[Via Communist Internet... http://www.egroups.com/group/Communist-Internet ]

   [ It would seem now a days that we are all vulnerable
    to being tear-gassed (see: Seatle, Quebec etc etc etc)
    I think it might be best if we all had an insight into
    this harmful chemical...                         Bill]
.
.
----- Original Message ----- 
From: mike sysiuk <[EMAIL PROTECTED]>
To: <[EMAIL PROTECTED]>; <[EMAIL PROTECTED]>
Sent: Thursday, June 28, 2001 3:26 PM
Subject: [mobilize-globally] The health impact of crowd-control agents, CMAJ


FYI,

Mike

     Skin that is exposed to CR gas may become extremely
     painful upon contact with water for up to 48 hours.

Public Health: The health impact of crowd-control agents

Canadian Medical Association Journal, date unknown
http://www.cma.ca/cmaj/vol-164/issue-13/1889.asp

Some observers say that the civil disobedience demonstrated in Quebec City 
this April and in Seattle 2 years ago represents merely the first wave of a 
grassroots movement that is emerging to support the casualties of capitalism 
and globalization. If such demonstrations erupt locally, physicians should 
be prepared to deal with the clinical effects of crowd-control agents such 
as tear gas; more than 5000 of these canisters were used against 
demonstrators in Quebec City during the Summit of the Americas.  (April 
2001)

Epidemiology: Data on injury patterns during social protests are scarce, 
since the fervour of protest can escalate rapidly and unexpectedly, making 
premeditated, systematic data collection difficult. Some insights can be 
gleaned from data collated by the National Poison Information Service in 
England. In 1997 it received 597 enquiries from physicians seeking advice 
about the management of patients who had been exposed to crowd-control 
agents.1

Most enquiries concerned ocular (irritation, lacrimation, corneal 
abrasions), dermal (rash, erythematous dermatitis, blisters, bullae, czema, 
edema), respiratory (coughing, dyspnea), neurologic (headache, drowsiness), 
cardiac (tachypnea, hypotension, chest pain) and gastrointestinal (buccal 
irritation, vomiting) symptoms.

Fifty-four people with dermal symptoms who presented within 6 hours after 
exposure had erythema and irritation, whereas 203 people with these symptoms 
who sought treatment 6 hours or more after exposure had blisters, bullae, 
eczema and edema. This difference suggests that there may be delayed adverse 
dermal effects to tear-gas exposure.

The agents most commonly used in tear gas are o-chlorobenzylidene 
malononitrile (CS), W-chloroacetophenone (CN) and dibenzoxazepine (CR).2   
At normal daily temperatures and pressure these agents form solid white 
crystals; when used for riot control they are dispersed as microparticulate 
clouds by pyrotechnic devices. To deploy them as sprays, the use of 
propellants and nonaqueous solvents, such as the industrial degreaser methyl 
isobutyl ketone, is required. Exposure to such solvents can by itself cause 
dermal scaling, peeling and blistering as well as irritation of the eyes and 
respiratory tract.3

Clinical management: CS, CN and CR gases irritate the skin, eyes and upper 
respiratory tact. They have been described as chemical barbs4 that cling to 
moist mucous membranes. They cause lacrimation, excruciating pain, 
blepharospasm and conjunctival erythema upon eye exposure. Rhinorrhea and 
nasal discomfort are common, as is a stinging sensation in the mouth, 
accompanied by nausea and vomiting. These symptoms may by accompanied by a 
sore throat, sneezing, coughing, chest tightness and increased salivation.2

Symptom onset occurs within 20 to 30 seconds after exposure and usually 
stops in 10 to 30 minutes if the exposed individual stays outside, ideally 
facing the wind, and removes all contaminated clothing.4   The ocular 
irritation typically lasts only 15 minutes but may persist up to 3 days. If 
the charge of tear gas is fired at close range, powder infiltration of the 
conjuctiva, corneas and sclera may occur. Reported complications include 
symblepharon, infective keratitis, hyphema and vitreous hemorrhage.5   
Delayed dermal effects have also been reported. CS gas can cause 
erythematous dermatitis and contact dermatitis with blisters, vesicles and 
crusts. This is often accompanied by marked edema; onset takes place between 
12 hours and 3 days after exposure. Skin that is exposed to CR gas may 
become extremely painful upon contact with water for up to 48 hours. CN gas 
may sensitize the skin and can produce allergic contact dermatitis within 72 
hours after exposure.2

If a person has been exposed to tear gas, contaminated clothing should be 
removed and sealed in a plastic bag to prevent secondary contamination; 
medical staff should wear gloves and goggles when providing treatment.  
Washing with soap and water is not recommended unless symptoms persist, 
because the chemical agents can dissolve in water and exacerbate symptoms or 
contaminate other surfaces. Hot water may cause any residual particles to 
vaporize and give rise to secondary contamination.6

Recommendations for treating eyes contaminated with CS vary. Some suggest 
blowing dry air with a fan over the eyes to vaporize the CS particles; the 
area downwind of the fan should be vacant to avoid secondary contamination. 
Others recommend irrigation with normal saline. Persistent ocular irritation 
is usually the result of a particle of CS embedded in the surface, so a 
thorough slit-lamp examination should be conducted.

Prevention: Current evidence suggests that tear-gas exposure is not 
dangerous to most people.4   Exposure may trigger laryngospasm or 
bronchospasm in people with pre-existing respiratory disease, such as asthma 
or bronchitis, and they are best advised to avoid voluntary exposure. 
Allergic contact dermatitis from repeated exposure to chemical-based control 
agents has been identified in both law-enforcement officers and 
demonstrators at protests.7 Susceptible individuals should avoid repeated 
exposure.

Erica Weir, CMAJ

References

1. Wheeler H, MacLehose R, Euripidou E, Murray V. Surveillance into crowd 
control agents [letter]. Lancet 1998;352:991-2.   [MEDLINE]

2. Karalliedde L, Wheeler H, MacLehose R, Murray V. Possible immediate and 
long-term health effects following exposure to chemical warfare agents 
[review]. Public Health 2000;114:238-48. [MEDLINE]

3. Gray PJ. Is CS spray dangerous? Formulation affects toxicity [letter]. 
BMJ 2000;321:46. [MEDLINE]

4. Fraunfelder FT. Is CS gas dangerous? Current evidence suggests not but 
unanswered questions remain [editorial]. BMJ 2000;320:458-9. [MEDLINE]

5. Gray PJ, Murray V. Treating CS gas injuries to the eye. Exposure at close 
range is particularly dangerous [letter]. BMJ 1995;311:871. [MEDLINE]

6. Blaho K, Stark MM. Is CS spray dangerous? CS is a particulate spray, not 
a gas [letter]. BMJ 2000;321:46. [MEDLINE]

7. Sommer S, Wilkinson SM. Exposure-pattern dermatitis due to CS gas. 
Contact Dermatitis 1999;40:46-7. [MEDLINE]

Copyright 2001 Canadian Medical Association or its licensors=20

http://www.cma.ca/cmaj/vol-164/issue-13/1889.asp
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