• What is Sulfur Mustard?
• What are the signs and symptoms of exposure to Sulfur Mustard?
• What toxicological information is available for Sulfur Mustard?
• What are the potential health effects from exposure to sulfur mustard?
• What are the airborne exposure limits for sulfur mustard?
• How long will Sulfur Mustard persist in the environment?
• What guidance is available for determining appropriate decontamination levels for sulfur mustard?
• What exposure values are available for sulfur mustard in other media such as soil, water, and waste?
• What resources are available for First Responders?
• What resources are available for Healthcare Workers?

What is Sulfur Mustard?

• Facts About Sulfur Mustard. Centers for Disease Control and Prevention (CDC). Overview of sulfur mustard, including signs, symptoms, and treatment.
  


• ToxFAQs™ for Sulfur Mustard. Agency for Toxic Substances and Disease Registry (ATSDR), (2003, September). Provides a fact sheet for the general public that answers the most frequently asked health questions about sulfur mustard.

Signs and Symptoms

• Toxic Syndrome Description: Vesicant/Blister Agent Poisoning. Centers for Disease Control and Prevention (CDC). Provides quick summary of signs and symptoms of exposure.

Toxicological Information

• Toxicological Profile for Sulfur Mustard. Agency for Toxic Substances and Disease Registry (ATSDR), (2003, September). Also available as a 3 MB PDF, 287 pages. Provides useful information on health effects, chemical and physical properties, potential for human exposure, analytical methods, and regulations.

Health Effects

• Toxicological Profile for Sulfur Mustard - Chapter 3 - Health Effects [878 KB PDF, 98 pages]. Agency for Toxic Substances and Disease Registry (ATSDR), (2003, September). Chapter 3 provides a detailed discussion of the local and systemic health effects associated with various routes of exposure.

Airborne Exposure Limits

• Summary of Chemical Agent Air Exposure Values Table 1 [87 KB PDF^*, 2 pages]. OSHA, (2004, August 3). Summarizes exiting airborne exposure limits including the CDC Airborne Exposure Limits and the Acute Exposure Guideline Levels.
  


• CDC Interim Recommendations for Airborne Exposure Limits for Chemical Warfare Agents H and HD (Sulfur Mustard) [91 KB PDF, 5 pages]. US Department of Health and Human Services (DHHS), Centers for Disease Control and Prevention (CDC) Federal Register, Vol. 69, No. 85, pp. 24164-2468, (2004, May 3). Interim recommendations for worker and general population airborne exposure limits for sulfur mustard associated with agent stockpile demilitarization practices. These limits replace previously recommended AELs originally issued in 1988 and are effective July 1, 2005. The limits are interim pending improved characterization of carcinogenic potential associated with sulfur mustard.
  


• Final Recommendations for Protecting Human Health and Safety Against Potential Adverse Effects of Long-term Exposure to Low Doses of Agents GA, GB, VX, Mustard Agent (H, HD, Y), and Lewisite (L). US Department of Health and Human Services (DHHS), Centers for Disease Control and Prevention (CDC), National Center for Environmental Health, (1988, March 15).
  


• Health Effects Associated With Sulfur Mustard Acute Exposure Guideline Levels (AEGLs) [150 KB PDF, 2 pages]. US Army Center for Health Promotion and Preventative Medicine (CHPPM), (2003, January). Summarizes the types of health effects anticipated at each of the three AEGL concentrations.
  


• Airborne Exposure Limits for Sulfur Mustard (HD): Occupational and General Population Exposure Criteria. (2000, November). Evaluates the US Army occupational and general population airborne exposure limits that were in effect in 2000 and makes recommendations for new limits using current risk assessment methodologies. This document is reference material for CDC’s interim AELs which were published in May 2004.
  


• Basic Questions Regarding Acute Exposure Guideline Levels (AEGLs) in Emergency Planning and Response [240 KB PDF, 1 page]. US Army Center for Health Promotion and Preventative Medicine (CHPPM), (2003, January).
  


• Frequently Asked Questions (FAQs) Regarding Acute Exposure Guideline Levels (AEGLs) at CSEPP [130 KB PDF, 6 pages]. OSHA, (2003, January). Provides basic information on how AEGLs are set, what the different levels are, and the meaning of some of the terms used with the AEGLs.
  


• Acute Exposure Guideline Levels (AEGL) Chemicals. Environmental Protection Agency (EPA).
  • Sulfur Mustard Results

Environment

• Toxicological Profile for Sulfur Mustard - Chapter 6 - Potential for Human Exposure [401 KB PDF, 18 pages]. Agency for Toxic Substances and Disease Registry (ATSDR), (2003, September). Chapter 6 summarizes the fate of sulfur mustard when released to the environment.

Decontamination Levels

• Health Based Environmental Screening Levels for Chemical Warfare Agents (HBESLs). US Army Center for Health Promotion and Preventative Medicine (CHPPM), (1999, May 28). Summarizes the existing health-based screening levels for soil where ground water contamination is not a consideration. These are pre-established environmental screening levels for compounds that can aid in the assessment process by their use as “action or no action” determinant criteria. They would be considered for response to the question of "How clean is clean?"

Exposure Levels and Other Media

• Summary of Multi-Media Chemical Agent Toxicity and Exposure Values Table 2 [206 KB PDF^*, 2 pages]. OSHA, (2004, August 3). Summarizes existing water, soil, and waste exposure values.

First Responders

• Sulfur Mustard. National Institute for Occupational Safety and Health (NIOSH). Includes information on identification, medical symptoms, prevention & personal protective equipment, firefighting, sampling & analytical methods, decontamination, spillage disposal, packaging & labeling information.
  


• OSHA/NIOSH Interim Guidance – Personal Protective Equipment Selection Matrix for Emergency Responders – Blister Agents. (2006, February).

Healthcare Workers

• OSHA Best Practices for Hospital-Based First Receivers of Victims from Mass Casualty Incidents Involving the Release of Hazardous Substances. OSHA. Provides guidance on planning, PPE, and work practices for hospital personnel decontaminating and treating potentially contaminated patients. See Tables 1-3 as a quick reference.
  


• Medical Management Guide for Blister Agents: Sulfur Mustard Agent H or HD (C₄H₈Cl₂S) and Sulfur Mustard Agent HT. Agency for Toxic Substances and Disease Registry (ATSDR). Provides information on protection of rescuers and medical personnel, victim decontamination (field and emergency department), triage information, clinical effects, and medical management (field, emergency department, and general).

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^*These files are provided for downloading.