Recently, World War II veterans have come forward to claim compensation for health effects they say were caused by their participation in chemical warfare experiments.

In response, the Veterans Administration asked the Institute of Medicine to study the issue. Based on a literature review and personal testimony from more than 250 affected veterans, this new volume discusses in detail the development and chemistry of mustard agents and Lewisite followed by interesting and informative discussions about these substances and their possible connection to a range of health problems, from cancer to reproductive disorders.

The volume also offers an often chilling historical examination of the use of volunteers in chemical warfare experiments by the U.S. military--what the then-young soldiers were told prior to the experiments, how they were "encouraged" to remain in the program, and how they were treated afterward.

This comprehensive and controversial book will be of importance to policymakers and legislators, military and civilian planners, officials at the Department of Veterans Affairs, military historians, and researchers.

Contents

• Committee To Survey the Health Effects of Mustard Gas and Lewisite
• Preface
• Acknowledgments
• Executive Summary
• 1. Introduction
• 2. Methods of Literature Collection and Survey
  • ONLINE DATABASES
  • OTHER SOURCES
  • SUPPLEMENTAL WORLD WAR II MILITARY REPORTS
  • LITERATURE TRANSLATION, DISSEMINATION, AND ANALYSIS
  • REFERENCES
• 3. History and Analysis of Mustard Agent and Lewisite Research Programs in the United States
  • INTRODUCTION
  • RESEARCH PROGRAMS OF WORLD WAR I AND THE POSTWAR PERIOD
  • TESTING PROGRAMS AND CHEMICAL WARFARE PRODUCTION IN WORLD WAR II
  • RESEARCH, USE, AND DISPOSAL OF CHEMICAL WEAPONS AFTER WORLD WAR II
  • CONCLUSIONS AND FURTHER ANALYSIS
  • REFERENCES
• 4. Findings from the Public Hearing Process
  • RESULTS AND FINDINGS
  • TREATMENT OF HUMAN SUBJECTS
  • CONCLUSIONS AND ACTIONS TAKEN
  • REFERENCES
• 5. Chemistry of Sulfur Mustard and Lewisite
  • SULFUR MUSTARD
  • LEWISITE
  • REFERENCES
• 6. Relationship of Mustard Agent and Lewisite Exposure to Carcinogenesis
  • ACUTE EFFECTS AND BIOLOGICAL MECHANISMS
  • EVIDENCE OF LONG-TERM HEALTH EFFECTS
  • SUMMARY
  • REFERENCES
• 7. Nonmalignant Respiratory Effects of Mustard Agents and Lewisite
  • PHYSIOLOGY AND ANATOMY
  • ACUTE EFFECTS AND BIOLOGICAL MECHANISMS
  • EVIDENCE OF LONG-TERM HEALTH EFFECTS
  • RELATIONSHIP BETWEEN ACUTE AND CHRONIC EFFECTS CAUSED BY EXPOSURES TO OTHER RESPIRATORY HAZARDS
  • SUMMARY
  • REFERENCES
• 8. Ocular Effects of Mustard Agents and Lewisite
  • PHYSIOLOGY AND ANATOMY OF THE EYE
  • ACUTE EFFECTS AND BIOLOGICAL MECHANISMS
  • EVIDENCE OF LONG-TERM HEALTH EFFECTS
  • SUMMARY
  • CONCLUSIONS
  • REFERENCES
• 9. Dermatological Effects of Mustard Agents and Lewisite
  • ANATOMY AND PHYSIOLOGY OF SKIN
  • ACUTE EFFECTS AND BIOLOGICAL MECHANISMS
  • EVIDENCE OF LONG-TERM HEALTH EFFECTS OF MUSTARD AGENTS
  • EVIDENCE OF LONG-TERM HEALTH EFFECTS OF LEWISITE
  • SUMMARY
  • REFERENCES
• 10. Other Physiological Effects of Mustard Agents and Lewisite
  • EFFECTS ON THE IMMUNE SYSTEM
  • EFFECTS ON SYSTEMS OTHER THAN THE IMMUNE SYSTEM
  • REPRODUCTIVE RISKS
  • REFERENCES
• 11. Relationship of Mustard Agent and Lewisite Exposure to Psychological Dysfunction
  • HISTORICAL DEVELOPMENT OF THE CONCEPT OF PTSD
  • CURRENT RESEARCH IN PTSD
  • EVIDENCE FROM STUDIES OF MILITARY PERSONNEL AND VETERANS
  • EVIDENCE FROM STUDIES OF THE PSYCHOLOGICAL EFFECTS OF ENVIRONMENTAL CONTAMINATIONS
  • CONCLUSIONS
  • REFERENCES
• 12. Summary of Findings and Recommendations
  • GENERAL CONCLUSIONS
  • CONCLUSIONS REGARDING THE CAUSAL RELATIONSHIPS OF EXPOSURE TO THE DEVELOPMENT OF SPECIFIC DISEASES
  • GAPS IN THE LITERATURE REGARDING MUSTARD AGENTS AND LEWISITE
  • RECOMMENDATIONS
• Bibliography
• APPENDIXES
  • A Scientific and Background Presentations Made to the Committee
  • B Excerpt from The Residual Effects of Warfare Gases (1933)
  • C Involvement of the National Academy of Sciences Complex in World War II Research Programs: A Summary
  • D Excerpts from Chamber Tests with Human Subjects I, II, and IX. Naval Research Laboratory Reports Nos. P-2208 and P-2579
  • E Interim Report and Addendum Han K. Kang, Dr. P.H.
  • F Summary of the Department of the Army Report by James R. Taylor and William Johnson
  • G Public Hearing Announcement
  • I Risk Assessment Considerations for Sulfur Mustard
  • J Examination of the Effects of Certain Acute Environmental Exposures on Future Respiratory Health Consequences
• List of Acronyms and Abbreviations

The work on which this publication is based was performed pursuant to Contract No. V101(93)P-1326 with the Department of Veterans Affairs. Funds for this contract were provided by the Department of Veterans Affairs.

NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for this report were chosen for their special competences and with regard for the appropriate balance.

This report has been reviewed by a group other than the authors according to procedures approved by a Report Review Committee consisting of members of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine.

The Institute of Medicine was chartered in 1970 by the National Academy of Sciences to enlist distinguished members of the appropriate professions in the examination of policy matters pertaining to the health of the public. In this, the Institute acts under both the Academy's 1863 congressional charter responsibility to be an advisor to the federal government and its own initiative in identifying issues of medical care, research, and education.