As evident from the previous paragraphs of this chapter, investigations on the toxi-cokinetics of nerve agents have centered on lethal and supralethal doses of nerve agent. However, the controversy on the possible relationship between the so-called Gulf War Syndrome and exposure to traces of nerve agent shortly after the Gulf War has emphasized that knowledge on the acute and delayed effects of trace exposure to nerve agents is almost nonexistent.32,33 Nevertheless, several situations can be envisaged in which trace exposures becomes realistic. In the case of chemical warfare, small amounts of agent may penetrate into gas masks and protective clothing or into a collective protective shelter. Small amounts of nerve agent may desorb from contaminated skin, clothing, or painted surfaces, posing a risk of long-term, low-level exposure. Miosis, rhinorrhea, dyspnea, and tightness of the chest were observed in rescue workers and medical personnel in hospitals due to secondary exposure to small amounts of agent subsequent to the terrorist attacks with sarin in Matsumoto and in metropolitan Tokyo.34-38 Sarin vapor could be detected in houses up to 12 h after the attack with sarin in Matsumoto. Some victims in this city reported their first
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