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Nine cases of accidental exposure to dimethyl sulphate—a potential chemical weapon
  1. J C R Rippey1,
  2. M I Stallwood2
  1. 1Emergency Physician, Royal Liverpool University Hospital, Prescot Street, Liverpool, L7 8XP, United Kingdom
  2. 2Clinical Fellow in Intensive Care Medicine, Intensive Therapy Unit, Royal Liverpool University Hospital, United Kingdom
  1. Correspondence to:
 James Charles Rowland Rippey
 Emergency Physician, Royal Liverpool University Hospital, Prescot Street, Liverpool, L7 8XP, United Kingdom; or


Dimethyl sulphate (DMS) is an innocuous appearing, widely used, and highly toxic chemical. It is used both as a methylating agent in industrial chemical synthesis and in medical laboratories for chemical cleavage of DNA. It is readily absorbed through the skin, mucous membranes, and gastrointestinal tract. Delayed toxicity allows potentially fatal exposures to occur prior to development of any warning symptoms. Toxicity is manifested initially by mucosal inflammation of eyes, nose, oropharynx, and airways. This can progress to severe airway oedema and necrosis, and non-cardiogenic pulmonary oedema. Other systemic effects include convulsions, delirium, coma, and renal, hepatic, and cardiac failure. All these features make DMS a potential chemical weapon.

We report nine cases of varying degrees of inhalational exposure to DMS, occurring as a result of a single chemical spillage incident in the United Kingdom. Industrial poisoning is surprisingly rare and there are few previous reports in the literature outside China.

  • DMS, dimethyl sulphate

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  • Competing interests: none declared