CAS RN: 505-60-2

Health Effects

    • A) USES: Mustard gas is used primarily as a vesicant agent in chemical warfare. It may also be used in organic synthesis.
    • B) TOXICOLOGY: Mustard gas crosslinks DNA and prevents normal cell division. The skin is the major target; once inside the skin, mustard gas damages the cells separating the epidermis (upper layer) from the dermis (lower layer). The two layers separate with the space between them becoming a blister. Similar effects occur in the airways and eyes, except blisters do not appear. Mustard gas may also induce long-term mutagenic and carcinogenic effects.
    • C) EPIDEMIOLOGY: Mustard gas has historically been used as a chemical warfare agent. Its use is prohibited by the Geneva Protocol (192
      • 5) and the Chemical Weapons Convention (1993). It has a potential use as a terrorist weapon of mass destruction. From July 1917 to the end of World War I, British causalities from mustard gas amounted to at least 125,000 with approximately 1859 deaths. Following World War II (1945 to 1948), large stockpiles of chemical weapons, including mustard gas, were dumped into the Baltic sea, leading to mustard gas poisoning of 23 fishermen in 1984. It was also used by Iraqi forces during the Iran-Iraq conflict.
      • 1) INGESTION: It produces nausea and vomiting, abdominal pain, bloody diarrhea, and prostration resulting in dehydration.
      • 2) DERMAL: Signs and symptoms occur within 2 to 24 hours of exposure. Itching and erythema occur 2 to 3 hours after dermal exposure to the gas or liquid; erythema spreads over the next 24 hours and yellowish blisters appear and can become ulcerated, which heal in 4 to 6 weeks after a transitory melanoderma. Thinner skin (neck, axillae, and groin) is more susceptible than thicker skin (soles and palms).
      • 3) INHALATION: Cough, dyspnea, and possibly pulmonary edema may occur up to 24 hours after inhalation of the gas. Ulceration of airway mucosa may occur. Mild pulmonary exposure produces rhinorrhea, sneezing, epistaxis, hoarseness, and cough within 12 to 24 hours of exposure. Severe exposure produces additional symptoms of productive cough and shortness of breath (mild to severe) 2 to 4 hours after exposure.
      • 4) EYES: Lacrimation, itching, burning, and dryness (gritty feeling) may occur with usual onset of 4 to 12 hours after exposure. Conjunctivitis appears early, developing 4 to 6 hours after exposure. Moderate exposure produces the above plus redness, eyelid swelling, and moderate pain. These symptoms usually begin 3 to 6 hours postexposure. Severe exposure produces marked swelling of lids, photophobia, corneal ulceration, and severe pain with onset of 1 to 2 hours after exposure. Loss of vision may occur. Visual disturbance may persist for up to 10 days.
    • A) DYSPNEA AND PAROXYSMAL COUGH are common. FEVER may occur.
0.2.4 HEENT
      • 1) SEVERE EYE IRRITANT inducing edema, burning discomfort, photophobia, lacrimation, and/or blepharospasm. CORNEAL ULCERATION and/or BLINDNESS ranging from burning discomfort to destruction of the eyeball may occur after severe exposure. LOCAL THROMBOSIS/ISCHEMIA with delayed hemorrhage has developed several days after exposure. PATHOGNOMONIC SIGNS are porcelain-white areas in the episcleral tissue with sausage-shaped varicose veins.
      • 2) RECURRENT KERATITIS of previously damaged areas may occur up to 40 YEARS after an acute exposure; opacification of the entire cornea may develop. The mechanism of action is not known, but it could be immune system mediated.
    • A) DYSRHYTHMIAS occur rarely.
    • A) Leukopenia, thrombocytopenia, and anemia may develop.
  • A) Possible human teratogen.
    • A) IARC Carcinogenicity Ratings for CAS505-60-2 (International Agency for Research on Cancer (IARC), 2016; International Agency for Research on Cancer, 2015; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2010; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2010a; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2008; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2007; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2006; IARC, 2004):
      • 1) IARC Classification
        • a) Listed as: Mustard gas (Sulfur mustard)
        • b) Carcinogen Rating: 1
      • 1) The agent (mixture) is carcinogenic to humans. The exposure circumstance entails exposures that are carcinogenic to humans. This category is used when there is sufficient evidence of carcinogenicity in humans. Exceptionally, an agent (mixture) may be placed in this category when evidence of carcinogenicity in humans is less than sufficient but there is sufficient evidence of carcinogenicity in experimental animals and strong evidence in exposed humans that the agent (mixture) acts through a relevant mechanism of carcinogenicity.
  • A) DNA damage, unscheduled DNA synthesis, DNA inhibition, mutations, and chromosome aberrations in a variety of prokaryotic and/or eukaryotic systems.
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