Presentation
HRCT evidence of bronchial wall thickening and with a lower frequency ILD were present despite normal CXR in 20% of the patients. [ncbi.nlm.nih.gov]
On section of the upper lobe a moist pink surface presents medially. Posteriorly a pinkish-red surface presents. There is a small amount of thin frothy fluid in the air sacs. [vlib.us]
Continuous variables are presented as the mean ± SD, whereas categorical data are presented as frequency distribution and percentages. Qualitative data were analyzed by using chi square test. [omicsonline.org]
But the staff of the White House panel said in a statement today that ''the evidence from the best detectors available in the field indicates mustard was present'' and that ''exposure should be presumed.'' Continue reading the main story [nytimes.com]
Entire Body System
- Fever
The digestive tract is also affected, resulting in abdominal pain, diarrhea, fever and vomiting. [livescience.com]
Digestive tract : Abdominal pain, diarrhea, fever, nausea, and vomiting may occur." Expected Health Issues: " Contact with sulfur mustard can cause bodily injury. [thechangeofethics.weebly.com]
[…] burning, inflammation and even blindness Skin: itchy redness that is replaced with yellow blisters Respiratory system: runny or bloody nose, sneezing, hoarse throat, shortness of breath, coughing, sinus pain Digestive system: abdominal pain, diarrhea, fever [science.howstuffworks.com]
Irritation of the respiratory tract can cause pain, shortness of breath, and a cough, among other symptoms, while exposure of the digestive tract can result in pain, nausea, vomiting, fever, and diarrhea. [borgenproject.org]
Digestive tract: abdominal pain, diarrhea, fever, nausea, and vomiting. [mashable.com]
- Military Personnel
Nearly 60,000 soldiers and military personnel were participants in mild exposures, and an estimated 4,000 were subjected to severe exposures due to field exercises over contaminated grounds. [fight4vets.com]
According to VA, nearly 60,000 military personnel were involved in a wide range of exposure tests, many of them mild exposures. Roughly 4,000 were subjected to “severe, full-body exposures” during field exercises on contaminated grounds. [dav.org]
This full destructiveness of the gas was really brought home for the Allied forces in 1943, when the SS John Harvey, an American ship carrying both mustard gas and military personnel, was bombed. [io9.gizmodo.com]
However, many more military personnel were exposed to significant levels of mustard agents or Lewisite than is obvious from service records. [nap.edu]
Like Agent Orange, those exposures were not recorded in military personnel records. [wusfnews.wusf.usf.edu]
Respiratoric
- Cough
All 23 patients were symptomatic with cough, dyspnea, and/or felt tight in the chest. All of them had significant air trapping in HRCT and a marked increase of residual volume in PFT. [ncbi.nlm.nih.gov]
Breathing sulfur mustard's can cause coughing, bronchitis, and other breathing symptoms. Exposure to very high levels can cause long-term respiratory disease or death. [thechangeofethics.weebly.com]
Mustard gas can burn skin, cause blisters and cause respiratory effects, such as coughing and bronchitis. Higher levels may cause death. It is also more harmful to the skin on hot, humid days, or in tropical climates. [foxnews.com]
This treatment alleviated dry cough but didn't cure the bronchial infection. For the most severe casualties, medics quarantined the affected patients and hoped for the best. [science.howstuffworks.com]
You may also need any of the following: Cool mist humidifier: This may make it easier for you to breathe and help decrease your cough. Eye drops or ointment: This may help decrease inflammation and help your eyes heal. [drugs.com]
- Rales
Lungs: Moist rales throughout. Summary of gross lesions. - Large blebs over back, chest, arms, face, and genitals. Few old adhesions in right pleura, left negative. [vlib.us]
- Painful Cough
Patients with a mild exposure may present with dyspnea, epistaxis, pain, coughing, or tachypnea. 10,13 More serious exposures may result in bone marrow suppression and leukopenia, reaching its nadir at day 9 postexposure. 11,12 A cohort of Iranian soldiers [centerforhealthsecurity.org]
Gastrointestinal
- Vomiting
They vomited, and there was erythema of the skin.(…) Later there was severe blistering of the skin.” Despite these less than pleasant effects, mustard gas is not generally fatal. [borgenproject.org]
GI involvement results in abdominal pain, nausea, vomiting, diarrhea, and weight loss. Blood system: Rarely, mustards cause unpredictable loss in the production of bone narrow. [emedicinehealth.com]
Digestive tract : abdominal pain, diarrhea, fever, nausea, and vomiting. [emergency.cdc.gov]
Soon after exposure, however, nausea, retching, vomiting and eye irritation may be reported. Acute systemic effects, such as central nervous excitation convulsions and death only after very severe exposure. [emro.who.int]
Initial likely symptoms of coughing, choking, tightness in the chest, nausea, and occasionally vomiting occur minutes after exposure. This may seem quick but it actually means that victims continue to inhale it until symptoms become apparent. [nationalinterest.org]
- Choking
Verifying Destruction of Old and Abandoned Chemical Weapons Types of Chemical Agents Choking agents Inflicting injury mainly on the respiratory tract, choking agents irritate the nose, throat, and especially the lungs. [opcw.org]
Phosgene is a choking agent that works by attacking lung tissue. Initial likely symptoms of coughing, choking, tightness in the chest, nausea, and occasionally vomiting occur minutes after exposure. [nationalinterest.org]
Phosgene as a weapon was more potent than chlorine in that while the latter was potentially deadly it caused the victim to violently cough and choke. [firstworldwar.com]
In all my dreams, before my helpless sight, He plunges at me, guttering, choking, drowning. [bbc.com]
Use as a Chemical Warfare Agent Before blister agents were introduced in 1917, most of the chemical weapons in use were choking agents-chlorine and phosgene gas-which necessitated the use of gas masks for respiratory protection. [centerforhealthsecurity.org]
Cardiovascular
Skin
- Blister
Furthermore, the blisters can take months to heal, and no medical countermeasures exist that can speed the rate of healing.” [coastguard.dodlive.mil]
Blistering is one of numerous symptoms of mustard gas exposure, along with eye irritation, respiratory and digestive problems, according to the Centers for Disease Control and Prevention. [southcoasttoday.com]
Larger blisters (> 2cm) may heal faster if lanced and debrided. [centerforhealthsecurity.org]
In many cases the result was appalling blistering. [chemistryworld.com]
Eight hours later, Fisher developed blisters, and physicians determined he'd come in contact with a liquid mustard chemical warfare agent. [archive.defense.gov]
Eyes
- Eye Irritation
By the time he and the other man were taken to the hospital, he had eye irritation, tingling around his mouth and an upset stomach but was released at about 1 a.m. St. [southcoasttoday.com]
Eyes : Irritation, pain, swelling, and tearing may occur within 3-12 hours. A more severe exposure may cause symptoms within 1-2 hours and may also include light sensitivity, severe pain, or blindness (lasting up to 10 days). [thechangeofethics.weebly.com]
You might experience some of the following symptoms after you inhaled or touched mustard gas [source: Centers for Disease Control ]: Eyes: irritation, redness, burning, inflammation and even blindness Skin: itchy redness that is replaced with yellow blisters [science.howstuffworks.com]
Eyes: irritation, pain, swelling, and tearing may occur within 3 to 12 hours of a mild to moderate exposure. [mashable.com]
Eyes : irritation, pain, swelling, and tearing may occur within 3 to 12 hours of a mild to moderate exposure. [emergency.cdc.gov]
- Blepharospasm
Main clinical symptoms Few hours after the exposure Eyes: gritty feeling, progressive soreness and bloodshot appearance, lachrymation, blepharospasm and photophobia Increased nasal secretion, sneezing Sore throat, coughing, hoarseness and dyspnoea Lung [emro.who.int]
The mustard gas also affects the cornea, causing conjunctivitis, blepharospasm and cheratinite. Concentrations of about 0.15 mg / liter of air are lethal in about 10 minutes. [flipper.diff.org]
An asymptomatic period for the eyes is followed by redness and irritation which can progress to corneal damage with photophobia, blepharospasm, excessive lacrimation, and blindness [ 8, 10, 11 ]. [omicsonline.org]
- Eye Pain
Eyes: Nerve agent liquid or vapor readily penetrates the eye tissues and may cause the pupils to contract, blurred and dim vision, headache, redness, tears, pain, nausea, and vomiting. [emedicinehealth.com]
Psychiatrical
- Fear
For readers wishing to know about its syntheses, the discovery that it causes blistering and other properties that made it a feared weapon, and its application in the war itself, I recommend its Wikipedia article as a good starting point. [chemistryworld.com]
The Allies feared the use of chemical agents, especially mustard gas, by the Germans and Japanese. The Navy soon produced secret tests of the defenses and uses of mustard gas. [fight4vets.com]
Image copyright ALAMY "I fear it will produce a tremendous scandal in the world... war has nothing to do with chivalry any more. [bbc.com]
Mustard gas wasn’t the most lethal chemical weapon of the First World War, but it was perhaps the most feared. “Here are some little-known facts about one of history’s most terrible weapons of mass destruction.” [militaryhistorynow.com]
British Prime Minister Winston Churchill was especially adamant that the incident remain secret for fear of a German propaganda coup. There was no medical follow up on either the military or civilians affected. [defensemedianetwork.com]
Face, Head & Neck
- Epistaxis
Patients with a mild exposure may present with dyspnea, epistaxis, pain, coughing, or tachypnea. 10,13 More serious exposures may result in bone marrow suppression and leukopenia, reaching its nadir at day 9 postexposure. 11,12 A cohort of Iranian soldiers [centerforhealthsecurity.org]
Neurologic
- Seizure
These agents initially stimulate and then paralyze certain nerve transmissions throughout the body and cause other toxic effects such as seizures. [emedicinehealth.com]
Example agents Tabun (GA) Sarin (GB) Soman (GD) Cyclosarin (GF) VX Dispersal Liquid, aerosol, vapour and dust Mode of Action Absorption through lungs (G-series); contact with skin (VX) Effects Causes seizures, loss of body control; paralyses muscles, [opcw.org]
Treatment
The final decision regarding which treatment is used for an individual patient remains the clinical responsibility of the prescriber. [medicinesinpregnancy.org]
The future is changing And so mustard gas went from the very real battleground of the WWI trenches into the frontline of cancer treatment. But for J.D, the treatment came too late. [scienceblog.cancerresearchuk.org]
Image: Public Domain, Canada [Source: Mustard Gas From The Great War To Frontline Chemotherapy, Evolution of Cancer Treatments ] [io9.gizmodo.com]
Food and Drug Administration seeking approval of the drug for this new treatment indication. [globalbiodefense.com]
Since then, the VA failed to adequately notify affected veterans of their eligibility for benefits or to provide proper treatment for the chronic and debilitating conditions that resulted from exposure to mustard agents. [walorski.house.gov]
Prognosis
Mustards Prognosis Victims with significant respiratory tract burns usually require admission to the hospital’s intensive care unit. [emedicinehealth.com]
Etiology
RESULTS: A relatively early age of lung cancer onset (ranging from 28 to 73 with a mean of 48) in mustard gas victims, particularly those in the non-smoking population (mean age of 40.7), may be an indication of a unique etiology for these cancers. [ncbi.nlm.nih.gov]
Epidemiology
[…] and Internal Medicine, Institute of Biomedical Sciences, Hiroshima University, Hiroshima, Japan 2 Department of Respiratory Medicine, Mazda Hospital, Hiroshima, Japan 3 Tadanoumi Branch Hospital, Kure Kyosai Hospital, Takehara, Japan 4 Department of Epidemiology [oem.bmj.com]
There were no epidemiologic studies done of mustard-agent exposed U.S. chemical weapons productions workers, war gas handlers and trainers, or combat casualties from WWII. [nationalacademies.org]
The committee was additionally dismayed that there were no epidemiological studies done of mustard agent-exposed, U.S. chemical weapons production workers, war gas handlers and trainers, or combat casualties from WWII. [nap.edu]
A chart of signs and symptoms is available from the North Carolina Statewide Program for Infection Control and Epidemiology. [emedicinehealth.com]
Prevention
This book provides a comprehensive review and analysis of the acute toxic effects of sulfur mustard (mustard gas); the injuries that this compound produces in skin, eye, airway, and other tissues; and possibilities for the prevention of these injuries [books.google.com]
Preincubation of cells with a serine protease inhibitor (PMSF), or a metalloprotease inhibitor (1,10-phenanthroline) prior to SM exposure partially prevented SM-induced degradation of laminin-5 subunits, beta3 and gamma2. [ncbi.nlm.nih.gov]
US Centers for Disease Control and Prevention, Agency for Toxic Substances and Disease Registry website. http://www.atsdr.cdc.gov/mmg/mmg.asp?id=922&tid=190. Accessed February 26, 2014. [centerforhealthsecurity.org]
“This is critical to preventing serious injury and death from any such attack.” [eohsi.rutgers.edu]
Biomedical Sciences, Hiroshima University, Hiroshima, Japan 2 Department of Respiratory Medicine, Mazda Hospital, Hiroshima, Japan 3 Tadanoumi Branch Hospital, Kure Kyosai Hospital, Takehara, Japan 4 Department of Epidemiology, Infectious Disease Control and Prevention [oem.bmj.com]