Reevaluating tear gas toxicity and safety.

Tear gases, or chemical demonstration control agents (DCA), were originally created as weapons that could severely disable or kill enemy troops. Though banned in war, these chemicals are still used in domestic policing. Here we review the available scientific literature on tear gas, summarizing findings from animal and environmental studies as well describing data from new human studies. We find a lack of scientific evidence supporting the safety of tear gas, especially regarding its long-term impacts on human health and the environment. Many of the available studies were published decades ago, and do not parse data by variables such as chemical type and exposure time, nor do they account for the diversity of individuals who are exposed to tear gas in real-life situations. Due to the dearth of scientific research and the misinterpretation of some of the available studies, we conclude that a serious reevaluation of chemical DCA safety and more comprehensive exposure follow-up studies are necessary.

Chlorobenzylidene malononitrile tear gas exposure: Rinsing with amphoteric, hypertonic, and chelating solution.

OBJECTIVE: Chlorobenzylidene malononitrile (CS) is the tear gas used by the police. The aim was to evaluate an amphoteric, hypertonic, and chelating rinsing solution in CS exposure. METHODS: The first (CS) group of six police officers was exposed to CS only. The second (preexposure) group of eight sprayed their faces with an aqueous, hypertonic, amphoteric, and chelating solution before CS exposure. The third (postexposure) group of eight sprayed their faces with an aqueous, hypertonic, amphoteric, and chelating solution after CS exposure. The time between exiting the CS cloud and arriving at the "ready for action" checkpoint was measured. Their facial pain both inside the CS cloud and at the checkpoint was assessed (0-10 points). RESULTS: The pain level inside the CS cloud was significantly lower in the preexposed group (5.6 ± 1.1; p = 0.01) than in the CS group (9.7 ± 0.5) and in the postexposure group (9.1 ± 0.4) where it was similar. The time interval between CS exposure and arrival at the checkpoint in the preexposure group (1:26 ± 0:44 min) was significantly shorter than both in the CS group (2:28 ± 0:25 min; p = 0.04) and postexposure group (2:30 ± 0:48 min; p = 0.02) where it was not different. The residual pain at the checkpoint in the preexposure (1.1 ± 0.4) and postexposure (1.4 ± 0.7) groups was similar with a significant lower pain level than in the CS group (2.3 ± 0.5; p = 0.02). CONCLUSION: CS decontamination with an aqueous, hypertonic, amphoteric, and chelating solution reduces facial pain, whereas prevention with it reduces pain and recovery time.

Can CS gas induce myocardial infarction?

"2-chlorobenzylidene malononitrile" also named CS gas is the most used riot-control agent in the world. Its reputation as the least toxic tear gas explains its large use by different authorities. Early exposure to CS spray commonly induces visual irritation, skin reactions, with increased mucous secretion in order to temporarily incapacitate targeted people. However, there is a large agreement that safety data of this product is limited and further studies need to be performed since serious problems could occur after heavy exposure such as loss of consciousness, laryngospasm, pulmonary edema and hemorrhage... Herein, we report a case of a young man who had acute myocardial infarction with serious cardiac sequelae after exposure to tear gas. To our knowledge, this is the second case since forty years in the literature that directly links documented acute heart infarction to CS gas exposure.

Can CS gas induce myocardial infarction?

"2-chlorobenzylidene malononitrile" also named CS gas is the most used riot-control agent in the world. Its reputation as the least toxic tear gas explains its large use by different authorities. Early exposure to CS spray commonly induces visual irritation, skin reactions, with increased mucous secretion in order to temporarily incapacitate targeted people. However, there is a large agreement that safety data of this product is limited and further studies need to be performed since serious problems could occur after heavy exposure such as loss of consciousness, laryngospasm, pulmonary edema and hemorrhage... Herein, we report a case of a young man who had acute myocardial infarction with serious cardiac sequelae after exposure to tear gas. To our knowledge, this is the second case since forty years in the literature that directly links documented acute heart infarction to CS gas exposure.

Exposición a gas CS: a propósito de un caso peculiar / Exposure to CS gas: Case study

El gas CS (o-clorobenzolideno malononitrilo) se incluye dentro del grupo de los gases lacrimógenos. La exposición a dicho gas ocurre durante su empleo como gas de defensa o antidisturbios, así como durante el entrenamiento rutinario de las fuerzas de choque especializadas. Su acción tóxica es ejercida a través de un efecto irritante sobre piel y mucosas, así como por mecanismos inmunoalérgicos. Presentamos el caso de un paciente de 24 años, perteneciente a una fuerza de choque, que consultó por lesiones cutáneas luego de una exposición a humo y dispersión de polvo de una granada de gas CS durante ejercicios de entrenamiento. Clínicamente se presentó características peculiares, referidas a sus manifestaciones cutáneas, localización y severidad de las mismas. Se analiza la etiopatogenia de las lesiones y los posibles mecanismos involucrados, diagnósticos diferenciales, así como los pilares del tratamiento frente a una exposición a gas CS...

[On the stability of the irritant dibenz-[b,f]-[1,4]-oxazepine (substance CR)].

The objective of the present study was to determine the duration and conditions of persistence of the irritant dibenz-[b,f]-[1,4]-oxazepine (substance CR) on the environmental objects. The quantitative analysis of the substance on cotton fabric specimens was carried out using the approved method of high performance liquid chromatography (HPLC) with UV detection at different time periods and envirobmental conditions. It was shown that the main factor determining the lifetime of dibenz-[b,f]-[1,4]-oxazepine on the cotton fabric is the ambient conditions. By way of example, the "open" and "closed", storage of such specimens during 300 days resulted in the decrease of the amount of substance CR to 22.5 and 79% of the initial level respectively. By the end experiment (day 600) these values lowered to 3 and 52.5% respectively. Taken together, the results of the study indicate that dibenz-[b,f]-[1,4]-oxazepine can be described as a substance resistant to environmental impacts. It is comparable in terms of stability with such known irritants as capsicum oleoresin and pelargonic acid morpholide.

Evaluation of oleoresin capsicum of Capsicum frutescenes var. Nagahari containing various percentages of capsaicinoids following inhalation as an active ingredient for tear gas munitions.

Comparative efficacy as peripheral sensory irritant, oral and inhalation exposure studies were carried out on oleoresin capsicum (OC) of Capsicum frutescence var. Nagahari containing various percentages of capsaicinoids and two synthetic isomers of capsaicin in Swiss albino male mouse model to come up with a suitable active ingredient from natural source for tear gas munitions. The compounds screened were OC having varying percentages of capsaicinoids (20, 40 and 80%, respectively) and synthetic isomers (E and Z) of capsaicin (8-methyl-N-vanillyl-6-nonenamide). Mice were exposed to pyrotechnically generated smoke of the compounds in an all glass static exposure chamber for 15 min to determine acute inhalation toxicity (LC50) and quantitative sensory irritation potential (RD50). Acute oral median lethal dose (LD50) was also evaluated. Safety index of tear gas (SITG), a ratio of lethal concentration 50% (LC50) and the concentration which depresses respiration by 50% (RD50) due to peripheral sensory irritation is also proposed. The compound having highest SITG is considered as the most suitable to be used for tear gas munitions. The study revealed that oleoresin capsicum containing 40% capsaicinoids had the highest SITG among the compounds studied. The oral dosage versus mortality pattern of some compounds did not follow a true dose-response curve (DRC); however, following inhalation, all the compounds followed DRC. It was concluded that oleoresin capsicum (40% capsaicinoids) may be considered as the most suitable and environmental friendly compound from natural source to be used as an active ingredient for tear gas munitions.

[The biological activity of the irritant dibenz-[b,f] - [1,4]-oxazepine (substance CR) persisting during a long period at the environmental objects].

The objective of the present study was to determine the biological activity of the irritant dibenz-[B,F]-[1,4]-oxazepine (substance CR) contained in the environmental samples in case of their "closed" storage during different periods of time. The experiments were carried out using male and female rabbits of the Chinchilla strain with the initial body mass of 3000-4000 g. The animals were administered an aqueous alcoholic extract from the tissue samples of the rabbit eye coat as described in the "Methodological guidelines on the medico-biological assessment of the safety of personal protection devices". The results of experiments indicate that extracts from tissue samples elicit irritation in the eyes of the laboratory animals even after their storage as long as 600 days. This observation suggests that substance CR retains the ability to cause irritation during a prolonged period.

Transient receptor potential ankyrin 1 antagonists block the noxious effects of toxic industrial isocyanates and tear gases.

The release of methyl isocyanate in Bhopal, India, caused the worst industrial accident in history. Exposures to industrial isocyanates induce lacrimation, pain, airway irritation, and edema. Similar responses are elicited by chemicals used as tear gases. Despite frequent exposures, the biological targets of isocyanates and tear gases in vivo have not been identified, precluding the development of effective countermeasures. We use Ca(2+) imaging and electrophysiology to show that the noxious effects of isocyanates and those of all major tear gas agents are caused by activation of Ca(2+) influx and membrane currents in mustard oil-sensitive sensory neurons. These responses are mediated by transient receptor potential ankyrin 1 (TRPA1), an ion channel serving as a detector for reactive chemicals. In mice, genetic ablation or pharmacological inhibition of TRPA1 dramatically reduces isocyanate- and tear gas-induced nocifensive behavior after both ocular and cutaneous exposures. We conclude that isocyanates and tear gas agents target the same neuronal receptor, TRPA1. Treatment with TRPA1 antagonists may prevent and alleviate chemical irritation of the eyes, skin, and airways and reduce the adverse health effects of exposures to a wide range of toxic noxious chemicals.

Tear gasses CN, CR, and CS are potent activators of the human TRPA1 receptor.

The TRPA1 channel is activated by a number of pungent chemicals, such as allylisothiocyanate, present in mustard oil and thiosulfinates present in garlic. Most of the known activating compounds contain reactive, electrophilic chemical groups, reacting with cysteine residues in the active site of the TRPA1 channel. This covalent modification results in activation of the channel and has been shown to be reversible for several ligands. Commonly used tear gasses CN, CR and CS are also pungent chemicals, and in this study we show that they are extremely potent and selective activators of the human TRPA1 receptor. To our knowledge, these are the most potent TRPA1 agonists known to date. The identification of the molecular target for these tear gasses may open up possibilities to alleviate the effects of tear gasses via treatment with TRPA1 antagonists. In addition these results may contribute to the basic knowledge of the TRPA1 channel that is gaining importance as a pharmacological target.

Increasingly irritable and close to tears: TRPA1 in inflammatory pain.

TRP cation channels transduce mechanical, thermal, and pain-related inflammatory signals. In this issue of Cell, it is reported that TRPA1 has a central role in the pain response to endogenous inflammatory mediators and to a diverse array of volatile irritants, including those found in tear gas and garlic. In contrast, mechano- and thermosensation are normal in TRPA1-deficient mice.

Tear gases and irritant incapacitants. 1-chloroacetophenone, 2-chlorobenzylidene malononitrile and dibenz[b,f]-1,4-oxazepine.

Irritant incapacitants, also called riot control agents, lacrimators and tear gases, are aerosol-dispersed chemicals that produce eye, nose, mouth, skin and respiratory tract irritation. Tear gas is the common name for substances that, in low concentrations, cause pain in the eyes, flow of tears and difficulty in keeping the eyes open. Only three agents are likely to be deployed: (i) 1-chloroacetophenone (CN); (ii) 2-chlorobenzylidene malononitrile (CS); or (iii) dibenz[b,f]-1,4-oxazepine (CR). CN is the most toxic lacrimator and at high concentrations has caused corneal epithelial damage and chemosis. It has accounted for at least five deaths, which have resulted from pulmonary injury and/or asphyxia. CS is a 10-times more potent lacrimator than CN but is less systemically toxic. CR is the most potent lacrimator with the least systemic toxicity and is highly stable. CN, CS and CR cause almost instant pain in the eyes, excessive flow of tears and closure of the eyelids, and incapacitation of exposed individuals. Apart from the effects on the eyes, these agents also cause irritation in the nose and mouth, throat and airways and sometimes to the skin, particularly in moist and warm areas. In situations of massive exposure, tear gas, which is swallowed, may cause vomiting. Serious systemic toxicity is rare and occurs most frequently with CN; it is most likely to occur when these agents are used in very high concentrations within confined non-ventilated spaces. Based on the available toxicological and medical evidence, CS and CR have a large safety margin for life-threatening or irreversible toxic effects. There is no evidence that a healthy individual will experience long-term health effects from open-air exposures to CS or CR, although contamination with CR is less easy to remove.