Used in the manufacture of dyes, drugs, perfumes, and pesticides, most poisonings from dimethyl sulphate come from the leakage of liquid and/or vapors. The poisoning and effects can be worsened if alcohol is present.

Immediate effects of vapor exposure include tearing; runny nose; swelling of mouth, lips, and throat tissues; sore throat; hoarseness; dyspnea; cyanosis; and death. Eye irritation causes conjunctivitis (pink eye), perforation of the nasal septum through the sinuses, much like one might see in a patient who is addicted to cocaine, and permanent vision problems. Liver and kidney damage may also occur.