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Clinical and physiological findings in 228 patients evaluated following the accidental release of a natural gas odorant mixture containing tetrahydrothiophene and tert-butyl mercaptan

Year: 2026

Type: article

Abstract: Background: Tetrahydrothiophene (THT) and tert-butyl mercaptan (TBM) are sulfur-containing odorants used to detect natural gas leaks. Data on acute human exposure to these substances are limited. Objective: To describe the clinical and toxicological findings recorded following a reported release of a THT-TBM mixture. Materials and Methods: This retrospective descriptive study reviewed records of 228 symptomatic patients with complete clinical files who were documented as present at the incident site after release of a 70% THT and 30% TBM mixture. The 5th Specialized Board of the Council of Forensic Medicine, Turkey, evaluated the records. Individual THT/TBM exposure measurements and odorant-specific biomarkers were unavailable Results: The mean patient age was 32.94 ± 8.67 years; 85.5% were female. The most frequently reported symptoms were nausea (88.2%), dizziness (74.1%), shortness of breath (71.5%), drowsiness (54.0%), fatigue (51.3%), and headache (48.7%). Mydriasis was recorded in 29.8% of patients, and tachycardia in 32.0%. Arterial pH was below 7.35 in 56.1% of patients, and PaCO₂ was above 45 mmHg in 53.1%; oxygenation was generally preserved. Median lactate was 2.3 mmol/L (interquartile range: 1.2-4.5; >2.0 mmol/L in 60.1%). Median COHb was 3.4% (range: 0.1-11%; smoking status unrecorded). These rates represent symptomatic presenting patients, not all exposed individuals. Conclusion: The reviewed records documented neurovegetative, respiratory, and ocular complaints. Acid-base and lactate abnormalities were nonspecific and cannot be causally linked to the event. No severe cardiopulmonary collapse or deaths were documented. Without long-term follow-up, delayed or persistent sequelae cannot be excluded.

Source: Toxicology Reports

DOI: 10.1016/j.toxrep.2026.102364

Authors: Eda Yigit, Faruk Asıcıoglu, Bayram Kaan Isıldak

Institutions: Istanbul University-Cerrahpaşa, Istanbul University

Language: English

Topic: Poisoning and overdose treatments

Subfield: Emergency Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,530