Mustard Gas

Background

Sulfur mustard is a human-made chemical warfare agent that causes blistering of the skin and mucous membranes on contact. This type of chemical warfare agent is called a vesicant or blistering agent.

Sulfur mustard is known as "mustard gas," "mustard agent," or by the military designation "H" or "HD."

Traits of mustard gas include:

• Solid at less than 58° Fahrenheit
• Oily-textured liquid at room temperature
• Clear to yellow or brown when liquid or solid
• Smells like garlic, onions, mustard, or no smell

Signs and symptoms

Signs and symptoms depend on how the person was exposed, the amount of sulfur mustard, and how long they were exposed.

Usually, signs and symptoms do not occur immediately. It may take up to 24 hours for some symptoms to occur. Sulfur mustard can have different effects on specific parts of the body.

Circulatory

Circulatory (heart and blood) signs and symptoms include decreased formation of blood cells and platelets. This can lead to weakness, bleeding, and infections.

Digestive

Digestive signs and symptoms include:

• Diarrhea
• Nausea
• Vomiting

Eyes

Eye signs and symptoms include:

• Eye irritation
• Eye swelling
• Eye pain
• Eye tearing
• Temporary blindness

Respiratory

Respiratory (breathing) signs and symptoms include:

• Difficulty breathing
• Cough
• Shortness of breath
• Sneezing
• Wheezing
• Hoarseness

Skin

Skin signs and symptoms include:

• Blistering of skin, yellow in color
• Skin itching
• Skin pain
• Skin redness

Other signs and symptoms include:

• Abdominal pain
• Bloody or runny nose
• Sinus (nose) pain

Exposure to large amounts of sulfur mustard:

• Convulsions (uncontrollable muscle shaking)
• Light sensitivity
• Insomnia (sleep disorder)
• Permanent or temporary blindness
• Respiratory (breathing) failure leading to death

Exposure

Sulfur mustard can last 1 to 2 days in the environment in average weather conditions. Sulfur mustard can last weeks to months in very cold conditions.

Follow any directions by local authorities.

Air

If sulfur mustard is in the air, people can be exposed through skin contact, eye contact, or breathing it in. Because sulfur mustard gas is heavier than air, it will sink to lower areas and increase chances of exposure there. Do not stay in lower areas.

Clothes

If clothing touched sulfur mustard, people can be exposed by touching or breathing in sulfur mustard gas from the clothing.

Food

Eating, drinking, or touching food or drink with sulfur mustard can expose people to sulfur mustard. Do not use or eat food that smells, tastes, or looks unusual.

Do not eat food that may have touched sulfur mustard if the food is not in a glass or metal container. If the food is in an unbroken and sealed glass or metal container, it should not be affected. Wash the outside of the container before using.

Water

If sulfur mustard is in water, people can be exposed by touching or drinking the water. People can also be exposed by swallowing liquid sulfur mustard, getting it on their skin, or getting it in their eyes.

What to do if you are exposed

Get away

Get away from the area where the sulfur mustard was released and breathe fresh air.

If the sulfur mustard release was outdoors, go indoors and shelter in place. Make sure windows are closed and ventilation systems are turned off to make sure the sulfur mustard does not come inside. If you cannot go indoors, leave the area where the sulfur mustard was released.

If the sulfur mustard release was indoors, get out of the building and go to higher ground.

If you cannot get away, go to the highest ground possible. Sulfur mustard is heavier than air and will sink to lower areas.

Get clean

Get clean by taking off all clothes, jewelry, and accessories, blotting any liquid, and showering. Ideally, undress, blot, and shower immediately or as soon as you can, as described below. If you cannot take off all layers, take off as many clothes as you can.

Take off your clothes

Do not pull clothing over your head. If you must pull clothing over your head, close your eyes and mouth, and hold your breath. This will stop the sulfur mustard from getting in your eyes, nose, or mouth. Put clothes in a plastic bag.

If you wear contact lenses, take them out and place them with your clothing. Do not put contact lenses back in.

Follow these steps to blot your body:

1. Use different dry, clean cloths, or paper towels to blot each part of your body where you feel liquid.
2. Start blotting with your head and hair.
3. Then blot your face, hands, body, arms, legs, and feet.
4. Blot your skin for 10 seconds.
5. Rub for 10 seconds any places on your skin or in your hair where you can see or feel liquid.
6. Drop the used cloths or towels to the floor.

Repeat the process several times if you still feel liquid on you. Use a different clean cloth or towel for each part of your body. Use a different clean cloth or towel each time you repeat the process.

Wash your body

Wash your hair, face, and hands, and then wash the rest of your body. Wash from your head to your feet with a lot of lukewarm water and mild soap (if available) for 90 seconds. Use soapy water for a minute, then rinse with plain water for 30 seconds. Try not to let the water run into your eyes, nose, or mouth. Do not scrub!

If your eyes are burning or you can't see normally, wash your eyes for 10 to 15 minutes with lukewarm water. Do not use eye drops.

Dry your face, then tilt your head back and dry your hair, and then dry down your body. Use anything that will soak up water. Drop used things to the floor. Dress in any available clean clothes to prevent hypothermia (low body temperature). This is especially important if temperatures are cool.

Clear the dirty items

If emergency response services are available, leave used items on the floor and report where they are to emergency teams. Move as far from the used items as possible.

Otherwise, put on waterproof or heavy gloves that won't let liquid go through. Gather all used things from the floor, including your clothes, and put them in a plastic bag. Remove gloves and put them in the plastic bag. Close the plastic bag and place it in a second plastic bag. Close up the second bag also.

Do not put the bags in the regular trash! Place the bags in an area where other people are unlikely to disturb them and touch sulfur mustard. Inform local authorities of the location of the bags for pick up.

Get help

Get help right away by:

• Calling 911.
• Going to the hospital if local officials say it is safe to leave.
• Calling the Poison Control Center at 1-800-222-1222.

Treatment

No known cure exists for sulfur mustard exposure.

Treatment involves removing sulfur mustard from the body as soon as possible and providing supportive medical care. Supportive medical care can be given in a hospital setting or by trained emergency personnel.

Long-term health effects

Exposure to sulfur mustard usually does not often cause death. Sulfur mustard use during World War 1 killed fewer than 5% of the people who were exposed and got medical care.

Eye exposure may cause temporary or permanent eye injury or chronic (long-term) eye infections.

Skin exposure to sulfur mustard may cause the following long-term effects:

• Second- and third-degree burns
• Skin scarring
• Pigment (color) changes
• Skin cancer.

Breathing in sulfur mustard may cause the following long-term effects:

• Loss of taste and smell
• Chronic respiratory (breathing) disease
• Repeated respiratory infections
• Respiratory cancers