Background. Sulfur mustard (SM) is a noxious gaseous substance that has been employed as a chemical warfare agent during armed conflicts. Individuals who have been exposed to SM continue to have adverse effects over an extended period of time. This study assessed the biological health of veterans with moderate-severe SM-chemical injuries categorized as having short or long telomere lengths (TL).

Methods. The calculation of the biological health score (BHS) involved the assessment of 18 biomarkers that are associated with the functioning of four physiological systems, namely the endocrine, inflammatory, cardiovascular, and metabolic systems, as well as two specific organs, namely the liver, and kidney. 43 people exposed to SM gas in 1987 at a moderate-severe level served as volunteers.

Results. The individuals with short TL subjected to moderate-to-severe SM had much-reduced testosterone levels and higher levels of LDL, cholesterol, and CRP compared to those with long TL. The results of principal component analysis revealed that testosterone had the highest degree of influence on intergroup variance among individuals who were subjected to moderate-severe levels of SM. Regarding moderate-severe SM-chemical veterans, our results demonstrated an inverse relationship between BHS and relative TL. Comparing the groups with short and long telomeres, the BHS was noticeably greater in the former.

Conclusion. The findings suggest that elevated BHS levels and reduced relative TL in veterans with moderate-severe SM exposure are indicative of diminished health quality. These indices may be valuable in assessing the health status of individuals exposed to SM, and using BHS and TL measurements might enhance the accuracy of such evaluations.