injuries and poisoning
Blistering Agents in Chemical Warfare
Symptoms of Blistering Chemical Warfare Injuries
Mustard compoundscause intense skin pain and redness. A few hours after exposure (sometimes as long as 36 hours later), blisters form. Blisters caused by sulfur mustard sometimes resemble a string of pearls around a central area that appears to be unaffected but is actually too damaged to blister. Blisters caused by nitrogen mustard are less likely to show this pattern. Blisters may become large and full of fluid. The eyes may be painfully inflamed, and the corneas may become cloudy. People cough and have hoarseness, wheezing, gasping, and windpipe spasms. They may feel tightness in their chest and be short of breath. Nausea may develop. Lewisitecauses pain within a minute or so of skin exposure. Skin redness is often noticeable within 15 to 30 minutes, and blisters develop after several hours. The blisters usually form at the center of the reddened area and spread outward. Pain begins to subside after the blisters form. Irritation of airways occurs soon after inhalation and leads to coughing, sneezing, wheezing, and shortness of breath from fluid leaking from small blood vessels into the alveoli (tiny air sacs in the lungs). After a few hours, people may feel tightness in their chest and be short of breath. Skin contact withphosgene oximecauses intense, stinging ("nettling") pain and whitening within 5 to 20 seconds. The affected skin then turns gray with a red border. Within 30 minutes of exposure, pale, slightly elevated swellings called wheals (similar to those in hives) develop. During the next 7 days, the skin becomes dark brown and then black as the skin and underlying tissues die. If not surgically removed, wheals may persist for more than 6 months. 