MUSTARD GAS
HAZARDTEXT ®
Information to help in the initial response for evaluating chemical incidents
-IDENTIFICATION
SYNONYMS
AGENT HD beta-CHLORO-2-(beta-CHLOROETHYLTHIO)ETHANE BIS(beta-CHLOROETHYL)SULFIDE BIS(beta-CHLOROETHYL)SULPHIDE BIS(2-CHLOROETHYL)SULFIDE BIS(2-CHLOROETHYL)SULPHIDE 1-CHLORO-2-(beta-CHLOROETHYLTHIO)ETHANE 2,2'-DICHLORODIETHYL SULFIDE 2,2'-DICHLORODIETHYL SULPHIDE DI-2-CHLOROETHYL SULFIDE DI-2-CHLOROETHYL SULPHIDE DICHLORODIETHYL SULFIDE z,z-DICHLORODIETHYL SULFIDE DICHLORO-DIETHYL-SULPHIDE DICHLOROETHYL SULFIDE beta,beta'-DICHLORODIETHYL SULFIDE beta,beta'-DICHLOROETHYL SULFIDE beta,beta'-DICHLOROETHYL SULPHIDE beta,beta-DICHLOR-ETHYL-SULPHIDE 2,2'-DICHLOROETHYL SULFIDE 2,2'-DICHLOROETHYL SULPHIDE DIETHYL SULFIDE, 2,2'-DICHLORO DISTILLED MUSTARD EA 1033 ETHANE, 1,1'-THIOBIS(2-CHLORO)- GELBKREUZ (Czech) H HD HD (chemical warfare agent) HS IPRIT KAMPFSTOFF "LOST" KAMPSTOFF "LOST" LOST MUSTARD GAS MUSTARD HD MUSTARD, SULFUR MUSTARD VAPOR SCHWEFEL-LOST S-LOST S MUSTARD SENFGAS SULFIDE, BIS(2-CHLOROETHYL) SULFUR MUSTARD SULFUR MUSTARD GAS SULPHUR MUSTARD SULPHUR MUSTARD GAS 1,1'-THIOBIS(2-CHLOROETHANE) Y YELLOW CROSS GAS YELLOW CROSS LIQUID YPERITE GS-YPERITE S-YPERITE DISTILLED MUSTARD GAS GAS, MUSTARD
IDENTIFIERS
2810-HD 2810-HN-1 2810-Mustard
SYNONYM REFERENCE
- ((HSDB, 2002); Lewis, 1998; OHM/TADS , 2001; SBCCOM , 2001; (STNEasy, 2001))
USES/FORMS/SOURCES
Mustard gas is used in organic synthesis and medicine and as a vesicant agent in chemical warfare (Borak & Sidell, 1992; Dacre & Goldman, 1996; Lewis, 1997). Mustard gas has been tested as an antineoplastic agent, but the tests have been minimal ((HSDB, 2002); Sittig, 1991). It was formerly used as a topical medication for the treatment of psoriasis ((HSDB, 2002)). Mustard gas is used as a model compound in biological studies on alkylating agents, in organic synthesis, and in medicine (Hathaway et al, 1996; (HSDB, 2002); Lewis, 1997; Sittig, 1991). "Yellow rain," a mixture of mycotoxins, mustard gas, and nerve agents (tabun, sarin, and soman), was used in the Iran-Iraq war in 1984. A case fatality rate of 20% was reported (Balali-Mood & Gorji, 1993; Drasch et al, 1987; Eisenmenger et al, 1991; Heyndrickx & Heyndrickx, 1990; Momeni et al, 1992; Pour-Jafari & Moushtaghi, 1992).
Mustard is available in a pure and technical grade which contains excess sulfur as polysulfide (Lewis, 1997). Lewisite is added to some types of mustard ammunition (2:3 ratio) to increase the effectiveness at lower temperatures (OPCW , 1997). An additional copolymer, styrene-butyl acrylate, added to mustard raises the viscosity known as Thickened HD (THD). It is not hazardous except in a fine powder form (OPCW , 1997; SBCCOM , 2001).
The mustard agent, H, is a mixture of 70% bis(2-chloroethyl)sulfide and 30% sulfur impurities produced by an unstable Levinstein process ((HSDB, 2002); USACHPPM , 2001). Mustard is prepared by bubbling ethylene through sulfur chloride, or from hydrogen sulfide and thiodiglycol (Lewis, 1997). The German process to produce mustard treats beta, beta-dihydroxyethyl sulfide with hydrochloric acid gas (Budavari, 2000). Mustard gas is stored in artillery shells, ton containers, and other munitions. Stockpiles in the United States are located at Aberdeen Proving Ground, MD; Anniston Army Depot, AL; Blue Grass Army Depot, KY; Pine Bluff, AR; Pueblo Depot Activity, CO, Tooele Army Depot, UT; and Umatilla Depot Activity, OR (USACHPPM , 2001a).
SYNONYM EXPLANATION
- HD (distilled mustard) is H that has been purified by washing and vacuum distillation to reduce the sulfur impurities (USACHPPM , 2001).
-CLINICAL EFFECTS
GENERAL CLINICAL EFFECTS
- USES: Mustard gas is used primarily as a vesicant agent in chemical warfare. It may also be used in organic synthesis.
- TOXICOLOGY: Mustard gas crosslinks DNA and prevents normal cell division. The skin is the major target; once inside the skin, mustard gas damages the cells separating the epidermis (upper layer) from the dermis (lower layer). The two layers separate with the space between them becoming a blister. Similar effects occur in the airways and eyes, except blisters do not appear. Mustard gas may also induce long-term mutagenic and carcinogenic effects.
- EPIDEMIOLOGY: Mustard gas has historically been used as a chemical warfare agent. Its use is prohibited by the Geneva Protocol (1925) and the Chemical Weapons Convention (1993). It has a potential use as a terrorist weapon of mass destruction. From July 1917 to the end of World War I, British causalities from mustard gas amounted to at least 125,000 with approximately 1859 deaths. Following World War II (1945 to 1948), large stockpiles of chemical weapons, including mustard gas, were dumped into the Baltic sea, leading to mustard gas poisoning of 23 fishermen in 1984. It was also used by Iraqi forces during the Iran-Iraq conflict.
INGESTION: It produces nausea and vomiting, abdominal pain, bloody diarrhea, and prostration resulting in dehydration. DERMAL: Signs and symptoms occur within 2 to 24 hours of exposure. Itching and erythema occur 2 to 3 hours after dermal exposure to the gas or liquid; erythema spreads over the next 24 hours and yellowish blisters appear and can become ulcerated, which heal in 4 to 6 weeks after a transitory melanoderma. Thinner skin (neck, axillae, and groin) is more susceptible than thicker skin (soles and palms). INHALATION: Cough, dyspnea, and possibly pulmonary edema may occur up to 24 hours after inhalation of the gas. Ulceration of airway mucosa may occur. Mild pulmonary exposure produces rhinorrhea, sneezing, epistaxis, hoarseness, and cough within 12 to 24 hours of exposure. Severe exposure produces additional symptoms of productive cough and shortness of breath (mild to severe) 2 to 4 hours after exposure. EYES: Lacrimation, itching, burning, and dryness (gritty feeling) may occur with usual onset of 4 to 12 hours after exposure. Conjunctivitis appears early, developing 4 to 6 hours after exposure. Moderate exposure produces the above plus redness, eyelid swelling, and moderate pain. These symptoms usually begin 3 to 6 hours postexposure. Severe exposure produces marked swelling of lids, photophobia, corneal ulceration, and severe pain with onset of 1 to 2 hours after exposure. Loss of vision may occur. Visual disturbance may persist for up to 10 days.
- POTENTIAL HEALTH HAZARDS - EMERGENCY RESPONSE GUIDEBOOK, GUIDE 153 (ERG, 2004)
TOXIC; inhalation, ingestion or skin contact with material may cause severe injury or death. Contact with molten substance may cause severe burns to skin and eyes. Avoid any skin contact. Effects of contact or inhalation may be delayed. Fire may produce irritating, corrosive and/or toxic gases. Runoff from fire control or dilution water may be corrosive and/or toxic and cause pollution.
ACUTE CLINICAL EFFECTS
TOXICOLOGY: Mustard gas crosslinks DNA and prevents normal cell division. The skin is the major target; once inside the skin, mustard gas damages the cells separating the epidermis (upper layer) from the dermis (lower layer). The two layers separate with the space between them becoming a blister. Similar effects occur in the airways and eyes, except blisters do not appear. Mustard gas may also induce long-term mutagenic and carcinogenic effects. EPIDEMIOLOGY: Mustard gas has historically been used as a chemical warfare agent. Its use is prohibited by the Geneva Protocol (1925) and the Chemical Weapons Convention (1993). It has a potential use as a terrorist weapon of mass destruction. From July 1917 to the end of World War I, British causalities from mustard gas amounted to at least 125,000 with approximately 1859 deaths. Following World War II (1945 to 1948), large stockpiles of chemical weapons, including mustard gas, were dumped into the Baltic sea, leading to mustard gas poisoning of 23 fishermen in 1984. It was also used by Iraqi forces during the Iran-Iraq conflict. EXPOSURE INGESTION: It produces nausea and vomiting, abdominal pain, bloody diarrhea, and prostration resulting in dehydration. DERMAL: Signs and symptoms occur within 2 to 24 hours of exposure. Itching and erythema occur 2 to 3 hours after dermal exposure to the gas or liquid; erythema spreads over the next 24 hours and yellowish blisters appear and can become ulcerated, which heal in 4 to 6 weeks after a transitory melanoderma. Thinner skin (neck, axillae, and groin) is more susceptible than thicker skin (soles and palms). INHALATION: Cough, dyspnea, and possibly pulmonary edema may occur up to 24 hours after inhalation of the gas. Ulceration of airway mucosa may occur. Mild pulmonary exposure produces rhinorrhea, sneezing, epistaxis, hoarseness, and cough within 12 to 24 hours of exposure. Severe exposure produces additional symptoms of productive cough and shortness of breath (mild to severe) 2 to 4 hours after exposure. EYES: Lacrimation, itching, burning, and dryness (gritty feeling) may occur with usual onset of 4 to 12 hours after exposure. Conjunctivitis appears early, developing 4 to 6 hours after exposure. Moderate exposure produces the above plus redness, eyelid swelling, and moderate pain. These symptoms usually begin 3 to 6 hours postexposure. Severe exposure produces marked swelling of lids, photophobia, corneal ulceration, and severe pain with onset of 1 to 2 hours after exposure. Loss of vision may occur. Visual disturbance may persist for up to 10 days.
Sinus dysrhythmias, first- and second-degree heart block, premature ventricular contractions, and premature atrial contractions, and possibly cardiac arrest have been reported following exposure to mustard gas. These symptoms were observed within the first week after exposure but all resolved within 6 months. In studies, 30% of exposed patients experienced nonspecific ST-segment changes (Geraci, 2008). Cardiac irregularities appear to occur only following extremely acute, high doses (generally attainable only in laboratory settings) ((Sidell, 2000); NATO, 1973).
SEVERE SKIN IRRITATION was produced at 2000 mg/m(3)/1 hour in humans using the standard Draize test; irritation was produced at 65 mcg in humans ((RTECS, 2002)). The median incapacitating dose for skin absorption was 2000 mg/min/m(3) (EPA, 1985). Mustard gas has more severe vesicant and irritant properties than its nitrogen analogue, nitrogen mustard. The first effect on the skin is often pallor, followed within a few hours by erythema, which is similar to that of a sunburn, with burning and itching. Over the next few hours small blisters (vesicles) appear that gradually combine to form large blisters. Clinical effects may progress for several days. Four to 6 days after exposure, necrosis is complete and separation of the necrotic slough begins; edema and erythema may persist. Approximately 16 to 20 days postexposure, separation is complete and reepithelialization has begun; healing may take 3 to 8 weeks (Rice, 2003; Sidell et al, 1998). The order of dermal effects is as follows (from initial to last effects): No evidence of injury will be evident for several hours after exposure; itching with or without dryness and pallor; erythema; vesicles; bullae; necrosis and ulceration; hypo- or hyperpigmentation((Garigan, 1996)). Healing and other effects that may be noted are as follows: Healing of erythema: 3 to 7 days; healing of ulcers: 6 to 8 weeks and occurs much more slowly in human as compared with animals; skin injuries more severe in humid and warm climates; most severe at warm and moist sites (eg, genitalia, perineal regions, groin, lower back and axillae, underarms, neck ) (Geraci, 2008; Sidell et al, 1998; (Garigan, 1996); Sidell et al, 1998; (Garigan, 1996)). In studies, the most common skin diagnosed disorders in patients exposed to sulfur mustard were eczema, seborrheic dermatitis, cherry angioma, and urticaria. Genitalia, face, and axilla are the most frequently involved areas (Shohrati et al, 2007). In a cross-sectional descriptive study evaluating 800 men with latent cutaneous effects 14 to 20 years after wartime exposure to sulfur mustard gas, more common symptoms or disorders included: xerosis (39.6%), hyperpigmentation (19%), cherry angioma (17.3%), seborrheic dermatitis (12.7%), and eczema (12.2%) (Emadi et al, 2008). SEQUELA: Long-term sequelae reported following mustard exposure includes pigmentation abnormalities of the skin, chronic skin ulceration and scar formation, alopecia, xerosis, keloids and skin cancer ((Sidell, 2000); Dowlati & Pierard, 1993).
Nausea, vomiting, diarrhea (or bloody diarrhea) and dehydration can be caused by ingestion or systemic absorption (Geraci, 2008; (Garigan, 1996); Ruhl et al, 1994). ABDOMINAL PAIN: Epigastric pain may occur following exposure to mustard gas (Geraci, 2008; Dacre & Goldman, 1996). LOSS OF APPETITE: Loss of appetite and cachexia may occur during the first week after exposure (Geraci, 2008; Pierard et al, 1990).
The eye is the most sensitive target organ for effects of mustard gas vapor (Dacre & Goldman, 1996; Borak & Sidell, 1992). All of the following ocular effects may occur following exposure to mustard gas: pain, lacrimation, photophobia, swelling, blepharospasm, ulceration, delayed healing of cornea, and opacification (Geraci, 2008; (Garigan, 1996)). ITCHING: Itching of the eye has been reported in subjects after mustard gas exposure (Balali-Mood et al, 2005; Shohrati et al, 2007). CONJUNCTIVITIS, ACUTE AND DELAYED: Conjunctivitis is the first ocular effect seen after acute exposure (Shohrati et al, 2007). Additionally, chronic conjunctivitis may occur, and generally precedes onset of delayed keratopathy (Blodi, 1971). EDEMA: Edema of the eyelids may occur and can be delayed by several hours after exposure (Sidell et al, 1998). CORNEAL ULCERATION: Corneal ulceration/opacity with burning discomfort may occur at a later stage of poisoning (Shohrati et al, 2007; Sidell et al, 1998). PHOTOPHOBIA: Photophobia has been produced (Shohrati et al, 2007; Grant & Schuman, 1993). In one study of 40 sulfur mustard-exposed patients, photophobia was reported in 30% of patients (Windholz et al, 1983). In another cohort study of 367 chemical war victims, photophobia was reported in 36.8% of subjects 20 years after exposure to mustard gas compared with 20.3% in the control group (p less than or equal to 0.001) (Ghasemi et al, 2008). LOCAL THROMBOSIS/ISCHEMIA: Thrombosis and ischemia has been reported following exposure, and delayed hemorrhage due to leakage through vessel walls may follow (Grant & Schuman, 1993). BLINDNESS: Loss of vision and/or permanent eye damage can occur (Geraci, 2008; Lewis, 1993). RECURRENT KERATITIS: Keratitis of previously damaged areas of ulceration and deterioration may occur up to 40 years after exposure. Corneal irregularity and/or infiltration have developed with impairment of vision (Geraci, 2008; (Sidell, 2000)). MICROBIOLOGICAL GROWTH: Patients previously exposed to mustard gas with signs of chronic blepharitis were compared to unexposed patients with chronic blepharitis. Isolations of the eyelid margin flora revealed higher rates of Staphylococcus epidermidis (78% vs 57%; p less than 0.01) and Staphylococcus aureus (30% vs 3%; p less than 0.001) in the exposed group compared with the control group. In addition, greater resistance to common antibiotics was noted in the exposed group compared with the control group. Positive fungal cultures were also observed more frequently in the exposed group compared with the control group (Karimian et al, 2011).
MYELOSUPPRESSION: Leukopenia, thrombocytopenia, and anemia have occurred because of depressed myelopoiesis. Destruction of precursor cells of the bone marrow results in pancytopenia (Geraci, 2008; (Sidell, 2000); Dacre & Goldman, 1996). Effects are usually not evident for 3 to 5 days after exposure, but several studies have reported that bone marrow suppression may become evident about 4 hours after exposure to mustard gas (Geraci, 2008; (Garigan, 1996)). EOSINOPHILIA: Among 14 children exposed in the Irag-Iran war, eosinophilia was the most commonly seen laboratory finding (Momeni & Aminjavaheri, 1994).
CUTANEOUS SENSITIZATION: Cutaneous sensitization may occur with repeated exposure of 1 to 3 weeks (NATO, 1973). Characteristic sensitization reactions are a morbilliform rash and eczematoid dermatitis around old skin lesions (NATO, 1973). INFECTION: Following absorption of a large amount of mustard, bone marrow damage resulting in decreased white and red blood cells may occur, with overwhelming infection often resulting (Sidell et al, 1998). Death may occur despite antibiotic use in these cases.
Dizziness, generalized malaise, anorexia, and lethargy can occur after acute exposure (Aasted et al, 1987). Mental or intellectual dullness is common following an acute mustard gas exposure ((Garigan, 1996)). CNS EXCITATION: CNS excitation with seizures may occur, followed by CNS DEPRESSION (Dacre & Goldman, 1996; NATO, 1973), and this excitation appears to occur only following extremely acute, high doses ((Sidell, 2000)). SENSORY LOSS: Sensory loss and motor nerve disorders were reported in veterans who were evaluated 16 to 20 years after exposure. Reported areas of dysfunction included the tibial and peroneal nerves (Balali-Mood et al, 2005). HEADACHE: Headache may occur following exposure (Weibrecht et al, 2012; NATO, 1973). NEUROPATHY: Patients may experience neuropathic pain for years after exposure to mustard gas. Allodynia, paresthesias, stinging, burning, and itching have been reported in patients exposed to mustard gas. Sunlight and shifts in temperature may aggravate these symptoms (Geraci, 2008).
PERSONALITY DISORDER: Long-term sequelae of mustard exposure has been reported in a study sponsored by the Veterans Administration. Psychological disorders, including mood disorders, anxiety disorders, and traumatic stress disorders, with a causal relationship to mustard exposure are reported ((Sidell, 2000)).
EARLY EFFECTS: Mild to moderate immediate symptoms include dyspnea, chest tightness, sneezing, rhinorrhea, hoarseness, aphonia, epistaxis, hacking coughs, and tachypnea. Serious respiratory problems (eg, tracheobronchitis, bronchopneumonitis, pulmonary edema, hemorrhage, acute respiratory distress syndrome, pulmonary fibrosis) may occur hours to days after exposure (Weibrecht et al, 2012; Geraci, 2008). Respiratory dysfunction is the most common cause of death ((Garigan, 1996)), and if a large amount is inhaled, the prognosis is more ominous if there is shorter onset of time to the lower airway effects (shortness of breath and severe productive cough) (Sidell et al, 1998). LATE EFFECTS: Possible chronic effects for those exposed to mustard gas include: asthma, chronic bronchitis, airway narrowing, pulmonary fibrosis, COPD, and bronchiectasis (Emad & Rezaian, 1997; Hefazi et al, 2005; Zojaji et al, 2009). ULCERATION: Irritation or ulceration of the respiratory tract can occur from acute exposure, and concomitant symptoms may include rhinitis, laryngitis, cough, dyspnea, inflammation, and bronchopneumonia (Dacre & Goldman, 1996; ITI, 1995). DYSPNEA: Dyspnea is a common effect following exposure. In one study evaluating 1428 patients exposed to mustard gas during the Iran-Iraq war, dyspnea occurred in 83% of patients (Balali-Mood & Gorji, 1993). ACUTE LUNG INJURY: Pulmonary edema and hemorrhage can occur, although it is uncommon except in the terminal stages ((Sidell, 2000); (Garigan, 1996)). PNEUMONITIS: Bronchopneumonitis may commonly occur following acute mustard gas exposures ((Garigan, 1996)). Occupationally exposed patients may be at a higher risk of mortality due to influenza, pneumonia, and chronic respiratory disease (Easton et al, 1988).
CHRONIC CLINICAL EFFECTS
- Dermal sensitization may occur from repeated exposure over 1 to 3 weeks (NATO, 1973).
- Chronic exposure may increase the risk of developing nonmalignant pulmonary disease. Risk of mortality from influenza, pneumonia, and chronic respiratory disease was higher than expected in persons occupationally exposed to mustard gas (Easton et al, 1988).
-FIRST AID
FIRST AID AND PREHOSPITAL TREATMENT
- PREHOSPITAL: Move patient from the toxic environment to fresh air. As soon as possible, remove contaminated clothing and wash exposed area extremely thoroughly with soap and water. Cut away and discard contaminated hair. Dilute (0.5%) hypochlorite solutions (prepared by a 10:1 dilution of 5% chlorine bleach with water) may also be used for skin decontamination. Irrigate eyes with water or saline.
-MEDICAL TREATMENT
LIFE SUPPORT
- Support respiratory and cardiovascular function.
SUMMARY
- FIRST AID - EMERGENCY RESPONSE GUIDEBOOK, GUIDE 153 (ERG, 2004)
Move victim to fresh air. Call 911 or emergency medical service. Give artificial respiration if victim is not breathing. Do not use mouth-to-mouth method if victim ingested or inhaled the substance; give artificial respiration with the aid of a pocket mask equipped with a one-way valve or other proper respiratory medical device. Administer oxygen if breathing is difficult. Remove and isolate contaminated clothing and shoes. In case of contact with substance, immediately flush skin or eyes with running water for at least 20 minutes. For minor skin contact, avoid spreading material on unaffected skin. Keep victim warm and quiet. Effects of exposure (inhalation, ingestion or skin contact) to substance may be delayed. Ensure that medical personnel are aware of the material(s) involved and take precautions to protect themselves.
DERMAL EXPOSURE Rescue personnel must wear protective clothing, eye protection, and lung protection respirator or air pack. Initial treatment of victims should include immediate removal of the victim from the contaminated area, stabilization of general and hemodynamic status, maintenance of the airway, and oxygenation. Remove contaminated clothing and wash exposed skin thoroughly with soap and water as soon as possible (ideally within 2 minutes as mustard fixes to the skin within minutes). Cut away and discard contaminated hair. In a mass casualty situation, if water is in short supply, adsorbent powders such as flour, talcum powder or Fuller's earth may be applied to the skin and then wiped off with a damp cloth. Dilute (0.5%) hypochlorite solutions (prepared by a 10:1 dilution of 5% chlorine bleach with water) may also be used for skin decontamination.
INHALATION EXPOSURE EYE EXPOSURE ORAL EXPOSURE The role of gastrointestinal decontamination is not clear for mustard ingestion. Most patients will have severe vomiting and gastrointestinal irritation. Activated charcoal is unlikely to be of utility since the toxic effects occur rapidly upon contact with tissue. DILUTION: If no respiratory compromise is present, administer milk or water as soon as possible after ingestion. Dilution may only be helpful if performed in the first seconds to minutes after ingestion. The ideal amount is unknown; no more than 8 ounces (240 mL) in adults and 4 ounces (120 mL) in children is recommended to minimize the risk of vomiting.
-RANGE OF TOXICITY
MINIMUM LETHAL EXPOSURE
1% mortality at 150 mg-min/m(3) (USACHPPM , 2001a). The median lethal dose of mustard by inhalation is 1500 mg-min/m(3) and 10,000 mg-min/m(3) for skin absorption (Sittig, 1991).
One ppm in air is a lethal concentration of mustard for dogs (OHM/TADS , 2001). 0.650 ppm mustard results in a 33% mortality rate in rabbits (OHM/TADS , 2001). In mice, sulfur mustard was more toxic when administered percutaneously than subcutaneously (percutaneous LD50 5.7 mg/kg in female and 2.4 mg/kg in male mice, subcutaneous LD50 23 mg/kg in female and 3.4 mg/kg in male mice) (Vijayaraghavan et al, 2004).
MAXIMUM TOLERATED EXPOSURE
- To date, OSHA has not promulgated permissible exposure concentrations for mustard gas (SBCCOM , 2001).
- Sidell & Hurst (2000) reported that a Ct (concentration x time) of 50 mg-min/m(3) or a droplet of 10 mcg of mustard on the skin is adequate to produce vesication ((Sidell, 2000)).
- No fatalities occurred at an exposure level of 100 mg-min/m(3) (USACHPPM , 2001a).
- DERMAL - Doses up to 50 mcg/cm(2) on the skin cause erythema, edema, and small vesicles. Exposures at 50 to 150 mcg/cm(2) may produce bullous-type vesicles and larger doses may cause necrosis and ulceration with vesication (Vogt et al, 1984). The smallest blister-causing dose on the skin is 0.02 mg of mustard (OPCW , 1997). Another source reported that a 0.1 mL drop of pure sulfur mustard contains 20,000 times the dose required to blister skin (Shohrati et al, 2007).
- OCULAR: Ocular lesions may be produced by exposure for two hours at concentrations barely detectable by smell (NATO, 1973). Eye lesions have been reported at a Ct of 10 mg-min/m(3) ((Sidell, 2000)).
- Biologically effective amounts in humans from mustard vapor are (Sidell et al, 1998; (Sidell, 2000)):
Ct50: 12-200 mg-min/m(3) (eye injuries) Ct50: 100-200 mg-min/m(3) (pulmonary injuries) Ct50: 200-1000 mg-min/m(3) (erythema)
- Carcinogenicity Ratings for CAS505-60-2 :
ACGIH (American Conference of Governmental Industrial Hygienists, 2010): Not Listed EPA (U.S. Environmental Protection Agency, 2011): Not Listed IARC (International Agency for Research on Cancer (IARC), 2016; International Agency for Research on Cancer, 2015; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2010; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2010a; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2008; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2007; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2006; IARC, 2004): 1 ; Listed as: Mustard gas (Sulfur mustard) 1 : The agent (mixture) is carcinogenic to humans. The exposure circumstance entails exposures that are carcinogenic to humans. This category is used when there is sufficient evidence of carcinogenicity in humans. Exceptionally, an agent (mixture) may be placed in this category when evidence of carcinogenicity in humans is less than sufficient but there is sufficient evidence of carcinogenicity in experimental animals and strong evidence in exposed humans that the agent (mixture) acts through a relevant mechanism of carcinogenicity.
NIOSH (National Institute for Occupational Safety and Health, 2007): Not Listed MAK (DFG, 2002): Category 1 ; Listed as: Bis(beta-chloroethyl)sulfide (mustard gas) NTP (U.S. Department of Health and Human Services, Public Health Service, National Toxicology Project ): K ; Listed as: Mustard Gas
TOXICITY AND RISK ASSESSMENT VALUES
- EPA Risk Assessment Values for CAS505-60-2 (U.S. Environmental Protection Agency, 2011):
References: ITI, 1995 Lewis, 2000 OPCW, 1997 RRIS, 2001 RTECS, 2002 SBCCOM, 2001 USACHPPM, 2001a ICt50- (INHALATION)HUMAN: LC50- (INHALATION)DOG: LC50- (INHALATION)MOUSE: LC50- (INHALATION)PRIMATE: LC50- (INHALATION)RABBIT: LC50- (INHALATION)RAT: LCLo- (INHALATION)DOG: LCLo- (INHALATION)HUMAN: LCLo- (INHALATION)MOUSE: LCLo- (INHALATION)RAT: LCt50- (INHALATION)HUMAN: LD50- (INTRAVENOUS)DOG: LD50- (SKIN)DOG: LD50- (ORAL)HUMAN: LD50- (SKIN)HUMAN: LD50- (INTRAVENOUS)MOUSE: LD50- (SKIN)MOUSE: LD50- (SUBCUTANEOUS)MOUSE: LD50- (INTRAVENOUS)RABBIT: LD50- (SKIN)RABBIT: LD50- (SUBCUTANEOUS)RABBIT: LD50- (INTRAVENOUS)RAT: 700 mcg/kg 3300 mcg/kg (ITI, 1995)
LD50- (ORAL)RAT: LD50- (SKIN)RAT: LD50- (SUBCUTANEOUS)RAT: 1500 mcg/kg -- gastrointestinal hypermotiltiy, diarrhea, weight loss or weight gain, change in food intake behavior
LDLo- (INTRAMUSCULAR)DOG: LDLo- (SUBCUTANEOUS)DOG: LDLo- (SKIN)HUMAN: LDLo- (SKIN)RAT: TCLo- (INHALATION)MOUSE: TCLo- (INHALATION)RAT: TDLo- (INTRAVENOUS)MOUSE: TDLo- (SUBCUTANEOUS)MOUSE: 6 mg/kg for 6W-intermittent -- equivocal tumorigenic agent (Lewis, 2000) 650 mg/kg for 6W-intermittent (ITI, 1995)
TDLo- (ORAL)RAT:
-STANDARDS AND LABELS
WORKPLACE STANDARDS
- ACGIH TLV Values for CAS505-60-2 (American Conference of Governmental Industrial Hygienists, 2010):
- AIHA WEEL Values for CAS505-60-2 (AIHA, 2006):
- NIOSH REL and IDLH Values for CAS505-60-2 (National Institute for Occupational Safety and Health, 2007):
- OSHA PEL Values for CAS505-60-2 (U.S. Occupational Safety, and Health Administration (OSHA), 2010):
- OSHA List of Highly Hazardous Chemicals, Toxics, and Reactives for CAS505-60-2 (U.S. Occupational Safety and Health Administration, 2010):
ENVIRONMENTAL STANDARDS
- EPA CERCLA, Hazardous Substances and Reportable Quantities for CAS505-60-2 (U.S. Environmental Protection Agency, 2010):
- EPA CERCLA, Hazardous Substances and Reportable Quantities, Radionuclides for CAS505-60-2 (U.S. Environmental Protection Agency, 2010):
- EPA RCRA Hazardous Waste Number for CAS505-60-2 (U.S. Environmental Protection Agency, 2010b):
- EPA SARA Title III, Extremely Hazardous Substance List for CAS505-60-2 (U.S. Environmental Protection Agency, 2010):
Listed as: Mustard Gas Reportable Quantity, in pounds: 500 Threshold Planning Quantity, in pounds: Note(s): d
- EPA SARA Title III, Community Right-to-Know for CAS505-60-2 (40 CFR 372.65, 2006; 40 CFR 372.28, 2006):
Listed as: Mustard gas [Ethane, 1,1'-thiobis[2-chloro-] Effective Date for Reporting Under 40 CFR 372.30: 1/1/87 Lower Thresholds for Chemicals of Special Concern under 40 CFR 372.28:
- DOT List of Marine Pollutants for CAS505-60-2 (49 CFR 172.101 - App. B, 2005):
- EPA TSCA Inventory for CAS505-60-2 (EPA, 2005):
SHIPPING REGULATIONS
- DOT -- Table of Hazardous Materials and Special Provisions for UN/NA Number 2810 (49 CFR 172.101, 2005):
Hazardous materials descriptions and proper shipping name: Compounds, tree killing, liquid or Compounds, weed killing, liquid Symbol(s): D, G D: identifies proper shipping names which are appropriate for describing materials for domestic transportation but may be inappropriate for international transportation under the provisions of international regulations (e.g., IMO, ICAO). An alternate proper shipping name may be selected when either domestic or international transportation is involved. G: identifies proper shipping names for which one or more technical names of the hazardous material must be entered in parentheses, in association with the basic description. (See 40 CFR 172.203(k).)
Hazard class or Division: 6.1 Identification Number: NA2810 Packing Group: I Label(s) required (if not excepted): 6.1 Special Provisions: T14, TP2, TP13, TP27 T14: Minimum test pressure (bar): 6; Minimum shell thickness (in mm-reference steel) (See sxn.178.274(d)): 6 mm; Pressure-relief requirements (See sxn.178.275(g)): section 178.275(g)(3); Bottom opening requirements (See sxn.178.275(d)): Prohibited. TP2: a. The maximum degree of filling must not exceed the degree of filling determined by the following: [Degree of filling = 95/1+alpha(tr - tf)], where tr is the maximum mean bulk temperature during transport, tf is the temperature in degrees celsius of the liquid during filling, and alpha is the mean coefficient of cubical expansion of the liquid between the mean temperature of the liquid during filling (tf) and the maximum mean bulk temperature during transportation (tr) both in degrees celsius; and b. For liquids transported under ambient conditions a may be calculated using the formula: [alpha = (d15-d50)/(35 x d50)], where d15 and d50 are the densities (in units of mass per unit volume) of the liquid at 15 degrees C (59 degrees F) and 50 degrees C (122 degrees F), respectively. TP13: Self-contained breathing apparatus must be provided when this hazardous material is transported by sea. TP27: A portable tank having a minimum test pressure of 4 bar (400 kPa) may be used provided the calculated test pressure is 4 bar or less based on the MAWP of the hazardous material, as defined in sxn. 178.275 of this subchapter, where the test pressure is 1.5 times the MAWP.
Packaging Authorizations (refer to 49 CFR 173.***): Exceptions: None Non-bulk packaging: 201 Bulk packaging: 243
Quantity Limitations: Vessel Stowage Requirements:
Hazardous materials descriptions and proper shipping name: Compounds, tree killing, liquid or Compounds, weed killing, liquid Symbol(s): Not Listed Hazard class or Division: 6.1 Identification Number: NA2810 Packing Group: II Label(s) required (if not excepted): 6.1 Special Provisions: IB2, T11, TP2, TP27 IB2: Authorized IBCs: Metal (31A, 31B and 31N); Rigid plastics (31H1 and 31H2); Composite (31HZ1). Additional Requirement: Only liquids with a vapor pressure less than or equal to 110 kPa at 50 °C (1.1 bar at 122 °F), or 130kPa at 55 °C (1.3 bar at 131 °F) are authorized. T11: Minimum test pressure (bar): 6; Minimum shell thickness (in mm-reference steel) (See sxn.178.274(d)): sxn.178.274(d)(2); Pressure-relief requirements (See sxn.178.275(g)): Normal; Bottom opening requirements (See sxn.178.275(d)): sxn.178.275(d)(3). TP2: a. The maximum degree of filling must not exceed the degree of filling determined by the following: [Degree of filling = 95/1+alpha(tr - tf)], where tr is the maximum mean bulk temperature during transport, tf is the temperature in degrees celsius of the liquid during filling, and alpha is the mean coefficient of cubical expansion of the liquid between the mean temperature of the liquid during filling (tf) and the maximum mean bulk temperature during transportation (tr) both in degrees celsius; and b. For liquids transported under ambient conditions a may be calculated using the formula: [alpha = (d15-d50)/(35 x d50)], where d15 and d50 are the densities (in units of mass per unit volume) of the liquid at 15 degrees C (59 degrees F) and 50 degrees C (122 degrees F), respectively. TP27: A portable tank having a minimum test pressure of 4 bar (400 kPa) may be used provided the calculated test pressure is 4 bar or less based on the MAWP of the hazardous material, as defined in sxn. 178.275 of this subchapter, where the test pressure is 1.5 times the MAWP.
Packaging Authorizations (refer to 49 CFR 173.***): Exceptions: 153 Non-bulk packaging: 202 Bulk packaging: 243
Quantity Limitations: Vessel Stowage Requirements:
Hazardous materials descriptions and proper shipping name: Compounds, tree killing, liquid or Compounds, weed killing, liquid Symbol(s): Not Listed Hazard class or Division: 6.1 Identification Number: NA2810 Packing Group: III Label(s) required (if not excepted): 6.1 Special Provisions: IB3, T7, TP1, TP28 IB3: Authorized IBCs: Metal (31A, 31B and 31N); Rigid plastics (31H1 and 31H2); Composite (31HZ1 and 31HA2, 31HB2, 31HN2, 31HD2 and 31HH2). Additional Requirement: Only liquids with a vapor pressure less than or equal to 110 kPa at 50 °C (1.1 bar at 122 °F), or 130 kPa at 55 °C (1.3 bar at 131 °F) are authorized, except for UN2672 (also see Special Provision IP8 in Table 3 for UN2672). T7: Minimum test pressure (bar): 4; Minimum shell thickness (in mm-reference steel) (See sxn.178.274(d)): sxn.178.274(d)(2); Pressure-relief requirements (See sxn.178.275(g)): Normal; Bottom opening requirements (See sxn.178.275(d)): sxn.178.275(d)(3). TP1: The maximum degree of filling must not exceed the degree of filling determined by the following: [Degree of filling = 97/1+alpha(tr - tf)], where tr is the maximum mean bulk temperature during transport, and tf is the temperature in degrees celsius of the liquid during filling. TP28: A portable tank having a minimum test pressure of 2.65 bar (265 kPa) may be used provided the calculated test pressure is 2.65 bar or less based on the MAWP of the hazardous material, as defined in sxn. 178.275 of this subchapter, where the test pressure is 1.5 times the MAWP.
Packaging Authorizations (refer to 49 CFR 173.***): Exceptions: 153 Non-bulk packaging: 203 Bulk packaging: 241
Quantity Limitations: Vessel Stowage Requirements:
Hazardous materials descriptions and proper shipping name: Toxic, liquids, organic, n.o.s Symbol(s): G Hazard class or Division: 6.1 Identification Number: UN2810 Packing Group: I Label(s) required (if not excepted): 6.1 Special Provisions: T14, TP2, TP13, TP27 T14: Minimum test pressure (bar): 6; Minimum shell thickness (in mm-reference steel) (See sxn.178.274(d)): 6 mm; Pressure-relief requirements (See sxn.178.275(g)): section 178.275(g)(3); Bottom opening requirements (See sxn.178.275(d)): Prohibited. TP2: a. The maximum degree of filling must not exceed the degree of filling determined by the following: [Degree of filling = 95/1+alpha(tr - tf)], where tr is the maximum mean bulk temperature during transport, tf is the temperature in degrees celsius of the liquid during filling, and alpha is the mean coefficient of cubical expansion of the liquid between the mean temperature of the liquid during filling (tf) and the maximum mean bulk temperature during transportation (tr) both in degrees celsius; and b. For liquids transported under ambient conditions a may be calculated using the formula: [alpha = (d15-d50)/(35 x d50)], where d15 and d50 are the densities (in units of mass per unit volume) of the liquid at 15 degrees C (59 degrees F) and 50 degrees C (122 degrees F), respectively. TP13: Self-contained breathing apparatus must be provided when this hazardous material is transported by sea. TP27: A portable tank having a minimum test pressure of 4 bar (400 kPa) may be used provided the calculated test pressure is 4 bar or less based on the MAWP of the hazardous material, as defined in sxn. 178.275 of this subchapter, where the test pressure is 1.5 times the MAWP.
Packaging Authorizations (refer to 49 CFR 173.***): Exceptions: None Non-bulk packaging: 201 Bulk packaging: 243
Quantity Limitations: Vessel Stowage Requirements:
Hazardous materials descriptions and proper shipping name: Toxic, liquids, organic, n.o.s Symbol(s): Not Listed Hazard class or Division: 6.1 Identification Number: UN2810 Packing Group: II Label(s) required (if not excepted): 6.1 Special Provisions: IB2, T11, TP2, TP13, TP27 IB2: Authorized IBCs: Metal (31A, 31B and 31N); Rigid plastics (31H1 and 31H2); Composite (31HZ1). Additional Requirement: Only liquids with a vapor pressure less than or equal to 110 kPa at 50 °C (1.1 bar at 122 °F), or 130kPa at 55 °C (1.3 bar at 131 °F) are authorized. T11: Minimum test pressure (bar): 6; Minimum shell thickness (in mm-reference steel) (See sxn.178.274(d)): sxn.178.274(d)(2); Pressure-relief requirements (See sxn.178.275(g)): Normal; Bottom opening requirements (See sxn.178.275(d)): sxn.178.275(d)(3). TP2: a. The maximum degree of filling must not exceed the degree of filling determined by the following: [Degree of filling = 95/1+alpha(tr - tf)], where tr is the maximum mean bulk temperature during transport, tf is the temperature in degrees celsius of the liquid during filling, and alpha is the mean coefficient of cubical expansion of the liquid between the mean temperature of the liquid during filling (tf) and the maximum mean bulk temperature during transportation (tr) both in degrees celsius; and b. For liquids transported under ambient conditions a may be calculated using the formula: [alpha = (d15-d50)/(35 x d50)], where d15 and d50 are the densities (in units of mass per unit volume) of the liquid at 15 degrees C (59 degrees F) and 50 degrees C (122 degrees F), respectively. TP13: Self-contained breathing apparatus must be provided when this hazardous material is transported by sea. TP27: A portable tank having a minimum test pressure of 4 bar (400 kPa) may be used provided the calculated test pressure is 4 bar or less based on the MAWP of the hazardous material, as defined in sxn. 178.275 of this subchapter, where the test pressure is 1.5 times the MAWP.
Packaging Authorizations (refer to 49 CFR 173.***): Exceptions: 153 Non-bulk packaging: 202 Bulk packaging: 243
Quantity Limitations: Vessel Stowage Requirements:
Hazardous materials descriptions and proper shipping name: Toxic, liquids, organic, n.o.s Symbol(s): Not Listed Hazard class or Division: 6.1 Identification Number: UN2810 Packing Group: III Label(s) required (if not excepted): 6.1 Special Provisions: IB3, T7, TP1, TP28 IB3: Authorized IBCs: Metal (31A, 31B and 31N); Rigid plastics (31H1 and 31H2); Composite (31HZ1 and 31HA2, 31HB2, 31HN2, 31HD2 and 31HH2). Additional Requirement: Only liquids with a vapor pressure less than or equal to 110 kPa at 50 °C (1.1 bar at 122 °F), or 130 kPa at 55 °C (1.3 bar at 131 °F) are authorized, except for UN2672 (also see Special Provision IP8 in Table 3 for UN2672). T7: Minimum test pressure (bar): 4; Minimum shell thickness (in mm-reference steel) (See sxn.178.274(d)): sxn.178.274(d)(2); Pressure-relief requirements (See sxn.178.275(g)): Normal; Bottom opening requirements (See sxn.178.275(d)): sxn.178.275(d)(3). TP1: The maximum degree of filling must not exceed the degree of filling determined by the following: [Degree of filling = 97/1+alpha(tr - tf)], where tr is the maximum mean bulk temperature during transport, and tf is the temperature in degrees celsius of the liquid during filling. TP28: A portable tank having a minimum test pressure of 2.65 bar (265 kPa) may be used provided the calculated test pressure is 2.65 bar or less based on the MAWP of the hazardous material, as defined in sxn. 178.275 of this subchapter, where the test pressure is 1.5 times the MAWP.
Packaging Authorizations (refer to 49 CFR 173.***): Exceptions: 153 Non-bulk packaging: 203 Bulk packaging: 241
Quantity Limitations: Vessel Stowage Requirements:
Hazardous materials descriptions and proper shipping name: Toxic, liquids, organic, n.o.s. Inhalation hazard, Packing Group I, Zone A Symbol(s): G Hazard class or Division: 6.1 Identification Number: UN2810 Packing Group: I Label(s) required (if not excepted): 6.1 Special Provisions: 1, B9, B14, B30, B72, T22, TP2, TP13, TP27, TP38, TP44 1: This material is poisonous by inhalation (see sxn. 171.8 of this subchapter) in Hazard Zone A (see sxn. 173.116(a) or sxn. 173.133(a) of this subchapter), and must be described as an inhalation hazard under the provisions of this subchapter. B9: Bottom outlets are not authorized. B14: Each bulk packaging, except a tank car or a multi-unit-tank car tank, must be insulated with an insulating material so that the overall thermal conductance at 15.5 °C (60 °F) is no more than 1.5333 kilojoules per hour per square meter per degree Celsius (0.075 Btu per hour per square foot per degree Fahrenheit) temperature differential. Insulating materials must not promote corrosion to steel when wet. B30: MC 312, MC 330, MC 331 and DOT 412 cargo tanks and DOT 51 portable tanks must be made of stainless steel, except that steel other than stainless steel may be used in accordance with the provisions of sxn. 173.24b(b) of this subchapter. Thickness of stainless steel for tank shell and heads for cargo tanks and portable tanks must be the greater of 7.62 mm (0.300 inch) or the thickness required for a tank with a design pressure at least equal to 1.5 times the vapor pressure of the lading at 46 °C (115 °F). In addition, MC 312 and DOT 412 cargo tank motor vehicles must: a. Be ASME Code (U) stamped for 100% radiography of all pressure-retaining welds; b. Have accident damage protection which conforms with sxn. 178.345-8 of this subchapter; c. Have a MAWP or design pressure of at least 87 psig: and d. Have a bolted manway cover. B72: Tank cars must have a test pressure of 34.47 Bar (500 psig) or greater and conform to Class 105J, 106, or 110. T22: Minimum test pressure (bar): 10; Minimum shell thickness (in mm-reference steel) (See sxn.178.274(d)): 10 mm; Pressure-relief requirements (See sxn.178.275(g)): sxn. 178.275(g)(3); Bottom opening requirements (See sxn.178.275(d)): Prohibited. TP2: a. The maximum degree of filling must not exceed the degree of filling determined by the following: [Degree of filling = 95/1+alpha(tr - tf)], where tr is the maximum mean bulk temperature during transport, tf is the temperature in degrees celsius of the liquid during filling, and alpha is the mean coefficient of cubical expansion of the liquid between the mean temperature of the liquid during filling (tf) and the maximum mean bulk temperature during transportation (tr) both in degrees celsius; and b. For liquids transported under ambient conditions a may be calculated using the formula: [alpha = (d15-d50)/(35 x d50)], where d15 and d50 are the densities (in units of mass per unit volume) of the liquid at 15 degrees C (59 degrees F) and 50 degrees C (122 degrees F), respectively. TP13: Self-contained breathing apparatus must be provided when this hazardous material is transported by sea. TP27: A portable tank having a minimum test pressure of 4 bar (400 kPa) may be used provided the calculated test pressure is 4 bar or less based on the MAWP of the hazardous material, as defined in sxn. 178.275 of this subchapter, where the test pressure is 1.5 times the MAWP. TP38: Each portable tank must be insulated with an insulating material so that the overall thermal conductance at 15.5 °C (60 °F) is no more than 1.5333 kilojoules per hour per square meter per degree Celsius (0.075 Btu per hour per square foot per degree Fahrenheit) temperature differential. Insulating materials may not promote corrosion to steel when wet. TP44: Each portable tank must be made of stainless steel, except that steel other than stainless steel may be used in accordance with the provisions of sxn. 173.24b(b) of this subchapter. Thickness of stainless steel for tank shell and heads must be the greater of 7.62 mm (0.300 inch) or the thickness required for a portable tank with a design pressure at least equal to 1.5 times the vapor pressure of the hazardous material at 46 °C (115 °F).
Packaging Authorizations (refer to 49 CFR 173.***): Exceptions: None Non-bulk packaging: 226 Bulk packaging: 244
Quantity Limitations: Vessel Stowage Requirements:
Hazardous materials descriptions and proper shipping name: Toxic, liquids, organic, n.o.s. Inhalation hazard, Packing Group I, Zone B Symbol(s): G Hazard class or Division: 6.1 Identification Number: UN2810 Packing Group: I Label(s) required (if not excepted): 6.1 Special Provisions: 2, B9, B14, B32, B74, T20, TP2, TP13, TP27, TP38, TP45 2: This material is poisonous by inhalation (see sxn. 171.8 of this subchapter) in Hazard Zone B (see sxn. 173.116(a) or sxn. 173.133(a) of this subchapter), and must be described as an inhalation hazard under the provisions of this subchapter. B9: Bottom outlets are not authorized. B14: Each bulk packaging, except a tank car or a multi-unit-tank car tank, must be insulated with an insulating material so that the overall thermal conductance at 15.5 °C (60 °F) is no more than 1.5333 kilojoules per hour per square meter per degree Celsius (0.075 Btu per hour per square foot per degree Fahrenheit) temperature differential. Insulating materials must not promote corrosion to steel when wet. B32: MC 312, MC 330, MC 331, DOT 412 cargo tanks and DOT 51 portable tanks must be made of stainless steel, except that steel other than stainless steel may be used in accordance with the provisions of sxn. 173.24b(b) of this subchapter. Thickness of stainless steel for tank shell and heads for cargo tanks and portable tanks must be the greater of 6.35 mm (0.250 inch) or the thickness required for a tank with a design pressure at least equal to 1.3 times the vapor pressure of the lading at 46 °C (115 °F). In addition, MC 312 and DOT 412 cargo tank motor vehicles must: a. Be ASME Code (U) stamped for 100% radiography of all pressure-retaining welds; b. Have accident damage protection which conforms with sxn. 178.345-8 of this subchapter; c. Have a MAWP or design pressure of at least 87 psig; and d. Have a bolted manway cover. B74: Tank cars must have a test pressure of 20.68 Bar (300 psig) or greater and conform to Class 105S, 106, 110, 112J, 114J or 120S. T20: Minimum test pressure (bar): 10; Minimum shell thickness (in mm-reference steel) (See sxn.178.274(d)): 8 mm; Pressure-relief requirements (See sxn.178.275(g)): sxn. 178.275(g)(3); Bottom opening requirements (See sxn.178.275(d)): Prohibited. TP2: a. The maximum degree of filling must not exceed the degree of filling determined by the following: [Degree of filling = 95/1+alpha(tr - tf)], where tr is the maximum mean bulk temperature during transport, tf is the temperature in degrees celsius of the liquid during filling, and alpha is the mean coefficient of cubical expansion of the liquid between the mean temperature of the liquid during filling (tf) and the maximum mean bulk temperature during transportation (tr) both in degrees celsius; and b. For liquids transported under ambient conditions a may be calculated using the formula: [alpha = (d15-d50)/(35 x d50)], where d15 and d50 are the densities (in units of mass per unit volume) of the liquid at 15 degrees C (59 degrees F) and 50 degrees C (122 degrees F), respectively. TP13: Self-contained breathing apparatus must be provided when this hazardous material is transported by sea. TP27: A portable tank having a minimum test pressure of 4 bar (400 kPa) may be used provided the calculated test pressure is 4 bar or less based on the MAWP of the hazardous material, as defined in sxn. 178.275 of this subchapter, where the test pressure is 1.5 times the MAWP. TP38: Each portable tank must be insulated with an insulating material so that the overall thermal conductance at 15.5 °C (60 °F) is no more than 1.5333 kilojoules per hour per square meter per degree Celsius (0.075 Btu per hour per square foot per degree Fahrenheit) temperature differential. Insulating materials may not promote corrosion to steel when wet. TP45: Each portable tank must be made of stainless steel, except that steel other than stainless steel may be used in accordance with the provisions of 173.24b(b) of this subchapter. Thickness of stainless steel for portable tank shells and heads must be the greater of 6.35 mm (0.250 inch) or the thickness required for a portable tank with a design pressure at least equal to 1.3 times the vapor pressure of the hazardous material at 46 °C (115 °F).
Packaging Authorizations (refer to 49 CFR 173.***): Exceptions: None Non-bulk packaging: 227 Bulk packaging: 244
Quantity Limitations: Vessel Stowage Requirements:
- ICAO International Shipping Name for UN2810 (ICAO, 2002):
LABELS
- NFPA Hazard Ratings for CAS505-60-2 (NFPA, 2002):
-HANDLING AND STORAGE
SUMMARY
"Locations where chemical agents and munitions are stored, handled, used, and processed require the use of chemical hazard symbols. These symbols shall be used by themselves or in conjunction with fire symbols as appropriate" (U.S. Army, 1997). "When equipment, tools, or others items or materials come into contact with liquid agent they will be marked, tagged or segregated to indicate the degree of contamination" (U.S. Army, 1997). For additional information refer to AR 385-61, the "Army Toxic Chemical Agent Safety Program," DA Pam 385-61, "Toxic Chemical Agent Safety Standards", and DA Pam 40-173, Occupational Health Guidelines for the Evaluation and Control of Occupational Exposure to HD Agents H, HD, and HT" (SBCCOM , 2001).
- PUBLIC HEALTH CONSIDERATIONS
Use the buddy system when handling chemical agents. No smoking, eating, or drinking is permitted in areas where the chemical is present (SBCCOM , 2001).
HANDLING
- Decontamination equipment should be readily available and marked (SBCCOM , 2001).
- Hands should be washed before meals. Personnel should shower thoroughly with special attention to hair, face, neck, and hands using plenty of soap and water before leaving at the end of the work day (SBCCOM , 2001).
STORAGE
Containers should be inspected periodically (visual or detector kit inspection) (SBCCOM , 2001). Ton containers should be kept painted and free from rust to enhance visual detection of leakage at the valves and plugs. Some agents (Mustard, Lewisite, GB, VX) act as a solvent on most paints. This may cause peeling, dissolution, blistering, and discoloring at the leak area (U.S. Army, 1997).
Laboratory agent containers should be stored in a single containment system within an approved laboratory hood (SBCCOM , 2001). Storage of larger quantities should be in a double containment system (SBCCOM , 2001). Large quantities should be stored in one ton steel containers, or other approved containers (SBCCOM , 2001) U.S.Army, 1997). "Ton containers of bulk agents will be stored in a horizontal position with the container oriented so that the valves are in vertical alignment" (U.S. Army, 1997). Glass is appropriate for Research, Development, Test, and Evaluation (RDTE) quantities (SBCCOM , 2001).
- ROOM/CABINET RECOMMENDATIONS
HD is stable at ambient temperatures for days to weeks and has a low volatility. It decomposes at temperatures between 149 to 177 degrees C (100 to 351 degrees F). Store in dry areas away from heat and ignition sources, and strong oxidizers (OPCW , 1997; SBCCOM , 2001; USACHPPM , 2001a). Exits must be clearly marked to allow for rapid evacuation (SBCCOM , 2001). Chemical showers and eye wash stations must be provided (SBCCOM , 2001). "Structures used for the storage of agent-filled items will have floors and floor surfacing which can de decontaminated" (U.S. Army, 1997). "Sites should be selected that are not in proximity to surface water sources and which are not located over underground water sources that could become contaminated" (U.S. Army, 1997). "Construction materials such as wood or other porous materials that absorb agent are difficult to decontaminate and should not be used in the construction of buildings where agent is to be stored, handled, or processed" (U.S. Army, 1997). "Buildings and/or equipment will be arranged according to the sequence of operations. Such an arrangement will make it possible to keep handling of agents at a minimum and will minimize the necessity for transferring of agents through nonagent areas" (U.S. Army, 1997).
At 65 degrees C, mustard will corrode steel at a rate of 0.0001 inches/month and causes brass to rapidly corrode (RRIS , 2001; SBCCOM , 2001; USACHPPM , 2001a). Pure undiluted calcium hypochlorite will burn on contact when mixed with mustard (RRIS , 2001). Mustard is slowly hydrolyzed in water and will react with water and steam to produce toxic and corrosive fumes (Lewis, 2000) Sittig, 1991; (USACHPPM , 2001a). Strong oxidizers can destroy mustard and cause a vigorous reaction (Lewis, 2000) Sittig, 1991; (USACHPPM , 2001a). Mustard is incompatible with bleaching powder and sodium hypochlorite; these materials can neutralize and inactivate the agent (Budavari, 2000; Lewis, 2000; OHM/TADS , 2001; SBCCOM , 2001).
-PERSONAL PROTECTION
SUMMARY
- RECOMMENDED PROTECTIVE CLOTHING - EMERGENCY RESPONSE GUIDEBOOK, GUIDE 153 (ERG, 2004)
Wear positive pressure self-contained breathing apparatus (SCBA). Wear chemical protective clothing that is specifically recommended by the manufacturer. It may provide little or no thermal protection. Structural firefighters' protective clothing provides limited protection. fire situations ONLY; it is not effective in spill situations where direct contact with the substance is possible.
- Mustard gas may penetrate leather and clothing (Aasted et al, 1987; NATO, 1973).
- Fully encapsulating chemical resistant suits, inner chemical-resistant gloves, chemical resistant boots/shoes and a positive pressure-demand, full facepiece self contained breathing apparatus will protect the body against vapor, liquid, and aerosol forms of chemical agents (RRIS , 2001).
- When responding to fires where chemical agents are stored, full firefighter protective clothing should be worn. Rescue/reconnaissance personnel should wear appropriate levels of protective clothing (SBCCOM , 2001).
- Laboratory operations require lab coats and gloves be worn. An approved respirator should be readily available. If handling contaminated animals, wear foot and head covers and clean smocks (SBCCOM , 2001).
- "The use of personnel protective clothing and equipment (PCE) is the least desirable method of complying with airborne exposure limits. Efforts will be made to reduce dependence upon PCE in agent operating environments through the increased use of engineering and administrative controls such as ventilation, isolation, remote operations, remove monitoring, and elimination of a nonessential entries into agent areas" (U.S. Army, 1997).
- "Do not allow an individual to reenter the area to conduct the operation after the maximum wear time has been reached. However, the local medical authority may use discretion to vary the wear time" (U.S. Army, 1997).
- Real-time, low-level monitors with an alarm are required. If a monitor is not present, it should be assumed the atmosphere is Immediately Dangerous to Life and Health (SBCCOM , 2001).
EYE/FACE PROTECTION
- Chemical goggles are minimal protection and should be worn. If there is a potential situation for splash hazards, use goggles and a face shield (SBCCOM , 2001).
RESPIRATORY PROTECTION
- Respiratory protection is required (SBCCOM , 2001).
- When there is a potential danger of oxygen deficiency, and when directed by a chemical accident/incident operations officer or by a fire chief, a NIOSH- approved positive-pressure, full face piece self-contained breathing apparatus will be worn (SBCCOM , 2001).
- "The protective mask canister/filter will not be used for more than two hours when the mask has been worn in an area known to be above the Airborne Exposure Limit" (U.S. Army, 1997).
PROTECTIVE CLOTHING
- CHEMICAL PROTECTIVE CLOTHING. Search results for CAS 505-60-2.
ENGINEERING CONTROLS
- Local exhaust is mandatory. It must to filtered and scrubbed to limit excessive concentrations, and meet local, state and federal regulations (SBCCOM , 2001).
- Laboratory hoods need to have an average inward face velocity of 100 linear feet per minute plus or minus 20% with the velocity at any point not deviating from the average face velocity by more than 20% (SBCCOM , 2001).
- Existing laboratory hoods should have an inward face velocity of 150 linear feet per minute, plus or minus 20% (SBCCOM , 2001).
- Cross-drafts should not exceed 20% of the inward face velocity (SBCCOM , 2001).
- Laboratory operations should be performed at least 20 cm inside the hood face (SBCCOM , 2001).
- Visual smoke tests can be administered to evaluate the performance of the hood. Hood performance tests should be conducted semiannually, after any maintenance procedures, or after modifications have been installed (SBCCOM , 2001).
- Recirculation of exhaust air from chemical areas is prohibited. Connection between areas through the ventilation system is also prohibited (SBCCOM , 2001).
- Emergency back up power must be provided (SBCCOM , 2001).
-PHYSICAL HAZARDS
FIRE HAZARD
POTENTIAL FIRE OR EXPLOSION HAZARDS - EMERGENCY RESPONSE GUIDEBOOK, GUIDE 153 (ERG, 2004) Combustible material: may burn but does not ignite readily. When heated, vapors may form explosive mixtures with air: indoors, outdoors and sewers explosion hazards. Those substances designated with a "P" may polymerize explosively when heated or involved in a fire. Contact with metals may evolve flammable hydrogen gas. Containers may explode when heated. Runoff may pollute waterways. Substance may be transported in a molten form.
HD can be ignited by large explosive charges (SBCCOM , 2001). Evacuate all persons not involved in the fire-fighting efforts (SBBCOM, 2001). Contain warfare agent fires to prevent spreading to uncontrolled areas (SBCCOM , 2001). When responding to fires where chemical agents are stored, full firefighter protective clothing should be worn. Rescue/reconnaissance personnel should wear appropriate levels of protective clothing (SBCCOM , 2001). Respiratory protection is required when fighting fires. A positive pressure, full facepiece, self-contained breathing apparatus (NIOSH-approved) will be worn when oxygen deficiency is a danger and when directed by the fire chief or chemical accident/incident officer (SBCCOM , 2001).
- FLAMMABILITY CLASSIFICATION
- NFPA Flammability Rating for CAS505-60-2 (NFPA, 2002):
- FIRE CONTROL/EXTINGUISHING AGENTS
- SMALL FIRE PRECAUTIONS - EMERGENCY RESPONSE GUIDEBOOK, GUIDE 153 (ERG, 2004)
- LARGE FIRE PRECAUTIONS - EMERGENCY RESPONSE GUIDEBOOK, GUIDE 153 (ERG, 2004)
Dry chemical, CO2, alcohol-resistant foam or water spray. Move containers from fire area if you can do it without risk. Dike fire control water for later disposal; do not scatter the material.
- TANK OR CAR/TRAILER LOAD FIRE PRECAUTIONS - EMERGENCY RESPONSE GUIDEBOOK, GUIDE 153 (ERG, 2004)
Fight fire from maximum distance or use unmanned hose holders or monitor nozzles. Do not get water inside containers. Cool containers with flooding quantities of water until well after fire is out. Withdraw immediately in case of rising sound from venting safety devices or discoloration of tank. ALWAYS stay away from tanks engulfed in fire.
- NFPA Extinguishing Methods for CAS505-60-2 (NFPA, 2002):
- Fog, foam, water mist, and CO2 are effective fire extinguishing agents. Do not use any fire-fighting methods that may cause the agent to splash or spread (SBCCOM , 2001).
- Fire may destroy most of the agent but measures must be taken to prevent the agent or contaminated liquids from entering the sewers and other areas (SBCCOM , 2001).
EXPLOSION HAZARD
- Mustard containers exposed to extreme heat for prolonged periods may violently rupture and rocket (AAR, 2000).
DUST/VAPOR HAZARD
- Do not breathe the fumes. Vapors attack the skin, eyes, lungs, and gastrointestinal tract and can be fatal (OPCW , 1997; SBCCOM , 2001).
- When contaminated surfaces are decontaminated, enough HD vapor may be produced to cause a physiological response (SBCCOM , 2001).
- Mustard agent vaporizes slowly at ordinary temperatures (USACHPPM , 2001).
- Mustard is slowly hydrolyzed in water, and will react with water and steam to produce toxic and corrosive fumes of hydrochloric acid (ITI, 1995; Lewis, 2000) Sittig, 1991; (OHM/TADS , 2001; USACHPPM , 2001a).
REACTIVITY HAZARD
- Mustard forms hydrochloric acid and thiodiglycol when hydrolyzed. Alkali is a catalyst in aqueous solutions (IARC, 1975; OPCW , 1997; SBCCOM , 2001; USACHPPM , 2001a).
- Mustard and nitric acid can form a vigorous oxidation reaction on glass surfaces (SBCCOM , 2001).
- Bleaching powder mixed with mustard forms a very exothermic reaction. Ignition is possible, particularly in the presence of water (Urben, 2000).
- Bleaching powder and chloramines react violently with mustard agent (OPCW , 1997).
- Never mix dry super tropical bleach or calcium hypochlorite; a violent reaction will occur and the mixture may burst into flames (RRIS , 2001).
- Mustard will burn on contact with pure, undiluted calcium hypochlorite (SBCCOM , 2001).
- Mustard is slowly hydrolyzed in water, and will react with water and steam to produce toxic and corrosive fumes of hydrochloric acid (ITI, 1995; Lewis, 2000) Sittig, 1991; (OHM/TADS , 2001; USACHPPM , 2001a).
- Strong oxidizers can destroy mustard and cause a vigorous reaction (Lewis, 2000) Sittig, 1991; (USACHPPM , 2001a).
- It emits highly toxic sulfide and chloride fumes when heated to decomposition, or in contact with acid or acid fumes (Lewis, 2000).
EVACUATION PROCEDURES
- Initial Isolation and Protective Action Distances (ERG, 2004)
Data presented from the Emergency Response Guidebook Table of Initial Isolation and Protective Action Distances are for use when a spill has occurred and there is no fire. If there is a fire, or if a fire is involved, evacuation information presented under FIRE - PUBLIC SAFETY EVACUATION DISTANCES should be used. Generally, a small spill is one that involves a single, small package such as a drum containing up to approximately 200 liters, a small cylinder, or a small leak from a large package. A large spill is one that involves a spill from a large package, or multiple spills from many small packages. Suggested distances to protect from vapors of toxic-by-inhalation and/or water-reactive materials during the first 30 minutes following the spill.
- SPILL - PUBLIC SAFETY EVACUATION DISTANCES - EMERGENCY RESPONSE GUIDEBOOK, GUIDE 153 (ERG, 2004)
Increase, in the downwind direction, as necessary, the isolation distance of at least 50 meters (150 feet) for liquids and at least 25 meters (75 feet) for solids in all directions.
- FIRE - PUBLIC SAFETY EVACUATION DISTANCES - EMERGENCY RESPONSE GUIDEBOOK, GUIDE 153 (ERG, 2004)
If tank, rail car or tank truck is involved in a fire, ISOLATE for 800 meters (1/2 mile) in all directions; also, consider initial evacuation for 800 meters (1/2 mile) in all directions.
- PUBLIC SAFETY MEASURES - EMERGENCY RESPONSE GUIDEBOOK, GUIDE 153 (ERG, 2004)
CALL Emergency Response Telephone Number on Shipping Paper first. If Shipping Paper not available or no answer, refer to appropriate telephone number: MEXICO: SETIQ: 01-800-00-214-00 in the Mexican Republic; For calls originating in Mexico City and the Metropolitan Area: 5559-1588; For calls originating elsewhere, call: 011-52-555-559-1588.
CENACOM: 01-800-00-413-00 in the Mexican Republic; For calls originating in Mexico City and the Metropolitan Area: 5550-1496, 5550-1552, 5550-1485, or 5550-4885; For calls originating elsewhere, call: 011-52-555-550-1496, or 011-52-555-550-1552; 011-52-555-550-1485, or 011-52-555-550-4885.
ARGENTINA: CIQUIME: 0-800-222-2933 in the Republic of Argentina; For calls originating elsewhere, call: +54-11-4613-1100.
BRAZIL: PRÓ-QUÍMICA: 0-800-118270 (Toll-free in Brazil); For calls originating elsewhere, call: +55-11-232-1144 (Collect calls are accepted).
COLUMBIA: CISPROQUIM: 01-800-091-6012 in Colombia; For calls originating in Bogotá, Colombia, call: 288-6012; For calls originating elsewhere, call: 011-57-1-288-6012.
CANADA: UNITED STATES:
For additional details see the section entitled "WHO TO CALL FOR ASSISTANCE" under the ERG Instructions. As an immediate precautionary measure, isolate spill or leak area in all directions for at least 50 meters (150 feet) for liquids and at least 25 meters (75 feet) for solids. Keep unauthorized personnel away. Stay upwind. Keep out of low areas. Ventilate enclosed areas.
- Evacuate all persons not involved in the fire-fighting efforts (SBBCOM, 2001).
- AIHA ERPG Values for CAS505-60-2 (AIHA, 2006):
- DOE TEEL Values for CAS505-60-2 (U.S. Department of Energy, Office of Emergency Management, 2010):
Listed as Bis(2-chloroethyl)sulfide; (HD; Sulfur mustard) TEEL-0 (units = ppm): 0.0035 TEEL-1 (units = ppm): 0.01 TEEL-2 (units = ppm): 0.02 TEEL-3 (units = ppm): 0.32 Definitions: TEEL-0: The threshold concentration below which most people will experience no adverse health effects. TEEL-1: The airborne concentration (expressed as ppm [parts per million] or mg/m(3) [milligrams per cubic meter]) of a substance above which it is predicted that the general population, including susceptible individuals, could experience notable discomfort, irritation, or certain asymptomatic, nonsensory effects. However, these effects are not disabling and are transient and reversible upon cessation of exposure. TEEL-2: The airborne concentration (expressed as ppm or mg/m(3)) of a substance above which it is predicted that the general population, including susceptible individuals, could experience irreversible or other serious, long-lasting, adverse health effects or an impaired ability to escape. TEEL-3: The airborne concentration (expressed as ppm or mg/m(3)) of a substance above which it is predicted that the general population, including susceptible individuals, could experience life-threatening adverse health effects or death.
- AEGL Values for CAS505-60-2 (National Research Council, 2010; National Research Council, 2009; National Research Council, 2008; National Research Council, 2007; NRC, 2001; NRC, 2002; NRC, 2003; NRC, 2004; NRC, 2004; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; United States Environmental Protection Agency Office of Pollution Prevention and Toxics, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; 62 FR 58840, 1997; 65 FR 14186, 2000; 65 FR 39264, 2000; 65 FR 77866, 2000; 66 FR 21940, 2001; 67 FR 7164, 2002; 68 FR 42710, 2003; 69 FR 54144, 2004):
Listed as: Sulfur mustard Final Value: AEGL-1 10 min exposure: ppm: 0.06 ppm mg/m3: 0.4 mg/m(3)
30 min exposure: ppm: 0.02 ppm mg/m3: 0.13 mg/m(3)
1 hr exposure: ppm: 0.01 ppm mg/m3: 0.067 mg/m(3)
4 hr exposure: ppm: 0.003 ppm mg/m3: 0.017 mg/m(3)
8 hr exposure: ppm: 0.001 ppm mg/m3: 0.008 mg/m(3)
Definitions: AEGL-1 is the airborne concentration of a substance above which it is predicted that the general population, including susceptible individuals, could experience notable discomfort, irritation, or certain asymptomatic non-sensory effects. However, the effects are not disabling, are transient, and are reversible upon cessation of exposure.
Listed as: Sulfur mustard Final Value: AEGL-2 10 min exposure: ppm: 0.09 ppm mg/m3: 0.6 mg/m(3)
30 min exposure: ppm: 0.03 ppm mg/m3: 0.2 mg/m(3)
1 hr exposure: ppm: 0.02 ppm mg/m3: 0.1 mg/m(3)
4 hr exposure: ppm: 0.004 ppm mg/m3: 0.025 mg/m(3)
8 hr exposure: ppm: 0.002 ppm mg/m3: 0.013 mg/m(3)
Definitions: AEGL-2 is the airborne concentration of a substance above which it is predicted that the general population, including susceptible individuals, could experience irreversible or other serious, long-lasting adverse health effects or an impaired ability to escape.
Listed as: Sulfur mustard Final Value: AEGL-3 10 min exposure: ppm: 0.59 ppm mg/m3: 3.9 mg/m(3)
30 min exposure: ppm: 0.41 ppm mg/m3: 2.7 mg/m(3)
1 hr exposure: ppm: 0.32 ppm mg/m3: 2.1 mg/m(3)
4 hr exposure: ppm: 0.08 ppm mg/m3: 0.53 mg/m(3)
8 hr exposure: ppm: 0.04 ppm mg/m3: 0.27 mg/m(3)
Definitions: AEGL-3 is the airborne concentration of a substance above which it is predicted that the general population, including susceptible individuals, could experience life-threatening health effects or death.
- NIOSH IDLH Values for CAS505-60-2 (National Institute for Occupational Safety and Health, 2007):
CONTAINMENT/WASTE TREATMENT OPTIONS
SPILL OR LEAK PRECAUTIONS - EMERGENCY RESPONSE GUIDEBOOK, GUIDE 153 (ERG, 2004) ELIMINATE all ignition sources (no smoking, flares, sparks or flames in immediate area). Do not touch damaged containers or spilled material unless wearing appropriate protective clothing. Stop leak if you can do it without risk. Prevent entry into waterways, sewers, basements or confined areas. Absorb or cover with dry earth, sand or other non-combustible material and transfer to containers. DO NOT GET WATER INSIDE CONTAINERS.
RECOMMENDED PROTECTIVE CLOTHING - EMERGENCY RESPONSE GUIDEBOOK, GUIDE 153 (ERG, 2004) Wear positive pressure self-contained breathing apparatus (SCBA). Wear chemical protective clothing that is specifically recommended by the manufacturer. It may provide little or no thermal protection. Structural firefighters' protective clothing provides limited protection. fire situations ONLY; it is not effective in spill situations where direct contact with the substance is possible.
Laboratory Spill: Use a decontamination solution for each gram of HD spilled (SBCCOM , 2001). Recommended decontamination solutions in order of preference are 5.25% sodium hypochlorite solution, calcium hypochlorite, contamination Solution No. 2 (DS2), and Super Tropical Bleach Slurry (STB). Agitate the solution and HD for the first hour. After the first hour, agitation is not necessary. Allow 24 hours for decontamination (SBCCOM , 2001). Test for active chlorine by adding several crystals potassium iodine to three mL of decontaminated solution and allow it to dissolve. Add 3 mL of 50 wt% sulfuric acid and look for immediate iodine color. If active chlorine exists, adjust the pH to between 10 and 11. If the test is negative, add more decontaminate solution and wait two hours before retesting for active chlorine again. This test is appropriate for 5.5% sodium hypochlorite and 10% calcium hypochlorite decontaminant (SBCCOM , 2001). Laboratory Spill: "Areas where liquid agent has been spilled will be clearly identified and controlled to prevent inadvertent access by unauthorized personnel" (U.S. Army, 1997). Laboratory Spill: Only personnel in full protective clothing are allowed in areas where there has been a spill or release of chemical agents (SBCCOM , 2001). Laboratory Spill: "The material must be encapsulated so that the concentration of agent on the outside of the encapsulating material does not exceed the Airborne Exposure Limit" (U.S. Army, 1997). Laboratory Spill: Place the neutralized substance and contaminated clothing into a DOT- approved container, cover the material with the decontaminating solution, decontaminate the outside, and label the sealed container according to EPA and DOT regulations (SBCCOM , 2001). Laboratory Spill: Leaking containers should be placed in a double containment system with a sorbent material between the interior and exterior container (SBCCOM , 2001). Laboratory Spill: Dispose of the decontaminate according to local, state and federal regulations (SBCCOM , 2001). Laboratory Spill: "The material must be encapsulated so that the concentration of agent on the outside of the encapsulating material does not exceed the Airborne Exposure Limit" (U.S. Army, 1997). Editor's Note: The decontamination solutions listed are not for dermal use.
Field Procedures: "Areas where liquid agent has been spilled will be clearly identified and controlled to prevent inadvertent access by unauthorized personnel" (U.S. Army, 1997). Field Procedures: Only personnel in full protective clothing are allowed in areas where there has been a spill or release of chemical agents (SBCCOM , 2001). Field Procedures: "Personnel who have been in areas of possible chemical agent exposure (normally, personnel downwind of an agent release or personnel who were in areas of known agent contamination) will remain at the installation for at least 30 minutes after leaving the area. They will then be observed for signs of agent exposure, and agent-related symptoms by the supervisor or his designated representative before departing the installation. If signs of possible exposure are noted the worker will be referred immediately to the medical family" (U.S. Army, 1997). Field Procedures: Cover spills with diatomaceous earth, vermiculite, clay, or fine sand (SBCCOM , 2001). Field Procedures: Use copious amounts of 5.25% sodium hypochlorite solution to decontaminate the area (SBCCOM , 2001). If 5.25% sodium hypochlorite solution is not available, the following decontaminants may be substituted, and are listed in order of preference: Calcium Hypochlorite, Decontaminating Agent (DS2), and Supertropical Bleach Slurry (STB) (SBCCOM , 2001). DS2 is a combination of diethylenetriamine (70%), ethylene glcol monomethyl ether (28%), and sodium hydroxide (2%) (SBCCOM , 2001). Dry calcium hypochlorite and super tropical bleach reacts violently with mustard and may burst into flames (RRIS , 2001). Field Procedures: Scoop the neutralized substance into a DOT-approved container, cover the material with the decontaminating solution, decontaminate the outside, and label the sealed container according to EPA and DOT regulations (SBCCOM , 2001). Field Procedures: Leaking containers should be placed in a double containment system with a sorbent material between the interior and exterior container (SBCCOM , 2001). Field Procedures: Dispose of the decontaminate according to local, state and federal regulations (SBCCOM , 2001). Field Procedures: "The material must be encapsulated so that the concentration of agent on the outside of the encapsulating material does not exceed the Airborne Exposure Limit" (U.S. Army, 1997). Editor's Note: The decontamination solutions listed are not for dermal use.
-ENVIRONMENTAL HAZARD MANAGEMENT
POLLUTION HAZARD
- Sulfur mustard [HD, bis(2-chloroethyl)sulfide], or mustard gas as it's commonly referred to, may have entered the environment from the chemical facility waste streams and stockpiles that existed during its production and use as a chemical warfare agent (CWA) in World Wars I and II (HSDB, 2005).
During and after the world wars, sulfur mustard was customarily dumped into coastal waters around Japan, Italy and the United States (ATSDR, 2003). Between 1945 and 1948, approximately 50,000 tons of stockpiled sulfur mustard were dumped into the sea near Christianso (an island belonging to Denmark). Another 2000 tons were dumped near the Swedish island of Gotland. Fishermen working these areas were exposed to mustard gas from corroded containers (Vena et al, 1994; Aasted et al, 1987).
- Soil and sheep's wool from the mountain regions in northern Iraq, where chemical agents were reportedly used in 1988, had detectable HD concentrations at 10.8 ppm and 27 ppb, respectively (HSDB, 2005).
- Leaking containers stockpiled at some U.S. Army bases released sulfur mustard into soil, groundwater and surface water. No known releases to the atmosphere occurred at these bases (ATSDR, 2003).
- Sulfur mustard may currently enter waste streams at facilities where small amounts are used in medicine (as tumor cell inhibitors) and in organic chemical production (HSDB, 2005).
- A chemical agent's stability in the environment mainly determines its human or environmental exposure potential. The stability of military chemical vesicants (blister agents) like mustard gas, largely depends on weather variables such as wind speed and direction, temperature gradients, humidity, and precipitation. The magnitude of the effect of each variable on downwind hazards and exposure are further influenced by local topography, vegetation, and soil conditions (U.S. Army, 2002).
ENVIRONMENTAL FATE AND KINETICS
Atmospheric conditions including temperature, temperature gradient, wind speed, and direction strongly influence the effectiveness and persistency of chemical agents like mustard gas (U.S. Army, 2002). Increases in temperature and high winds tend to increase evaporation rates and dissipation of liquid chemical agents (U.S. Army, 2002). High winds increase the evaporative rate of liquid chemical agents and dissipate chemical clouds more rapidly than low winds (U.S. Army, 2002). Wind speed and direction along with surface terrain features control migration of chemical clouds. Chemical agent clouds may pass over and around rather than penetrate heavily wooded areas. Agent clouds also tend to flow over rolling terrain, around large hills, and up and down valleys (U.S. Army, 2002).
The vapor pressure of sulfur mustard gas (HD) is low, but sufficient enough for vapors to surround droplets of liquid sulfur mustard (Munro et al, 1999). Solid HD has a measured vapor pressure (heat of sublimation) of 19.3 kcal/mole (independent of temperature), according to a first-time study using vapor saturation technology (Buchanan, 2005). Sulfur mustard has an atmospheric half life of 1.4 days (at a hydroxyl radical concentration of 5 x 10(5)/cm(3)), given an estimated rate constant of 11.4 x 10(-12) cm(3)/mol/sec at 25 degrees C (Munro et al, 1999).
SURFACE WATER Volatilization of sulfur mustard (HD) from water is a significant environmental fate process (Munro et al, 1999). While sulfur mustard may form a film on water surfaces, it usually hydrolyzes or volatilizes within a few days (Munro et al, 1999). The reported hydrolysis half-life for sulfur mustard is 8.5 minutes in distilled water at 25 degrees C and 60 minutes in salt water at 25 degrees C. Dissolved sulfur mustard has a hydrolysis half-life ranging from 158 minutes at 0.6 degrees C to approximately 1.5 minutes at 40 degrees C, with little variation across the normal environmental pH range (Munro et al, 1999). In seawater, sulfur mustard sinks to the bottom and slowly dissolves. Hydrolysis is faster in freshwater than seawater, as high chlorine levels in seawater inhibit hydrolysis (Munro et al, 1999).
Sulfur mustard can retain its vesicant properties in water for a considerable amount of time, if the water is kept at low temperatures and free from turbulence (Munro et al, 1999). Estimated environmental volatilization half-lives for sulfur mustard are 50 hours in a model river and 20 days in a model lake, assuming a Henry's Law constant of 2.4 x 10(-5) atm-m(3)/mole (HSDB, 2005).
GROUND WATER
TERRESTRIAL Sulfur mustard's persistence in the terrestrial environment depends on the munitions types used and the weather. Under average weather conditions, heavily splashed sulfur mustard liquid can persist for 1 to 2 days at concentrations significant enough to cause casualties. Under very cold conditions, sulfur mustard can persist in soil for several months (ATSDR, 2003; USACHPPM , 2001a). Sulfur mustard can also persist in snow. Field studies conducted in Norway showed solid particles of sulfur mustard formed on the snow's surface low temperatures (-1 degrees C). The droplets evaporated quickly with only 0.0001% remaining after 2 weeks (ILO ICSC, 2005; Munro et al, 1999). Sulfur mustard can remain active in soil up to 3 years, depending on soil moisture, pH, and other physical and chemical conditions. Loss of mustard gas from the soil surface is primarily by evaporation. At soil temperatures around 25 degrees C, sulfur mustard usually evaporates within 30 to 50 hours, depending on local weather conditions. Sulfur mustard can remain undegraded if buried deeply in soil and not subject to weathering or vaporization (USACHPPM , 2001a; Munro et al, 1999).
ABIOTIC DEGRADATION
- The principal environmental fate processes for sulfur mustard gas (HD) are hydrolysis and evaporation. Stored or buried sulfur mustard degrades by hydrolysis (from soil moisture) into the intermediate products, hydrochloric acid (HCl) and thiodiglycol (TDG) (USACHPPM , 2001a; Munro et al, 1999).
- Sulfur mustard is fairly persistent in the environment because its intermediate breakdown products (HCL and TDG) can coat the mustard droplets thereby inhibiting further hydrolysis. Its water solubility is also low (Munro et al, 1999).
In World War I, the average sulfur mustard concentration on European battlefields may have ranged up to 5 ppm. Following World War I, mustard gas was still detectable in some French soils (IARC, 1975; Case & Lea, 1955).
- Photodegradation is not an important environmental fate process for sulfur mustard, as it does not absorb ultraviolet radiation above 290 nm (Munro et al, 1999).
BIODEGRADATION
- Biodegradation in soil may occur slowly via thioether oxidation, reductive dehalogenation or dehydrohalogenation. Biodegradation has not been achieved in laboratory settings most likely because of its toxicity to microorganisms (Munro et al, 1999).
BIOACCUMULATION
ENVIRONMENTAL TOXICITY
- Mustard is considered extremely toxic to all species, although its low solubility limits its toxicity(Munro et al, 1999).
- Fish are considered the most susceptible aquatic organisms to sulfur mustard toxicity, with lethal water concentrations ranging from 25 to 50 ppm. A 30-day toxicity threshold of 2 mg/L was reported for three sensitive species: bluegill sunfish (Lepomis macrochirus), red-eared sunfish (Lepomis microlophus), and black bullheads (Ameiurus melas) (Munro et al, 1999).
- Guppies died after exposure to 20 ppm mustard gas for 0.3 hours (OHM/TADS, 2005).
- Mustard gas is toxic to livestock at 500 ppm (OHM/TADS, 2005).
-PHYSICAL/CHEMICAL PROPERTIES
MOLECULAR WEIGHT
DESCRIPTION/PHYSICAL STATE
- Mustard agent is an oily liquid normally amber to black, or yellow to brown in color. In its pure state it is water clear. The vapor is colorless with an odor resembling garlic, mustard or horseradish. HD decomposes at 149 to 117 degrees C (100 to 351 degrees F) and will form yellow prisms upon cooling ((HSDB, 2002); Munro et al, 1999; SBCCOM , 2001; USACHPPM , 2001).
PH
VAPOR PRESSURE
- 0.069 mmHg (at 20 degrees C) (SBCCOM , 2001)
- 0.072 mmHg (at 20 degrees C) (U.S. Army, 1975; (USACHPPM , 2001a)
- 0.11 mmHg (at 25 degrees C) ((HSDB, 2002); Munro et al, 1999; OPCW , 1997; SBCCOM , 2001; USACHPPM , 2001a)
SPECIFIC GRAVITY
- OTHER TEMPERATURE AND/OR PRESSURE
- TEMPERATURE AND/OR PRESSURE NOT LISTED
DENSITY
- NORMAL TEMPERATURE AND PRESSURE
(25 degrees C; 77 degrees F and 760 mmHg) 1.268 g/mL (SBCCOM , 2001) 1.2685 g/mL (U.S. Army, 1975)
- OTHER TEMPERATURE AND/OR PRESSURE
1.27 g/mL (at 20 degrees C) (Munro et al, 1999) 1.274 g/mL (at 20 degrees C) (SBCCOM , 2001)
- TEMPERATURE AND/OR PRESSURE NOT LISTED
FREEZING/MELTING POINT
13-15 degrees C (Munro et al, 1999) 14.45 degrees C (U.S. Army, 1975) 14.5 degrees C (USACHPPM , 2001a)
13-14 degrees C ((HSDB, 2002); Munro et al, 1999) 14 degrees C (OPCW , 1997) 14.45 degrees C (SBCCOM , 2001)
BOILING POINT
- 215-217 degrees C ((HSDB, 2002); Lewis, 2000; ITI, 1995; Munro et al, 1999; USACHPPM , 2001a)
- 217 degrees C (OPCW , 1997)
- 217 degrees C (calculated) (Decomposes; decomposition temperature range of 149-177 degrees C.) (US Army, 1975)
- 217.5 degrees C; 423.5 degrees F (calculated) (decomposed) (SBCCOM , 2001)
FLASH POINT
- 105 degrees C (SBCCOM , 2001) Sittig, 1991; U.S. Army, 1975; (USACHPPM , 2001a)
SOLUBILITY
0.06% (at 20 degrees C) (OPCW , 1997) 0.92 g/100g (at 22 degrees C) (SBCCOM , 2001) Mustard very sparingly or negligibly soluble in water (OPCW , 1997; USACHPPM , 2001a) 0.684 mg/L (at 25 degrees C) ((HSDB, 2002))
Mustard is soluble in gasoline and kerosene (SBCCOM , 2001). Mustard is soluble at greater than 10% in benzene ((HSDB, 2002)). Mustard is miscible with petroleum ether ((HSDB, 2002)).
HD is miscible with organophosphorus nerve agents (SBCCOM , 2001). It is freely soluble in fats, fat solvents, animal oils, organic solvents ((HSDB, 2002); USACHPPM , 2001a). Mustard id soluble in the following (SBCCOM , 2001): acetone alcohol carbon tetrachloride ether ethylbenzoate fats and oils tetrachloroethane
Mustard is soluble at greater than 10% in acetone, ethanol and ether ((HSDB, 2002)).
OCTANOL/WATER PARTITION COEFFICIENT
- Log Kow = 1.37 (Munro et al, 1999)
HENRY'S CONSTANT
- 2.4X10(-5) atm x m(3)/mol (Munro et al, 1999)
- 2.1X10(-5) atm x m(3)/mol (Munro et al, 1999)
OTHER/PHYSICAL
0.6 mg/m(3) (SBCCOM , 2001) 0.03 mg/L or 0.015 mg/m(3) ((HSDB, 2002))
- ORGANIC CARBON PARTITION COEFFICIENT
15.3 kcal/mole (liquid vaporization at melting point) (Buchanan, 2005) 19.3 kcal/mole (heat of sublimation for solid; independent of temperature) (Buchanan, 2005)
-REFERENCES
GENERAL BIBLIOGRAPHY- 40 CFR 372.28: Environmental Protection Agency - Toxic Chemical Release Reporting, Community Right-To-Know, Lower thresholds for chemicals of special concern. National Archives and Records Administration (NARA) and the Government Printing Office (GPO). Washington, DC. Final rules current as of Apr 3, 2006.
- 40 CFR 372.65: Environmental Protection Agency - Toxic Chemical Release Reporting, Community Right-To-Know, Chemicals and Chemical Categories to which this part applies. National Archives and Records Association (NARA) and the Government Printing Office (GPO), Washington, DC. Final rules current as of Apr 3, 2006.
- 49 CFR 172.101 - App. B: Department of Transportation - Table of Hazardous Materials, Appendix B: List of Marine Pollutants. National Archives and Records Administration (NARA) and the Government Printing Office (GPO), Washington, DC. Final rules current as of Aug 29, 2005.
- 49 CFR 172.101: Department of Transportation - Table of Hazardous Materials. National Archives and Records Administration (NARA) and the Government Printing Office (GPO), Washington, DC. Final rules current as of Aug 11, 2005.
- 62 FR 58840: Notice of the National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances - Proposed AEGL Values, Environmental Protection Agency, NAC/AEGL Committee. National Archives and Records Administration (NARA) and the Government Publishing Office (GPO), Washington, DC, 1997.
- 65 FR 14186: Notice of the National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances - Proposed AEGL Values, Environmental Protection Agency, NAC/AEGL Committee. National Archives and Records Administration (NARA) and the Government Publishing Office (GPO), Washington, DC, 2000.
- 65 FR 39264: Notice of the National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances - Proposed AEGL Values, Environmental Protection Agency, NAC/AEGL Committee. National Archives and Records Administration (NARA) and the Government Publishing Office (GPO), Washington, DC, 2000.
- 65 FR 77866: Notice of the National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances - Proposed AEGL Values, Environmental Protection Agency, NAC/AEGL Committee. National Archives and Records Administration (NARA) and the Government Publishing Office (GPO), Washington, DC, 2000.
- 66 FR 21940: Notice of the National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances - Proposed AEGL Values, Environmental Protection Agency, NAC/AEGL Committee. National Archives and Records Administration (NARA) and the Government Publishing Office (GPO), Washington, DC, 2001.
- 67 FR 7164: Notice of the National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances - Proposed AEGL Values, Environmental Protection Agency, NAC/AEGL Committee. National Archives and Records Administration (NARA) and the Government Publishing Office (GPO), Washington, DC, 2002.
- 68 FR 42710: Notice of the National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances - Proposed AEGL Values, Environmental Protection Agency, NAC/AEGL Committee. National Archives and Records Administration (NARA) and the Government Publishing Office (GPO), Washington, DC, 2003.
- 69 FR 54144: Notice of the National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances - Proposed AEGL Values, Environmental Protection Agency, NAC/AEGL Committee. National Archives and Records Administration (NARA) and the Government Publishing Office (GPO), Washington, DC, 2004.
- AAR: Emergency Handling of Hazardous Materials in Surface Transportation, Bureau of Explosives, Association of American Railroads, Washington, DC, 2000.
- AIHA: 2006 Emergency Response Planning Guidelines and Workplace Environmental Exposure Level Guides Handbook, American Industrial Hygiene Association, Fairfax, VA, 2006.
- ATSDR: Toxicological Profile for Sulfur Mustard (Update). Agency for Toxic Substances and Disease Registry, US Dept of Health and Human Services. Atlanta, GA, USAAvailable from URL: http://www.atsdr.cdc.gov/toxprofiles/tp49.html. As accessed 3 August 2005.
- Aasted A, Darre E, & Wulf HC: Mustard gas: clinical, toxicological, and mutagenic aspects based on modern experience. Ann Plastic Surg 1987; 19:330-333.
- Akhavan A, Ajalloueyan M, Ghanei M, et al: Late laryngeal findings in sulfur mustard poisoning. Clin Toxicol (Phila) 2009; 47(2):142-144.
- Amalric P, Bessou P, & Farenc M: Les recidives tardives de la keratite par yperite (French). Bull Soc Ophtamol France 1965; 65:101-106.
- American Conference of Governmental Industrial Hygienists : ACGIH 2010 Threshold Limit Values (TLVs(R)) for Chemical Substances and Physical Agents and Biological Exposure Indices (BEIs(R)), American Conference of Governmental Industrial Hygienists, Cincinnati, OH, 2010.
- Andreassi L: Chemical warfare and the skin. Intn J Dermatol 1991; 30:252-253.
- Ansell-Edmont: SpecWare Chemical Application and Recommendation Guide. Ansell-Edmont. Coshocton, OH. 2001. Available from URL: http://www.ansellpro.com/specware. As accessed 10/31/2001.
- Artigas A, Bernard GR, Carlet J, et al: The American-European consensus conference on ARDS, part 2: ventilatory, pharmacologic, supportive therapy, study design strategies, and issues related to recovery and remodeling.. Am J Respir Crit Care Med 1998; 157:1332-1347.
- Ashby J, Tinwell H, & Callander RD: Genetic activity of the human carcinogen sulphur mustard towards Salmonella and the mouse bone marrow. Med War 1995; 11:34-44.
- Balali-Mood M & Gorji A: Late respiratory complications of sulfur mustard poisoning in 1428 patients. Vet Human Toxicol 1993; 35:369.
- Balali-Mood M, Hefazi M, Mahmoudi M, et al: Long-term complications of sulfur mustard poisoning in severely intoxicated Iranian veterans. Fundam Clin Pharmacol 2005; 19:713-721.
- Balszuweit F, John H, Schmidt A, et al: Silibinin as a potential therapeutic for sulfur mustard injuries. Chem Biol Interact 2013; 206(3):496-504.
- Bata Shoe Company: Industrial Footwear Catalog, Bata Shoe Company, Belcamp, MD, 1995.
- Beauchesne MF & Shalansky SJ: Nonchemotherapy drug-induced agranulocytosis: a review of 118 patients treated with colony-stimulating factors. Pharmacotherapy 1999; 19(3):299-305.
- Beebe GW: Lung cancer in World War I veterans: possible relation to mustard-gas injury and 1918 influenza epidemic. J Natl Cancer Inst 1960; 25:1231-1252.
- Benschop HP: Verification, dosimetry and biomonitoring of mustard gas exposure via immunochemical detection of mustard gas adducts to DNA and proteins.GRA&I, NTIS, Springfield, VA, 1993, pp 12.
- Berghoff RS: The more common gases: their effect on the respiratory tract. Arch Internat Med 1919; 24:678-684.
- Best Manufacturing: ChemRest Chemical Resistance Guide. Best Manufacturing. Menlo, GA. 2002. Available from URL: http://www.chemrest.com. As accessed 10/8/2002.
- Best Manufacturing: Degradation and Permeation Data. Best Manufacturing. Menlo, GA. 2004. Available from URL: http://www.chemrest.com/DomesticPrep2/. As accessed 04/09/2004.
- Betten DP, Cantrell FL, Thomas SC, et al: A prospective evaluation of shortened course oral N-acetylcysteine for the treatment of acute acetaminophen poisoning. Ann Emerg Med 2007; 50(3):272-279.
- Bismuth C, Blanchet-Bardon, & Baud FJ: Delayed admission of five soldiers intoxicated with mustard gas. Annals of Emergency Medicine 1995; 26:715.
- Black RM & Read RW: Methods for the analysis of thiodiglycol sulphoxide, a metabolite of sulphur mustard, in urine using gas chromatography-mass spectrometry. J Chromatogr 1991; 558:393-404.
- Black RM, Brewster K, & Clarke RJ: Biological fate of sulphur mustard, 1,1'-thiobis(2-chloroethane): isolation and identification of urinary metabolites following intraperitoneal administration to rat. Xenobiotica 1992a; 22:405-418.
- Black RM, Clarke RJ, & Harrison JM: Biological fate of sulphur mustard: identification of valine and histidine adducts in haemoglobin from casualties of sulphur mustard poisoning. Xenobiotica 1997; 27:499-512.
- Black RM, Hambrook JL, & Howells DJ: Biological fate of sulfur mustard, 1,1'-thiobis(2-chloroethane). Urinary excretion profiles of hydrolysis products and beta-lyase metabolites of sulfur mustard after cutaneous application in rats. J Anal Toxicol 1992b; 16:79-84.
- Blodi FC: Mustard Gas Keratopathy. In: Smith ME (Ed), Ocular Pathology. Internat Opthalmol Clin 1971; II:1-13.
- Bobb AJ, Arfsten DP, & Jederberg WW: N-acetyl-L-cysteine as prophylaxis against sulfur mustard. Military Med 2005; 170:52-6.
- Borak J & Sidell FR: Agents of chemical warfare: Sulfur mustard. Annals of Emergency Medicine 1992; 213:303-307.
- Boss Manufacturing Company: Work Gloves, Boss Manufacturing Company, Kewanee, IL, 1998.
- Brower RG, Matthay AM, & Morris A: Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. N Eng J Med 2000; 342:1301-1308.
- Buchanan, JH: Vapor Pressure of Solid HD. Edgewood Chemical Biological Center, Research and Technology Directorate, USARDEC. Aberdeen Proving Ground, MDAvailable from URL: http://stinet.dtic.mil/cgi-bin/GetTRDoc?AD=A432504&Location=U2&doc=GetTRDoc.pdf.
- Budavari S: The Merck Index, 12th ed. on CD-ROM. Version 12:3a. Chapman & Hall/CRCnetBASE. Whitehouse Station, NJ. 2000.
- Carvajal HF & Stewart CE: Emergency management of burn patients: the first few hours. Emerg Med Reports 1987; 8:129-136.
- Case RAM & Lea AJ: Mustard gas poisoning, chronic bronchitis, and lung cancer. An investigation into the possibility that poisoning by mustard gas in the 1914-18 war might be a factor in the production of neoplasia. Br J Prev Soc Med 1955; 9:62-72.
- Cataletto M: Respiratory Distress Syndrome, Acute(ARDS). In: Domino FJ, ed. The 5-Minute Clinical Consult 2012, 20th ed. Lippincott Williams & Wilkins, Philadelphia, PA, 2012.
- Centers for Disease Control and Prevention (CDC): Notes from the field: Exposures to discarded sulfur mustard munitions - Mid-Atlantic and New England States 2004-2012. MMWR Morb Mortal Wkly Rep 2013; 62(16):315-316.
- ChemFab Corporation: Chemical Permeation Guide Challenge Protective Clothing Fabrics, ChemFab Corporation, Merrimack, NH, 1993.
- Chyka PA, Seger D, Krenzelok EP, et al: Position paper: Single-dose activated charcoal. Clin Toxicol (Phila) 2005; 43(2):61-87.
- Comasec Safety, Inc.: Chemical Resistance to Permeation Chart. Comasec Safety, Inc.. Enfield, CT. 2003. Available from URL: http://www.comasec.com/webcomasec/english/catalogue/mtabgb.html. As accessed 4/28/2003.
- Comasec Safety, Inc.: Product Literature, Comasec Safety, Inc., Enfield, CT, 2003a.
- Cowan FM, Broomfield CA, & Smith WJ: Sulfur mustard exposure enhances Fe receptor expression on human epidermal keratinocytes in cell culture: implications for toxicity and medical countermeasures. Cell Biol Toxicol 1998; 14:261-266.
- DFG: List of MAK and BAT Values 2002, Report No. 38, Deutsche Forschungsgemeinschaft, Commission for the Investigation of Health Hazards of Chemical Compounds in the Work Area, Wiley-VCH, Weinheim, Federal Republic of Germany, 2002.
- Dachir S, Fishbeine E, Meshulam Y, et al: Amelioration of sulfur mustard skin injury following a topical treatment with a mixture of a steroid and a NSAID. J Appl Toxicol 2004; 24:107-113.
- Dacre JC & Goldman M: Toxicology and pharmacology of the chemical warfare agent sulfur mustard. Pharmacological Reviews 1996; 48:289-326.
- Daly FF, Fountain JS, Murray L, et al: Guidelines for the management of paracetamol poisoning in Australia and New Zealand--explanation and elaboration. A consensus statement from clinical toxicologists consulting to the Australasian poisons information centres. Med J Aust 2008; 188(5):296-301.
- Dorr RT & Fritz WL: Cancer Chemotherapy Handbook, Elsevier, New York, NY, 1980.
- Dowlati A & Pierard GE: Epidermal hyperplasia with or without atypia in patients exposed to mustard gas (letter). Arch Dermatol 1993; 129:245.
- Drasch G, Kretschmer E, & Kauert G: Concentrations of mustard gas (bis(2-chloroethyl)sulfide) in the tissues of a victim of a vesicant exposure. J Forens Sci 1987; 32:1788-1793.
- DuPont: DuPont Suit Smart: Interactive Tool for the Selection of Protective Apparel. DuPont. Wilmington, DE. 2002. Available from URL: http://personalprotection.dupont.com/protectiveapparel/suitsmart/smartsuit2/na_english.asp. As accessed 10/31/2002.
- DuPont: Permeation Guide for DuPont Tychem Protective Fabrics. DuPont. Wilmington, DE. 2003. Available from URL: http://personalprotection.dupont.com/en/pdf/tyvektychem/pgcomplete20030128.pdf. As accessed 4/26/2004.
- DuPont: Permeation Test Results. DuPont. Wilmington, DE. 2002a. Available from URL: http://www.tyvekprotectiveapprl.com/databases/default.htm. As accessed 7/31/2002.
- EPA: EPA chemical profile on mustard gas, US Environmental Protection Agency, Washington, DC, 1985.
- EPA: Search results for Toxic Substances Control Act (TSCA) Inventory Chemicals. US Environmental Protection Agency, Substance Registry System, U.S. EPA's Office of Pollution Prevention and Toxics. Washington, DC. 2005. Available from URL: http://www.epa.gov/srs/.
- ERG: Emergency Response Guidebook. A Guidebook for First Responders During the Initial Phase of a Dangerous Goods/Hazardous Materials Incident, U.S. Department of Transportation, Research and Special Programs Administration, Washington, DC, 2004.
- Easton DF, Peto J, & Doll R: Cancers of the respiratory tract in mustard gas workers. Br J Ind Med 1988; 45:652-659.
- Eisenmenger W, Drasch G, & von Clarmann M: Clinical and morphological findings on mustard gas (bis(2-chloroethyl)sulfide) poisoning. J Forens Sci 1991; 36:1688-1698.
- Eldad A, Ben Meir P, & Breiterman S: Superoxide dismutase (SOD) for mustard gas burns. Burns 1998; 24:114-119.
- Elliot CG, Colby TV, & Kelly TM: Charcoal lung. Bronchiolitis obliterans after aspiration of activated charcoal. Chest 1989; 96:672-674.
- Emad A & Rezaian GR: The diversity of the effects of sulfur mustard gas inhalation on respiratory system 10 years after a single, heavy exposure. Chest 1997; 112:734-738.
- Emad A & Rezaian R: Characteristics of bronchoalveolar lavage fluid in patients with sulfur mustard gas-induced asthma or chronic bronchitis. Am J Med 1999; 106:625-628.
- Emadi SN , Mortazavi M , & Mortazavi H : Late cutaneous manifestations 14 to 20 years after wartime exposure to sulfur mustard gas: a long-term investigation. Arch Dermatol 2008; 144(8):1059-1061.
- FDA: Poison treatment drug product for over-the-counter human use; tentative final monograph. FDA: Fed Register 1985; 50:2244-2262.
- FR Sidell : Long-term health effects of nerve agents and mustard. Office of The Surgeon General Department of the Army at TMM Publications. Washington, D.C. 2000. Available from URL: http:\\www.nbc-med.org/SiteContent/HomePage/Whatsnew/MedAspects/Ch-7electrv699.pdf. As accessed Accessed on 7/26/00.
- Fidder A, Noort D, & de Jong AL: Monitoring of in vitro and in vivo exposure to sulfur mustard by GC/MS determination of the N-terminal valine adduct in hemoglobin after a modified Edman degradation. Chem Res Toxicol 1996; 9:788-792.
- Foulhoux P: Travaux orignaux (Original studies) (French). Rev Corps Sante Med 1963; 6:693-722.
- Freitag L, Firusian N, & Stamatis G: The role of bronchoscopy in pulmonary complications due to mustard gas inhalation. Chest 1991; 100:1436-1441.
- Fulgosi A: Survey of two cases of mustard gas poisoning (SerboCroatian). Vojnosanit Pregl 1956; 13:500-502.
- Geraci MJ : Mustard gas: imminent danger or eminent threat?. Ann Pharmacother 2008; 42(2):237-246.
- Ghanei M, Khalili AR, Arab MJ, et al: Diagnostic and therapeutic value of short-term corticosteroid therapy in exacerbation of mustard gas-induced chronic bronchitis. Basic Clin Pharmacol Toxicol 2005; 97(5):302-305.
- Ghasemi H, Ghazanfari T, Babaei M, et al: Long-term ocular complications of sulfur mustard in the civilian victims of Sardasht, Iran. Cutan Ocul Toxicol 2008; 27(4):317-326.
- Ghasemi H, Ghazanfari T, Yaraee R, et al: Long-term ocular consequences of sulfur mustard in lung-injured war veterans. Cutan Ocul Toxicol 2012; 31(1):33-37.
- Ghassemi-Broumand M, Aslani J, & Emadi SN: Delayed ocular, pulmonary, and cutaneous complications of mustards in patients in the city of Sardasht, Iran. Cutan Ocul Toxicol 2008; 27(4):295-305.
- Gille R: Pathogenese, Klinik und therapie der resorptiven allegemeinschadigung durch hautschadiegende kampfstoffe (German). Zschr Militaermed 1969; 2:94-99.
- Golej J, Boigner H, Burda G, et al: Severe respiratory failure following charcoal application in a toddler. Resuscitation 2001; 49:315-318.
- Golikov AI & Stojkov IJ: Rukovodstvo po medicinskoj sluzbe grazdanskoj oboroni (Russian). Medicina (Moskava) 1983; 413-444.
- Graff GR, Stark J, & Berkenbosch JW: Chronic lung disease after activated charcoal aspiration. Pediatrics 2002; 109:959-961.
- Graham JS, Stevenson RS, Mitcheltree LW, et al: Medical management of cutaneous sulfur mustard injuries. Toxicology 2009; 263(1):47-58.
- Grant WM & Schuman JS: Toxicology of the Eye, 4th ed, Charles C Thomas, Springfield, IL, 1993.
- Guardian Manufacturing Group: Guardian Gloves Test Results. Guardian Manufacturing Group. Willard, OH. 2001. Available from URL: http://www.guardian-mfg.com/guardianmfg.html. As accessed 12/11/2001.
- Guignabert C, Taysse L, Calvet JH, et al: Effect of doxycycline on sulfur mustard-induced respiratory lesions in guinea pigs. Am J Physiol Lung Cell Mol Physiol 2005; 289:L67-L74.
- HSDB : Hazardous Substances Data Bank. National Library of Medicine. Bethesda, MD (Internet Version). Edition expires 2005; provided by Truven Health Analytics Inc., Greenwood Village, CO.
- HSDB: Hazardous Substances Data Bank. National Library of Medicine. Bethesda, MD, USA (Internet Version). Edition expires 2002; provided by Truven Health Analytics Inc., Greenwood Village, CO.
- Haas CF: Mechanical ventilation with lung protective strategies: what works?. Crit Care Clin 2011; 27(3):469-486.
- Hackett PL, Rommereim RL & Burton FG et al: Teratology studies on lewisite and sulfur mustard agent; Effects of sulfur mustard in rats and rabbits, ISS Order No AD-A187 495 and AD-A189161. US Army Medical Research and Development Command, US Department of Army, 1987.
- Hambrook JL, Harrison JM, & Howells DJ: Biological fate of sulphur mustard (1,1'-thiobis(2-chloroethane)): Urinary and faecal excretion of 35S by rat after injection or cutaneous application of 35S-labelled sulphur mustard. Xenbiotica 1992; 22:65-75.
- Hambrook JL, Howells DJ, & Schock C: Biological fate of sulphur mustard (1,1'-thiobis(2-chloroethane)): Uptake, distribution and retention of super(35)S in skin and in blood after cutaneous application of super(35)S-sulphur mustard in rat and comparison with human blood in vitro. Xenobiotica 1993; 23:537-561.
- Harris CR & Filandrinos D: Accidental administration of activated charcoal into the lung: aspiration by proxy. Ann Emerg Med 1993; 22:1470-1473.
- Hartman LC, Tschetter LK, Habermann TM, et al: Granulocyte colony-stimulating factor in severe chemotherapy-induced afebrile neutropenia.. N Engl J Med 1997; 336:1776-1780.
- Hathaway GJ, Proctor NH, & Hughes JP: Proctor and Hughes' Chemical Hazards of the Workplace, 4th ed, Van Nostrand Reinhold, New York, NY, 1996.
- Haynes BW Jr: Emergency department management of minor burns. Top Emerg Med 1981; 3:35-40.
- Hefazi M, Attaran D, Mahmoudi M, et al: Late respiratory complications of mustard gas poisoning in Iranian veterans. Inhl Toxicol 2005; 17:587-592.
- Helmke B, Starz H, Bachter D, et al: Metastasising porocarcinoma following exposure to poison gas. Lancet 2002; 359(9318):1685-1685.
- Heyndrickx A & Heyndrickx B: Management of war gas injuries (letter). Lancet 1990; 336:1248-1249.
- Hirade J & Ninomiya A: Studies on the mechanism of the toxic action of organic halogen compounds. J Biochem 1949; 37:19-34.
- IARC Working Group on the Evaluation of Carcinogenic Risks to Humans : IARC Monographs on the Evaluation of Carcinogenic Risks to Humans: 1,3-Butadiene, Ethylene Oxide and Vinyl Halides (Vinyl Fluoride, Vinyl Chloride and Vinyl Bromide), 97, International Agency for Research on Cancer, Lyon, France, 2008.
- IARC Working Group on the Evaluation of Carcinogenic Risks to Humans : IARC Monographs on the Evaluation of Carcinogenic Risks to Humans: Formaldehyde, 2-Butoxyethanol and 1-tert-Butoxypropan-2-ol, 88, International Agency for Research on Cancer, Lyon, France, 2006.
- IARC Working Group on the Evaluation of Carcinogenic Risks to Humans : IARC Monographs on the Evaluation of Carcinogenic Risks to Humans: Household Use of Solid Fuels and High-temperature Frying, 95, International Agency for Research on Cancer, Lyon, France, 2010a.
- IARC Working Group on the Evaluation of Carcinogenic Risks to Humans : IARC Monographs on the Evaluation of Carcinogenic Risks to Humans: Smokeless Tobacco and Some Tobacco-specific N-Nitrosamines, 89, International Agency for Research on Cancer, Lyon, France, 2007.
- IARC Working Group on the Evaluation of Carcinogenic Risks to Humans : IARC Monographs on the Evaluation of Carcinogenic Risks to Humans: Some Non-heterocyclic Polycyclic Aromatic Hydrocarbons and Some Related Exposures, 92, International Agency for Research on Cancer, Lyon, France, 2010.
- IARC: IARC Monographs on the Evaluation of the Carcinogenic Risk of Chemicals to Man, 9, International Agency for Research on Cancer, World Health Organization, Geneva, Switzerland, 1975, pp 181-192.
- IARC: List of all agents, mixtures and exposures evaluated to date - IARC Monographs: Overall Evaluations of Carcinogenicity to Humans, Volumes 1-88, 1972-PRESENT. World Health Organization, International Agency for Research on Cancer. Lyon, FranceAvailable from URL: http://monographs.iarc.fr/monoeval/crthall.html. As accessed Oct 07, 2004.
- ICAO: Technical Instructions for the Safe Transport of Dangerous Goods by Air, 2003-2004. International Civil Aviation Organization, Montreal, Quebec, Canada, 2002.
- ILC Dover, Inc.: Ready 1 The Chemturion Limited Use Chemical Protective Suit, ILC Dover, Inc., Frederica, DE, 1998.
- ILO ICSC: International Chemical Safety Card (ICSC) 0418: Sulfur Mustard. International Labour Organization; prepared in cooperation with the International Occupational Safety and Health Information Centre (CIS) and the International Programme on Chemical Safety (IPCS) and the European Commission. Available from URL: http://www.ilo.org/public/english/protection/safework/cis/products/icsc/dtasht/_icsc04/icsc0418.htm. As accessed 3 August 2005.
- ITI: Toxic and Hazardous Industrial Chemicals Safety Manual, The International Technical Information Institute, Tokyo, Japan, 1995.
- International Agency for Research on Cancer (IARC): IARC monographs on the evaluation of carcinogenic risks to humans: list of classifications, volumes 1-116. International Agency for Research on Cancer (IARC). Lyon, France. 2016. Available from URL: http://monographs.iarc.fr/ENG/Classification/latest_classif.php. As accessed 2016-08-24.
- International Agency for Research on Cancer: IARC Monographs on the Evaluation of Carcinogenic Risks to Humans. World Health Organization. Geneva, Switzerland. 2015. Available from URL: http://monographs.iarc.fr/ENG/Classification/. As accessed 2015-08-06.
- Jelenko C III: Chemicals that "burn". J Trauma 1974; 14:65-72.
- Jostes RF, Sasser LB, & Rausch RJ: Toxicology studies on lewisite and sulfur mustard agents: Genetic toxicity of sulfur mustard (HD) in Chinese hamster ovary cells, GRA&I, NTIS, Springfield, VA, 1990, pp 07.
- Jugg B, Fairhall S, Smith A, et al: N-acetyl-L-cysteine protects against inhaled sulfur mustard poisoning in the large swine. Clin Toxicol (Phila) 2013; 51(4):216-224.
- Kadar T, Fishbine E, Meshulam J, et al: A topical skin protectant against chemical warfare agents. IMAJ 2003; 5:717-719.
- Kappler, Inc.: Suit Smart. Kappler, Inc.. Guntersville, AL. 2001. Available from URL: http://www.kappler.com/suitsmart/smartsuit2/na_english.asp?select=1. As accessed 7/10/2001.
- Karakcijev N: Toksikologija OV i zascita ot oruzija massovogo porazenija (Russian). Medicina (Taskent) 1973; 158-189.
- Karimian F, Zarei-Ghanavati S, A BR, et al: Microbiological evaluation of chronic blepharitis among Iranian veterans exposed to mustard gas: a case-controlled study. Cornea 2011; 30(6):620-623.
- Kenar L, Karayilanogly T, Yuksel A, et al: Evaluation of protective ointments used against dermal effects of nitrogen mustard, a vesicant warfare agent. Military Med 2005; 170:1-6.
- Khateri S, Ghanei M, Keshavarz S, et al: Incidence of lung, eye, and skin lesions as late complications in 34,000 Iranians with wartime exposure to mustard agent . J Occup Environ Med 2003; 45:1136-1143.
- Kimberly-Clark, Inc.: Chemical Test Results. Kimberly-Clark, Inc.. Atlanta, GA. 2002. Available from URL: http://www.kc-safety.com/tech_cres.html. As accessed 10/4/2002.
- Kjellstrom BT, Persson JK, & Runn P: Surgical treatment of skin lesions induced by sulfur mustard ("mustard gas") -- an experimental study in the guinea pig. Ann Acad Med Singapore 1997; 26:30-36.
- Kollef MH & Schuster DP: The acute respiratory distress syndrome. N Engl J Med 1995; 332:27-37.
- Kurozumi S, Harada Y, & Sugimoto Y: Airway malignancy in poisonous gas workers. J Laryngol Otol 1977; 91:217-225.
- LaCrosse-Rainfair: Safety Products, LaCrosse-Rainfair, Racine, WI, 1997.
- Lawley PD: Carcinogenesis by alkylating agents, in: Chemical Carcinogenesis, American Chemical Society, Washington, DC, 1976, pp 83-244.
- Lewis RA: Lewis' Dictionary of Toxicology, Lewis Publishers, Boca Raton, FL, 1998.
- Lewis RJ: Hawley's Condensed Chemical Dictionary, 12th ed, Van Nostrand Reinhold Company, New York, NY, 1993.
- Lewis RJ: Hawley's Condensed Chemical Dictionary, 13th ed, John Wiley & Sons, Inc, New York, NY, 1997.
- Lewis RJ: Sax's Dangerous Properties of Industrial Materials, 10th ed, Van Nostrand Reinhold Company, New York, NY, 2000.
- Lewis RJ: Sax's Dangerous Properties of Industrial Materials, 8th ed, Van Nostrand Reinhold Company, New York, NY, 1992.
- Ludlum DB, Austinritchie P, & Hagopian M: Detection of sulfur mustard-induced DNA modifications. Chem Biol Interact 1994; 91:39-49.
- MAPA Professional: Chemical Resistance Guide. MAPA North America. Columbia, TN. 2003. Available from URL: http://www.mapaglove.com/pro/ChemicalSearch.asp. As accessed 4/21/2003.
- MAPA Professional: Chemical Resistance Guide. MAPA North America. Columbia, TN. 2004. Available from URL: http://www.mapaglove.com/ProductSearch.cfm?id=1. As accessed 6/10/2004.
- Mahmoudi M, Hefazi M, Rastin M, et al: Long-term hematological and immunological complications of sulfur mustard poisoning in Iranian veterans. Int Immunopharmacol 2005; 5:1479-1485.
- Maisonneuve A, Callebat I, & Debordes L: Biological fate of sulphur mustard in rat: toxicokinetics and disposition. Xenobiotica 1993; 23:771-780.
- Maisonneuve A, Callebat I, & Debordes L: Specific and sensitive quantitation of 2,2'-dichlorodiethyl sulphide (sulphur mustard) in water, plasma and blood: application to toxicokinetic study in the rat after intravenous intoxication. J Chromatogr 1992; 583:23:771-780.
- Mar-Mac Manufacturing, Inc: Product Literature, Protective Apparel, Mar-Mac Manufacturing, Inc., McBee, SC, 1995.
- Marigold Industrial: US Chemical Resistance Chart, on-line version. Marigold Industrial. Norcross, GA. 2003. Available from URL: www.marigoldindustrial.com/charts/uschart/uschart.html. As accessed 4/14/2003.
- Masta A, Gray PJ, & Phillips DR: Effect of sulphur mustard on the initiation and elongation of transcription. Carcinogenesis 1996; 17:525-532.
- Memphis Glove Company: Permeation Guide. Memphis Glove Company. Memphis, TN. 2001. Available from URL: http://www.memphisglove.com/permeation.html. As accessed 7/2/2001.
- Mi L, Gong W, Nelson P, et al: Hypothermia reduces sulphur mustard toxicity. Toxicol Appl Pharamacol 2003; 193:73-83.
- Momeni AZ & Aminjavaheri M: Skin manifestations of mustard gas in a group of 14 children and teenagers -- a clinical study. Internat J Dermatol 1994; 33:184-187.
- Momeni AZ, Enshaeih S, & Meghdadi M: Skin manifestations of mustard gas. A clinical study of 535 patients exposed to mustard gas. Archives of Dermatology 1992; 128:775-780.
- Montgomery Safety Products: Montgomery Safety Products Chemical Resistant Glove Guide, Montgomery Safety Products, Canton, OH, 1995.
- Morad Y, Banin E, Averbukh E, et al: Treatment of ocular tissues exposed to nitrogen mustard: beneficial effect of zinc desferrioxamine combined with steroids. Invest Ophthalmol Vis Sci 2005; 46:1640-6.
- Moylan JA: Burn care after thermal injury. Top Emerg Med 1980; 2:39-52.
- Munro N, Talmage S, & Griffin G: The Sources Fate, and Toxicity of Chemical Warfare Agent Degradation Products. Envir Health Perspectives 1999; 107:933-974.
- NATO: NATO Handbook on the Medical Aspects of NBC Defensive Operations. AMedP-6, Part III, North Atlantic Treaty Organization, Brussels, Belgium, 1973, pp 3-1-7-10.
- NFPA: Fire Protection Guide to Hazardous Materials, 13th ed., National Fire Protection Association, Quincy, MA, 2002.
- NHLBI ARDS Network: Mechanical ventilation protocol summary. Massachusetts General Hospital. Boston, MA. 2008. Available from URL: http://www.ardsnet.org/system/files/6mlcardsmall_2008update_final_JULY2008.pdf. As accessed 2013-08-07.
- NRC: Acute Exposure Guideline Levels for Selected Airborne Chemicals - Volume 1, Subcommittee on Acute Exposure Guideline Levels, Committee on Toxicology, Board on Environmental Studies and Toxicology, Commission of Life Sciences, National Research Council. National Academy Press, Washington, DC, 2001.
- NRC: Acute Exposure Guideline Levels for Selected Airborne Chemicals - Volume 2, Subcommittee on Acute Exposure Guideline Levels, Committee on Toxicology, Board on Environmental Studies and Toxicology, Commission of Life Sciences, National Research Council. National Academy Press, Washington, DC, 2002.
- NRC: Acute Exposure Guideline Levels for Selected Airborne Chemicals - Volume 3, Subcommittee on Acute Exposure Guideline Levels, Committee on Toxicology, Board on Environmental Studies and Toxicology, Commission of Life Sciences, National Research Council. National Academy Press, Washington, DC, 2003.
- NRC: Acute Exposure Guideline Levels for Selected Airborne Chemicals - Volume 4, Subcommittee on Acute Exposure Guideline Levels, Committee on Toxicology, Board on Environmental Studies and Toxicology, Commission of Life Sciences, National Research Council. National Academy Press, Washington, DC, 2004.
- Nat-Wear: Protective Clothing, Hazards Chart. Nat-Wear. Miora, NY. 2001. Available from URL: http://www.natwear.com/hazchart1.htm. As accessed 7/12/2001.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for 1,2,3-Trimethylbenzene (Proposed). United States Environmental Protection Agency. Washington, DC. 2006k. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020d68a&disposition=attachment&contentType=pdf. As accessed 2010-08-12.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for 1,2,4-Trimethylbenzene (Proposed). United States Environmental Protection Agency. Washington, DC. 2006m. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020d68a&disposition=attachment&contentType=pdf. As accessed 2010-08-16.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for 1,2-Butylene Oxide (Proposed). United States Environmental Protection Agency. Washington, DC. 2008d. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648083cdbb&disposition=attachment&contentType=pdf. As accessed 2010-08-12.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for 1,2-Dibromoethane (Proposed). United States Environmental Protection Agency. Washington, DC. 2007g. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=09000064802796db&disposition=attachment&contentType=pdf. As accessed 2010-08-18.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for 1,3,5-Trimethylbenzene (Proposed). United States Environmental Protection Agency. Washington, DC. 2006l. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020d68a&disposition=attachment&contentType=pdf. As accessed 2010-08-16.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for 2-Ethylhexyl Chloroformate (Proposed). United States Environmental Protection Agency. Washington, DC. 2007b. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648037904e&disposition=attachment&contentType=pdf. As accessed 2010-08-12.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Acrylonitrile (Proposed). United States Environmental Protection Agency. Washington, DC. 2007c. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648028e6a3&disposition=attachment&contentType=pdf. As accessed 2010-08-12.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Adamsite (Proposed). United States Environmental Protection Agency. Washington, DC. 2007h. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020fd29&disposition=attachment&contentType=pdf. As accessed 2010-08-16.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Agent BZ (3-quinuclidinyl benzilate) (Proposed). United States Environmental Protection Agency. Washington, DC. 2007f. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=09000064803ad507&disposition=attachment&contentType=pdf. As accessed 2010-08-18.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Allyl Chloride (Proposed). United States Environmental Protection Agency. Washington, DC. 2008. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648039d9ee&disposition=attachment&contentType=pdf. As accessed 2010-08-12.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Aluminum Phosphide (Proposed). United States Environmental Protection Agency. Washington, DC. 2005b. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020c5ed&disposition=attachment&contentType=pdf. As accessed 2010-08-16.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Arsenic Trioxide (Proposed). United States Environmental Protection Agency. Washington, DC. 2007m. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=0900006480220305&disposition=attachment&contentType=pdf. As accessed 2010-08-16.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Automotive Gasoline Unleaded (Proposed). United States Environmental Protection Agency. Washington, DC. 2009a. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=0900006480a7cc17&disposition=attachment&contentType=pdf. As accessed 2010-08-12.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Biphenyl (Proposed). United States Environmental Protection Agency. Washington, DC. 2005j. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=09000064801ea1b7&disposition=attachment&contentType=pdf. As accessed 2010-08-16.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Bis-Chloromethyl Ether (BCME) (Proposed). United States Environmental Protection Agency. Washington, DC. 2006n. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648022db11&disposition=attachment&contentType=pdf. As accessed 2010-08-16.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Boron Tribromide (Proposed). United States Environmental Protection Agency. Washington, DC. 2008a. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=09000064803ae1d3&disposition=attachment&contentType=pdf. As accessed 2010-08-12.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Bromine Chloride (Proposed). United States Environmental Protection Agency. Washington, DC. 2007d. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648039732a&disposition=attachment&contentType=pdf. As accessed 2010-08-12.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Bromoacetone (Proposed). United States Environmental Protection Agency. Washington, DC. 2008e. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=09000064809187bf&disposition=attachment&contentType=pdf. As accessed 2010-08-12.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Calcium Phosphide (Proposed). United States Environmental Protection Agency. Washington, DC. 2005d. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020c5ed&disposition=attachment&contentType=pdf. As accessed 2010-08-16.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Carbonyl Fluoride (Proposed). United States Environmental Protection Agency. Washington, DC. 2008b. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=09000064803ae328&disposition=attachment&contentType=pdf. As accessed 2010-08-12.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Carbonyl Sulfide (Proposed). United States Environmental Protection Agency. Washington, DC. 2007e. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648037ff26&disposition=attachment&contentType=pdf. As accessed 2010-08-12.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Chlorobenzene (Proposed). United States Environmental Protection Agency. Washington, DC. 2008c. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=09000064803a52bb&disposition=attachment&contentType=pdf. As accessed 2010-08-12.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Cyanogen (Proposed). United States Environmental Protection Agency. Washington, DC. 2008f. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=09000064809187fe&disposition=attachment&contentType=pdf. As accessed 2010-08-15.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Dimethyl Phosphite (Proposed). United States Environmental Protection Agency. Washington, DC. 2009. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=0900006480a7cbf3&disposition=attachment&contentType=pdf. As accessed 2010-08-12.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Diphenylchloroarsine (Proposed). United States Environmental Protection Agency. Washington, DC. 2007l. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020fd29&disposition=attachment&contentType=pdf. As accessed 2010-08-16.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Ethyl Isocyanate (Proposed). United States Environmental Protection Agency. Washington, DC. 2008h. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648091884e&disposition=attachment&contentType=pdf. As accessed 2010-08-15.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Ethyl Phosphorodichloridate (Proposed). United States Environmental Protection Agency. Washington, DC. 2008i. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=0900006480920347&disposition=attachment&contentType=pdf. As accessed 2010-08-15.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Ethylbenzene (Proposed). United States Environmental Protection Agency. Washington, DC. 2008g. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=09000064809203e7&disposition=attachment&contentType=pdf. As accessed 2010-08-15.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Ethyldichloroarsine (Proposed). United States Environmental Protection Agency. Washington, DC. 2007j. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020fd29&disposition=attachment&contentType=pdf. As accessed 2010-08-16.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Germane (Proposed). United States Environmental Protection Agency. Washington, DC. 2008j. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=0900006480963906&disposition=attachment&contentType=pdf. As accessed 2010-08-15.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Hexafluoropropylene (Proposed). United States Environmental Protection Agency. Washington, DC. 2006. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=09000064801ea1f5&disposition=attachment&contentType=pdf. As accessed 2010-08-15.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Ketene (Proposed). United States Environmental Protection Agency. Washington, DC. 2007. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020ee7c&disposition=attachment&contentType=pdf. As accessed 2010-08-15.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Magnesium Aluminum Phosphide (Proposed). United States Environmental Protection Agency. Washington, DC. 2005h. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020c5ed&disposition=attachment&contentType=pdf. As accessed 2010-08-16.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Magnesium Phosphide (Proposed). United States Environmental Protection Agency. Washington, DC. 2005g. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020c5ed&disposition=attachment&contentType=pdf. As accessed 2010-08-16.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Malathion (Proposed). United States Environmental Protection Agency. Washington, DC. 2009k. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=09000064809639df&disposition=attachment&contentType=pdf. As accessed 2010-08-15.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Mercury Vapor (Proposed). United States Environmental Protection Agency. Washington, DC. 2009b. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=0900006480a8a087&disposition=attachment&contentType=pdf. As accessed 2010-08-12.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Methyl Isothiocyanate (Proposed). United States Environmental Protection Agency. Washington, DC. 2008k. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=0900006480963a03&disposition=attachment&contentType=pdf. As accessed 2010-08-15.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Methyl Parathion (Proposed). United States Environmental Protection Agency. Washington, DC. 2008l. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=0900006480963a57&disposition=attachment&contentType=pdf. As accessed 2010-08-12.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Methyl tertiary-butyl ether (Proposed). United States Environmental Protection Agency. Washington, DC. 2007a. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=09000064802a4985&disposition=attachment&contentType=pdf. As accessed 2010-08-15.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Methylchlorosilane (Proposed). United States Environmental Protection Agency. Washington, DC. 2005. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020c5f4&disposition=attachment&contentType=pdf. As accessed 2010-08-15.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Methyldichloroarsine (Proposed). United States Environmental Protection Agency. Washington, DC. 2007i. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020fd29&disposition=attachment&contentType=pdf. As accessed 2010-08-16.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Methyldichlorosilane (Proposed). United States Environmental Protection Agency. Washington, DC. 2005a. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020c646&disposition=attachment&contentType=pdf. As accessed 2010-08-15.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Nitrogen Mustard (HN1 CAS Reg. No. 538-07-8) (Proposed). United States Environmental Protection Agency. Washington, DC. 2006a. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020d6cb&disposition=attachment&contentType=pdf. As accessed 2010-08-15.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Nitrogen Mustard (HN2 CAS Reg. No. 51-75-2) (Proposed). United States Environmental Protection Agency. Washington, DC. 2006b. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020d6cb&disposition=attachment&contentType=pdf. As accessed 2010-08-15.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Nitrogen Mustard (HN3 CAS Reg. No. 555-77-1) (Proposed). United States Environmental Protection Agency. Washington, DC. 2006c. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020d6cb&disposition=attachment&contentType=pdf. As accessed 2010-08-15.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Nitrogen Tetroxide (Proposed). United States Environmental Protection Agency. Washington, DC. 2008n. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648091855b&disposition=attachment&contentType=pdf. As accessed 2010-08-12.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Nitrogen Trifluoride (Proposed). United States Environmental Protection Agency. Washington, DC. 2009l. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=0900006480963e0c&disposition=attachment&contentType=pdf. As accessed 2010-08-12.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Parathion (Proposed). United States Environmental Protection Agency. Washington, DC. 2008o. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=0900006480963e32&disposition=attachment&contentType=pdf. As accessed 2010-08-12.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Perchloryl Fluoride (Proposed). United States Environmental Protection Agency. Washington, DC. 2009c. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=0900006480a7e268&disposition=attachment&contentType=pdf. As accessed 2010-08-12.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Perfluoroisobutylene (Proposed). United States Environmental Protection Agency. Washington, DC. 2009d. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=0900006480a7e26a&disposition=attachment&contentType=pdf. As accessed 2010-08-15.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Phenyl Isocyanate (Proposed). United States Environmental Protection Agency. Washington, DC. 2008p. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648096dd58&disposition=attachment&contentType=pdf. As accessed 2010-08-12.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Phenyl Mercaptan (Proposed). United States Environmental Protection Agency. Washington, DC. 2006d. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020cc0c&disposition=attachment&contentType=pdf. As accessed 2010-08-16.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Phenyldichloroarsine (Proposed). United States Environmental Protection Agency. Washington, DC. 2007k. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020fd29&disposition=attachment&contentType=pdf. As accessed 2010-08-16.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Phorate (Proposed). United States Environmental Protection Agency. Washington, DC. 2008q. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648096dcc8&disposition=attachment&contentType=pdf. As accessed 2010-08-12.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Phosgene (Draft-Revised). United States Environmental Protection Agency. Washington, DC. 2009e. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=0900006480a8a08a&disposition=attachment&contentType=pdf. As accessed 2010-08-12.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Phosgene Oxime (Proposed). United States Environmental Protection Agency. Washington, DC. 2009f. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=0900006480a7e26d&disposition=attachment&contentType=pdf. As accessed 2010-08-12.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Potassium Cyanide (Proposed). United States Environmental Protection Agency. Washington, DC. 2009g. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=0900006480a7cbb9&disposition=attachment&contentType=pdf. As accessed 2010-08-15.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Potassium Phosphide (Proposed). United States Environmental Protection Agency. Washington, DC. 2005c. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020c5ed&disposition=attachment&contentType=pdf. As accessed 2010-08-16.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Propargyl Alcohol (Proposed). United States Environmental Protection Agency. Washington, DC. 2006e. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020ec91&disposition=attachment&contentType=pdf. As accessed 2010-08-16.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Selenium Hexafluoride (Proposed). United States Environmental Protection Agency. Washington, DC. 2006f. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020ec55&disposition=attachment&contentType=pdf. As accessed 2010-08-16.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Silane (Proposed). United States Environmental Protection Agency. Washington, DC. 2006g. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020d523&disposition=attachment&contentType=pdf. As accessed 2010-08-16.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Sodium Cyanide (Proposed). United States Environmental Protection Agency. Washington, DC. 2009h. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=0900006480a7cbb9&disposition=attachment&contentType=pdf. As accessed 2010-08-15.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Sodium Phosphide (Proposed). United States Environmental Protection Agency. Washington, DC. 2005i. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020c5ed&disposition=attachment&contentType=pdf. As accessed 2010-08-16.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Strontium Phosphide (Proposed). United States Environmental Protection Agency. Washington, DC. 2005f. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020c5ed&disposition=attachment&contentType=pdf. As accessed 2010-08-16.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Sulfuryl Chloride (Proposed). United States Environmental Protection Agency. Washington, DC. 2006h. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020ec7a&disposition=attachment&contentType=pdf. As accessed 2010-08-16.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Tear Gas (Proposed). United States Environmental Protection Agency. Washington, DC. 2008s. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648096e551&disposition=attachment&contentType=pdf. As accessed 2010-08-12.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Tellurium Hexafluoride (Proposed). United States Environmental Protection Agency. Washington, DC. 2009i. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=0900006480a7e2a1&disposition=attachment&contentType=pdf. As accessed 2010-08-12.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Tert-Octyl Mercaptan (Proposed). United States Environmental Protection Agency. Washington, DC. 2008r. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648096e5c7&disposition=attachment&contentType=pdf. As accessed 2010-08-12.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Tetramethoxysilane (Proposed). United States Environmental Protection Agency. Washington, DC. 2006j. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020d632&disposition=attachment&contentType=pdf. As accessed 2010-08-17.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Trimethoxysilane (Proposed). United States Environmental Protection Agency. Washington, DC. 2006i. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020d632&disposition=attachment&contentType=pdf. As accessed 2010-08-16.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Trimethyl Phosphite (Proposed). United States Environmental Protection Agency. Washington, DC. 2009j. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=0900006480a7d608&disposition=attachment&contentType=pdf. As accessed 2010-08-12.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Trimethylacetyl Chloride (Proposed). United States Environmental Protection Agency. Washington, DC. 2008t. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648096e5cc&disposition=attachment&contentType=pdf. As accessed 2010-08-12.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Zinc Phosphide (Proposed). United States Environmental Protection Agency. Washington, DC. 2005e. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020c5ed&disposition=attachment&contentType=pdf. As accessed 2010-08-16.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for n-Butyl Isocyanate (Proposed). United States Environmental Protection Agency. Washington, DC. 2008m. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=09000064808f9591&disposition=attachment&contentType=pdf. As accessed 2010-08-12.
- National Asthma Education and Prevention Program: Expert Panel Report 3 (EPR-3): Guidelines for the Diagnosis and Management of Asthma-Summary Report 2007. J Allergy Clin Immunol 2007; 120(5 Suppl):S94-S138.
- National Heart,Lung,and Blood Institute: Expert panel report 3: guidelines for the diagnosis and management of asthma. National Heart,Lung,and Blood Institute. Bethesda, MD. 2007. Available from URL: http://www.nhlbi.nih.gov/guidelines/asthma/asthgdln.pdf.
- National Institute for Occupational Safety and Health: NIOSH Pocket Guide to Chemical Hazards, U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Cincinnati, OH, 2007.
- National Research Council : Acute exposure guideline levels for selected airborne chemicals, 5, National Academies Press, Washington, DC, 2007.
- National Research Council: Acute exposure guideline levels for selected airborne chemicals, 6, National Academies Press, Washington, DC, 2008.
- National Research Council: Acute exposure guideline levels for selected airborne chemicals, 7, National Academies Press, Washington, DC, 2009.
- National Research Council: Acute exposure guideline levels for selected airborne chemicals, 8, National Academies Press, Washington, DC, 2010.
- Neese Industries, Inc.: Fabric Properties Rating Chart. Neese Industries, Inc.. Gonzales, LA. 2003. Available from URL: http://www.neeseind.com/new/TechGroup.asp?Group=Fabric+Properties&Family=Technical. As accessed 4/15/2003.
- None Listed: Position paper: cathartics. J Toxicol Clin Toxicol 2004; 42(3):243-253.
- Norman JE Jr: Lung cancer mortality in World War I veterans with mustard-gas injury: 1919-1965. J Natl Cancer Inst 1975; 54:311-317.
- North: Chemical Resistance Comparison Chart - Protective Footwear . North Safety. Cranston, RI. 2002. Available from URL: http://www.linkpath.com/index2gisufrm.php?t=N-USA1. As accessed April 30, 2004.
- North: eZ Guide Interactive Software. North Safety. Cranston, RI. 2002a. Available from URL: http://www.northsafety.com/feature1.htm. As accessed 8/31/2002.
- OHM/TADS : Oil and Hazardous Materials/Technical Assistance Data System. US Environmental Protection Agency. Washington, DC (Internet Version). Edition expires October/2001; provided by Truven Health Analytics Inc., Greenwood Village, CO.
- OHM/TADS: Oil and Hazardous Materials Technical Assistance Data System. US Environmental Protection Agency. Washington, D.C. (Internet Version). Edition expires 2005; provided by Truven Health Analytics Inc., Greenwood Village, CO.
- OPCW : Mustard Agents. The Organisation for the Prohibition of Chemical Weapons. The Hague, Netherlands. 1997. Available from URL: http://www.opcw.org/resp/html/mustard.html. As accessed Accessed 20 Dec 2001. URL inactive 6/18/03.
- Panahi Y, Ghanei M, Vahedi E, et al: Effect of recombinant human IFN in the treatment of chronic pulmonary complications due to sulfur mustard intoxication. J Immunotoxicol 2014; 11(1):72-77.
- Pierard GE, Dowlati A, & Dowlati Y: Chemical warfare casualties and Yperite-induced xerodermoid. Am J Dermatopathol 1990; 12:565-570.
- Playtex: Fits Tough Jobs Like a Glove, Playtex, Westport, CT, 1995.
- Pleyer U, Sherif Z, Baatz H, et al: Delayed mustard gas keratopathy: clinical findings and confocal microscopy. Am J Ophthalmol 1999; 128(4):506-507.
- Pollack MM, Dunbar BS, & Holbrook PR: Aspiration of activated charcoal and gastric contents. Ann Emerg Med 1981; 10:528-529.
- Pour-Jafari H & Moushtaghi AA: Alterations of libido in gassed Iranian men. Vet Human Toxicol 1992; 34:547.
- Pour-Jafari H: Congenital malformations in the progenies of Iranian chemical victims. Vet Human Toxicol 1994; 36:562-563.
- Prakash UBS: Chemical warfare and bronchoscopy. Chest 1991; 100:1486-1487.
- Prescott LF, Illingworth RN, & Critchley JA: Intravenous N-acetylcysteine: the treatment of choice for paracetamol poisoning. Br Med J 1979; 2:1097.
- Product Information: ACETADOTE(R) IV injection, acetylcysteine IV injection. Cumberland Pharmacuticals,Inc, Nashville, TN, 2006.
- Product Information: LEUKINE(R) injection, sargramostim injection. Berlex, Seattle, WA, 2006.
- Product Information: NEUPOGEN(R) injection, filgrastim injection. Amgen,Inc, Thousand Oaks, CA, 2006.
- RRIS : Rapid Response Information System. Accessed 2001 Aug 10. FEMA. Washington, DC. 2001. Available from URL: http://www.rris.fema.gov.
- RTECS : Registry of Toxic Effects of Chemical Substances. National Institute for Occupational Safety and Health. Cincinnati, OH (Internet Version). Edition expires 2002; provided by Truven Health Analytics Inc., Greenwood Village, CO.
- Rau NR, Nagaraj MV, Prakash PS, et al: Fatal pulmonary aspiration of oral activated charcoal. Br Med J 1988; 297:918-919.
- Renshaw B: Mechanisms in production of cutaneous injuries by sulfur and nitrogen mustards, in: US Office of Scientific Research and Development, National Defense Research Committee, "Chemical Warfare Agents and Related Chemical Problems" Chapter 23, 1, US Office of Scientific Research and Development, Washington, DC, 1946, pp 479-518.
- Requena L, Requena C, & Sanchez M: Chemical Warfare. Cutaneous lesions from mustard gas. J Am Acad Dermatol 1988a; 19:529-536.
- Requena L, Requena C, & Sanchez M: Chemical warfare. Cutaneous lesions from mustard gas. J Am Acad Dermatol 1988; 19:529-536.
- Rice P, Brown RFR, & Lam DGK: Dermabrasion - a novel concept in the surgical management of sulphur mustard injuries. Burns 2000; 26:34-40.
- Rice P: Sulphur mustard injuries of the skin. Toxicol Rev 2003; 22(2):111-118.
- River City: Protective Wear Product Literature, River City, Memphis, TN, 1995.
- Roberts JR: Minor burns (Pt II). Emerg Med Ambulatory Care News 1988; 10:4-5.
- Ross WCJ: Biological Alkylating Agents, Butterworths, London, UK, 1962.
- Ruhl CM, Park SJ, & Danisa O: A serious skin sulfur mustard burn from an artillery shell. J Emerg Med 1994; 12:159-166.
- SBCCOM : Distilled Mustard. Material Safety Data Sheet. Accessed 2001 Aug 21. U.S. Army Soldier and Biological Chemical Command. Aberdeen Proving Ground, MD. 2001. Available from URL: http://www.sbccom.apgea.army.mil/RDA/MSDS/lw.html.
- STNeasy: Display for Registry 505-60-2. Chemical Abstract Service. Columbus, OHAvailable from URL: www.stneasy.cas.org/tmp/175274-0416213098-200/162854773.html. As accessed Accessed 2001 Dec 20.
- Safety 4: North Safety Products: Chemical Protection Guide. North Safety. Cranston, RI. 2002. Available from URL: http://www.safety4.com/guide/set_guide.htm. As accessed 8/14/2002.
- Sasser LB, Cushing JA, & Dacre JC: Dominant lethal effect of sulfur mustard in rats. Toxicologist 1990; 10:225.
- Sasser LB, Cushing JA, & Dacre JC: Two-generation reproduction study of sulfur mustard in rats. Reprod Toxicol 1996; 10:311-319.
- Schnurr PP, Friedman MJ, & Green BL: Post-traumatic stress disorder among World War II mustard gas test participants. Military Med 1996; 161:131-136.
- Sedghipour MR, Shenasi A, Rahbani Nobar MB, et al: The ocular complications of mustard gas poisoning and their association with the respiratory system involvement: an experience in 112 Iranian veterans. Cutan Ocul Toxicol 2012; 31(1):48-52.
- Seidel R & Westphal J: Behandlung und verlauf schwerer yperitschaden an der haut (German). Dtsch Gesundheitswes 1973; 28:2472-2476.
- Servus: Norcross Safety Products, Servus Rubber, Servus, Rock Island, IL, 1995.
- Shabestari MM , Jabbari F , Gohari B , et al: Coronary artery angiographic changes in veterans poisoned by mustard gas. Cardiology 2011; 119(4):208-213.
- Shohrati M, Peyman M, Peyman A, et al: Cutaneous and ocular late complications of sulfur mustard in Iranian veterans. Cutan Ocul Toxicol 2007; 26(2):73-81.
- Sidell FR, Patrick WC, & Dashiell TR: Jane's Chem-Bio Handbook, Jane's Information Group, Alexandria, VA, 1998.
- Sinclair DC: The clinical features of mustard-gas poisoning in man. Br Med J 1948; 2:290-294.
- Sittig M: Handbook of Toxic and Hazardous Chemicals and Carcinogens, 2nd ed, Noyes Publications, Park Ridge, NJ, 1985.
- Sittig M: Handbook of Toxic and Hazardous Chemicals and Carcinogens, 3rd ed, Noyes Publications, Park Ridge, NJ, 1991.
- Smith KJ, Hurst CG, & Moeller RB: Sulfur mustard -- its continuing threat as a chemical warfare agent, the cutaneous lesions induced, progress in understanding its mechanism of action, its long-term health effects, and new developments for protection and therapy. J Am Acad Dermatol 1995; 32:765-776.
- Smith KJ: The prevention and treatment of cutaneous injury secondary to chemical warfare agents. Derm Clin 1999; 17:41-60.
- Solberg Y, Alcalay M, & Belkin M: Ocular injury by mustard gas. Surv Ophthalmol 1997; 41:461-466.
- Somani SM & Babu SR: Toxicodynamics of sulfur mustard. Internat J Clin Pharmacol Ther Toxicol 1989; 27:419-435.
- Standard Safety Equipment: Product Literature, Standard Safety Equipment, McHenry, IL, 1995.
- Steward DL, Sass EJ & Fritz LK et al: GRA&I 3: Toxicology studies on lewisite and sulfur mustard agents: Mutagenicity of sulfur mustard in the Salmonella histidine reversion assay. National Technical Information Service, 1990.
- Stolbach A & Hoffman RS: Respiratory Principles. In: Nelson LS, Hoffman RS, Lewin NA, et al, eds. Goldfrank's Toxicologic Emergencies, 9th ed. McGraw Hill Medical, New York, NY, 2011.
- Stull DM, Bilmes R, Kim H, et al: Comparison of sargramostim and filgrastim in the treatment of chemotherapy-induced neutropenia. Am J Health Syst Pharm 2005; 62(1):83-87.
- T Garigan: Medical treatment of chemical warfare casualties. Uniformed Services Academy of Family Physicians. Okinawa, Japan. 1996. Available from URL: http:\\www.usafp.org/op_med/fieldclinical/chemcascare.html. As accessed Accessed June 13, 2000.
- Takeshima Y, Inai K, & Bennett WP: Mutations in lung cancers from Japanese mustard gas workers. Carcinogenesis 1994; 15:2075-2079.
- Tingley: Chemical Degradation for Footwear and Clothing. Tingley. South Plainfield, NJ. 2002. Available from URL: http://www.tingleyrubber.com/tingley/Guide_ChemDeg.pdf. As accessed 10/16/2002.
- Trelleborg-Viking, Inc.: Chemical and Biological Tests (database). Trelleborg-Viking, Inc.. Portsmouth, NH. 2002. Available from URL: http://www.trelleborg.com/protective/. As accessed 10/18/2002.
- Trelleborg-Viking, Inc.: Trellchem Chemical Protective Suits, Interactive manual & Chemical Database. Trelleborg-Viking, Inc.. Portsmouth, NH. 2001.
- Tsai CL, Chang WT, Weng TI, et al: A patient-tailored n-acetylcysteine protocol for acute acetaminophen intoxication. Clin Ther 2005; 27:336-341.
- U.S. Army: Toxic Chemical Agent Safety Standards. Pamphlet 385-61 (DA PAM 385-61), Headquarters, Department of the Army, Washington, DC, 2002.
- U.S. Department of Energy, Office of Emergency Management: Protective Action Criteria (PAC) with AEGLs, ERPGs, & TEELs: Rev. 26 for chemicals of concern. U.S. Department of Energy, Office of Emergency Management. Washington, DC. 2010. Available from URL: http://www.hss.doe.gov/HealthSafety/WSHP/Chem_Safety/teel.html. As accessed 2011-06-27.
- U.S. Department of Health and Human Services, Public Health Service, National Toxicology Project : 11th Report on Carcinogens. U.S. Department of Health and Human Services, Public Health Service, National Toxicology Program. Washington, DC. 2005. Available from URL: http://ntp.niehs.nih.gov/INDEXA5E1.HTM?objectid=32BA9724-F1F6-975E-7FCE50709CB4C932. As accessed 2011-06-27.
- U.S. Environmental Protection Agency: Discarded commercial chemical products, off-specification species, container residues, and spill residues thereof. Environmental Protection Agency's (EPA) Resource Conservation and Recovery Act (RCRA); List of hazardous substances and reportable quantities 2010b; 40CFR(261.33, e-f):77-.
- U.S. Environmental Protection Agency: Integrated Risk Information System (IRIS). U.S. Environmental Protection Agency. Washington, DC. 2011. Available from URL: http://cfpub.epa.gov/ncea/iris/index.cfm?fuseaction=iris.showSubstanceList&list_type=date. As accessed 2011-06-21.
- U.S. Environmental Protection Agency: List of Radionuclides. U.S. Environmental Protection Agency. Washington, DC. 2010a. Available from URL: http://www.gpo.gov/fdsys/pkg/CFR-2010-title40-vol27/pdf/CFR-2010-title40-vol27-sec302-4.pdf. As accessed 2011-06-17.
- U.S. Environmental Protection Agency: List of hazardous substances and reportable quantities. U.S. Environmental Protection Agency. Washington, DC. 2010. Available from URL: http://www.gpo.gov/fdsys/pkg/CFR-2010-title40-vol27/pdf/CFR-2010-title40-vol27-sec302-4.pdf. As accessed 2011-06-17.
- U.S. Environmental Protection Agency: The list of extremely hazardous substances and their threshold planning quantities (CAS Number Order). U.S. Environmental Protection Agency. Washington, DC. 2010c. Available from URL: http://www.gpo.gov/fdsys/pkg/CFR-2010-title40-vol27/pdf/CFR-2010-title40-vol27-part355.pdf. As accessed 2011-06-17.
- U.S. Occupational Safety and Health Administration: Part 1910 - Occupational safety and health standards (continued) Occupational Safety, and Health Administration's (OSHA) list of highly hazardous chemicals, toxics and reactives. Subpart Z - toxic and hazardous substances. CFR 2010 2010; Vol6(SEC1910):7-.
- U.S. Occupational Safety, and Health Administration (OSHA): Process safety management of highly hazardous chemicals. 29 CFR 2010 2010; 29(1910.119):348-.
- US Army: Military Chemistry and Chemical Compounds Field Manual. Department of the Army (Field Manual 3-9), 1975.
- USACHPPM : Detailed Facts about Sulfur Mustard Agents H and HD. U.S. Army Center for Health and Promotion and Preventive Medicine. Aberdeen Proving Ground, MD. 2001a. Available from URL: http://chppm-www.apgea.army.mil/. As accessed Accessed 2001 Dec 26.
- USACHPPM : General Facts about Sulfur Mustard Agents H and HD. Accessed 2001 Dec 26. U.S. Army Center for Health and Promotion and Preventive Medicine. Aberdeen Proving Ground, MD. 2001. Available from URL: http://chppm-www.apgea.army.mil/.
- United States Environmental Protection Agency Office of Pollution Prevention and Toxics: Acute Exposure Guideline Levels (AEGLs) for Vinyl Acetate (Proposed). United States Environmental Protection Agency. Washington, DC. 2006. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020d6af&disposition=attachment&contentType=pdf. As accessed 2010-08-16.
- Urben PG: Bretherick's Reactive Chemical Hazards Database, Version 3.0, Butterworth-Heinemann Ltd, Oxford, UK, 2000.
- Vahedi E, Fazeli Varzaneh AR, Ghanei M, et al: The effect of nightly nasal CPAP treatment on nocturnal hypoxemia and sleep disorders in mustard gas-injured patients. Sleep Breath 2014; 18(4):741-748.
- Varma SD, Henein M, Ali AH, et al: Morphological correlates of the protection afforded by varma mixture in rat cornea exposed to half mustard (CEES): A proposed new treatment for sulfur mustard toxicity. Cutan Ocul Toxicol 2000; 19(2):153-163.
- Vena GA, Foti C, & Grandolfo M: Contact irritation associated with airborne contact irritation from mustard gas. Contact Dermatitis 1994; 31:130-131.
- Vijayaraghavan R, Kulkarni A, Pant SC, et al: Differential toxicity of sulfur mustard administered through percutaneous, subcutaneous, and oral routes. Toxicol Appl Pharmacol 2004; 202:180-8.
- Vijayaraghavan R, Kumar P, Joshi U, et al: Prophylactic efficacy of amifostine and its analogues against sulphur mustard toxicity. Toxicology 2001; 163(2-3):83-91.
- Vogt RF Jr, Dannenberg AM Jr, & Schofield BH: Pathogenesis of skin lesions caused by sulfur mustard. Fundam Appl Toxicol 1984; 4:S71-S83.
- Vojvodic V, Milosavljevic Z, & Boskovic B: The protective effect of different drugs in rats poisoned by sulfur and nitrogen mustards. Fundam Appl Toxicol 1985; 5:S160-S168.
- Vycudilik W: Detection of mustard gas bis(2-chloroethyl)-sulfide in urine. Forens Sci Internat 1985; 28:131-136.
- Wada S, Miyanishi M, & Nishimoto Y: Mustard gas as a cause of respiratory neoplasia in man. Lancet 1968; 1:1161-1163.
- Weger N: Massnahmen gegen lost-vergiftung (German). Selecta 1975; 27:2462-2464.
- Weibrecht K, Rhyee S, Manuell ME, et al: Sulfur mustard exposure presenting to a community emergency department. Ann Emerg Med 2012; 59(1):70-74.
- Wells Lamont Industrial: Chemical Resistant Glove Application Chart. Wells Lamont Industrial. Morton Grove, IL. 2002. Available from URL: http://www.wellslamontindustry.com. As accessed 10/31/2002.
- Willson DF, Truwit JD, Conaway MR, et al: The adult calfactant in acute respiratory distress syndrome (CARDS) trial. Chest 2015; 148(2):356-364.
- Wils ERJ, Hulst AG, & van Laar J: Analysis of thiodiglycol in urine of victims of an alleged attack with mustard gas, Part II. J Anal Toxicol 1988; 12:15-19.
- Wilson DF, Thomas NJ, Markovitz BP, et al: Effect of exogenous surfactant (calfactant) in pediatric acute lung injury. A randomized controlled trial. JAMA 2005; 293:470-476.
- Windholz M, Budavari S, & Blumetti RF: The Merck Index, 10th ed, Merck & Co, Inc, Rahway, NJ, 1983, pp 904.
- Woo OF, Anderson IB, & Kim SY: Shorter duration of n-acetylcysteine (NAC) for acute acetaminophen poisoning (abstract). J Toxicol Clin Toxicol 1995; 33:508.
- Woo OF, Mueller PD, Olson KR, et al: Shorter duration of oral N-acetylcysteine therapy for acute acetaminophen overdose. Ann Emerg Med 2000; 35(4):363-368.
- Workrite: Chemical Splash Protection Garments, Technical Data and Application Guide, W.L. Gore Material Chemical Resistance Guide, Workrite, Oxnard, CA, 1997.
- Yamakido M, Ishioka S, & Hiyama K: Former poison gas workers and cancer: Incidence and inhibition of tumor formation by treatment with biological response modifier N-CWS. Environ Health Perspect 1996; 104(Suppl 3):485-488.
- Yanagida J, Hozawa S, & Ishioka S: Somatic mutation in peripheral lymphocytes of former workers at the Okunojima poison gas factory. Jpn J Cancer Res 1988; 79:1276-1283.
- Zojaji R , Balali-Mood M , Mirzadeh M , et al: Delayed head and neck complications of sulphur mustard poisoning in Iranian veterans. J Laryngol Otol 2009; 123(10):1150-1154.
- van Helden HPM, Kuijpers WC, & Diemel RV: Asthmalike symptoms following intratracheal exposure of guinea pigs to sulfur mustard aerosol: therapeutic efficacy of exogenous lung surfactant curosurf and salbutamol. Inhal Toxicol 2004; 16:537-548.
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