handbook of chemical and biological warfare agents

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

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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 battleeld, 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.

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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.

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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 biological 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.

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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 common 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., organophosphorus 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, components, 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 letter 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 decomposition products) Protection (evacuation recommendations, personal protective requirements, decontamination) Medical [Centers for Disease Control and Prevention (CDC), case denition, differential diagnosis, signs and symptoms, mass-casualty triage recommendations, casualty management, fatality management]

30. Ellison: 1434_c000 2007/7/4 20:25 page xxx #30 xxx 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 management) 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

31. Ellison: 1434_c000 2007/7/4 20:25 page xxxi #31 Explanatory 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.

32. Ellison: 1434_c000 2007/7/4 20:25 page xxxii #32 xxxii 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 concentration (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 performance. 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 individuals. 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 recommended 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.

33. Ellison: 1434_c000 2007/7/4 20:25 page xxxiii #33 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 parentheses. 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 contaminated environment in a short period of time, t

handbook of chemical and biological warfare agents

Engineering

gseries nerve agents

gvseries nerve agents

novichokseries nerve

organophosphorus nerve

novichok series

binary agents

modied agents

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