Nerve agents: emergency preparedness

Abstract

Nerve agents (NAs) are a highly toxic group of chemical warfare agents. NAs are organophosphorus esters with varying physical and chemical properties depending on the individual agent. The most recently developed class of NA is ‘Novichok’, the existence of which was first revealed in the early 1990s, just before Russia signed the Chemical Weapons Convention. In 1984, Iraq became the first nation to deploy NA on the battlefield when they used tabun against Iranian military forces in Majnoon Island near Basra. The first terrorist use of an NA is believed to be the attack in Matsumoto, Japan, on 27 June 1994 by the Aum Shinrikyo doomsday cult. Symptoms and ultimate toxicity from NA poisoning are related to the agent involved, the form and degree of exposure, and rapidity of medical treatment. The classic toxidrome of significant exposure to NA comprises bronchorrhoea, bronchospasm, bradycardia and convulsions, with an onset period of as early as a few seconds depending on the mode and extent of exposure. If medical management is not instituted rapidly, death may occur in minutes by asphyxiation and cardiac arrest. In the UK, emergency preparedness for NA poisoning includes an initial operational response programme across all blue light emergency services and key first responders. This paper describes the development, pathophysiology, clinical effects and current guidance for management of suspected NA poisoning. It also summarises the known events in which NA poisoning has been confirmed.

Identification of organophosphate modifications by high‐resolution mass spectrometry

“…3 Third, the death of Kim Jong-Nam, a member of the North Korean dictator's family, was reported at a Malaysia airport in 2017 from exposure to V-type nerve agent (VX), 4 which was probably made in Russia by Russian military intelligence officer Sergei Skripla and his daughter Yulia Skripal, who defected to the United Kingdom from Russia in 2018. 5 Fourth, cases of poisoning with a putative Novichok agent have been reported. 6 These nerve agents belong to the OP compound group.…”

3D Core–Shell TiO2@MnO2 Nanorod Arrays on Microcantilevers for Enhancing the Detection Sensitivity of Chemical Warfare Agents

“…Chemical warfare agents (CWAs) and more particularly nerve agents are extremely toxic molecules. These agents can rapidly lead to clinical effects or death which depends on the agent, the route of exposure, and the absorbed amount of the agent . They are potent acetylcholinesterase-active agents and highlight a steep dose–response curve. , They may have various and different effects on the peripheral and central nervous systems with ocular, respiratory, gastrointestinal, systemic, or muscarinic effects. , Organophosphorous agents (OPs) can be classified into four types: (i) “G” agents (G stands for German agents), mostly represented by tabun, sarin, and soman, (ii) “V” agents (V stands for venomous), where the most known agents are VE, VG, VX, and Chinese VX, (iii) “GV” agents, which have the combined properties of both G and V agents, and (iv) Novichok agents. ,, Despite the existence of the Organization for the Prohibition of Chemical Weapons (OPCW), these toxic agents have been used not only on the battlefield in Iraq in 1984 but also more recently on civilians over the past 3 years. , …”

“…These agents can rapidly lead to clinical effects or death which depends on the agent, the route of exposure, and the absorbed amount of the agent. 1 They are potent acetylcholinesterase-active agents and highlight a steep dose−response curve. 2,3 They may have various and different effects on the peripheral and central nervous systems with ocular, respiratory, gastrointestinal, systemic, or muscarinic effects.…”

“…1,2 Organophosphorous agents (OPs) can be classified into four types: (i) "G" agents (G stands for German agents), mostly represented by tabun, sarin, and soman, (ii) "V" agents (V stands for venomous), where the most known agents are VE, VG, VX, and Chinese VX, (iii) "GV" agents, which have the combined properties of both G and V agents, and (iv) Novichok agents. 1,3,4 Despite the existence of the Organization for the Prohibition of Chemical Weapons (OPCW), these toxic agents have been used not only on the battlefield in Iraq in 1984 but also more recently on civilians over the past 3 years. 1,5 Due to their high threat potential, the development of sensors able to detect very low concentrations of CWAs has become a priority to protect civilians and military forces deployed in overseas operations.…”

“…1,3,4 Despite the existence of the Organization for the Prohibition of Chemical Weapons (OPCW), these toxic agents have been used not only on the battlefield in Iraq in 1984 but also more recently on civilians over the past 3 years. 1,5 Due to their high threat potential, the development of sensors able to detect very low concentrations of CWAs has become a priority to protect civilians and military forces deployed in overseas operations. Sensors must be mainly sensitive, selective, inexpensive, and portable with a fast response time to the threat.…”