Abstract
The third edition of Ramesh Gupta’s “Handbook of Toxicology of Chemical Warfare Agents” is the current update of the second edition which was released in mid-2015. Dr Gupta, Chair of the Toxicology Department at Murray State University in Kentucky (USA), edited this volume, which includes contributions from over 160 worldwide experts. Seventy-one of the contributors are from the United States and constitute the majority of the contributing authors. The United States is followed by Russia with 20 contributors; the Czech Republic with 16; Japan with 10; and 8 contributors from India. There were also contributors from Spain, Iran, Germany, Australia, Canada, Italy, Slovenia, Serbia, the Netherlands, the United Kingdom, and Bosnia–Herzegovina. These world renowned experts—under the guidance of Dr Gupta—present the premier collection of scientific information of toxic chemicals used in warfare and terrorism available today. The book describes the history of chemical warfare agents starting in ancient times and up to current use by terrorists in many areas of the world. This is an extremely detailed text providing background on the attacks, as well as information on clinical and experimental studies on nearly all of the agents that have been and are being used. The book describes and discusses in detail the agents, target organ toxicity, toxic effects in animals and human, and effects on the environment. Also discussed are field and laboratory methodologies, test results including toxicokinetics, mechanisms of toxicity, and nonclinical study data from critical studies on most agents. Risk assessing methodology is detailed as well as modes of detection, prevention, therapeutic treatments, and countermeasures. For over a century, agreements and treaties such as the 1907 Hague Convention, the Geneva Protocol, and the 1933 Chemical Weapons Convention in Geneva have been signed by many of the world’s nations. These agreements and treaties prohibit the development and use of toxic chemical agents, but many ignore the agreements and continue to use these agents illegally right up to the present day. Among the most prominent offenders are the following: Germany used chlorine, phosgene, and mustard during WWI; Adolf Hitler used hydrogen cyanide in the concentration camps during WWII; Saddam Hussein used nerve agents during the 1980s; Victor Yushchenko was poisoned with dioxin in 1994; the “Gulf War Syndrome” resulted from low-level exposure to nerve agents, mustard, pyridostigmine bromide, and pesticides in the 1990s; the organophosphate (OP) nerve agent sarin was used in attacks in Japan in the 1994 and again in 1995; Alexander Litvinenko was fatally poisoned with polonium 210 in late 2006. These are just a few of the numerous attacks and chemicals discussed in considerable detail in this updated volume. This third edition also includes additional chapters on emergency preparedness for these agents and now includes the recent chemical attack in 2018 in Amesbury, United Kingdom, using a Novichok nerve agent identified as A-234. In addition, the remaining chapters have been reviewed and updated from the second edition. This is truly the go-to publication if one needs a compendium of all of the relevant data such as technical, chemical, locational, and relevant treaty agreements. Further, descriptions of the most critical poisonings in history and those more recent attacks are fully characterized.
“Handbook of Toxicology of Chemical Warfare Agents—3rd Edition” contains 1318 pages with a total of 73 mostly stand-alone chapters that are further divided into 9 major sections, as follows: (1) Historical Perspective and Epidemiology; (2) Agents That Can be Used as Weapons of Mass Destruction; (3) Target Organ Toxicity; (4) Special Topics; (5) Toxicokinetics, Toxicodynamics, and Physiologically-Based Pharmacokinetics; (6) Analytical Methods, Biosensors, and Biomarkers; (7) Risks to Animals and Wildlife; (8) Prophylactic, Therapeutic, and Countermeasures; and (9) Decontamination and Detoxification. Each chapter has a brief conclusion and a detailed reference section and most of the references are web linked to the original articles to further assist the reader with additional study details, if needed. In addition to these sections, there is a detailed table of contents, an introduction, and a 35-page index which was amplified by the use of the PDF searching capabilities in my e-Text version. The hardcopy weighs just under 6.5 pounds. I reviewed the e-text version which was very user-friendly in locating specific agents and effects.
Section 1 is 94 pages in length and is further subdivided into 7 chapters covering everything from the history of toxicology and the use of chemical warfare agents to their use during and after WWII to the sarin attacks in Japan and a chapter on epidemiology of these agents and their use in terrorist attacks. Section 2 is 384 pages in length and is subdivided into 23 chapters that provide background, toxicology data, and risk assessment information on agent classes such as sulfur mustards, Novichok type agents, blister agents, riot control agents, phosgene, oximes, psychotomimetic agent BZ (3-quinuclidinyl benzilate), fluoroacetate, strychnine, warfarin, polychlorinated biphenyls (PCBs), polycyclic aromatic hydrocarbons (PAHs), thallium, arsenicals, chlorine, phosgene, cyanides, methyl isocyanate, ricin, and many other agents. Section 3 is 226 pages in length and contains 10 chapters about target organ toxicity on a variety of warfare agents. Section 4 is 168 pages in length and contains 12 chapters on peripheral agents such as radiation and brain trauma from blast pressure. Section 5 contains 94 pages that are subdivided into 8 chapters delving into the toxicokinetic effects of nerve agents and vesicants. Section 6 has 71 pages and 4 chapters on monitoring exposure, the analytical methods involved as well as utilizing biosensors. Section 7 is 42 pages in length and contains 3 chapters that discuss how agents cause contamination of livestock and their feedstock and the dangers presented to wildlife. Section 8 is 142 pages in length and contains 8 chapters which cover therapeutic treatment and prophylactic and countermeasures that can be employed before and after a chemical attack. Section 9 has 18 pages and contains a single chapter that describes how one would decontaminate and detoxify individuals who are exposed to various agents.
Overall, this was clearly a huge undertaking that assembled so many worldwide experts and covered the breadth of toxic chemicals used in weaponry since prehistoric times up to present day and everything in between. Many agents have stand-alone chapters which provide seemingly endless data for biologists, toxicologists, pharmacologists, forensic scientists, analytical chemists, local/state/federal officials, physicians, poison control centers, and academic researchers in the area of nuclear, chemical, and biological warfare agents. The scope and depth of the data are quite impressive, and the data are easy to locate. Its use as a reference text would be a welcome asset. I have added this new volume to my personal library and in this reviewer's opinion, “Handbook of Toxicology of Chemical Warfare Agents—3rd Edition” would be a terrific addition to any practicing toxicologist’s library.