Mustard: a potential agent of chemical warfare and terrorism.

Abstract

As one of the most important vesicant agents, the destructive properties of mustards on the skin, eyes and respiratory system, combined with a lack of antidote, makes them effective weapons. Such weapons are inexpensive, easily obtainable and frequently stockpiled. Sulphur mustard (mustard gas) has been used as a chemical warfare agent in at least 10 conflicts. In this article, the use of mustard as a potential agent of chemical warfare and terrorism is outlined. The dose-dependent effects of acute sulphur mustard exposure on the skin, eyes, and respiratory system are described, as well as the possible extents of injuries, the mechanisms of action and the long-term complications. Prevention and management of mustard exposure are briefly discussed. The need for awareness and preparedness in the dermatological community regarding mustard exposure is emphasized.

Ebselen Analogues Reduce 2-chloroethyl Ethyl Sulphide Toxicity in A-431 Cells

“…It has been nearly one hundred years since mustards were fi rst used as chemical warfare agents, yet an effective medical countermeasure is still sought after (23,24). The cellular mechanisms involved in mustard toxicity are well established and include oxidative stress, DNA damage, and the overactivation of PARP-1 (5,25,26).…”

Postexposure Application of Fas Receptor Small-Interfering RNA to Suppress Sulfur Mustard–Induced Apoptosis in Human Airway Epithelial Cells: Implication for a Therapeutic Approach

“…Its use is now re-emerging as a major threat not only to the military but also to civilians (Saladi et al, 2006). However, in spite of intense research on its mechanisms of action and intervention of toxicity, there is no available therapy against SM-exposure effects.…”

Detection of vesicant-induced upper airway mucosa damage in the hamster cheek pouch model using optical coherence tomography

“…9 Irritation, hoarseness, coughing, tracheobronchitis, airway obstruction, and in severe cases, hemorrhagic pulmonary edema are "acute" complications that manifest themselves over time, ranging from hours to as much as eight days post-exposure. 3,6 While the eye and skin can be monitored noninvasively by gross visual observation, most of the respiratory tract can be observed only by bronchoscopy. Noninvasive monitoring of the progression of injury or of the response to therapy is precluded using existing techniques.…”

“…Upper respiratory tract exposure to aerosolized mustard gas is usually followed by a latent or clinically asymptomatic period lasting from 0 to 24 h referring to Ref. 3, although in some instances, damage may lead to immediate bronchospasm. 9 Irritation, hoarseness, coughing, tracheobronchitis, airway obstruction, and in severe cases, hemorrhagic pulmonary edema are "acute" complications that manifest themselves over time, ranging from hours to as much as eight days post-exposure.…”

“…[1][2][3] The majority of the vesicants used as chemical warfare agents are alkylating compounds known as mustards. [3][4][5][6] They are easy to manufacture, store, and disperse. These lipophilic agents are difficult to protect against, as they readily penetrate epithelial surfaces such as skin and mucosa.…”