The percutaneous absorption of soman in a damaged skin porcine model and the evaluation of WoundStat™ as a topical decontaminant

Exposure to organophosphorus compounds: best practice in managing timely, effective emergency responses

Increasing indications, reports and studies demonstrate that threats from the deliberate use of chemical weapons remain high and are evolving. One of the deadliest classes of chemical weapons are the organophosphorus nerve agents. It is now clear that both state and non-state actors have the ability to deploy and use these types of weapons against individuals and the wider civilian population posing a real and significant threat. The objective of this article is to provide an overview of the issues impacting on a timely critical response to the accidental or deliberate release of Organophosphorus Nerve Agents in order to enhance the understanding of their effects and provide guidance on how first responders might better treat themselves or victims of exposure through a discussion of available evidence and best practices for rapid skin decontamination. The article also examines use of the current nomenclature of 'wet' and 'dry' to describe different forms of decontamination. One of the key conclusions of this article is that adequate preparedness is essential to ensuring that responders are trained to understand the threat posed by Organophosphorus Nerve Agents as well as how to approach a contaminated environment. A key aspect to achieving this will be to ensure that generic medical countermeasures are forward-deployed and available, preferably within minutes of a contamination and that first responders know how to use them.

Skin decontamination of Carfentanil in vitro

Skin decontamination of Chemical Biological Radioactive and Nuclear (CBRN) materials involves the timely and effective removal of the contaminants from the skin surface. The current work evaluated Fuller's Earth & The Reactive Skin Decontaminant Lotion Kit (RSDL®) to investigate whether they were as efficacious against free base Carfentanil skin contamination as they are against chemical warfare agents. The in vitro methodology used allowed for evaluation of decontamination regimens as specified by the decontaminant manufacturer rather than as an application of a bolus dose left in situ for the study duration. A selection of novel decontaminants, including Dermal Decontamination Gel (DDGel), Trivorex®, itaconic acid (IA), N,N'-methylenebisacrylamide (MBA), 2-trifluoromethylacrylic acid (TFMAA) and NanoSan Sorb were also tested for efficacy. All the evaluated decontaminants were successful at removing the majority of the Carfentanil skin surface contamination. The current work has shown that the Fuller's Earth decontamination kit, removes as much (or more) free base carfentanil from the skin surface in comparison to other products tested in this study series.

Aqueous suspensions of Fuller's earth potentiate the adsorption capacities of paraoxon and improve skin decontamination properties

Fuller's earth (FE) is a phyllosilicate used as a powder for household or skin decontamination due to its adsorbent properties. Recent studies have shown that water suspensions exhibit similar adsorbent capacities. FE is heterogeneous due to its composition of elementary clay aggregates and heavy metal particles. Here, FE toxicity was assessed in vitro on skin cells and in vivo on Danio rerio embryos. Among the suspensions tested (5%, 9.1% and 15% w/w), only the highest one shows weak toxicity. Suspensions were tested for ex vivo dermal decontamination into pig ear skin and human abdominal skin using diffusion cells and paraoxon as organophosphorus contaminant. After 24 h of diffusion, no difference was observed in the paraoxon concentration in the receptor compartment whether the decontamination was carried out with FE in powder or in suspension form. In presence of FE suspensions, we observed the disappearance of paraoxon from the stratum corneum, the reservoir compartment, independently of the suspensions' concentration. We suggest that water potentiates the absorbing capacities of FE powder by intercalating between clay lamellas leading to the appearance of new adsorption zones and swelling. These data support the use of FE aqueous suspensions as a safe tool for organophosphorus skin decontamination.

Skin decontamination procedures against potential hazards substances exposure

Decontamination of unprotected skin areas is crucial to prevent excessive penetration of chemical contaminants after criminal or accidental release. A review of literature studies was performed to identify the available decontamination methods adopted to treat skin contamination after chemical, radiological and metal exposures. In this bibliographic review, an overview of the old and recent works on decontamination procedures followed in case of potential hazards substances contaminations with a comparison between these systems are provided. Almost all data from our 95 selected studies conducted in vitro and in vivo revealed that a rapid skin decontamination process is the most efficient way to reduce the risk of intoxication. The commonly-used or recommended conventional procedures are simple rinsing with water only or soapy water. However, this approach has some limitations because an easy removal by flushing may not be sufficient to decontaminate all chemical deposited on the skin, and skin absorption can be enhanced by the wash-in effect. Other liquid solutions or systems as adsorbent powders, mobilizing agents, chelation therapy are also applied as decontaminants, but till nowadays does not exist a decontamination method which can be adopted in all situations. Therefore, there is an urgent need to develop more efficient and successful decontaminating formulations.