In this chapter we will discuss the history of chemical, biological, and radiological (CBR) warfare, and the recognition and treatment of CBR-produced conditions. We will also discuss the Medical Department's role in meeting the medical aspects of CBR defense, which includes protection from CBR hazards, mass casualty decontamination, decontamination stations, and supplies for decontamination. Table 8-1 provides a summary of CBR symptoms and treatments.

CHEMICAL WARFARE

LEARNING OBJECTIVE: Select the appropriate treatment and decontamination procedure for chemical, biological, or radiological exposures.

The use of chemical agents in warfare, frequently referred to as "gas warfare," is defined as the use of chemical agents in gaseous, solid, or liquid states to harass personnel, produce casualties, render areas impassable or untenable, or contaminate food and water. The chances of surviving a chemical attack are increased as knowledge of the nature of the agents and of the use of correct protective measures is increased.

HISTORY
The first large-scale use of chemical agents came in World War I when, in 1915, the Germans released chlorine gas against the Allied positions at Ypres, Belgium. Over 5,000 casualties resulted. There were other gas attacks by both combatant forces during World War I, and it is well documented that approximately one-third of all American casualties in this conflict were due to chemical agent attacks.

During the interval between World Wars I and II, each of the major powers continued to develop its capability for chemical warfare, in spite of a ban by the Geneva Treaty. In isolated cases in the late 1930s, toxic chemicals were used; however, they were not used during World War II. Nor were toxic chemicals authorized for use in Korea, Vietnam, or Desert Storm.

Defoliants and riot-control agents were used with some degree of effectiveness in the jungles of Vietnam, in tunnel and perimeter-clearing operations.

DISPERSAL
Chemical agents are dispersed by modern weapons for strategic as well as tactical purposes. However, the areas of their use are limited by the range of the weapons or aircraft used by the combatant force.

Anaval unit afloat finds itself in a unique situation with respect to defending against toxic chemical agents. Agents can be released as clouds of vapor or aerosol. These can envelope the exterior of a vessel and penetrate the hull of the ship. Extensive contamination can result from such an attack, and the ship must be decontaminated while the personnel manning it continue to eat, sleep, live, and fight on board.

To properly meet the medical needs of the ship, the medical officer or Hospital Corpsman on independent duty must organize the Medical Department well in advance of the actual threat of a chemical agent attack. All hands must be indoctrinated in the use of protective equipment and self-aid procedures, and close liaison and planning must be maintained with damage control personnel responsible for area decontamination.