to
members of EMS units, hazmat teams, police SWAT teams, and bomb
squads. During the anthrax events of 2001, he helped state and
local governments as well as Fortune 500 companies to develop and
implement response plans for biolo- gical threats. He currently
advises clients on issues of hazardous materials, and related
safety and security concerns. In addition, he is a member of the
Department of Health and Human Services DMORT-WMD emergency
response team, which has the primary mission for recovery and
decontamination of fatalities contaminated with radiological,
biological, or chemical materials. Ellison earned a master of
science in chemistry from the University of California, Irvine. His
graduate research involved methods to synthesize poisons extracted
from Colombian poison dart frogs. He has a bachelor of science in
chemistry from the Georgia Institute of Technology. He is a member
of the American Chemical Society and Federation of American
Scientists. In addition to his works on weapons of mass
destruction, he is the author of a chapter on the hazardous
properties of materials in the sixth edition of the Handbook on
Hazardous Materials Management, a textbook published in 2002 by the
Institute of Hazardous Materials Management.
28. Ellison: 1434_c000 2007/7/4 20:25 page xxviii #28
29. Ellison: 1434_c000 2007/7/4 20:25 page xxix #29 Explanatory
Notes In this handbook, information about the agents is divided
into classes based on the com- mon military groupings of chemical
(i.e., nerve, vesicant, blood, pulmonary, incapacitating, and riot
control), biological (i.e., bacterial, viral, rickettsial, and
fungal), and toxin agents. In instances where the divisions are too
broad to allow appropriate identication of the chemical or
physiological properties of the individual agents, additional
classes (e.g., organ- ophosphorus nerve agents and carbamate nerve
agents) are provided. There are also classes for nontraditional
agents that do not t neatly into one of the common military
groupings (e.g., convulsants), and for industrial materials that
could be used as improvised agents. Classes are identied by a
number that corresponds to the rst 20 chapters in this handbook
(i.e., C01C20). Classes contain general information about that
specic group of agents. Although this book covers most of the major
classes of chemical, biological, and toxin agents, it does not deal
with antiplant chemicals, antimaterial agents, bioregulators or
modulators, or incendiary and smoke agents. At the end of each
class is detailed technical information about individual agents,
com- ponents, or decomposition products within that class. Each of
these individual materials is assigned a handbook number to allow
for rapid identication and cross-referencing throughout the book.
The rst three characters identify the agent class (e.g., C01). The
let- ter following the hyphen (e.g. C01-A) indicates that the
material is primarily an agent (A), component or precursor of that
class of agents (C), or is a signicant decomposition product or
impurity of that class of agents (D). The three digits that follow
the letter indicate the specic agent in the order that it appears
in the class (e.g., C01-A001). Chapter 21 contains four indices to
allow easy access to specic agents in this handbook. These indices
are the Alphabetical Index of names, the Chemical Abstract Service
(CAS) numbers index, the International Classication of Diseases
(ICD-10) numbers index, and the Organization for the Prohibition of
Chemical Weapons (OPCW) agent numbers index. These indices contain
synonyms and identifying numbers for the agents in this handbook
that are cross-referenced to the individual agents via the handbook
number. Information in classes for chemical agents and toxins is in
the following general format: General information Toxicology
(effects, pathways and routes of exposure, general exposure
hazards, latency period) Characteristics (physical appearance/odor,
stability, persistency, environmental fate) Additional hazards
(exposure, livestock/pets, re, reactivity, hazardous decompos-
ition products) Protection (evacuation recommendations, personal
protective requirements, decon- tamination) Medical [Centers for
Disease Control and Prevention (CDC), case denition, differ- ential
diagnosis, signs and symptoms, mass-casualty triage
recommendations, casualty management, fatality management]
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Explanatory Notes Information in classes for biological (i.e.,
pathogen) agents is in the following general format: General
information Response (personal protective requirements,
decontamination, fatality manage- ment) Information on the
individual chemical agents is in the following general format:
Handbook number Name and reference numbers (CAS, RTECS, UN, ERG)
Formula Description of the agent Additional information including
mixtures with other agents, industrial uses, threat, or treaty
listing Exposure hazards Properties AEGLs status and exposure
values Information on the individual toxins is in the following
general format: Handbook number Name and reference numbers (CAS,
RTECS) Formula and molecular weight (if known) Description of the
toxin and source Routes of exposure and signs and symptoms
Additional information including medicinal uses, threat, or treaty
listing Exposure hazards Information on the individual pathogens is
in the following general format: Handbook number Name, disease, and
ICD-10 Description of the disease including natural transmission,
natural reservoir, and a biosafety level if established Additional
information including threat or treaty listing The disease as it
appears in people including the CDC case denition, communicab-
ility, normal routes of exposure, infectious dose, secondary
hazards, incubation period, signs and symptoms, suggested
alternatives for differential diagnosis, and the untreated
mortality rate The disease as it appears in animals including
agricultural target species, com- municability, normal routes of
exposure, secondary hazards, incubation period, signs and symptoms,
suggested alternatives for differential diagnosis, and the
untreated mortality rate The disease as it appears in plants
including agricultural target species, normal routes of exposure,
secondary hazards, and signs
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Notes xxxi Abbreviations used in identifying individual agent are
listed below. CAS: Chemical Abstracts Service registry number. It
is unique for each chemical without inherent meaning that and is
assigned by the Chemical Abstracts Service, a division of the
American Chemical Society. It allows for efcient searching of
computerized databases. ICD-10: Tenth revision of the International
Statistical Classication of Diseases and Related Health Problems.
It is the international standard diagnostic classication for all
general epidemiological and many health management purposes. RTECS:
Registry of Toxic Effects of Chemical Substances number is a unique
and unchanging number used to cross-reference the RTECS database,
which is a com- pendium of data extracted from the open scientic
literature. Six types of toxicity dataareincludedineachle:
(1)primaryirritation, (2)mutageniceffects, (3)repro- ductive
effects, (4) tumorigenic effects, (5) acute toxicity, and (6) other
multiple dose toxicity. UN: United Nations identication number used
in transportation of hazardous materials. ERG: 2004 Emergency
Response Guidebook number. As in the Guidebook, the letter P
following the guide number indicates that the material has a
signicant risk of violent polymerization if not properly
stabilized. Unless otherwise indicated, exposure hazards are for a
standard man (i.e., a male weigh- ing 70 kg/154 lbs) with a
respiratory tidal volume of 15 L/min (i.e., involved in light
activity). If a different breathing rate is used, then it is
indicated in parentheses. If tem- perature is a factor, then the
critical values are indicated. The military typically classies
moderate temperatures as 6585F. Temperatures above 85F are classied
as hot. For any given parameters, a dash (i.e., ) means that the
value is unavailable because it has not been determined or has not
been published. Conversion Factor: Ratio of parts per million to
milligrams per cubic meter at 77F. LCt50: Is an expression of the
dose of vapor or aerosolized agent necessary to kill half of the
exposed population. These values are expressed as milligram-minute
per cubic meter (mg-min/m3). The lethal concentration (LC50) is
determined by dividing the LCt50 by the duration of exposure in
minutes. Values are for inhalation (Inh) and percutaneous (Per)
exposures. These doseresponse values are not universally valid over
all exposure periods. For inhalation of agent, time parameters are
generally 28 min. For percutaneous absorption of agent, time
parameters are generally 30 min to 6 h. Typically, a lethal
concentration in parts per million (ppm) for a set exposure time is
included in parentheses following the mg-min/m3 value. LC50:
Concentrationofvapororaerosolizedagentnecessarytokillhalfoftheexposed
population. Used when a specic set of exposure conditions (i.e.,
concentration and duration of exposure) are known but a generalized
doseresponse (LCt50) is not available. LD50: Amount of liquid or
solid material required to kill half of the exposed population.
Values are for ingestion (Ing), percutaneous (Per) exposures, and
subcutaneous injection (Sub). These values are expressed as total
grams per individual.
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Explanatory Notes Miosis: Concentration in parts per million (ppm)
required to induce signicant constriction of the pupil of the eye
following a 2-min exposure to the agent. ICt50: Is an expression of
the dose of vapor or aerosolized agent necessary to incapacitate
half of the exposed population. These values are expressed as
milligram-minute per cubic meter (mg-min/m3). The incapacitating
concentra- tion (IC50) is determined by dividing the ICt50 by the
duration of exposure in minutes. Values are for inhalation (Inh)
and percutaneous (Per) exposures; and in the case of vesicants,
damage to the skin (Skin) and eyes (Eyes). These dose response
values are not universally valid over all exposure periods. For
inhalation of agent, time parameters are generally 28 min. For
percutaneous absorption of agent, as well as damage to the skin and
eyes, time parameters are generally 2 min to 6 h. Typically, an
incapacitating concentration in parts per million (ppm) for a set
exposure time is included in parentheses following the mg-min/m3
value. Irritation values for eyes, skin, and respiratory system.
These values are expressed as a concentration (ppm for gases, mg/m3
for aerosols) for a 2-min exposure. Intolerable concentrations
cited in the literature are also noted. Vomiting: Inhaled
concentration of vapor or aerosolized agent necessary to induce
signicant nausea and vomiting in half of the exposed population.
These values are expressed as a concentration (ppm for gases, mg/m3
for aerosols) for a 2-min exposure. MEG: Military exposure
guidelines for deployed personnel. Levels reported in this handbook
are for 1-h exposures and consider three health endpoints. Minimal
(Min): Continuous exposure to concentrations above these levels
could produce mild, transient, reversible effects but should not
impair military operational per- formance. Signicant (Sig):
Continuous exposure to concentrations above these levels could
produce irreversible, permanent, or serious health effects, and
could degrade military operational performance and even
incapacitate some individu- als. Severe (Sev): Continuous exposure
to concentrations above these levels could produce life-threatening
or lethal effects in some individuals. WPL AEL: Worker Population
Airborne Exposure Limits developed for the military by the CDC.
They are based on a time-weighted average exposure over an 8-h
period and 40-h work week. OSHA PEL: Federal Permissible Exposure
Limits based on a time-weighted average exposure over an 8-h period
and 40-h work week. A [Skin] notation indicates that percutaneous
absorption of the material is a potential hazard and may contribute
to the overall exposure. ACGIH TLV: American Conference of
Governmental Industrial Hygienists recom- mended Threshold Limit
Values based on a time-weighted average exposure over an 8-h period
and 40-h work week. A [Skin] notation indicates that percutaneous
absorption of the material is a potential hazard and may contribute
to the overall exposure. AIHA WEEL: American Industrial Hygiene
Association recommended Workplace Environmental Exposure Levels
based on a time-weighted average exposure over an 8-h period and
40-h work week. STEL: Short-Term Exposure Limits based on a
time-weighted average exposure of 15 min (unless otherwise noted).
A [Skin] notation indicates that percutaneous absorption of the
material is a potential hazard and may contribute to the overall
exposure.
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Explanatory Notes xxxiii Ceiling: Exposure limit that species the
concentration of vapor, dust, or aerosol that should not be
exceeded at any time during the workday. In some instances, a time
limit for exposure to the ceiling value is established and is
indicated in par- entheses. A [Skin] notation indicates that
percutaneous absorption of the material is a potential hazard and
may contribute to the overall exposure. IDLH: Immediately Dangerous
to Life or Health levels indicate that exposure to the listed
concentrations of airborne contaminants is likely to cause death,
immediate or delayed permanent adverse health effects, or prevent
escape from the contam- inated environment in a short period of
time, t
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