A recent exposure to mustard gas in the United States: clinical findings of a cohort (n = 247) 6 years after exposure.

OBJECTIVE: To describe the acute and long-term effects of mustard gas (MG) and propose a screening protocol to prevent complications.

METHODS: Follow-up of (n = 247) workers exposed to MG with a standard protocol.

RESULTS: Healing of burns varied according to natural pigmentation of skin, not reported elsewhere. Multiple and chronic skin infections developed on burns. Liver functions and cardiac conduction were temporarily altered in burn cases without other complications. No fatalities were noted. Months after exposure, bronchitis and posttraumatic stress disorder became prevalent regardless of initial presentation. Other symptoms did not lead to any organ pathology except one case of Barrett's esophagus and another of oral metaplasia. Two infants conceived after exposure appeared healthy. Although the screening protocol administered became an effective screening tool, follow-up of cases was severely flawed by a lack of cooperation between providers and noncompliance by patients after settlement of lawsuits.

CONCLUSION: Research of findings attributable to MG needs close follow-up of this group of patients due to latent carcinogenic, hematologic, pulmonary, and infertility effects. Therefore, annual follow-up screens, instruction on the effects of MG, and prevention, including immunization and autopsy in all cases of death, are strongly suggested.