Sulfur mustards ocular toxicity

War I. More recent use occurred in Middle East conflicts. Its oily nature makes it persistent on surfaces it contacts. Because sulfur mustard exerts toxic effects following dermal, ocular, and inhalation exposure, its use necessitated fiill body protection which, in tmn, required the development of protective clothing and significant changes in warfare operations. 

Acute lethality data in animals are summarized in Table 8.7. Based upon the animal data, interspecies variability in the lethal response to sulfur mustard vapor is less than an order of magnitude. For nonlethal effects, the animal data suggest that test species exhibit signs of toxicity that are qualitatively similar to humans when acutely exposed to sulfur mustard vapor. Ocular and respiratory tract irritations are clearly evident in studies using dogs, rats, mice, rabbits, and guinea pigs. 

Ocular, percutaneous, inhalation, ingestion, and injection are all possible routes of exposure. Effects may be local, systemic, or both. All of the nitrogen mustards are oily liquids that are colorless to pale yellow and evaporate slowly. They are more dangerous than sulfur mustard but, like sulfur mustard, they are derivatives of ammonia. The most toxic and most volatile of the three nitrogen mustards is HN-2, but HN-3 is used more because it is stable. 

The second exception is that while an antidote is available for systemic effects of Lewisite exposure, there are no antidotes for nitrogen mustard or sulfur mustard toxicity, with one minor caveat if given within minutes after exposure, intravenous sodium thiosulfate may prevent death due to sulfur mustard exposure (25). Otherwise, the medical management for skin, ocular, and respiratory exposure is only supportive. One guideline physicians can follow is to keep skin, eye, and airway lesions free from infection. 

Petrali JP, Oglesby SB, Mills KR. Ultrastructural correlates of sulfur mustard toxicity. J Toxicol Cutan Ocular Toxicol. 1990 9 193-204. 

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