Nitrogen Mustard

Background

Nitrogen mustards were produced in the 1920s and 1930s as potential chemical warfare weapons. They are vesicants (agents that cause blisters) similar to the sulfur mustards.

The nitrogen mustards are also known by their military names of HN-1, HN-2, and HN-3.

Traits of nitrogen mustards include:

• Fishy, musty, soapy, or fruity smell
• Oily-textured liquid, gas, or solid
• Liquids at room temperature
• Clear, pale amber, or yellow-colored in liquid or solid form

Where it is found

Nitrogen mustards are not found naturally in the environment.

The nitrogen mustards were never used in warfare.

HN-1 originally was designed to remove warts but was later found to be a potential chemical warfare agent.

HN-2 was designed as a military agent but was later used in cancer treatment. Other treatment agents have now replaced it.

HN-3 was designed only for military purposes.

How it works

Nitrogen mustards are powerful irritants. This means it is a substance that can cause pain, itching, or discomfort.

Nitrogen mustards can damage the skin, eyes, and respiratory (breathing) tract. They can enter the body's cells very quickly and damage the immune system and bone marrow.

Signs and symptoms

Effects caused by nitrogen mustards depend on the amount, how someone was exposed, and how long they were exposed.

Usually, signs and symptoms of nitrogen mustard exposure do not happen immediately. Depending on the level of exposure, symptoms may not occur for several hours.

Nitrogen mustard can have different effects on specific parts of the body. Showing these signs or symptoms does not necessarily mean that a person has been exposed to a nitrogen mustard.

Brain

The following may happen after a large exposure:

• Incoordination
• Seizures
• Tremors

Digestive tract

The following may happen after exposure:

• Abdominal pain
• Diarrhea
• Nausea
• Vomiting

Eyes

The following may happen after exposure:

• Eye irritation
• Pain
• Swelling
• Tearing

High levels of nitrogen mustard can cause burns and blindness.

Respiratory (breathing) tract

The following may happen within hours:

• Cough
• Nose and sinus pain
• Shortness of breath
• Sore throat

Fluid in the lungs is uncommon.

Skin

Redness usually develops within several hours after exposure. Blisters show up within 6 to 12 hours.

Exposure

Air

People could be exposed through skin contact, eye contact, or breathing it in. Because it is heavier than air, nitrogen mustard gas will sink to lower areas.

Water

People can be exposed by touching or drinking the water. People can also be exposed by touching liquid nitrogen mustards directly.

What to do if you are exposed

Because no cure exists for nitrogen mustard exposure, the best thing to do is avoid it.

If the nitrogen mustard release was indoors, get out of the building.

If the release was outdoors, move away from the area, stay upwind if possible, and go to higher ground. Moving to an area with fresh air is a good way to reduce the chance of death.

Evacuate or "shelter-in-place"

If you are near a nitrogen mustard release, emergency teams may tell you to evacuate the area or "shelter in place" inside.

Take your clothes off

Remove the clothing as quickly as possible. Cut clothes off instead of pulling it over the head. If you are helping others, do not touch unsafe areas and take off the clothes quickly.

Wash your body

As quickly as possible, wash any nitrogen mustard from your skin with lots of soap and water. Washing with soap and water will help protect you from any chemicals on your body.

If your eyes are burning or your vision is blurred, rinse your eyes with plain water for 10 to 15 minutes.

If you wear contacts, remove them and put them with the dirty clothing. Do not put the contacts back in your eyes (even if they are not disposable contacts).

If you wear eyeglasses, wash them with soap and water. You can put your eyeglasses back on after you wash them.

Throw your clothes away

After you have washed yourself, place your clothing inside a plastic bag. Do not touch unsafe areas of the clothing. If you have to touch unsafe areas, or you aren't sure where the unsafe areas are, wear rubber gloves. You can also use tongs, tool handles, sticks, or similar objects to put the clothing in the bag.

Anything that touches the dirty clothing should also be placed in the bag. If you wear contacts, put them in the plastic bag, too.

Tie the bag, and then put that bag inside another plastic bag. Throwing away your clothes this way helps protect you and others from any chemicals that might be on your clothes.

When the local or state health department or emergency team arrive, tell them what you did with your clothes. The health department or emergency team will arrange for further disposal. Do not handle the plastic bags yourself.

Treatment

No cure exists for nitrogen mustard exposure.

Treatment involves removing nitrogen mustard from the body as soon as possible and providing supportive medical care in a hospital setting.

Long-term health effects

The long-term health effects depend on the way in which you were exposed:

Bones

Nitrogen mustards may cause bone marrow suppression beginning as early as 3 to 5 days after exposure. Bone marrow suppression can cause anemia, bleeding, and higher chances of infection. If severe, these effects could lead to death.

Breathing

Breathing in large amounts of the gas can cause chronic respiratory disease (long-term breathing issues).

Cancer

Prolonged (long exposures) or repeated exposures to nitrogen mustards have caused cancer in animals. There is some evidence that prolonged or repeated exposures to nitrogen mustards cause leukemia (cancer of the blood) in humans.

Eyes

High levels of eye exposure can cause long-lasting eye problems.

Skin

Liquid nitrogen mustard is more likely to cause second- and third- degree burns and later scarring than the gas form.

More information

You can contact one of the following:

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