Toxicokinetics of Sulfur Mustard in Humans

Human volunteers have been exposed in a controlled way to sulfur mustard liquid and vapor in order to observe the adverse effects on the exposed skin (see overview by Papirmeister et al., 1991 ), whereas the effects on the respiratory tract do not appear to have been studied. Furthermore, no reports can be found that describe the toxicokinetics of sulfur mustard in humans. 

Smith et al (2008) reported the analysis of metabolites in the urine of the same two patients. This included the free and conjugated simple hydrolysis products thiodiglycol (TDG) and its sulfoxide (TDG-sulfoxide), the P-lyase metabolites l,l -sulfonylbis[2-(methylsulfinyl)ethane] (SBMSE) and l,l -methylsulfinyl-2-[2-(methylthio)-ethylsulfonyl]ethane (MSMTESE), as 

The reported findings are in reasonable agreement with those of Benschop et al (1997), who detected the Ai -adduct to guanine and the N-terminal valine adduct of hemoglobin in the blood of two Iranian victims 22-26 days after the alleged exposure. One of the victims showed clear signs of sulfur mustard exposure, ie. skin injuries but no respiratory effects, whereas the other victim showed symptoms that were only vaguely compatible with sulfur mustard. 

In a sulfur mustard vapor environment, unprotected military personnel will be exposed simultaneously via the respiratory and percutaneous routes. Such a combined exposure has not yet been studied, but it would be interesting to see which route would be predominant. Obviously, the environmental conditions will have a profound influence on the relative importance of the two exposure routes. 

The generated toxicokinetic data can be used for validation of physiologically based toxicokinetic models. Such models should take into account that sulfur mustard may influence physiological parameters in a dose 

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