Cancer Events After Acute or Chronic Exposure to Sulfur Mustard: A Review of the Literature

Abstract

Background: Sulfur mustard (SM) has been considered as a carcinogen in the laboratory studies. However, its carcinogenic effects on human beings were not well discussed. The main
purpose of our study is to assess carcinogenesis of SM following acute and/or chronic exposures in human beings.

Methods: The valid scientific English and Persian databases including PubMed, Web of Science, Scopus, IranMedex, and Irandoc were searched and the collected papers reviewed. The used keywords were in two languages: English and Persian. The inclusion criteria were the published original articles indexed in above‑mentioned databases. Eleven full‑texts out of 296 articles were found relevant and then assessed.

Results: Studies on the workers of the SM factories during the World Wars showed that the long‑term chronic exposure to mustards can cause a variety of cancers in the organs such as
oral cavity, larynx, lung, and skin. Respiratory system was the most important affected system. Acute single exposure to SM was assumed as the carcinogenic inducer in the lung and blood
and for few cancers including basal cell carcinoma and squamous cell carcinoma.

Conclusions: SM is a proven carcinogen in chronic situations although data are not enough to strongly conclude in acute exposure.

Keywords: Cancer, chemical warfare, Iraq‑Iran war, mustard gas, sulfur mustard