GB is a colorless liquid organophosphate nerve agent with low persistence (evaporation rate about the same as water). It has a faintly fruity odor (which is absent for the pure material).

CHEMICAL AND PHYSICAL PROPERTIES

DETECTION

Nerve agent sensitive chemical agent detectors (e.g., CAM, M18A2, M256, etc.) and papers (e.g., M8, M9) may be used for detection.

In addition to direct analysis, it may be identified based on degradation products, of which the most prominent in soil samples are likely to be methylphosphonic acid and monoisopropyl methylphosphonate. Isopropylmethyphosphonic acid has also been found. Nagao, et al (Toxicology and Applied Pharmacology 144, 198-203 (1997)) describe a forensic technique for analysis of blood for sarin degradation products. Minami, et al (Journal of Chromatography B 695, 237-244 (1997) describe a method for analyzing urine samples for sarin metabolites.

SYMPTOMS AND EFFECTS

Lowered acetylcholinesterase levels are indicators of nerve agent intoxication in victims.

Depending on the degree of intoxication, symptoms may include:

Onset is usually rapid, occurring within minutes of exposure.

MEDICAL COUNTERMEASURES

Useful Drugs	Atropine sulfate	Pralidoxime salts	Diazepam

Remove victims from exposure as rapidly as possible. Victims must not be moved into clean treatment areas where unmasked/ungloved personnel are working until decontamination is complete.

Medical treatment should include decontamination of victims at as early a stage as possible. See the section DECONTAMINATION.

Medical personnel treating casualties should avoid direct (skin-to skin) contact; protective gear including breathing protection should be worn when treating casualties prior to decontamination. Latex gloves are not adequate protection. Chemical protective (butyl rubber) gloves must be worn.

The immediate treatment for nerve agent intoxication is intravenous injection of 2 mg atropine sulfate (intramuscular injection should be considered if the patient is hypoxic and ventilation can not be initiated, as there is a risk of ventricular fibrillation). This should be followed by additional injections of atropine at 10-15 minute intervals, continuing until bradycardia has been reversed (e.g., until the heart rate is at 90 beats/minute). If breathing has stopped, a mechanical respirator should be used to ventilate the patient. While exhaled air is not ordinarily a hazard, DO NOT ATTEMPT MOUTH-TO-MOUTH RESUCITATION without proper shields owing to the possible presence of residual agent on the face. If possible, oxygen or oxygen-enriched air should be used for ventilation. If possible, monitor cardiac activity.

Pralidoxime salts are effective in restoring acetylcholinesterase activity after exposure to sarin. Thus, as a supplement to treatment with atropine, treatment with pralidoxime salts should be initiated as soon as possible after exposure, with a slow intravenous infusion of 500 mg to 1 g being given initially.

Atropine eye drops reportedly gave some symptomatic relief for eye problems following the use of sarin by terrorists in the Tokyo subway system.

Diazepam should be administered to control convulsions. It also has value in controlling fear on the part of the patient. An initial dose of 5 mg may be followed by additional doses at 15 minute intervals up to a total of 15 mg.

PHYSICAL COUNTERMEASURES

Protective equipment (self-contained breathing equipment or gas mask with appropriate filter, barrier suit) must be used.

agent absorbed by cloth (clothing, blankets, etc.) may be released as a vapor by the cloth for 30 minutes or more after exposure.

Also refer to 2004 Emergency Response Guidebook (ERG2004) Guide 153.

DECONTAMINATION

Surface decontamination may be accomplished using hypochlorite bleach slurries, dilute alkalis, or DS2 decontaminating solution. Steam and ammonia may be used for the decontamination of confined spaces. Hot, soapy water can also be effective.

Decontamination of victims is accomplished by removing the victim from the contaminated area, removal of clothing, and removal or neutralization of agent present on the skin. Any visible droplets should be blotted (not wiped) away using an absorbant material (e.g., paper towels, facial tissues, etc.); if available, towelettes moistened with a neutralizing solution should be used. Adsorbant powders may also be used for removal of droplets (in the absence of standard adsorbants, field expedients such as flour may be useful). Hair should be thoroughly cleaned using soap and water, with care being taken to prevent wash water from contacting skin.

GB is miscible with water and readily soluble in common organic solvents. Sarin hydrolyzes readily in water, with a pH-dependent rate (half-life at pH=7 and 25° is 5.4 hours). Hydrolysis occurs more rapidly in alkaline solutions. Hydrolysis under acid conditions will produce hydrofluoric acid, and should be avoided.

SELECTED PRECURSORS

• Ammonium bifluoride
• Dimethyl methylphosphonate
• Diethylphosphite
• Dimethylphosphite
• Hydrogen fluoride
• Methylphosphonous difluoride
• Methylphosphonyl dichloride
• Methylphosphonyl difluoride
• Potassium bifluoride
• Potassium fluoride
• Phosphorus trichloride
• Sodium bifluoride
• Sodium fluoride
• Thionyl chloride
• Trimethyl phosphite

COMMENTS

Binary weapons

Binary weapons in which GB is formed at the time of use have been developed by several countries. The agent from the binary weapons is sometimes designated GB2 to distinguish it from that dispersed by unitary weapons. The weapons are also sometimes described as GB2 [shells, bombs, etc.].

One component in the U.S. binary is methylphosphonyldifluoride (Code DF; CAS Registry Number 676-99-3) and the other is either isopropanol (CAS Registry Number 67-63-0) alone or OPA, where OPA is a mixture of isopropanol 72% with isopropylamine (CAS Registry Number 75-31-0) 28%.

GB-GF Mixtures

Iraq fielded munitions filled with mixtures of GB and cyclosarin (GF). Tests on mice have indicated that GB-GF mixtures have a toxicity intermediate between the toxicities of GB and GF; thus, there appear to be no synergistic effects producing enhanced or unexpected toxic effects that would require any special treatment protocols in those exposed to a mixture.

Historical Notes

GB is a "first generation" nerve agent, identified in 1938 as a potential chemical agent by German researchers examining toxic organophosphates as a result of the discovery of GA (Tabun). During the research, GB was identified by the code number T-144. After its toxic properties made it a candidate for weaponization, it was given the name Sarin, which is derived from the names of the researchers involved in the project (Schrader, Ambros, Ritter, and Linde).

GB was the most expensive (in terms of raw materials) nerve agent selected for mass production by the Germans as part of their Grün 3 program, requiring 1058 tons of raw materials to produce 100 tons of agent. A more efficient production method was subsequently identified, requiring only 893 tons of raw materials to produce 100 tons of GB, but this is still large in comparison to the 356 tons of raw materials required to produce 100 tons of Tabun. GB produced by the second method is referred to in some documents of the period as Sarin-2.

Pilot production was undertaken at the Dyherrnfurth plant, with mass production slated for Falkenhagen. Anorgana and Monturon, both members of the IG-Farben conglomerate, were contracted to produce GB. Total wartime production was 61 tons, with 38 tons produced in 1944 and 23 in 1945.

After the war ended, the victors became aware of the German research into, and weaponization of, nerve agents. They immediately began their own investigations into these materials.

The Soviet Union would divide their attention between sarin and soman, but sarin was certainly not scanted (in 1946, the Stalin Prize, First Class was awarded to M. I. Kabachnik for research on the industrial production of sarin - the first, but not the last such award for work on nerve agents). Full-scale production is said not to have gotten underway until 1959 at the S. M. Kirov plant in what was then named Stalingrad (and a Lenin prize was awarded in 1960 to a team in part because they apparently overcame some problems associated with the industrial production of sarin). The Russian Federation would declare that about 12,900 tons (11,700 metric tons) of stockpiled sarin were under its control on signing the Chemical Weapons Convention.

The United States and other NATO countries would decide to make sarin their major nerve agent (later supplementing it with VX). The United States built a production plant in the North Plants complex at the Rocky Mountain Arsenal in Colorado that was capable of producing an estimated (the actual figures remain classified) 10 tons a day of the agent. Construction of the plant extended over the period 1951-1953, and GB was produced there from February, 1953 until August, 1957. The site was also used to fill weapons with GB from bulk stocks, with the last such filling operation being completed in 1969.

The North Plants complex would also be the site of the first major effort by the United States to dispose of some of its chemical weapons. Destruction ("demiltarization") of weapons that were obsolete was, of course, a part of the routine of the Army. The Rocky Mountain Arsenal was the facility that was usually given the responsibility for demilitarizing chemical weapons, the chemical agents from the weapons being either recycled or chemically destroyed. Considerable experience was acquired at the arsenal over the years - in the period 1955-1970, more than 204,000 GB-filled munitions were reported to have been demilitarized there.

The experience gained from these routing disposal operations led to the decision to assign responsibility to the Rocky Mountain Arsenal for disposing of GB from both obsolete weapons and from some bulk storage containers when the U.S. Army decided on a major cleanup of its chemical weapons inventory in 1969. The disposal operation, known as Project Eagle Phase 2 (Phase 1 was the destruction of sulfur mustard) began on October 29, 1973. A chemical neutralization process in which alkaline hydrolysis of the agent was induced using a sodium hydroxide solution was employed. Some 4,188 tons of GB had been destroyed when the project ended in November of 1976.

The disposal process did not proceed totally smoothly, however. More than 100 incidents in which workers were exposed to sarin occurred during the demilitarization operations, in part because the existing M-3 rubber protective suits were not up to the job of protecting the workers. In 1974, the Colorado Health Department complained about finding DIMP (diisopropylmethylphosphonate, a byproduct of the GB destruction product) in drinking water. And the tests for residual GB seemed to indicate that sometimes the process didn't completely eliminate the sarin (although it was subsequently concluded that this was an artifact of the testing process). A consequence of these difficulties would be that, when faced with the need to completely destroy the nerve agent stockpiles after the United States signed the Chemical Weapons Convention, the chemical neutralization process would initially be rejected.

In large part in response to concerns over the safety of the nerve agent stockpile, the U.S. Army had also undertaken development of a binary 155 mm shell. The first successful test firing of a binary shell took place on September 16, 1969 at the Dugway Proving Ground. Seven years later the design of the shell was finally standardized as the M687 Binary GB2 155 mm projectile. This shell did not enter production immediately as the U.S. Congress elected to restrict the production of binary weapons unless the President certified that such production was essential. The M687 would finally enter production on December 16, 1987 after President Reagan certified the need for the weapons. The life of the shells would be short, however, as the United States and the Soviet Union would sign a bilateral agreement to destroy chemical weapons on June 1, 1990. The destruction of the 258,548 M687 shells (and the associated OPA canisters) was completed in July of 1999.

The production of sarin was not limited solely to superpowers. Chemical weapons were seen as a relatively simple and cheap (especially on contrast to nuclear weapons) weapon of mass destruction, and nerve agents were the stars of the chemical warfare world. While it is impossible to be sure about what countries have actually mass produced sarin, there is much speculation that it has been investigated by countries such as North Korea and most of the countries in the Middle East, including Israel, as indicated by the consequences of the crash, on October 4, 1992, of an El Al cargo plane in Amsterdam. Subsequently, health problems among those living near the crash site prompted an investigation, which revealed that the cargo included the sarin precursors dimethyl methylphosphanate, hydrogen fluoride, and isopropyl alcohol consigned to the Israeli CBW research facility at Nes Ziona.

The most notorious possessor of sarin was, of course, Iraq, which not only produced this agent but which also used it in substantial quantities against both its enemies in the Iran-Iraq war and against its own citizens.

During its war with Iran, Iraq initiated the use of chemical weapons, beginning with sulfur mustard in 1983, progressing to tabun in 1984, and then to sarin (and eventually VX) beginning in 1987. Sarin was also used in attacks on Iraqi civilians, most notably in the March, 1988 destruction of the Halabja, where civilian deaths caused by a cocktail of different agents have been estimated at 5000.

Iraq mass produced sarin during the Iran-Iraq war with the expectation that it would be used quickly, and they therefore skipped several purification steps. Fresh agent was about 60% pure and heavily contaminated with hydrogen fluoride (which, of course, also causes health problems in exposed individuals). When production caught up with demand, the Iraqis started storing their sarin in refrigerated "igloos" to prolong its storage life. However, even when stored in the igloos, the material rapidly degraded, becoming less than 10% pure within 2 years.

This was one of the factors that lead the Iraqis to investigate binary weapons, for which sarin is particularly well suited. A project (described in the revised "Full, Final, and Complete" disclosures issued by Iraq after the defection of Hussein al Kamal) was established which achieved some success in the design and construction of binary munitions using 122 mm rockets and 155 mm artillery shells, although the project does not seem to have progressed to full scale manufacture. This is not so surprising - as can be inferred from the seven year gap between the first successful U.S. binary shell test firing and the standardization of a design, the actual implementation of the binary concept is somewhat complex. There is no evidence that more than a few hundred binary shells were produced - more than were needed as prototypes, perhaps, but nowhere near what would have been needed for use against the Iranians had the war continued.

But, while they still had not mastered the art of manufacturing binary munitions in which the mixing of the precursors occured after firing ("mix-in-flight") at the time of the invasion of Kuwait, they had developed a simple process for generating the agent immediately before use: a warhead or bomb would be given a partial fill of isopropanal (and often cyclohexanol, a precursor for the related nerve agent GF, sometimes known as cyclosarin) and stored along with plastic containers of methylphosphonic difluoride (DF). Shortly before the munition was to be used an Iraqi soldier would be provided with a gas mask and would pour an appropriate amount of the DF into the munition. This reduced storage issues.

While sarin does not appear to have been intentionally released during the Gulf War, a link between Gulf War Syndrome and the possible release of sarin during bombing raids and during the destruction of weapons depots following the war has been suggested. The issue, at this writing, is far from settled.

Sarin in the News

On June 7, 1998 the Cable News Network (CNN) and TIME magazine brought sarin into the public eye Allegations that the United States had used sarin gas to cover a withdrawal of troops on a secret mission in Laos as part of "Operation Tailwind" in 1970. The story was spectacular, and was used to kick-off a new program "NewsStand" on CNN. As soon as they were aired, the allegations began to fall apart (the most obvious problem was a statement by a supposed participant that he had discarded his mask - apparently so he could breath more easily while running - while still in the agent cloud). Nevertheless, the U.S. Department of Defense undertook an investigation into the allegations, and determined that no records supported it. Several of the individuals who had been interviewed complained that they had been ignored or that comments had been aired completely out of context. On July 2, CNN and Time retracted their reports.

Sarin has also appeared in the news for reasons related to its disposal (a thorny issue, required to comply with the Chemical Weapons Convention, and also needed because the stockpile of munitions is getting old and dangerous). Accidents at storage facilities tend to make the news, at least in the neighborhoods of the facilities, for obvious reasons. In the United States, which is currently destroying its sarin stocks, accidents at storage facilities were used to bolster the case for incinerators to destroy the materials, while an accident at an incinerator was used to make a case against them, complicating the plans for disposal. And the issue of accounting for stocks took a hit when the Rocky Mountain Arsenal found that sarin-containing M-139 bomblets had apparently simply been tossed onto a scrap heap - resulting in a requirement that the 27 square miles of the arsenal be checked over to see if any other odd bits of chemical weaponry had been mislaid.

Terrorist Use

Aum Shinrikyo

GB was the first agent to be employed to cause mass casualties by nonstate actors when it was used for attacks by the Aum Shinrikyo cult in Japan during 1994 and 1995.

Aum Shinrikyo had first attempted to buy sarin, placing an order in 1988 with what they thought was a weapons smuggler (but which was actually a sting operation underwritten by the U.S. Customs service) for some 250 tons of sarin-containing bombs. For obvious reasons, the bombs were never delivered. Efforts were also made to obtain ex-Soviet agents after the demise of the Soviet Union, but these also failed. As a result Aum's leadership decided to develop an internal capability for chemical agent production.

The program was coordinated by one Masami Tsuchiya, who started small - only 20 grams of sarin were in the first batch produced in October, 1993. This was ramped up quickly - 1 kilogram in November, then 5 kilograms in December, all produced using laboratory scale equipment. The agent was tested on sheep on a ranch owned by the sect in Australia. Once it was clear that they were able to produce a lethal agent, they began to consider how to produce it and use it.

The head of the cult, Shoko Asahara, wanted more, however, and a facility, "Satyan 7," for mass production of sarin was constructed. Satyan 7 reportedly cost $10 million to build, and an associated analytical facility is said to have cost the cult a further $1 million. The facility included computer-controlled reactors and industrial packaging equipment which automatically bagged specified amounts of the sarin and sealed the bags. The production target for the facility was two tons of sarin per day. This level of expenditure makes it clear why Tsuchiya would subsequently attempt to explain his involvement with the cult in part because Aum's laboratories were better than those at the university where he had studied.

The first attempt to employ sarin was undertaken at the direction of the cult's leader, who wanted Daisaku Ikeda, leader of the Soka Gakkai Buddhists, killed. The attempts were made in March, 1994, but the spray apparatus failed (either spraying backwards or catching fire - published accounts are contradictory; in some accounts, it is stated that Tomomitsu Niimi, Aum's chief of security was exposed to the agent but survived due to rapid administration of atropine).

Three months later, they tried again, successfully releasing sarin in Matsumoto, Japan on June 27, 1994, killing 7 people and injuring at least 500. The apparatus used to dispense the sarin was very simple - reduced to its essentials, it consisted of a container of liquid sarin from which perhaps as much as 20 kilograms of sarin was dropped onto a heated surface to produce sarin vapor; the sarin vapor was then blown into the air by fan. The dispersal took about twenty minutes.

Emergency response after the first calls was rapid, and the chief fire officer at the scene seems to have quickly recognized what had happened, although he didn't identify the agent, describing the incident as a mass disaster caused by an unknown toxic gas. Victims were dispersed to six area hospitals, where the doctors recognized the symptoms as those of organophosphate poisoning, and treated the patients as they would have those exposed to pesticides.

The goal of the attack had been the death of three judges who were hearing a lawsuit over a real-estate dispute involving Aum. The judges were affected, but all eventually recovered, although the suit had largely been rendered moot by the time they were all again available. However, 7 people died, and more than 500 were affected (58 were admitted to hospitals, including the 7 fatalities; 253 received outpatient care, and a subsequent survey identified 277 people who experienced symptoms but did not seek medical care).

In the aftermath of the attack, the investigation was initially misdirected. Like the physicians who thought they might be dealing with a pesticide released by accident, the police couldn't imagine anyone doing this on purpose, even when the agent was identified as sarin. As a result, they focused their attentions initially on a former chemical company employee who they believed had accidentally made the sarin while trying to compound garden chemicals.

But the focus began to change. The first problem was that sarin couldn't be produced the way the police thought it had. At the same time, complaints came in from neighbors of Aum Shinrikyo's Kamikuishiki compound, where the Satyan 7 production facility was located, about strange odors (the cult attempted to explain the odors with statements about innocuous manufacturing activities and wild claims about an attack on the cult with chemical agents by the U.S. Navy).

More information began to come in pointing to the cult as the originators of the sarin, but the Japanese police had their hands tied because, without direct evidence, they had to avoid actions that might look like persecution of a religion owing to the very strong restrictions designed to maintain freedom of religion contained in the Japanese Constitution. These restrictions were so strong that, even though the police obtained soil samples from just outside the Kamikuishiki compound containing sarin precursor degradation products, the police could not act - there was, after all, no law in Japan at the time that said you couldn't make nerve gas, and making it didn't mean Aum had used it.

Nevertheless, the police gathered enough evidence to act - although not about the use of sarin in Matsumoto. Members of Aum had carried out a kidnapping (and had murdered the kidnapee, one Kiyoshi Kariya, a relative of an Aum member who had decided to leave the cult, although the police did not know this at the time), and the police had managed to find a link between the crime and Aum (fingerprints of an Aum member on papers for a rental car used in the kidnapping). They used this to get a warrant to enter the Kamikuishiki compound, planning a massive raid which they hoped would also allow them to shut down the nerve agent production facility. The police made a mistake, however - they sent the policemen who were to make the raid to a Japanese Self Defense Force facility to undergo training in chemical protective measures. Members of Aum inside the JSDF sent word of the planned raid to the cult.

The cult had known it was under suspicion since an article suggesting they were at fault for Matsumoto had appeared in the Yomiuri Shimbun newspaper on January 1, 1995, but they had convinced themselves they had not left a trail that the police could legally follow. The leadership decided they had to take drastic action to protect the cult.

The way to dissuade the police that the cult's leadership decided on was to stage a major attack with sarin. An attack on the subway at 8:00 AM (timed to cause maximum casualties among police arriving for the 8:30 shift change) was felt to be the best option.

There was one problem - the Satyan 7 production facility had had so many accidents that its use had been suspended, and the cult didn't have any sarin on hand. So, an March 18, a batch was made up by hand using an existing stock of precursors, and the resulting sarin was then poured into eleven plastic bags which were sealed, placed in larger bags, and covered with newspapers. (The purpose of the newspapers was to make the actions of the cult members when they were piercing the bags seem a little less odd - poking at a pile of newspapers with an umbrella was seen as less likely to attract attention than poking at a liquid filled bag.)

The bags were assigned to five men for the attack, with four of the men getting two bags each and a fifth getting three bags. The men were to drop their bags on the floor of a train while in or just before reaching a subway station, puncture the bags, and leave the train and the station. Each man was paired with a second cult member who would drive a getaway car positioned outside the station. Each man was provided with an antidote kit (atropine-filled hypodermics) to be used in case of accidental exposure, and they were also provided with a pill (probably pyridostigimine bromide) to be taken before the action which they were told would reduce their susceptibility to the sarin.

Each of the attackers was assigned to a different subway train, on one of three lines which converged at the Kasumigaseki station. The plan was for the attackers to pierce the bags and leave at a station before Kasumigaseki; it was expected that the trains would proceed on, poisoning stops along the line to Kasumigaseki and delivering a massive concentration where they converged.

On March 20, 1995, beginning shortly before 8:00 in the morning, the attackers begin poking holes in their bags of sarin. The attack would leave 12 people dead, 54 critically/severely injured, and and affect 6000.

On March 22, 1995, the police moved in force against Aum Shinrikyo, and in the ensuing days brought all those involved in the attack to justice.

As bad as the attack was, several factors combined to keep it from being worse. Owing to its rushed "by hand" production, the sarin was very impure, with a purity lower than 30%. Indeed, before the bags were filled, when Seiicho Endo, a chemist involved with its production, went to Asahara to announce that production had been completed, he felt it necessary to mention that the mixture was not pure sarin. Asahara indicated that the attack should go ahead anyway. During the attack, not all of the sarin-filled bags were punctured, with one remaining completely intact and another apparently bursting when stepped on by passengers leaving the car. A passenger kicked the bags out of one of the cars at the stop after they were punctured - this probably saved many people in the car, although there were deaths at the station. At Kasumigaseki Station, Assistant Stationmasters Kazumasa Takahashi and Tsuneo Hishinuma soaked up the loose liquid with newspapers and picked up the bags, still wrapped in newspaper, put the material in a plastic bag, and carried it into the station office. Both lost their lives, but they prevented further dissemination of the agent.

Then, too, the Matsumoto release had served as an alert. Matsumoto certainly improved both the probability of recognition and awareness of proper responses. Many physicians had, at least informally, brushed up on the effects of and treatment for sarin intoxication. Emergency officials had, at least in the back of their minds, the thought that another attack might occur. And the experience in Matsumoto meant that there were people in Japan who had a good idea of what was happening when Japanese television stations started broadcasting reports. At least one physician, Dr. Hiroshi Morita, who had treated patients in Matsumoto called hospitals in Tokyo to alert them to the fact that the symptoms he was seeing on television matched those he'd seen in the sarin exposure, helping to direct the medical staff to a correct diagnosis. The Shinsu University Hospital faxed information about sarin treatment to the hospitals in Tokyo. Within 2 hours of the attack, JSDF experts arrived at the hospitals in the Tokyo area to advise on treatment. A plan to stockpile the nerve agent treatment drugs 2-PAM and atropine in hospitals had not been implemented, but when officers of Sumitomo Kagaku (a manufacturer of 2-PAM) in Osaka saw the news reports, they took the initiative and sent a supply of 2-PAM to Tokyo without waiting for a government request.

There were many rough spots, however. The first emergency response was initiated at 8:09, roughly 20 minutes after the first bag of sarin had been punctured. It would be another forty minutes before an advisory recommending the use of protective masks would be issued. Emergency responders had received no special training and had no idea what they were approaching - many thought that tear gas had been disseminated, despite the fact that deaths had already occured (8 deaths occured initially, with 4 more victims succumbing after reaching the hospital). No decontamination would be undertaken at the scene, and the conditions of victims being transported would continue to worsen as they were taken to the hospital. Emergency responders would also suffer the effects of secondary exposure, especially while transporting patients (instructions were issued to drive with the windows open, which seemed to help). No decontamination was initially undertaken at hospitals, either, and some hospital employees also suffered the effects of secondary exposure, especially when overflow patients were moved out of the emergency rooms (whose doors were constantly opening to admit fresh air) into areas with poorer air circulation. At 9:40 AM, the Tokyo fire department, equipped with IR spectrometers for gas analysis, misidentified the agent as acetonitrile because the database used to identify gases did not include nerve agents (fortunately, this misidentification was largely ignored because the hospitals had already been advised that the agent was probably sarin by physicians with experience with chemical agents). At 11:00 AM, when the police informed the press that they had identified the agent as sarin from GC-MS data, but they didn't bother to inform the hospitals, who learned of the definitive identification of the agent from television news reports. The absence of a disaster plan resulted in the majority of the victims being taken to a single hospital, St. Luke's, which was nearly overwhelmed.

The use of sarin by Aum Shinrikyo at Matsumoto and in the Tokyo subway did provide some valuable lessons. In the area of protection, Matsumoto showed that the idea of sheltering in place might well be valuable, even with materials as toxic as nerve agents - for instance, those who had gone to sleep with their windows open on that nice spring night (including many who died) were much more likely to be strongly affected than those who had gone to sleep with their windows shut. The importance of decontamination of victims was also shown - a significant number of emergency responders and emergency room personnel showed the effects of secondary exposure. The need for greater preplanning for such incidents and for training in reacting to them, was also shown - things went much more smoothly in Tokyo because some lessons had already been learned from Matsumoto than they might have otherwise, although there was still much room for improvement. And finally, and perhaps most importantly, the Aum Shinrikyo attacks showed that the threat of terrorist chemical attack was real, ensuring that future investigations will not be hampered by the idea that "nobody would actually do it.""

Since Aum, no other terrorist group has actually used sarin, although threats of its use have escalated, presumably as a result of the publicity surrounding the Tokyo attack.

al Qaeda

The al Qaeda terrorist group has displayed a strong interest in obtaining weapons of mass destruction. In November of 2001, Osama bin Laden stated that Al Qaeda has a chemical capability ("I wish to declare that if America used chemical and nuclear weapons against us, then we may retort with chemical and nuclear weapons. We have the weapons as a deterrent." - interview with Hamid Mir for Dawn), but did not specify the agents.

Julio Fuentes, a correspondent for the Spanish publication El Mundo, reported on November 19, 2001 that he had discovered at least 300 ampules (7 cm in length) containing a yellow to clear liquid packaged in boxes labeled "SARIN/V-GAS" in Cyrillic script at Farm Hada, an al Qaeda base south of Jalalabad in Afghanistan. Other labels indicated that atropine was antidotal. A similar report was published in the Italian daily Corriere della Sera by the reporter Maria Grazia Cutuli.

Iraqi Insurgents

On May 17, 2004,it was announced that "a couple of days ago" an improvised explosive device produced using a sarin-containing 155 mm artillery round had detonated, apparently while US troops were attempting to disarm it. The announcement indicated that two individuals were exposed and successfully treated. The shell was described as a binary weapon in which precursors are combined to produce the agent after firing. It is presumed that the shell was an Iraqi weapon of the type the Iraqi government claimed to have destroyed in accordance with the settlement of the 1991 Gulf War.

The use of the shell as an improvised explosive device would have minimized the amount of sarin produced. Since such devices are detonated while in fixed positions rather than after having been fired from an artillery piece, little mixing of the precursors would occur.

Related International Classification of Diseases Codes

Heading	ICD-9-CM
Toxic effect of organophosphate & carbamate	989.3
Toxic effect of unspecified gases, fumes, or vapors	987.9
Accidental poisoning by other specified solid and liquid substances	E866.8
Accidental poisoning by unspecified solid and liquid substances	E866.9
Accidental poisoning by other specified gases and vapors	E869.8
Accidental poisoning by unspecified gases and vapors	E869.9
Suicide and self-inflicted poisoning using other and unspecified solid and liquid substances	E950.9
Suicide and self-inflicted poisoning using other specified gases and vapors	E952.8
Suicide and self-inflicted poisoning using unspecified gases and vapors	E952.8
Assault by poisoning using other solid and liquid substances	E962.1
Assault by poisoning using other gases and vapors	E962.2
Injury due to terrorism involving chemical weapons	E979.7
Injury due to war operations by gases, fumes, and chemicals	E997.2
Death due to terrorism involving chemical weapons	U01.7
Heading	ICD-10
Accidental poisoning by and exposure to other and unspecified chemicals and noxious substances	X49
Intentional self-poisoning (suicide) by and exposure to other gases and vapors	X67
Assault (homicide) by gases and vapors	X88
Assault (homicide) by other specified chemicals and noxious substances	X89
Assault (homicide) by unspecified chemical or noxious substance	X90
War operations involving chemical weapons and other forms of unconventional warfare	Y36.7

Selected References and Resources

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