CCEP
Developed by a multi-disciplinary team of DoD and VA medical specialists, the CCEP provides a two-phase, comprehensive medical evaluation. Phase I is conducted at the local medical treatment facility (MTF) and consists of a history and medical examination comparable in scope and thoroughness to an in-patient hospital admissions evaluation. The medical review includes questions about family history, health, occupation, unique exposures in the Gulf War, and a structured review of symptoms.
Health care providers specifically inquire about the symptoms and Persian Gulf exposures listed on the CCEP Provider-Administered Patient Questionnaire. The medical examination focuses on patients' symptoms and health concerns and includes standard laboratory tests (complete blood count, urinalysis, serum chemistries) and other tests as clinically indicated.
Individuals who require additional evaluation after completing the MTF-level Phase I evaluation and appropriate consultations may be referred to one of 14 Regional Medical Centers (RMCs) for Phase II evaluations. RMCs are tertiary care medical centers that have representation from most major medical disciplines. Phase II evaluations consist of symptom-specific examinations, additional laboratory tests, and specialty consultations according to the prescribed protocol.
Reference: CCEP Report dated 2 Apr 96, can be found on homepage: http://www.tricare.osd.mil/pgulf/18k-a.htm
Cyclosarin
A nerve gas agent commonly referred to as GF, similar to sarin (GB) ( see below), but more persistent.
References: Agency for Toxic Substances and Disease Registry (ATSDR). 1992. Toxicological profile for Cyclosarin. Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service.
Detection Paper
Detection paper is based on certain dyes being soluble in chemical warfare agents. Normally, two dyes and one pH indicator are used, which are mixed with cellulose fibers in a paper without special coloring (unbleached). When a drop of chemical warfare agent is absorbed by the paper, it dissolves one of the pigments. Mustard agent dissolves a red dye and nerve agent a yellow. In addition, VX causes the indicator to turn to blue which, together with the yellow, will become green/green-black.
Detection paper can thus be used to distinguish between three different types of chemical warfare agents. A disadvantage with the papers is that many other substances can also dissolve the pigments. Consequently, they should not be located in places where drops of, e.g., solvent, fat, oil or fuel can fall on them. Drops of water give no reaction.
On the basis of spot diameter and density on the detection paper, it is possible to obtain an opinion on the original size of the droplets and the degree of contamination. A droplet of 0.5 mm diameter gives a spot sized about 3 mm on the paper. A droplet/cm2 of this kind corresponds to a ground contamination of about 0.5 g/m2. The lower detection limit in favorable cases is 0.005 g/m2.
Reference: Detection of Chemical Weapons: An overview of methods for the detection of chemical warfare agents; homepage: http://www.opcw.nl/chemhaz/detect.htm
M256AI Chemical Agent Detection Kit
The M256A1 kit is a portable, expendable item capable of detecting and identifying hazardous concentrations of chemical agent. The M256 kit is used after a chemical attack to determine if it is safe to unmask. The M256A1 kit has replaced the M256 kit. The only difference between the two kits is that the M256A1 kit will detect lower levels of nerve agent. This improvement was accomplished by using an eel enzyme for the nerve test in the M256A1 kit in place of the horse enzyme used in the M256 kit.
Reference: Worldwide Chemical Detection Equipment Handbook, p. 430
M8A1 Chemical Alarm
The M8A1 is an automatic chemical agent detection and warning system designed to detect the presence of nerve agent vapors or inhalable aerosols. The M8A1 will automatically signal the presence of the nerve agent in the air by providing troops with both a audible and visible warning. The M8A1 was fielded to replace the wet chemical M8 detector with a dry system which eliminated the M229 refill kit, the logistic burden and associated costs. The M8A1 operates in a fixed, portable, or vehicle mounted configuration.
Reference: Worldwide Chemical Detection Equipment Handbook, p. 412
Mustard
Mustard "gas" refers to several manufactured chemicals including sulfur mustard. They do not occur naturally in the environment. The term gas is in quotes because mustard "gas" does not behave as a gas under ordinary conditions. Mustard "gas" is really a liquid and is not likely to change into a gas immediately if it is released at ordinary temperatures. As a pure liquid, it is colorless and odorless, but when mixed with other chemicals, it looks brown and has a garlic-like smell. Mustard "gas" was used in chemical warfare and was made in large amounts during World Wars I and II. It was reportedly used in the Iran-Iraq war in 1984-1988. It is not presently used in the United States, except for research purposes.
The only way that mustard "gas" would enter the environment [other than through use as a weapon] would be through an accidental release. Some evaporates from water and soil into air. It does not easily go into water, and the amount that does breaks down quickly. It is more stable in soil than in water but still breaks down within days, depending on the outside temperature (cold weather makes it more stable). It does not go from soil to groundwater. Mustard "gas" does not build up in the tissues of animals because it breaks down so quickly. Mustard "gas" makes your eyes burn, your eyelids swell, and causes you to blink a lot. If you breathe mustard "gas," it can cause coughing, bronchitis, and long-term respiratory disease.
References: Agency for Toxic Substances and Disease Registry (ATSDR). 1992. Toxicological profile for mustard "gas." Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service
Sarin
Sarin is a light brown liquid. It is odorless, and evaporates about as fast as gasoline. It is toxic both as fumes and to the touch. It is not as persistent an agent as Tabun or Soman, the other two of the trinity of nerve gases developed in Germany.
Sarin, along with Tabun and Soman was invented not long before the Second World War by German scientist Dr. Gerhard Schrader. While developing insecticides similar to malathion and parathion, he discovered the first "nerve gas" agents, as they were then called. In 1936 he discovered Sarin. The Germans stockpiled these weapons during the Second World War, but never used them, probably because of Hitler's personal distaste for the weapons (he himself was a victim of gas attacks in Flanders during the First World War). Sarin is now known as "GB."
Only very small amounts of Sarin are needed to kill. A single milligram of Sarin coming in contact with the skin is sufficient to kill. In a vaporous form, it takes a concentration of 100 milligrams per cubic meter to be fatal. Nerve gases such as Sarin are known as "organophosphorus anticholinesterases" or "OP's." Their chemical method of killing is to block the enzyme cholinesterase. The body's muscles receive electrical impulses caused by choline. Cholinesterase break down choline, making sure these impulses stop at the proper time. Cholinesterase attaches itself to choline and breaks it down, thus halting the impulse. Sarin fools thecholinesterase into acting upon the Sarin as it would choline. When the cholinesterase attaches itself to Sarin, it doesn't break down. Thus, choline is not broken down, and the body goes into convulsions.
The first symptoms start in the eyes, where the pupils contract and vision is blurred. It causes breathing problems and chest tightness. Finally it produces vomiting and headaches, after which the heart and lungs stop as the body convulses. The antidote is a substitute for the missing cholinesterase, which is atropine.
The armed forces in the Gulf War were given Oxime tablets in case of gas attack, which acts to release cholinesterase from the Sarin.
References: Agency for Toxic Substances and Disease Registry (ATSDR). 1992. Toxicological profile for Sarin. Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service.
UN Security Council Resolution
This resolution was adopted by the UN Security Council at its 2981st meeting, on 3 April 1991. The pertinent section of this resolution, as related to the Khamisiyah report, follows:
6. Notes that as soon as the Secretary-General notifies the Security Council of the completion of the deployment of the United Nations observer unit, the conditions will be established for the Member States cooperating with Kuwait in accordance with resolution 678 (1990) to bring their military presence in Iraq to an end consistent with resolution 686 (1991);
Invites Iraq to reaffirm unconditionally its obligations under the Geneva Protocol for the Prohibition of the Use in War of Asphyxiating, Poisonous or Other Gases, and of Bacteriological Methods of Warfare, signed at Geneva on 17 June 1925, and to ratify the Convention on the Prohibition of the Development, Production and Stockpiling of Bacteriological (Biological) and Toxin Weapons and on Their Destruction, of 10 April 1972;
Decides that Iraq shall unconditionally accept the destruction, removal, or rendering harmless, under international supervision, of:
(a) All chemical and biological weapons and all stocks of agents and all related subsystems and components and all research, development, support and manufacturing facilities;
(b) All ballistic missiles with a range greater than 150 kilometres and related major parts, and repair and production facilities;
Decides, for the implementation of paragraph 8 above [paragraph 6 is only numbered paragraph in document], the following:
(a) Iraq shall submit to the Secretary-General, within fifteen days of the adoption of the present resolution, a declaration of the locations, amounts and types of all items specified in paragraph 8 and agree to urgent, on-site inspection as specified below;
(b) The Secretary-General, in consultation with the appropriate Governments and, where appropriate, with the Director-General of the World Health Organization, within forty-five days of the passage of the present resolution, shall develop, and submit to the Council for approval, a plan calling for the completion of the following acts within forty-five days of such approval:
Reference: UN Security Council Resolution 687, dated April 1991