Skip to main content

Chemical Warfare

Chemical weapons, developed and extensively used during World War I, have caused more than one million casualties over the past 100 years. Recent events in Syria and the threat of terrorism have pushed concerns about these weapons into the forefront of media attention. Although 98% of UN member states have signed the UN’s Chemical Weapons Convention prohibiting the manufacture, stockpiling, and use of such weapons, stockpiles remain in countries including Syria and North Korea. Evidence overwhelmingly suggests that chemical weapons, if available, will be used to further the aims of both terrorists and governments.

Currently, two broad categories are major health concerns: (1) vessicating, or blistering, agents (e.g., mustard gas) and (2) nerve agents (e.g., Sarin, Tabun, VX). Blistering agents readily penetrate most clothing and protective equipment and persist for long periods; decontamination requires incineration of affected materials. While these agents are readily absorbed through the skin, eyes, nose, lungs and gastrointestinal tract, exposure may initially go undetected since effects take several hours to appear before rapidly progressing. Common effects include severe inflammation, pain, swelling, blistering, and scarring that can lead to vision loss, infection and breathing difficulties. The eye is particularly vulnerable, with eye injury occurring in 86% of those exposed to mustard gas in World War I. Ocular effects may be persistent, resolving initially only to reappear years later. Aggressive ocular lubrication and irrigation, supplemental oxygen, burn unit treatment, and antibiotics are the mainstays of treatment for exposure to blistering agents. 

Nerve agents act by interfering with central nervous system functioning, resulting in constant muscle stimulation, paralysis, and death by asphyxiation. Exposure occurs through skin absorption, inhalation and ingestion. While these agents do not have direct permanent ocular effects, exposure can lead to extreme miosis (pinpoint pupils), "dimming" of vision from decreased intraocular illumination, reduced visual acuity, light sensitivity, and eye pain. Prompt identification of exposure and treatment with nerve agent antidote kits, respiratory support, and suctioning can dramatically improve survival. Evacuation from the exposure site and destruction of contaminated clothing are also essential.

Education and training are key to proper identification and response to chemical weapon attacks. Service members, despite being equipped with chemical alarm kits and protective equipment, must remain vigilant to the threats posed by these weapons. Civilian populations, who are often lacking in training and protective equipment, are particularly vulnerable and must be educated and protected along with our Service members whenever possible.