CHAPTER 4 - The Tokyo Subway Sarin Attack: Toxicological Whole Truth

Abstract

This chapter discusses sarin toxicity based on experiences of the attacks in Matsumoto and the Tokyo subway, and also the Iran–Iraq war. The chapter provides some conclusions drawn from the toxicological issues related to sarin. Given the low concentration and means of dispersal, the Tokyo subway sarin attack can be referred to as a ‘‘passive’’ attack. The implication of such an assumption is therefore that mankind has not yet witnessed a ‘‘full-scale’’ sarin attack in any major city. While valuable information can certainly be gained from the Tokyo subway sarin attack; the experience obtained from the more aggressive Matsumoto sarin attack, and the Iran–Iraq war should also be considered when developing initiatives directed at dealing with a potential ‘‘full-scale’’ attack in the future, where the effects will be more serious. Importantly, reliable epidemiologic data is lacking regarding the long-term effects of sarin toxicity, whether low dose exposure to sarin has any long-term effects, and specific effects on children, pregnant women, and fetuses. The sporadic and limited epidemiologic surveys undertaken to date suggest that some long-term effects are present. Thus, well-designed international epidemiologic studies should be conducted in victims exposed to sarin in Japan, Iran, and during the Persian Gulf War.