Chemical Weapons in the Iran-Iraq War (1980–1988) 5. Accumulated Experience in the Treatment of Lesions Caused by Sulfur Mustard

Abstract

ulfur mustard was widely used during the Iran-Iraq war (1980–1988) and in other conflicts in the Middle East. Due to its availability, it can be used by terrorist organizations on the territory of the Russian Federation. Iran is the only country, against which mustard gas was used in modern warfare. The aim of this work is to analyze and summarize the experience of treating of sulfur mustard exposure, accumulated by Iranian specialists during the Iran-Iraq war (1980–1988). The UN official documents and materials, declassified CIA documents, articles of Iranian authors as well as other open sources have been used during its preparation. The Iraqi army used mustard gas in two aggregate states: liquid and dry. Dry mustard gas was a novelty of that war. It was a powdered silica steeped in mustard gas, with a particle size of less than 5 μm. The first signs and symptoms of poisoning could appear after 15 minutes, while acute poisoning effects of exposure to mustard gas vapour or liquid were typically delayed for several hours. The reasons for the severe mustard lesions of the servicemen were the lack of personal protective equipment, untimely evacuation from the mustard gas contamination zone, and the absence of mobile reserves of clean water and degassing installations in battle formations. Iranian experts consider 0.5% sodium hypochlorite solution to be the most effective decontaminant. The only safe antidote is sodium thiosulfate, administered within 60 minutes after exposure to mustard gas. During the evacuation of victims and their treatment in hospitals it is necessary, in severe cases, to insert an intravenous catheter, carry out a tracheotomy with the installation of a tracheotomy tube, and use bronchoscopy as early as possible to flush the bronchi. The treatment of skin and eye lesions should be conservative. In case of a corneal perforation, if its diameter is more than 2 mm – keratoplasty, if it is less – cyanoacrylate glue. Treatment of respiratory lesions aims to relieve symptoms and reduce the severity of complications. For this, bronchodilators, antitussives, mucolytics and, if necessary, antibiotics are used. The use of corticosteroids should be limited to the treatment of those patients with bronchospasm, who can not be treated by bronchodilators. The Iranians also consider gene therapy and treatment with mesenchymal stem cells to be the promising method used in the treatment of lung lesions