August 2013 & April 2017: Sarin Gas
The chemical weapon attacks in Syria began in August 2013, when rockets carrying sarin gas hit the towns of Ain Tarma, Zamalka, Jobar and Muadamiya. Residents who heard the explosions and lived to tell about it described the event as sounding like “a water tank bursting,” followed by the smell, which “burned the eyes and throat, like onions or chlorine.”
As a result in September 2013, the United States and Russia, came to the agreement that Syria’s arsenal of chemical weapons would be removed or destroyed by mid-2014. However, as we all know this did little to stop Syria from continuing to use chemical weapons. In fact, on April 4th 2017, hundreds of people died in Northern Syria in a town called Khan Sheikhoun following another sarin gas attack.
Sarin Gas
Sarin gas is a chemical nerve agent that penetrates the skin, eyes and lungs. Once absorbed, it binds to and inactivates the enzyme acetylcholinesterase. Acetylcholinesterase is an enzyme that is responsible for breaking down acetylcholine into acetic acid and choline in the body. Once inactivated, acetylcholine can no longer be broken down which causes it to continuously stimulate nicotinic and muscarinic receptors. As a result, acetylcholine causes increased secretions, termed cholinergic crisis. This results in increased saliva, tears, diarrhea, vomiting, constriction of the pupils as well as the lungs. The end result is that people exposed to sarin gas, accumulate fluid in their lungs and end up suffocating to death, if treatment is not given within 4 to 6 hours.
The treatment for sarin gas is 2 mg of Atropine and repeated until secretions are dried. Atropine antagonizes or blocks the effects of acetylcholine at the muscarinic receptor. Therefore, it causes the secretions to dry and relaxes the smooth muscle of the lungs.
Another treatment option is 600 mg to 1 gram of pralidoxime chloride (2-PAM). Pralidoxime acts as a crowbar by removing the chemical nerve agent from the acetylcholinesterase enzyme. This enables the body to effectively break down acetylcholine into acetic acid and choline
May 2015 & September 2016: Chlorine Gas
In May 2015, two years following Syria’s agreement to dismantle its chemical weapons stockpile, evidence of chlorine bombs being dropped on insurgent-held areas began to surface. Residents reported a helicopter that would fly low and drop barrels that would explode on impact, distributing clouds of chlorine gas.
Then again in September 2016, barrels of chlorine gas were dropped over the city of Aleppo. The problem however, laid in the fact that although chlorine used as a chemical weapon was forbidden. Chlorine has many civilian uses and was therefore still being easily being accessed in order to use as a chemical weapon throughout Syria.
Chlorine Gas
Chlorine gas is a greenish-yellowish gas that causes severe and life threatening injury after inhalation. In fact, chlorine gas is 30x more irritating to the lungs than hydrochloric acid!! Once exposed, chlorine gas causes eye irritation, cough, shortness of breath, and wheezing. If treatment is delayed, death usually ensues within 12 to 24 hours due to fluid buildup within the lungs which causes suffocation.
Treatment of chlorine gas exposures consist of removal from the source of exposure, followed by decontamination of the skin and eye. Oxygen and bronchodilators such as albuterol can be given for difficulty breathing and shortness of breath. However, treatment is mostly supportive in nature due to the caustic effects of chlorine on the tissue.
August 2015: Mustard Gas
In the city of Marea, more than 50 patients showed up to the Syrian American Medical Society with blisters associated with the use of mustard gas.
Sulfur Mustard (Mustard Gas)
Sulfur Mustard is a vesicant agent that quickly damages the DNA of the exposed area which usually includes the eyes, lungs, and skin, leading to cell death. Sulfur Mustard acts a lot like radiation does to cells and can causes eye pain and swelling, blisters of the skin, hacking cough, nausea, vomiting, fluid buildup in the lungs, and bone marrow suppression.
The treatment of Sulfur Mustard is generally supportive and depends on the area affected most. However, all people must be removed from the affected area and decontaminated as quickly as possible by removing clothing and washing with soap and water.
April 2018: ‘Chemical Agent’
In the latest chemical warfare attack, more than 500 people had symptoms of exposure to a chemical agent that included trouble breathing, foaming at the mouth, burning eyes, and reports of a “chlorine-like odor.” While this could be another use of chlorine gas, due to Syria's repeated history of using chlorine gas as a chemical warfare agent. It's also possible that this attack is included a mixture or cocktail of chemical warfare agents as chlorine gas generally does not present with foaming of the mouth. This is more characteristic of an organophosphate nerve gas agent such as Sarin Gas.
In fact, White Helmets member Ammar Al-Selmo, stated that his assessment was inline with mine and looked as though both chlorine and sarin gas were used. While Russia continues to maintain the position of denial stating that no chemical attack ever took place at all and it was all faked. Enough time has now passed to have allowed evidence to be tampered with and a cover-up to take place. So all in all, while we may never know the exact chemical warfare agent used in the April 2018 attack. One fact does remain, which is the use of chemical warfare agents needs to be banned! Not only in Syria but throughout the world.
Sources:
• Goldfrank's Toxicologic Emergencies
• Burning Eyes, Foaming Mouths: Years of Suspected Chemical Attacks in Syria
• Chemical weapons experts not in Douma, State Department says
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