Public Health Statement for Sulfur Mustard
formerly called Mustard Gas
Spanish: Mostaza de azufre
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This Public Health Statement is the
summary chapter from the Toxicological
Profile for Sulfur Mustard. It is one in a series of Public
Health Statements about hazardous substances and their health
effects. A shorter version, the ToxFAQs™,
is also available. This information is important because this
substance may harm you. The effects of exposure to any hazardous
substance depend on the dose, the duration, how you are exposed,
personal traits and habits, and whether other chemicals are
present. For more information, call the ATSDR Information
Center at 1-888-422-8737.
This public health statement tells you
about sulfur mustard and the effects of exposure.
The Environmental Protection Agency (EPA)
identifies the most serious hazardous waste sites in the nation.
These sites make up the National Priorities List (NPL) and
are the sites targeted for long-term federal cleanup activities.
Sulfur mustard has been found in at least 3 of the 1,636 current
or former NPL sites. However, the total number of NPL sites
evaluated for this substance is not known. As more sites are
evaluated, the sites at which sulfur mustard is found may
increase. This information is important because exposure to
this substance may harm you and because these sites may be
sources of exposure.
When a substance is released from a large
area, such as an industrial plant, or from a container, such
as a drum or bottle, it enters the environment. This release
does not always lead to exposure. You are exposed to a substance
only when you come in contact with it. You may be exposed
by breathing, eating, or drinking the substance, or by skin
If you are exposed to sulfur mustard,
many factors determine whether you'll be harmed. These factors
include the dose (how much), the duration (how long), and
how you come in contact with it. You must also consider the
other chemicals you're exposed to and your age, sex, diet,
family traits, lifestyle, and state of health.
What is sulfur mustard?
Sulfur mustard is a thick liquid, which
was made for use as a chemical weapon. Presently, the chemical
is found at a few Army facilities in large quantities and
at several locations in smaller quantities. It is often called
by its common name, 'mustard gas.' However, the term 'mustard
gas' can be confusing, since it is stored as a liquid and
is not likely to change into a vapor immediately if it is
released at ordinary temperatures. As a liquid, it is colorless
when pure and it is brown when mixed with other chemicals.
It is odorless when pure, but can have a slight garlic smell
when mixed with other chemicals. It dissolves easily in fats,
oils, alcohol, and gasoline. Sulfur mustard dissolves slowly
in unstirred water, but within minutes in stirred water. When
it does dissolve, it reacts with water and turns into different
chemicals. It was used in chemical warfare as early as World
War I and as late as the Iran-Iraq War in 1980-1988. It is
not used in the United States, except for laboratory testing
of health effects and antidotes. More information on the physical
and chemical properties of sulfur mustard can be found in
Chapters 4 and 5. Information about mustard agents other than
sulfur mustard, such as nitrogen mustard, thickened mustard,
and lewisite, is not included in this document.
What happens to sulfur mustard when it enters the environment?
Sulfur mustard is not found naturally
in the environment in any amount. If sulfur mustard is accidentally
spilled at an Army base where it is stored, it could be released
into the environment. Currently, all of the sulfur mustard
at these Army bases is being destroyed by burning or neutralization.
U.S. law requires that the Department of Defense destroy all
sulfur mustard by 2004. However, complete destruction of sulfur
mustard may continue beyond this date. Once all of the sulfur
mustard is destroyed, it will no longer be dangerous. If sulfur
mustard is put on soil, it will remain there for at least
a day, but may remain for several days or longer. The time
it takes for sulfur mustard to disappear from soil depends
on how hot it is outside and how strongly the wind is blowing.
If it is hot and the wind is strong, then sulfur mustard will
disappear faster. When sulfur mustard disappears from soil,
it becomes a vapor or changes into other compounds if the
soil is wet. If sulfur mustard is buried underground, it may
not disappear for several years. Sulfur mustard will not move
through soil to underground water. If sulfur mustard is put
in water, it dissolves within minutes if the water is stirred,
and slowly if is not. When it does dissolve, it reacts with
water and changes to other compounds. The time necessary for
a quantity of sulfur mustard that is dissolved in water to
decrease by half is about 2 minutes at 40 °C (104 °F).
If large amounts of sulfur mustard are spilled into water,
most of the sulfur mustard will change to other compounds
very slowly or not at all. If sulfur mustard is released into
air, it will react with components in the air to form other
compounds. The time necessary for a quantity of sulfur mustard
in air to decrease by half is about 2 days at 25 °C (77
°F). Because sulfur mustard changes to other chemicals
in the environment, it will not concentrate in plants or animals.
For more information on what happens when sulfur mustard enters
the environment, see Chapter 6.
How might I be exposed to sulfur mustard?
Sulfur mustard is not currently being
produced in the United States. The general public might be
exposed through accidental release from the Army bases where
it is stored. These storage areas are heavily guarded, and
storage buildings are sealed. People who work at Army bases
that store sulfur mustard are more likely to be exposed than
the general public. However, the Army has taken many precautions
to protect the public from exposure to sulfur mustard. The
general public may be exposed to sulfur mustard at hazardous
waste sites that contain sulfur mustard. In addition, the
use of sulfur mustard by terrorists is of concern. Persons
involved in the transport or disposal of sulfur mustard may
be exposed to mustard agents generated unintentionally through
mishap. Spouses, children, and others may be exposed if workers
unknowingly bring the mustard agents out of the factory on
their skin or clothing. Sulfur mustard readily passes through
ordinary clothing. Mixed in water, sulfur mustard changes
its form within minutes, so it is very unlikely that you would
drink it. The likelihood of the general population being exposed
by way of water (drinking, cooking, bathing, and swimming)
is therefore very small. Sulfur mustard does not occur naturally;
therefore, there are no background levels in the soil, air,
water, or food. If it is accidentally released, it will stay
in the air or on the ground for 1-3 days. Under certain conditions,
it may remain on the ground or in water for long periods.
For more information on possible exposures, see Chapter 6.
How can sulfur mustard enter and leave my body?
Sulfur mustard can enter your body easily
and quickly if it gets in your eyes or on your skin, or if
you breathe sulfur mustard vapors. It can easily pass through
your clothing to get onto your skin. It is possible that you
could come into contact with sulfur mustard at hazardous waste
sites that contain this material. Sulfur mustard changes into
other chemicals in your body, and these chemicals mostly leave
your body in the urine within a few weeks. For more information,
see Chapter 3.
How can sulfur mustard affect my health?
To protect the public from the harmful
effects of toxic chemicals and to find ways to treat people
who have been harmed, scientists use many tests.
One way to see if a chemical will hurt
people is to learn how the chemical is absorbed, used, and
released by the body; for some chemicals, animal testing may
be necessary. Animal testing may also be used to identify
health effects such as cancer or birth defects. Without laboratory
animals, scientists would lose a basic method to get information
needed to make wise decisions to protect public health. Scientists
have the responsibility to treat research animals with care
and compassion. Laws today protect the welfare of research
animals, and scientists must comply with strict animal care
Sulfur mustard can harm you depending
on how much of the chemical you were exposed to and for how
long. Sulfur mustard may make your eyes burn, your eyelids
swell, or cause you to blink a lot. Sulfur mustard may burn
your skin and cause skin blisters within a few days. Your
eyes and the parts of your body that are sweaty are the most
likely to be harmed. If you breathe it, sulfur mustard can
cause coughing, bronchitis, and long-term respiratory disease.
Sulfur mustard may affect reproduction. Some men exposed to
sulfur mustard during war have reported decreased sexual drive
and have had problems with sexual function due to scarring
of genital tissues and lower sperm counts. The International
Agency for Research on Cancer has determined that sulfur mustard
is carcinogenic to humans. The Department of Health and Human
Services has also determined that sulfur mustard is a known
carcinogen. It can cause cancer in your airways, lungs, skin,
and maybe other areas of your body later in life. If you are
exposed to a very large amount of sulfur mustard, you can
eventually die from it. Some of the chemicals that are formed
when sulfur mustard is burned or spilled into water can also
be irritating to the skin.
How can sulfur mustard affect children?
This section discusses potential health
effects from exposures during the period from conception to
maturity at 18 years of age in humans.
Sulfur mustard causes the eyes and skin
of children to burn similarly to adults; however, the burns
may be more severe in children. Blisters may appear sooner
in children than adults, as early as 4 hours after sulfur
mustard contacts the skin. Coughing and vomiting have been
reported as early symptoms of exposure to sulfur mustard in
children. Sulfur mustard vapors are heavier than air and since
young children are closer to the ground or floor because of
their height, they may be exposed to more sulfur mustard vapors
than adults during accidental exposures. Sulfur mustard may
cause birth defects or affect the development of children.
An increased incidence of birth defects has been reported
among newborn babies of sulfur mustard victims exposed during
war. Studies in animals also indicate that sulfur mustard
may affect development. It is not known if sulfur mustard
can cross the placenta or be passed to infants in breast milk.
How can families reduce the risk of exposure to sulfur mustard?
If your doctor finds that you have been
exposed to significant amounts of sulfur mustard, ask whether
your children might also be exposed. Your doctor might need
to ask your state health department to investigate.
The risk of exposure to sulfur mustard
to the general public may be slightly greater for those who
live or work near Army bases and other facilities that store
it. However, the Army has instituted precautions to protect
the public from exposure to sulfur mustard. Sulfur mustard
is currently being destroyed at these facilities, and thus
the risk of exposure due to accidents is decreasing.
Is there a medical test to determine whether I have been exposed to sulfur mustard?
Sulfur mustard or some of the chemicals
that it makes in your body can be found by testing your urine
or blood. However, a test for sulfur mustard exposure is not
readily available at local physicians' offices or hospitals.
A urine or blood sample may be sent to a special laboratory
for testing. For further assistance, see Section 1.10.
What recommendations has the federal government made to protect human health?
The federal government develops regulations
and recommendations to protect public health. Regulations
can be enforced by law. Federal agencies that develop regulations
for toxic substances include the Environmental Protection
Agency (EPA), the Occupational Safety and Health Administration
(OSHA), and the Food and Drug Administration (FDA). Recommendations
provide valuable guidelines to protect public health but cannot
be enforced by law. Federal organizations that develop recommendations
for toxic substances include the Agency for Toxic Substances
and Disease Registry (ATSDR) and the National Institute for
Occupational Safety and Health (NIOSH).
Regulations and recommendations can be
expressed in not-to-exceed levels in air, water, soil, or
food that are usually based on levels that affect animals;
then they are adjusted to help protect people. Sometimes these
not-to-exceed levels differ among federal organizations because
of different exposure times (an 8 hour workday or a 24 hour
day), the use of different animal studies, or other factors.
Recommendations and regulations are also periodically updated as more information becomes available. For the most current information, check with the federal agency or organization that provides it. Some regulations and recommendations for sulfur mustard include the following:
The federal government considers sulfur mustard an extremely hazardous substance. In 1985, Congress directed the U.S. Army to begin destroying the stockpile of U.S. chemical agents including sulfur mustard. As a result, the U.S. Army's Chemical Stockpile Disposal Program (CSDP) was started. As part of this program, the U.S. Army has continued to study how workers and the general public might best be protected from harm by sulfur mustard. The U.S. Army is the primary source of safety recommendations for sulfur mustard. The federal government has recommended maximum concentrations in air to which the general public should be exposed for different lengths of time. The maximum concentration for long-term exposure is 0.0001 milligrams per cubic meter of air. Higher concentrations may be tolerated for shorter periods. Stored quantities of 500 pounds or more must be reported to the State Emergency Response Commission, the fire department, and the Local Emergency Planning Committee. Spills of over 1 pound must be reported to the National Response Center. For more information, see Chapter 8.
The National Advisory Committee has developed acute exposure guideline levels (AEGLs) to protect people from the harmful effects of a short-term (8 hours or less) exposure to sulfur mustard. Three types of AEGLs have been developed: AEGL-1, AEGL-2, and AEGL-3. For sulfur mustard, the AEGL-1 values range from 0.40 mg/m3 for a 10 minute exposure to 0.008 mg/m3 for an 8 hour exposure; exposure to higher concentrations may result in eye irritation. The AEGL-2 values range from 0.60 mg/m3 for 10 minutes to 0.013 mg/m3 for 8 hours; exposure to higher concentrations may result in swelling of the eyes, sensitivity to light, and eye irritation. The AEGL-3 values range from 3.9 mg/m3 for 10 minutes to 0.27 mg/m3 for 8 hours; exposure to higher concentrations may result in death. For more information on the AEGLs, see Appendix D.
Agency for Toxic Substances and Disease Registry (ATSDR). 2003. Toxicological profile for Sulfur Mustard. Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service.
Where can I get more information?
If you have questions or concerns, please contact your community or state health or environmental quality department or:
For more information, contact:
Agency for Toxic Substances and Disease Registry
Division of Toxicology and Human Health Sciences
4770 Buford Highway
Chamblee, GA 30341-3717
Phone: 1-800-CDC-INFO 888-232-6348 (TTY)
Email: Contact CDC-INFO
ATSDR can also tell you the location of occupational and environmental health clinics. These clinics specialize in recognizing, evaluating, and treating illnesses resulting from exposure to hazardous substances.