Mustard lung

Mustard gas (Sulfur mustard) Lung, larynx, pharynx... 

Respiratory complications are the greatest cause of long-term disability among people with SM exposure. A pulmonologist who investigated the pulmonary complications in Iranian veterans in 2007 named it mustard lung (Ghanei and Adibi, 2007). 

Poursaleh, Z., Harandi, A.A., Vahedi, E., et al, 2012. Treatment for sulfur mustard lung injuries new therapeutic approaches from acute to chronic phase. Treatment for sulfur mustard lung injuries new therapeutic approaches from acute to chronic phase. Daru J. Pharm. Sd. 20 (1), 20-27. 

Mustard and Related Vesicants. Mustard, bis(2-chloroethyl) sulfide [505-60-2] (Chemical Agent Symbol HD), C1(CH2)2S(CH2)2C1, is a colodess, oily hquid when pure. Most samples have a characteristic garliclike odor. It is primarily a vesicant bUsters are formed by either Hquid or vapor contact. Mustard also attacks the eyes and lungs and is a systemic poison, so that protection of the entire body must be provided. It is insidious in its action there is no pain at the time of exposure, and symptoms usually do not appear until several hours after exposure. 

Physiological Effects. The sulfur and nitrogen mustards act first as cell irritants and finally as a cell poison on all tissue surfaces contacted. The first symptoms usually appear in 4—6 h (4). The higher the concentration, the shorter the interval of time between the exposure to the agent and the first symptoms. Local action of the mustards results in conjunctivitis (inflammation of the eyes) erythema (redness of the skin), which may be followed by blistering or ulceration and an inflammatory reaction of the nose, throat, trachea, bronchi, and lung tissue. Injuries produced by mustard heal much more slowly and are much more Fable to infection than bums of similar intensity produced by physical means or by other chemicals. 

Nitrogen mustard is clinically used for the treatment of lymphomas and some forms of lung cancer. The major indication for mechlorethamine is Hodgkin s disease as a part of the MOPP regimen (mechlorethamine + vincristine (oncovin) + procarbazine + prednisone). The usual dose consists of 6 mg/m2 on days 1 and 8. This drug has pronounced hematological toxicity (myelo-suppression). 

Blister agents such as distilled mustard (HD) and nitrogen mustard (HN) have a slow rate of action and might be persistence for three days to one week in warm weather and for some weeks in cold weather, while lewisite (L) and mustard/lewisite (HL) have a quick rate of action and would be persistent for one to three days during summer and for weeks during winter. Route of entry for these blister agents would be nearly the same eyes, lungs, and skin for vapor or aerosol, but for liquid, the points of entry would be the eyes and skin for HD and HN and eyes, skin, and mouth for L and HL. 

Symptoms Erythema, Blisters, Irritation of the Eyes, Cough, Dyspnea, Asymtomatic Latent Period (hours). Also, mild upper respiratory signs to marked airway damage, GI effects and bone marrow stem cell suppression possible. Mustard is a blister agent that affects the eyes, lungs, and skin. A person exposed to mustard will feel very little pain and... 

Chronic Exposure Lewisite can cause sensitization and chronic lung impairment. Also, by comparison to agent mustard and arsenical compounds, it can be considered as a suspected human carcinogen. 

Blister agents were developed for military purposes and are intended to inflict casualties (delayed following exposure), restrict terrain access, and slow troop movement. They affect the eyes and lungs and blister the skin. Mustard was the primary blister agent used in World War I. It was recognized by its distinctive odor. Modern... 

Blister agents were developed to inflict casualties, restrict terrain access, and slow troop movement. They affect the eyes and lungs and blister the skin. Mustard was... 

In pure liquid form, lewisite causes blindness, immediate destruction of lung tissue, and systemic blood poisoning. It is absorbed through the skin like distilled mustard, but is much more toxic to the skin. Skin exposure results in immediate pain a rash forms within 30 minutes. Severe chemical burns are possible. Blistering of the skin takes up to 13 hours to develop. Lewisite does not dissolve in human sweat. It commingles with sweat, then flows to tender skin areas such as the inner arm, buttocks, and crotch. 

After skin is exposed to HN-2 an epidermal rash develops within approximately an hour. If initial exposure is very low, a rash may not develop. As with HN-1, HN-2 exposure is cumulative. If a person receives multiple low-level exposures, a rash will eventually appear. Blistering will begin about 12 hours after the onset of the skin rash. As with other blister agents, great irritation results when HN-2 vapor or liquid mixes with sweat and flows to tender skin areas (e.g., armpits, buttocks, crotch). Pulmonary effects from exposure to HN-2 are not as severe as for distilled mustard. Dry-land drowning syndrome can occur as the lungs flood with mucus, dead tissue, and blood. The victim dies from a combination of asphyxiation and heart failure. 

Mustard gas has been tested for carcinogenicity in mice, producing lung tumors after inhalation or intravenous injection and local sarcomas after subcutaneous injection. 

Case RAM, Lea AJ Mustard gas poisoning, chronic bronchitis and lung cancer. An investigation into the possibility that poisoning by mustard gas in the 1914-18 war might be a factor in the production of neoplasia. Br J Prev Soc Med 9 62-72, 1955... 

Beebe GW Lung cancer mortality in World War I veterans possible relation to mustard gas injury and 1918 influenza epidemic. 

The lARC has classified nitrogen mustard HN-2 as probably carcinogenic to humans based on evidence that it causes leukemia in humans and cancers of the lung, liver, uterus, and large intestine in animals. ... 

HN-2 nitrogen mustard, administered mainly as the hydrochloride, has been tested for carcinogenicity in mice and rats by subcutaneous, intravenous, and intraperitoneal administration and by skin painting. It produced mainly lung tumors and lymphomas in mice after subcutaneous, intravenous, and intraperitoneal administration. Intravenous injection of nitrogen mustard to rats induced tumors in different organsk Application by skin... 

Atkinson provided details on two of his patients who had suffered mustard poisoning from the vapor both eyes and lungs were affected. He found no decrease in visual acuity (both men being practically perfect in acuity) between prewar and 20-yr-postwar examinations. Both had some corneal haziness, which proved the precursor of progressive deterioration of vision. 

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