Skin penetration and decontamination efficacy following in vitro human skin exposure to sulfur mustard

Sulfur mustard (HD) is a chemical warfare agent. Dermal injuries are most common following exposure and only supportive treatment exists. Consequently, skin decontamination is important to avoid severe injuries. In the present study, selected decontamination protocols were evaluated following in vitro human skin exposure to HD. The degradation kinetics of HD in receptor solution was also evaluated and a sample analysis method was developed. Rapid HD-degradation to thiodiglycol (TDG) was observed in the standard receptor solution (ethanol and water; 1:3). No intact HD was detected after 2 h. Low HD-degradation was detected in 100 % ethanol during 20 h (90 % intact agent). Subsequently, both HD and TDG was measured in all skin penetration samples. HD skin penetration experiments using the standard receptor solution or 100 % ethanol as receptor solution indicated that agent degradation primarily occurred in the receptor solution and not during agent penetration through skin. Reactive Skin Decontamination Lotion (RSDL) followed by wet decontamination displayed the highest decontamination efficacy following skin exposure to neat HD. Dry removal using an absorbent pad followed by wet decontamination and wet decontamination alone resulted in a significant efficacy, of which, wet decontamination alone resulted in the lowest efficacy. RSDL has displayed the highest decontamination efficacy following skin exposure to both HD and the nerve agent VX in experiments using the same skin penetration model. The present study supports previously reported benefits of dry removal prior to wet decontamination and should be recommended to enable rapidly initiated decontamination if specific resources are lacking.