Medical Aspects of Chemical Warfare (2008) - The Black Vault

Medical DiagnosticsTable 22-12Published Reports (1997–2006) of Laboratory Analysis of Human Blood Samples FollowingSuspected Exposure to Sulfur MustardPatient Sample Hemoglobin Hemoglobin Albumin Blood ProteinInformation* DNA Adduct † Adduct ‡ Adduct § Adduct ¥ Adducts Iranian casualties, 2 Patient 1: patient 1: 900 nm nm nm nmindividuals, collected lymphocytes = 220 nM,22 days (Patient 1) & granulocytes = 160 nM26 days (Patient 2) after Patient 2: patient 2: 900 nMincident (1988) 1lymphocytes = 430 nM,granulocytes = 150 nMIranian casualties, 4 NM Range: Range: nm nmindividuals, treated at 0.3–0.8 ng/mL 0.7–2.5 ng/mLGhent hospital; collected5 & 10 days afterincident (1986) 2Accidental exposure to NM 0.3 ng/mL 2.5 ng/ml nm nmWWI munition; 1individual, collected 2days after incident(1992) 2Iranian casualties, 9 NM Range: 0.3–2 µM NM Range: NMindividuals, treated at 0.4–1.8 µMUtrecht hospital;collected 8–9 days afterincident (1986) 3,4Accidental exposure to nm nm nm patient D1: 350 Patient D1: 97WWI munition; 2 and 90 nM for and 23 nM forindividuals, collected days 2 & 42 days 2 & 422–42 days after incident after exposure after exposure,(2004) 5,6 respectively; respectivelypatient D2:16–18 nM fordays 2, 4, 7after exposure*This information includes known incident information and sample collection time after suspected exposure.† N7-(2-HETE)-2’-deoxyguanosine‡ (HETE)-N-terminal valine§ (HETE)-histidine¥ S-[2-(HETE)]-Cys-Pro-Phe (HETE)-aspartic & glutamic acidsDNA: deoxyribonucleic acidHETE: hydroxyethylthioethylNM: not measuredData sources: (1) Benschop HP, van der Schans GP, Noort D, Fidder A, Mars-Groenendijk RH, de Jong LP. Verification of exposure to sulfurmustard in two casualties of the Iran-Iraq conflict. J Anal Toxicol. 1997;21:249–251. (2) Black RM, Clarke RJ, Harrison JM, Read RW. Biologicalfate of sulphur mustard: identification of valine and histidine adducts in haemoglobin from casualties of sulphur mustard poisoning.Xenobiotica. 1997;27:499–512. (3) Noort D, Hulst AG, de Jong LP, Benschop HP. Alkylation of human serum albumin by sulfur mustard invitro and in vivo: mass spectrometric analysis of a cysteine adduct as a sensitive biomarker of exposure. Chem Res Toxicol. 1999;12:715–721.(4) Benschop HP, Noort D, van der Schans GP, de Jong LP. Diagnosis and dosimetry of exposure to sulfur mustard: development of standardoperating procedures; further exploratory research on protein adducts. Rijswijk, The Netherlands: TNO Prins Maurits Laboratory. Finalreport DAMD17-97-2-7002, ADA381035, 2000. (5) Barr JR, Young CL, Woolfit AR, et al. Comprehensive quantitative tandem MS analysis ofurinary metabolites and albumin adducts following an accidental human exposure to sulfur mustard. In: Proceedings of the 53rd Conferenceof the American Society of Mass Spectrometry. San Antonio, Tex: June 5–9, 2005. (6) Korte WD, Walker EM, Smith JR, et al. The determinationof sulfur mustard exposure by analysis of blood protein adducts. Wehrmed Mschr. 2005;49:327.727