Biomonitoring of exposure to chemical warfare agents: a review

In this report an overview of the methods currently available for detection of exposure to a number of chemical warfare agents (CWA), i.e., sulfur mustard, lewisite and nerve agents, is presented. Such methods can be applied for various purposes, e.g., diagnosis and dosimetry of exposure of casualties, confirmation of nonexposure, verification of nonadherence to the Chemical Weapons Convention, health surveillance, and forensic purposes. The methods are either based on mass spectrometric or immunochemical analysis of CWA adducts with DNA or proteins or based on mass spectrometric analysis of urine or plasma metabolites that result from hydrolysis and/or glutathione conjugation. Several of the methods have been successfully applied to actual cases.