History of Use and Epidemiology of Mustard Compounds


Year

Scientist

Development events

1822

Cesar Mansuète Despretz

Reaction of sulfur dichloride and ethane no irritating properties

1854

Frenchman Alfred Riche

Predicting by chlorine and diethyl sulfide

1860

Frederick Guthrie

Irritating properties

1886

Victor Meyer

Completely described the chemical structure 2-chloroethanol +potassium sulfide + phosphorus trichloride fatal in animal test

1886

Albert Niemann

Blister forming properties

1913

Hans Thacher Clarke

Replaced phosphorus trichloride by hydrochloric acid

1913

Emil Fischer

Reported Belistering property




2.2.1 Different Names of Sulfur Mustard After Synthesis


The German named SM as LOST in 1916; combination the first two letters of the last name of two scientists; Wilhelm Lommel and Wilhelm Steinkopf. These two chemists were working in Fritz Haber laboratory at the Kaiser Wilhelm Institute; when they established an industrial method for large-scale production of SM for Imperial German Army (Anonymous 2013; Peano and Bernardi 2015). SM is also named Yperite (Ypres, the place of the first military use of SM in Belgium), and yellow cross, because German shells with vesicants were labeled with a yellow cross (Sun and Zheng 2012).



2.3 Use of Sulfur Mustard During the Wars



2.3.1 World War One (WWI)


During the latter part of WWI on 12 July 1917, German army used “LOST” for the first time against British soldiers in a field near Ypres Belgium (Table 2.2) (Peano and Bernardi 2015; Ellison 2007; Hurst et al. 2007). SM was also named Yperit because of this event (Peano and Bernardi 2015; Kehe and Szinicz 2005). Germany fired more than 1 million SM missiles, during 10 days against Allied troops (Balali-Mood and Hefazi 2005a). A large number of Allied soldiers suffered from the eyes and lung injuries and most of them underwent chronic complication 30–40 year after exposure (Organisation for the Prohibition of Chemical Weapons 2015; Khateri 2013). German army used SM against the second French Army, for the second time in WWI (Hilmas et al. 2008; Duchovic and Vilensky 2007).


Table 2.2
Brief history of sulfur mustard uses in conflicts between 1917 and 2015




































































Year (s)
 
Against

1917 (WWI)

Germany

French (at Ypres)

1919

United Kingdom

Red Army of Russian

1921–1927

Spain and France

Rif insurgents in Morocco

1930

Italy

Libya

1934 and 1936–1937

Soviet Union

Xinjiang, China

1935–1940

Italy

Abyssinia (now Ethiopia)

1939

Poland

Germany

WWII

Germany

Poland

WWII

Germany

Soviet Union

1937–1945

Japan

China

1963–1967

Egypt

North Yemen

1981–1988

Iraq

Iran

1988

Iraq

Kurds on Halabja

1995 and 1997

Sudan

Insurgents in the civil war

The Allies had been able to use SM at Cambrai, France, in November 1917 after they captured the German SM shells (Peano and Bernardi 2015). One year later, Britania used his own SM, in September 1918, during Hindenburg Line (Peano and Bernardi 2015; Hilmas et al. 2008; Duchovic and Vilensky 2007).


2.3.2 Rif War in Morocco (1921–1926)


One of the first governments that used CWA against civilian has been Spain that applied SM against the Rif rebellion (Javier 2006). Rif War (1921–26) was a conflict between Spanish colonial forces (later assisted by France) and Moroccan Berbers of the Rif mountainous region led by Muhammad Abd el-Krim (Balfour 2002; Jernigan et al. 2002). On the first part of war, Berbers used the guerrilla warfare and defeated Spanish force and could capture Spanish weapons (Balfour 2002). Through 3 weeks, 8000–10,000 Spanish soldiers were killed (Kehe and Szinicz 2005). Then the Spaniards extensively used SM against Rif civilian and troops in 1924 (Anonymus 2014). This happened 1 year before time that “the protocol of Prohibition of the Use in War of Asphyxiating, Poisonous or other Gases, and of Bacteriological Methods of Warfare”; as the Geneva Protocol; had been signed (Anonymus 2014). The applied CWA were produced in National Chemical Factory of Spain at La Marañosa near Madrid (Balfour 2002). Hugo Stoltzenberg; a German chemist who later became a citizen of Spain, had great help in the production of these compounds (Anonymus 2014).

The main targets of Spain CWAs attacks were civilian populations, markets, and rivers (Anonymus 2014; Balfour 2002). For the first time on November 27, 1921, these events were revealed in Francophone newspaper which was published in Tangier (Balfour 2002). Then, the usage of SM by Spanish government was described in an article called Cartas de un soldado (Letters of a soldier) on August 16, 1923 in a Spanish newspaper La Correspondencia de España (Balfour 2002). Hidalgo de Cisneros, a pilot of Farman F60 Goliath aircraft, wrote in his autobiographical book that in the summer of 1924 he dropped a 100-kg over Rif people (Balfour 2002).


2.3.3 Italian-Ethiopian War (1935–1936)


Mussolini ordered that around 200,000 Italian soldiers to attack the Ethiopian on 3 October 1935 and then second Italiano-Abyssinian War started. They could not develop as much as they suggested. Italian ignored the Geneva Protocol, that had been singed 7 years earlier (on 26 December 1925), and used poison gas and large-scale aerial bombardment (Khateri 2013; Wikipedia 2015; Anonymous 2013; SMART 1997). The massive air attacks with SM, were done against unprotected Ethiopian forces and civilian population. About 150,000 SM casualties were reported. The Italian attack, contaminated agricultural land and destroyed Ethiopian villages (Anonymous 2013; Balali-Mood and Hefazi 2005b; Wikipedia 2015). Ethiopian had named this event “terrible rain that burned and killed” (Barker 1971). Italian also attacked the Red Cross and the Red Crescent hospitals (Kehe and Szinicz 2005; Barker 1971). The Italian tried to justified their performances and ignoring Geneva Protocol by stating that Ethiopians had tortured their Captives and killed wounded soldiers (SMART 1997).


2.3.4 EGYPT-Yaman War (1963–1967)


The Egyptian air force used CWA in Yemen for 5 years (1963–67). They applied CW against Yamanian royalists who sheltered in inaccessible caves of Yamane’s North Mountains that conventional warfare was not effective. Egyptian army used mixed of CWAs such as tear gas (CN), SM and phosgene as an asphyxiant (Shoham 1998). The CWA attacks induced approximately 1500 fatalities and 1500 injuries (Hadden 2012).

Cairo decided to increase the power of CWA when they assumed to attack Israel in the Yom Kippur War, in 1973. Egypt tried to raise its technology and knowledge of CWAs synthesis and try to improved CWAs’ quality and power (Shoham 1998). Ain-Shams University, the Central Military Chemical Laboratories of the Egyptian Army, Egyptian National Research Center and the Technical University of Budapest in Hungary and some institutions and laboratories in the Unit States and West Germany studied on organophosphorus nerve agents, glycolates BZ, nitrogen and SM (Shoham 1998). The CWA which produced in the institutes and factories were filled into mines, artillery shells, mortar bombs, rockets and aerial bombs (Shoham 1998).


2.3.5 World War II (1939–1945)


Large amounts of SM was made during WWII (Balali-Mood and Hefazi 2005b; Anonymous 2013). Only Germany had produced and accumulated around 25,000 t of SM and 2000 t of nitrogen mustard (John Aa et al. 2002). In 8 September 1939, a polish officer and his troops destroyed a bridge and blocked a road near Jasło. This combat induced two deaths and 12 injured German soldiers. Berlin did not do any retaliation activities (Anonymous 2013).

On 2 December 1943, U.S. ship; SS John Harvey, which had warfare and sulfur mustard grenades, on harbor of Bari, Southern Italy, was bombarded and hit and sunk by German airplane. A part of shipment sank in water and other parts exploded and fired which induced 83 death and nearly 600 human injuries. Due to highly classified of this shipment, the U.S. Army killed all injured who could not treated properly (Kehe and Szinicz 2005; Balali-Mood and Hefazi 2005a; Wikipedia 2015). British and U.S. Armies tested SM on Australian Army volunteers in Queensland in 1943–1944 (Goodwin 1998).


2.3.6 Japan-China War (1939–1945)


The Imperial Japanese Army in 1939 applied SM and Lewisit gases in conflict against Chinese Kuomintang and Communist (Wikipedia 2015; Khateri 2013). The Japanese forces abandoned several barrels of SM in a building at urban Qiqihar in 1945 when they exited from china (Sun and Zheng 2012). On August 4, 2003, 5 SM barrels leaked and injured 43 person (39 males and 5 females) and killed one patient due to multiple organs failure (Sun and Zheng 2012; Hurst et al. 2007). The victims suffered from ocular lesions, cutaneous blisters and pulmonary injuries (Sun and Zheng 2012).


2.3.7 Iraq – Iran War (1981–1988)


In 1881, Iraq began a widespread offensive attack against Iran and occupied large areas of Iran in a short time (Javed 2001; Ahmadi et al. 2010). But moving forward in Iran’s territory didn’t follow the preplanned programs, and lots of Iraqi army’s parts crippled, stopped moving forward, and took a defensive position (Yekta 2012). After the freedom of Khorramshahr (a city in Suth west Iran) in 1883, and the Iraqi’s primary withdrawal, the Iraqi army in order to stop the attacks and moving forward of Iranian troops used tear gas (CS), and yellow rain (Javed 2001; Balali Mood et al. 2014a). Then Iraq found the power of chemical facilities against Iranian troops’ attacks and progress. Therefore, Iraq trained distinct and regular chemically military units as the pattern of chemical units of the Soviet Union, that had a special position in Iraqi army (Cordesman and Wagner 1990).

According to The Los Angeles Times, Iraqis in order to crush the Iranians’ troop’s army organization in night raids used SM sporadically, since December 1982.

On 8 August 1983, Iraqi army targeted different places in western Iran including Haj-Omran, Shiveh Roush, Tamarchin, Doyeraj river and its surrounding area by artillery and aircraft, with nauseous and vesicant gas, later diagnosed as SM. On these battles, around 300 combatants were poisoned. In addition, on the 23rd of August, Qamtareh heights (Chamartheh) were targeted by artillery and vesicatory gases caused the death of three people and injuring of 200 people (Iranian Revolutionary Guards of the Islamic Revolution 1985; Yekta 2012).

In October 1983 during the Iran war operation of Valfajr 4 in the public area of Sulaymaniyah and the Panjwin region, Iraqi forces attacked the positions occupied by Iranian with SM. As a result, around 300 combatants were injured, which by that time was unprecedented (Yekta 2012). A few days later, in November 1983, Iraqi army attacked the Iranian troops and even the civilians with SM on a large area of west Iran. Apart from the military areas, the civilians of Marivan, Sardasht (3rd of October), Bane (8th of November) cities and neighboring villages were under attack (Javed 2001; Security Council of the United Nations 21 April 1988).

In a report that a few days after the incident was transmitted, Islamic Republic News Agency stated more details on how the event took place (Islamic Republic News Agency 1983; Security Council of the United Nations 21 April 1988):

“At 17:00 h on 16 November 1983, while the Iraqi regime had suffered another defeat in the Valfajr 4, area targeted the area between Schiller the mountain range by four of its planes that were armed with chemical weapons. This time, another type of chemical weapons, was tested by Iraq.”

Four days after the onset of Iran war Khaybar operation in south of Iran; on 7th March 1984, Iraq began a massive and widespread chemical attack against Iranian forces (Iranian Revolutionary Guards of the Islamic Revolution 1985). In the first 48 h of the attack by the explosion of over 100 mustard gas bombs; about 500 t of SM was dropped on Iranian forces. As a result 1100 people were injured that 150 of whom were in critical condition (Yekta 2012). Up to 27th of March a large number of chemical attacks with SM were done, the most important of them were performed on 9th March 1984 and 14 March 1984. On 9th March 1984, 543 Iranian soldiers were poisoned, mostly in Majnoon islands (Yekta 2012; Javed 2001). On 14 March 1984, a group of Esfehan Jihad volunteers; who were taking a rest, were under attack with SM that poisoned all of them (Yekta 2012).

On 12 March 1985, Iraqi army attacked Majnoun Islands with nerve gas and then mustard gas in large scales (Yekta 2012). In one of the Iran’s authorities’ letters to the United Nations Organization, it is noted that in the first week of chemical attack (from 13 to 20 March 1985), 77 bombs, 23 rockets, and 639 chemical cannonball were shot to Iran that resulted in 2231 injuries and 32 deaths (Javed 2001). On April 23, 1985 after sending a group of patients with SM poisoning to European hospitals for treatment, the second UN report on Iraq’s use of these bombs was presented (Yekta 2012; Security Council of the United Nations 21 April 1988).

In winter 1986, another Iran war operation (Karbala 4) was performed in southern region and on 26th December 1986, Abadan was under the chemical attack with SM by Iraqi forces. The attack had left 2000 injured combatants that were mostly mild SM poisoning (Yekta 2012; Javed 2001).

After the Karbala 5 operation in Shalamcheh by the Iranian Army, Iraq army performed extensive chemical attacks by SM for 2 months (Security Council of the United Nations 21 April 1988). The number of moderate and severe SM poisoned patients was around 3000, with the sum of mild injuries it was around 7000 chemical casualties. And within a month, 170 people died from exposure to SM (Yekta 2012). On 31th December 1986, Iraqi army attacked Sumar field hospital. As the result of this chemical attack with SM 400 injuries and 20 deaths were reported. Some of the chemical injured combatants were sent to Paris Saint Antoine Hospital (Yekta 2012; Javed 2001; Cordesman and Wagner 1990). Before this event, the other Iranian military hospitals were chemically bombarded by Iraq, too. For example, the bombing of Fatima field hospital on February 27, 1986 caused the hospital to be unusable for weeks, because it was polluted chemically by SM (Javed 2001; Security Council of the United Nations 21 April 1988; Iranian Revolutionary Guards of the Islamic Revolution 1985).

During the war, Iraqi army used numerous chemical and possibly biological factors separately or in combination (Balali-Mood et al. 2013, 2014c). It was estimated that more than half of the Iraq-Iran war chemical casualties were due to SM poisoning, but 32,000 of them have medical records and around 30,000 of them are now suffering from the delayed toxic effects of SM. (Lvarsson et al. 1992; Security Council of the United Nations 21 April 1988; Javed 2001; Yekta 2012). The Acting Permanente Representative of I.R.Iran in united nations sent a letter to security council of UN, which is preserved as S/19816 document of UN, as a report on Iraqi Chemical and biological attacks against Iranian troops and people (Security Council of the United Nations 21 April 1988).


2.3.7.1 Sardasht


The most tragic use of mustard gas was the chemical bombardment of the city of Sardasht (Khateri et al. 2004; Security Council of the United Nations 1986, 30 June 1987a, Jul 30 1987b). In the spring of 1987, the Iraqi army released four 250-kg mustard gas bombs on Sardasht, a small Kurdish town in northwestern Iran (Security Council of the United Nations 30 June 1987a). An estimated of 4500 innocent civilians were exposed to SM and over one-third of them developed moderate to severe medical complications that require hospitalization (Security Council of the United Nations 1986, 30 June 1987a). Many suffered from injuries from the explosions in addition to their exposure to SM (Security Council of the United Nations 30 June 1987a; Mansour Razavi et al. 2012). Sulfur mustard attracts of Iraqi army against Iranian troops and civilians in 1983–1988 were described in Table 2.3.


Table 2.3
Sulfur mustard attracts of Iraqi army against Iranian troops and civilians in 1983–1988



















































































Place

Date

Means

Numberof victims

Shiveh Rash

8 Aug 1983

Aircraft

24

Haaj Omraan

8 Aug 1983

Aircraft


Piranshahr

8 Aug 1983

Aircraft

10

Tamr Chin

9 Aug 1983

Aircraft

30

Ghamtareh heights

14 Aug 1983

Artillery

203

Badamjan Village

23 Oct 1983

Aircraft

30

Bayenjan Village

28 Oct 1983

Artillery


Shatte Ali

26 Feb 1984

Aircraft


Hour Alhoveyzeh

27 Feb 1984

Aircraft

1100

Majnoon

10 Mar 1984

Aircraft

543

Majnoon

11 Mar 1984

Aircraft

20

Road between Kiyand Dasht and Shate Ali

15 Mar 1985

Aircraft


North Port of Shate Ali

15 Mar 1985

Aircraft

738

AE Rahr Fath

15 Mar 1985

Artillery

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Oct 1, 2016 | Posted by in GENERAL SURGERY | Comments Off on History of Use and Epidemiology of Mustard Compounds

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