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Veterans at Risk: The Health Effects of Mustard Gas and Lewisite (1993)
Institute of Medicine (IOM)

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. "5 Chemistry of Sulfur Mustard and Lewisite." Veterans at Risk: The Health Effects of Mustard Gas and Lewisite. Washington, DC: The National Academies Press, 1993.

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Veterans at Risk: The Health Effects of Mustard Gas and Lewisite

With ammonia and primary amines, a thiomorpholine is formed (5-14):

Two molecules of amine may react with one of sulfur mustard (5-15):

Tertiary amines form quaternary ammonium salts (5-16):

When heated with a concentrated aqueous solution of thiourea, sulfur mustard gives the isothiouronium salt, which is decomposed by aqueous NaOH. Acidification produces the mercaptan in high yield

Reactions of Biologic Importance

As is obvious from the chemistry described above, sulfur mustard can react with a number of important functional groups of the large variety of compounds present in cells and tissues. The reactive groups that are of greatest interest are the sulfhydryl group; the phosphate and pyrophosphate ions; organic phosphates such as nucleotides and phospholipids; aromatic nitrogen atoms such as in nicotinamide, adenine, cytosine, and histidine; the carboxyl groups of amino acids and of intermediates of glucose metabolism; the sulfides such as methionine and thiodiglycol; and the amino groups of amino acids, peptides, purines, and pyrimidines. It should be noted, however, that at physiologic pH, most amines are present predominantly in the protonated form rather than as the free base, diminishing the probability of extensive reaction with sulfur mustard.

Evidence that the cytotoxicity of sulfur mustard is due to the alkylation of DNA was first obtained in the late 1940s from studies with bacteria, DNA-containing bacterial viruses, and transforming DNA. The later discovery that the sensitivity of bacterial and mammalian cells is critically dependent on the cell's capacity for repairing sulfur mustard-induced DNA damage strongly supports the DNA target hypothesis.

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75
Front Matter (R1-R20)
Executive Summary (1-8)
1 Introduction (9-13)
2 Methods of Literature Collection and Survey (14-20)
3 History and Analysis of Mustard Agent and Lewisite Research Programs in the United States (21-60)
4 Findings from the Public Hearing Process (61-70)
5 Chemistry of Sulfur Mustard and Lewisite (71-80)
6 Relationship of Mustard Agent and Lewisite Exposure to Carcinogenesis (81-111)
7 Nonmalignant Respiratory Effects of Mustard Agents and Lewisite (112-130)
8 Ocular Effects of Mustard Agents and Lewisite (131-147)
9 Dermatological Effects of Mustard Agents and Lewisite (148-178)
10 Other Physiological Effects of Mustard Agents and Lewisite (179-198)
11 Relationship of Mustard Agent and Lewisite Exposure to Psychological Dysfunction (199-213)
12 Summary of Findings and Recommendations (214-226)
Bibliography (227-330)
A. Scientific and Background Presentations Made to the Committee (331-334)
B. Excerpt from The Residual Effects of Warfare Gases (335-337)
C. Involvement of the National Academy of Sciences Complex in World War II Research Programs: A Summary (338-339)
D. Excerpts from Chamber Tests with Human Subjects I, II, and IX. Naval Research Laboratory Reports Nos. P-2208 and P-2579 (340-369)
E. Interim Report and Addendum: Feasibility of Developing a Cohort of Veterans Exposed to Mustard Gas During WWII Testing Programs (370-377)
F. Summary of the Department of the Army Report: Use of Volunteers in Chemical Agent Research (378-381)
G. Public Hearing Announcement (382-385)
H. Letter from Dr. Jay Katz to Dr. David P. Rall (386-389)
I. Risk Assessment Considerations for Sulfur Mustard (390-398)
J. Examination of the Effects of Certain Acute Environmental Exposures on Future Respiratory Health Consequences (399-416)
List of Acronyms and Abbreviations (417-420)
Index (421-428)