Four Decades Experience of Clinical Management of Chemical War Veterans

Publish Year: 1398
نوع سند: مقاله کنفرانسی
زبان: English
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TOXICOLOGY15_008

تاریخ نمایه سازی: 15 بهمن 1398

Abstract:

Introduction: Chemical warfare agents (CWA) were used in large scales during the World War one (WWI) and in the Iraq-Iran conflict (1983-88). Chlorine and sulfur mustard (SM) were used in the WWI. SM, Tabun and Sarin were applied during the Iraq-Iran conflict. Recent uses of CWA in the civil war of Syria and during the Islamic state war in Iraq have also been the world concern. Therefore, all health professionals, particularly toxicologists should be familiar with CWASulfur mustard: SM is an alkylating agent with long term toxicity. Inhalation is the major route of SM exposure which induces ocular, dermal and respiratory irritation, followed by systemic toxicity. The eyes are the most sensitive organs, but the respiratory tract is the major target organ. DNA alkylation plays an important role in the delayed toxic effects of SM. There is no effective antidote for SM poisoning. Therefore, the early and delayed SM toxic effects on the different body organs of the veterans over the past four decades treated as supportive and symptomatic.Nerve agents: Nerve agents (NAs) are extremely potent cholinesterase inhibitors which include G and V agents. Tabun (GA) was used by the Iraqi army against the Iranian troops in Majnoon Island (1983), which poisoned several thousands and killed more than 300 combatants in the field. Sarin (GB) was applied in Sardasht and Halabjah (1987) massacre with high mortality. Neurotoxic effects of NA include cholinergic (muscarinic and nicotinic) syndromes and CNS toxicity. Despite the antidote (atropine, oxime) used, mortality was high, but long term toxicity has rarely been observed.Conclusion: The threat of CWA use is still exist and thus preparedness for the prevention and management of CWA exposure is required.

Authors

Mahdi Balali-Mood

MD, PhD, FTWAS, Medical Toxicology Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran