22:T501,Based on a study of the literature and our own experience treating fisherman poisoned fry mustard gas, this article outlines the clinical effects, and toxicological and mutagenic properties of the agent. Mustards are very persistent chemical agents that easily penetrate clothing. Mustard gas usually causes clinical symptoms after the liquid penetrates the skin or the vapor is inhaled. Skin lesions are similar to first- or second-degree burns and usually heal spontaneously in 4 to 6 weeks. Eye symptoms are photophobia and reduced vision. Following inhalation of the agent, pulmonary edema and long-term dyspnea may be seen. As mustard gas is an alkyldting substance, it is conceivable that the risk of developing cancer may be increased, as observed in people who were involved with the production of mustard gas and in animals exposed to the gas. Also, transient significantly increased sister chromatid exchange rates have been found in fishermen exposed to mustard gas. Patients exposed to mustard gas must be treated immediately after exposure. Treatment should consist of cleaning of the exposed skin and clothes with an antigas powder and water and soap. The skin lesions should be treated as bums. Eye lesions and respiratory problems should be treated symptomatically.23:T499,

OUTLINE

Incidence Dose necessary to produce lesion Course of severe corneal burns Action on tissue Local Action Liberation of hydrochloric acid Derivatives Whole molecule Tissue hypersensitivity Systemic Action Break-down products Metabolism Bone marrow Antibodies Changes secondary to burns Fundus changes Prophylaxis Treatment Patients without corneal involvement Reassurance Irrigations Bland solutions Hypertonic solutions Neutralizing agents Irrigating apparatus Dark glasses or eye shade Convalescence Patients with corneal involvement Immediate treatment Oily drops and ointments Ascorbic acid Secondary infections Mild silver protein and boric acid Antiseptics Sulfanilamide and derivatives Convalescence Late treatment Summary of present treatment

I. INCIDENCE

The present treatment of mustard gas—dichlorodiethylsulfide, or ClCH₂CH₂)₂S—injuries to the eyes is largely derived from the methods developed during the first World War. The incidence of mustard gas injuries during that period, with the clinical and the pathologic characteristics, has been summarized in the "Official History of the War."¹

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Abstract

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