Facts About Sulfur Mustard

What sulfur mustard is

• Sulfur mustard is a type of chemical warfare agent. These kinds of agents cause blistering of the skin and mucous membranes on contact. They are called vesicants or blistering agents.
• Sulfur mustard is also known as “mustard gas or mustard agent,” or by the military designations H, HD, and HT.
• Sulfur mustard sometimes smells like garlic, onions, or mustard and sometimes has no odor. It can be a vapor (the gaseous form of a liquid), an oily-textured liquid, or a solid.
• Sulfur mustard can be clear to yellow or brown when it is in liquid or solid form.

Where sulfur mustard is found and how it is used

• Sulfur mustard is not found naturally in the environment.
• Sulfur mustard was introduced in World War I as a chemical warfare agent. Historically it was available for use in the treatment of a skin condition called psoriasis. Today it has no medical use.

How people can be exposed to sulfur mustard

• If sulfur mustard is released into the air as a vapor, people can be exposed through skin contact, eye contact, or breathing. Sulfur mustard vapor can be carried long distances by wind.
• If sulfur mustard is released into water, people can be exposed by drinking the contaminated water or getting it on their skin.
• People can be exposed to liquid sulfur mustard by eating it or getting it on their skin.
• Sulfur mustard can last from 1 to 2 days in the environment under average weather conditions and from weeks to months under very cold conditions.
• Sulfur mustard breaks down slowly in the body, so repeated exposure may have a cumulative effect (that is, it can build up in the body).

How sulfur mustard works

• Adverse health effects caused by sulfur mustard depend on how much people are exposed to, how they were exposed (the route of exposure), and the length of time that people are exposed.
• Sulfur mustard is a powerful irritant and blistering agent that damages the skin, eyes, and respiratory (breathing) tract.
• Sulfur mustard damages DNA, a vital component of cells in the body, especially in the bone marrow. This causes decreased formation of blood cells (aplastic anemia) or decreased red or white blood cells and platelets (pancytopenia).
• Sulfur mustard vapor is heavier than air, so it will settle in low-lying areas.

Immediate signs and symptoms of sulfur mustard exposure

• Exposure to sulfur mustard usually is not fatal. When sulfur mustard was used during World War I, it killed fewer than 5% of the people who were exposed and got medical care.
• People may not know right away that they have been exposed, because sulfur mustard may not have a smell or have a smell that might not cause alarm.
• Typically, signs and symptoms do not occur immediately. Depending on the severity of the exposure, symptoms may not occur for up to 24 hours. Some people are more sensitive to sulfur mustard than are other people, and may have signs and symptoms sooner.
• Sulfur mustard can have the following effects on specific parts of the body:
  • Skin: redness and itching of the skin may occur 2 to 48 hours after exposure and may eventually change to yellow blistering of the skin.
  • Eyes: irritation, pain, swelling, and tearing may occur within 3 to 12 hours of a mild to moderate exposure. A severe exposure may cause signs and symptoms within 1 to 2 hours and may include the symptoms of a mild or moderate exposure plus light sensitivity, severe pain, or blindness lasting up to 10 days.
  • Respiratory tract: runny nose, sneezing, hoarseness, bloody nose, sinus pain, shortness of breath, and cough within 12 to 24 hours of a mild exposure and within 2 to 4 hours of a severe exposure.
  • Digestive tract: abdominal pain, diarrhea, fever, nausea, and vomiting.
  • Bone marrow: decreased formation of blood cells (aplastic anemia) or decreased red or white blood cells and platelets (pancytopenia) leading to weakness, bleeding and infections.
• Showing these signs and symptoms does not necessarily mean that a person has been exposed to sulfur mustard.

What the long-term health effects may be

• Exposure to sulfur mustard liquid is more likely to produce second- and third- degree burns and later scarring than is exposure to sulfur mustard vapor. Extensive skin burning can be fatal.
• Extensive breathing in of the vapors can cause chronic respiratory disease, repeated respiratory infections, or death.
• Extensive eye exposure can cause permanent blindness.
• Exposure to sulfur mustard may increase a person’s risk for lung and respiratory cancer.

How people can protect themselves and what they should do if they are exposed to sulfur mustard

• Because no antidote exists for sulfur mustard exposure, the best thing to do is avoid it. Immediately leave the area where the sulfur mustard was released. Try to find higher ground, because sulfur mustard is heavier than air and will settle in low-lying areas.
• If avoiding sulfur mustard exposure is not possible, rapidly remove the sulfur mustard from the body. Getting the sulfur mustard off as soon as possible after exposure is the only effective way to prevent or decrease tissue damage to the body.
• Quickly remove any clothing that has liquid sulfur mustard on it. If possible, seal the clothing in a plastic bag, and then seal that bag inside a second plastic bag.
• Immediately wash any exposed part of the body (eyes, skin, etc.) thoroughly with plain, clean water. Eyes need to be flushed with water for 5 to 10 minutes. Do NOT cover eyes with bandages, but do protect them with dark glasses or goggles.
• If someone has ingested sulfur mustard, do NOT induce vomiting. Give the person some water or milk to drink, if they can swallow.
• Seek medical attention right away.

How sulfur mustard exposure is treated

The most important factor is removing sulfur mustard from the body. Exposure to sulfur mustard is treated by giving the victim supportive medical care to minimize the effects of the exposure. Though no antidote exists for sulfur mustard, exposure is usually not fatal.

Where people can get more information about sulfur mustard

For more information about sulfur mustard, people can contact the following:

• Regional poison control center: 1-800-222-1222
• Centers for Disease Control and Prevention
  • Public Response Hotline (CDC)
    • 800-CDC-INFO
    • 888-232-6348 (TTY)
  • E-mail inquiries: cdcinfo@cdc.gov