Mass Decontamination of Companion Dogs in Disaster: Planning for Personnel, Water, and Time Requirements

OBJECTIVE

The importance of companion animals in the daily lives of people, and the increasing incidence and severity of natural disasters impacting people and their animals, is very well documented. However, despite the advancement of companion animal response capabilities, decontamination remains an inconsistently implemented component of disaster response. The challenge for local authorities is their need for planning factors and protocols specific to companion animal decontamination which are generally lacking. Data is provided on the average time requirements, water use and containment resources necessary, and the personnel required to decontaminate (decon) a large number of companion dogs.

METHODS

Sixty-three lightly contaminated, medium weight, short to medium coat, highly tractable dogs (Labradors and Hounds) from a State facility colony were used to determine the water requirements, soap effectiveness, and time required to complete decon (washing/bathing). Data were collected over a 6-mo period using 2 personnel that were randomly assigned to wash the dogs. Difference in weight, bathing time, and water use between groups was evaluated using a 2-tailed 2-sample t-test for independent data.

RESULTS

The time and water requirements were significantly different between medium coated dogs and short coated dogs. On average, for a short coated dog, the amount of time to complete decon was 7 min, and the amount of water was 8-10 gal. For medium coated dogs, the time increased to 10-12 min to complete the process and 12-15 gal water.

DISCUSSION

The results of this study provide important insights emergency management planners, animal response team members, and community personnel tasked with implementation of mass decontamination of companion dogs following a natural or man-made disaster.

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.

Management of decontamination in chemical accidents: a laboratory model

Rapid and efficient decontamination of the skin is a major task for emergency rescue services in the event of a chemical accident involving humans. While rinsing the skin with water (and soap) has been the standard procedure, some skepticism has developed in recent years regarding the situational suitability of this method. The efficacy of three different decontamination materials/techniques (Easyderm® cleaning cloth, water-soaked all-purpose sponge, rinsing with water) in removing Capsaicin, Bromadiolone, Paraquat and 2,2'-dichlorodiethylether (DCEE) from porcine skin was compared. Different cleaning motions (wiping, twisting, pressing) with the Easyderm® were evaluated for their effectiveness in removing Capsaicin from porcine skin. Finally, the impact of different exposure times of the skin to Capsaicin on the decontamination process were investigated. Contaminant recovery rates (CRRs) were analysed in the skin and in each decontamination material using high-performance-liquid-chromatography (HPLC; used for Capsaicin, Bromadiolone, Paraquat) or gas chromatography (GC; used for DCEE). Wiping the skin with the amphiphilic Easyderm® was most effective for decontamination of Capsaicin and DCEE, while the water rinsing method gave the best results for removing Paraquat and Bromadiolone. Both wiping with the Easyderm® and rotating the Easyderm® were significantly more effective in cleaning Capsaicin-contaminated skin than pressing the Easyderm® on the contamination area alone. Prolonged exposure times of the porcine skin to Capsaicin were associated with a decrease in efficacy of the following decontamination. Emergency rescue services should have materials available that can remove both hydrophilic and hydrophobic substances from skin. Since not all of our results for comparing different decontamination materials were as distinct as we expected, there are likely several other factors determining the efficacy of skin decontamination in some cases. Time is key; therefore, first responders should try to begin the decontamination process as soon as possible after arriving at the scene.

Comparison of skin decontamination strategies in the initial operational response following chemical exposures

In mass casualty incidents including hazardous chemical skin exposure, decontamination is the primary intervention to avoid systemic uptake of the toxic compound. The protocol needs to be both simple and efficient to enable a rapid response and avoid delay of patient management. In the present study, decontamination strategies included in the initial operational response were evaluated following human skin exposure in vitro to four different contaminants. Results demonstrated that the efficacy of selected decontamination procedures was highly dependent on the chemical contaminant used. Dry removal of the sulfur mustard simulant methyl salicylate prior to wet decontamination was found beneficial compared to wet decontamination alone. Rapidly initiated wet decontamination was more efficient compared to dry and wet removal of the industrial chemical 2-butoxyethanol and the nerve agent tabun. Following VX-exposure, all wet decontamination procedures resulted in increased agent penetration compared to the control. In conclusion, challenges in establishing simple and efficient decontamination procedures for a broad-spectrum of chemicals have been demonstrated. The impact of including a dry removal step during decontamination was evidently agent specific. Despite the variation in efficacy, immediately initiated dry removal may facilitate patient management until wet decontamination resources are available and to reduce the risk of secondary contamination.

Efficacy of soap and water-based skin decontamination using in vitro animal models: A systematic review

Water and/or soap and water solutions have historically been used as first-line decontamination strategies for a wide variety of dermal contaminants from workplace exposure, environmental pesticides, and civilian chemical warfare. Although water and/or soap and water solutions are often considered a gold standard of decontamination, many studies have found other decontamination methods to be superior. This systematic review summarizes the available data on in vitro animal models contaminated with a various chemicals and their decontamination with water and/or soap and water solutions using in vitro animal models. A comprehensive literature search was performed using Concordance, Embase, PubMed, Medline, Web of Science, and Google Scholar to find in vitro animal studies that provided data on dermal decontamination using water and/or soap and water solutions. Five studies were included that analyzed 11 contaminants across two in vitro animal models (rats and pigs). Water alone was used as a decontamination method for 63.6% of the contaminants (n = 7/11) and water and soap solutions for decontamination in 54.6% of contaminants (n = 6/11). Water alone provided incomplete contaminant removal of five of seven contaminants studied; soap and water did not show significant difference in decontamination when compared with other solutions for all four contaminants and was superior to water for both contaminants studied. Water and/or soap and water are used as decontamination strategies for a variety of dermal contamination events, but for many contaminants, they do not provide complete contamination when compared with newer decontamination solutions studied with in vitro animal models.

Efficacy of water-based skin decontamination of occupational chemicals using in vitro human skin models: a systematic review

Percutaneous absorption of chemicals is a potential route of topical and systemic toxicity. Skin decontamination interrupts this process by removing contaminants from the skin surface. Decontamination using water-only or soap and water solutions is the current gold standard despite limited efficacy data. A summary of studies evaluating their efficacy in decontaminating occupational contaminants from in vitro human skin models is presented. Embase, MEDLINE, PubMed, Web of Science, and Google Scholar were searched for relevant articles and data extracted from 15 investigations that reported on 21 occupational contaminants, which were further classified as industrial chemicals, drugs, or pesticides. Water-only decontamination yielded no response in 4.3% (n = 6/140) and partial decontamination in 95.7% (n = 134/140) of skin samples. Soap and water decontamination yielded complete decontamination in 4.9% (n = 13/264) and partial decontamination in 95.1% (n = 251/264) of skin samples. Four studies (26.7%, n = 4/15) reported increased penetration rates or skin concentration of contaminants following decontamination, demonstrating a "wash-in" effect. Varying study methodologies hinder our ability to compare data and determine when water alone or soap and water are best used. International harmonized efficacy protocol might enhance our decontamination understanding and enable a more customized approach to decontamination clinical practice and research.

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.

Skin decontamination efficacy of sulfur mustard and VX in the pig model: A comparison between Fuller's earth and RSDL

Skin decontamination following exposure to chemical agents is a most important component of the individual defense doctrine, removing the agent, ceasing its penetration and preventing secondary contamination of the first responders. The goal of the current study was to compare the efficacy of Reactive Skin Decontaminant Lotion (RSDL) and Fuller's Earth (FE) following exposure to sulfur mustard (SM) and VX, aiming to find the optimal procedure for mass casualty decontamination protocol. Decontamination efficacy was evaluated in pigs by measurement of lesion area and erythema (SM) and cholinesterase inhibition and clinical symptoms (VX). FE and RSDL were highly effective against both agents. Following SM exposure, the two decontaminants demonstrated a significant decrease in lesions' size together with the decrease in exposure duration. Likewise, skin decontamination following exposure to VX with either FE or RSDL resulted in reduction in clinical symptoms and prevention of death. Decontamination was worthwhile even if postponed, up to 30 min (SM) and 2 h (VX). In conclusion, both decontamination products were efficient in ameliorating the toxic effects even though in a different mechanism. Finally, for mass casualty scenario, FE is preferred as a universal decontaminant, considering its safety, ease of use and longer shelf life.

Clinical Manifestations, Treatment, and Prevention of Acute Irritant Contact Dermatitis Caused by 2,4-Dichloro-5-Methylpyrimidine

Background

There are no reported cases of 2,4-dichloro-5-methylpyrimidine (DCP)–induced irritant contact dermatitis (ICD).

Objective

The aim of the study was to summarize the clinical features, treatment, and protective measures for DCP-induced ICD.

Methods

We retrospectively reviewed the clinical data from 64 patients with DCP-induced ICD and the protective measures in a DCP manufacturing factory.

Results

Disease onset occurred 1 to 10 minutes after DCP single exposure in all 64 patients. The contact site developed edematous erythematous skin lesions with clear boundaries. Other symptoms included a burning sensation (n = 48), pruritus (n = 16), headache (n = 4), nausea/vomiting (n = 3), and syncope (n = 1). Ten patients developed pruritic rash over the whole body 1 to 4 days after contacting DCP. Histopathologic examination of the lesions was performed in 8 patients; all 8 showed manifestations of ICD. A patch test with 1% DCP ethanol solution was performed in 7 patients. One patient withdrew because of pruritus and massive erythema over the whole body. Four patients had a strong reaction, and 2 patients had a very strong reaction. All patients were cured. Positive-pressure inflatable protective clothing protected workers from the outside environment to prevent DCP-induced ICD.

Conclusions

2,4-Dichloro-5-methylpyrimidine exposure induces acute ICD and a delayed allergic reaction in some patients (15.6%). Positive-pressure inflatable protective clothing prevents DCP-induced ICD.

Effect of superabsorbent polymers (SAP) and metal organic frameworks (MOF) wiping sandwich patch on human skin decontamination and detoxification in vitro

Most chemical warfare agents partition rapidly into stratum corneum (SC) and subsequently slowly diffuse through - or are retained in the membrane. Since chemicals can interact with SC components during the process, skin decontamination poses a challenging yet important problem. To address these issues, we have developed a new method in combination with wet and dry decon technologies with new materials for emergency or delayed contamination scenarios. An in vitro human skin diffusion system was employed to model various dermal exposures of radiolabeled chemical warfare simulants, followed by surface decontamination with metal organic frameworks (MOFs), super-absorbent polymers (SAP), and/or dermal decontamination gel (DDGel). All samples measured for radioactive recovery and acetylcholinesterase activity to ascertain relative decon efficacy. Results demonstrated powerful water absorption of SAP, strong catalysis of UiO-66 MOF, and decon enhancement of pre-wetting surface contaminants. SAP had no interfering interactions with MOF yet provided additional benefits as porosity and reactivity that allowed for fast liquidized chemical transportation, absorption, and degeneration. We then designed a cotton-based SAP/MOF patch that worked cooperatively in decontamination and detoxification. Together with pre-wet, SAP/MOF wipe, and DDGel applications, maximum effect was observed in early and/or extended dermal exposure, and no "wash-in" effect occurred.

Analysis of Tick Surface Decontamination Methods

Various microbial pathogens have been found in ticks such as Ixodes ricinus. However, most studies assessed tick microbiomes without prior decontamination of the tick surface, which may alter the results and mislead conclusions regarding the composition of the tick-borne microbiome. The aim of this study was to test four different decontamination methods, namely (i.) 70% ethanol, (ii.) DNA Away, (iii.) 5% sodium hypochlorite and (iv.) Reactive Skin Decontamination Lotion (RSDL), which have been previously reported for tick surface and animal or human skin decontamination. To test the efficiency of decontamination, we contaminated each tick with a defined mixture of Escherichia coli, Micrococcus luteus, Pseudomonas fluorescens, dog saliva and human sweat. No contamination was used as a negative control, and for a positive control, a no decontamination strategy was carried out. After nucleic acid extraction, the recovery rate of contaminants was determined for RNA and DNA samples by qPCR and tick-borne microbiome analyses by bacterial 16S rRNA and 16S rRNA gene amplicon sequencing. Ticks treated with 5% sodium hypochlorite revealed the lowest number of contaminants followed by DNA Away, RSDL and 70% ethanol. Moreover, tick microbiomes after 5% sodium hypochlorite decontamination clustered with negative controls. Therefore, the efficiency of decontamination was optimal with 5% sodium hypochlorite and is recommended for upcoming studies to address the unbiased detection of tick-borne pathogens.

Corrosive attacks in the UK - Psychosocial perspectives and decontamination strategies

Acid attacks, or vitriolage, are defined as violent assaults involving the deliberate throwing of an acid or similarly corrosive substance with the intention to "maim, disfigure, torture or kill" [1]. The Acid Survivors Trust International suggest a prevalence of 1500 attacks reported worldwide per annum, although this is likely to be an underestimate by 40% [2]. The UK is thought to have one of the highest of rates of recorded corrosive attacks, with an increase from 228 attacks in 2012 to 601 in 2016. Most were reported by the London Metropolitan police force followed by Northumbria, Cambridgeshire, Hertfordshire, Greater Manchester and Humberside [[2]]. The chemical agents involved include acids, alkalis, oxidising and reducing agents, alkylating and chelating agents and solvents. They cause injury by producing a chemical interaction which can lead to extensive tissue destruction and extreme pain. Herein, we present a review on the changing epidemiology of corrosive attacks in the UK and currently employed management strategies.

Decontamination and management of contaminated hair following a CBRN incident

This in vitro study evaluated the "triple protocol" of dry decontamination, the ladder pipe system, a method for gross decontamination, and technical decontamination in the decontamination of hair following chemical contamination. First, we assessed the efficacy of the three protocols, alone or in combination, on excised porcine skin and human hair contaminated with either methyl salicylate (MS), phorate (PHR), sodium fluoroacetate (SFA) or potassium cyanide (KCN). A second experiment investigated the residual hair contamination following decontamination with the triple protocol at different intervals post exposure. In a third experiment, hair decontaminated after exposure to MS or PHR was evaluated for off-gassing. Though skin decontamination was highly effective, a substantial proportion (20-40%) of the lipophilic compounds (MS and PHR) remained within the hair. The more water-soluble contaminants (SFA and KCN) tended to form much smaller reservoirs within the hair. Interestingly, substantial off-gassing of MS, a medium volatility chemical, was detectable from triple-decontaminated hair up to five days post exposure. Overall, the decontamination strategies investigated were effective for the decontamination of skin, but less so for hair. These findings highlight the importance of contaminated hair serving as a source of potential secondary contamination by contact or inhalation. Therefore, consideration should be given to the management of contaminated hair following exposure to toxic chemicals.

Should we instruct patients to rub topical agents into skin? The evidence

Background: At least 15 factors influence the ability of compounds to penetrate the skin. Massage (rubbing) may be another factor that has gone relatively unrecognized. Method: PubMed, Google Scholar, and EMBASE databases were accessed online in March 2018 in search of studies measuring absorption through skin with and without rubbing or massage. Results: While some studies noted no difference in dermal absorption with regards to rubbing, others have demonstrated the opposite. In general, massage technique does indeed sometimes enhance dermal absorption. In addition to increase skin temperature and blood flow, rubbing likely modifies stratum corneum (SC) structure to enhance diffusion rates and increase retained penetrant amount within the skin. Conclusions: Understanding the mechanism of massage and its role in percutaneous penetration may help elucidate skin barrier function, dermal absorption, skin decontamination, and dermatotoxicology. To achieve such goals, an in vitro model that models in vivo behaviors must first be established. Subsequently, experiments with different penetrants, vehicles, massage time, and other variables may be considered.

Hybrid in vitro diffusion cell for simultaneous evaluation of hair and skin decontamination: temporal distribution of chemical contaminants

Most casualty or personnel decontamination studies have focused on removing contaminants from the skin. However, scalp hair and underlying skin are the most likely areas of contamination following airborne exposure to chemicals. The aim of this study was to investigate the interactions of contaminants with scalp hair and underlying skin using a hybrid in vitro diffusion cell model. The in vitro hybrid test system comprised “curtains” of human hair mounted onto sections of excised porcine skin within a modified diffusion cell. The results demonstrated that hair substantially reduced underlying scalp skin contamination and that hair may provide a limited decontamination effect by removing contaminants from the skin surface. This hybrid test system may have application in the development of improved chemical incident response processes through the evaluation of various hair and skin decontamination strategies.

Further studies of the efficacy of military, commercial and novel skin decontaminants against the chemical warfare agents sulphur Mustard, Soman and VX

BACKGROUND/AIMS

Following an incident involving toxic chemicals, deployment of countermeasures before the arrival of specialised services at the scene may provide a "therapeutic" window in which to mitigate skin absorption.

METHODS

Five potential candidates (itaconic acid, N,N'-methylenebisacrylamide, 2-trifluoromethylacrylic acid, fuller's earth and Fast-Act®) previously found effective against a simulant (methyl salicylate) were evaluated against a 10 μL droplet of ¹⁴C-sulphur mustard (HD), soman (GD) or VX applied to the surface of porcine skin mounted on static skin diffusion cells.

RESULTS

All the decontaminants applied to the skin 5 min post exposure achieved a marked reduction in the amount of ¹⁴C contaminant remaining within the skin at 24 h. Itaconic acid significantly (p < .05) reduced the amount of ¹⁴C-HD, GD and VX remaining in the skin at 24 h. Additionally, 2-trifluoromethylacrylic acid significantly reduced the amount of ¹⁴C-HD, whilst fuller's earth significantly reduced the amounts of ¹⁴C-HD and VX recovered within the skin at 24 h.

CONCLUSION

All of the products evaluated in this study performed well in reducing the dermal absorption of all the chemical warfare agents tested.

Handler training improves decontamination of working canines with oil-based exposure in field conditions using disposable kits

Exposure to contaminants in the field is a reality for deployed canines. To date, there is no data evaluating the benefits of training for handlers associated with canine decontamination efforts. The objective of our work was to investigate the impact of handler training on the reduction of oil-based contaminants in working canines. Canine teams (n = 10) were randomly assigned to either TRAINED or UNTRAINED groups. Each team (handler and dog) in the TRAINED group received 30-minutes of interactive training using an illustrated guide on proper utilization of equipment provided. Teams in the UNTRAINED group received the same equipment and illustrated guide but no interactive training. Decontamination efforts were measured using an oil-based pseudo-contaminant (GloGerm®, Moab, UT) topically applied to four anatomical locations: cranial neck, between the shoulder blades, left medial hindlimb and left hind paw with pre- and post-washing images collected from a fixed distance of 20 inches. Visual assessment of contaminant reduction was scored as follows: 0 = <24% contaminant reduction; 1 = 25-50% contaminant reduction; 2 = 51-75% contaminant reduction; and 3 = >76% contaminant reduction. No score discrepancies >1 were reported between reviewers. Trained handlers were more effective at contamination reduction (P = .0093) as compared to their untrained counterparts. These results indicate that handlers, when properly trained, can achieve reduction of oil-based contaminants with a disposable decontamination kit and a garden hose.

RSDL decontamination of human skin contaminated with the nerve agent VX

Dermal exposure to low volatile organophosphorus compounds (OPC) may lead to penetration through the skin and uptake in the blood circulation. Skin decontamination of toxic OPCs, such as pesticides and chemical warfare nerve agents, might therefore be crucial for mitigating the systemic toxicity following dermal exposure. Reactive skin decontamination lotion (RSDL) has been shown to reduce toxic effects in animals dermally exposed to the nerve agent VX. In the present study, an in vitro flow-through diffusion cell was utilized to evaluate the efficacy of RSDL for decontamination of VX exposed to human epidermis. In particular, the impact of timing in the initiation of decontamination and agent dilution in water was studied. The impact of the lipophilic properties of VX in the RSDL decontamination was additionally addressed by comparing chemical degradation in RSDL and decontamination efficacy between the VX and the hydrophilic OPC triethyl phosphonoacetate (TEPA). The epidermal membrane was exposed to 20, 75 or 90% OPC diluted in deionized water and the decontamination was initiated 5, 10, 30, 60 or 120min post-exposure. Early decontamination of VX with RSDL, initiated 5-10min after skin exposure, was very effective. Delayed decontamination initiated 30-60min post-exposure was less effective but still the amount of penetrated agent was significantly reduced, while further delayed start of decontamination to 120min resulted in very low efficacy. Comparing RSDL decontamination of VX with that of TEPA showed that the decontamination efficacy at high agent concentrations was higher for VX. The degradation mechanism of VX and TEPA during decontamination was dissected by ³¹P NMR spectroscopy of the OPCs following reactions with RSDL and its three nucleophile components. The degradation rate was clearly associated with the high pH of the specific solution investigated; i.e. increased pH resulted in a more rapid degradation. In addition, the solubility of the OPC in RSDL also influenced the degradation rate since the degradation of VX was significantly faster when the NMR analysis was performed in the organic solvent acetonitrile compared to water. In conclusion, we have applied the in vitro flow-through diffusion cell for evaluation of skin decontamination procedures of human epidermis exposed to OPCs. It was demonstrated that early decontamination is crucial for efficient mitigation of epidermal penetration of VX and that almost complete removal of the nerve agent from the skin surface is possible. Our data also indicate that the pH of RSDL together with the solubility of OPC in RSDL are of primary importance for the decontamination efficacy.

Hydrogen sulphide and phosphine interactions with human skin in vitro

Accidental or intentional releases of toxic gases can have significant public health consequences and emergency resource demands. Management of exposed individuals during hazardous material incidents should be risk and evidence based, but there are knowledge gaps in relation to dermal absorption of gases and management advice for potentially exposed individuals. Using a modified Organization for Economic Co-operation and Development (OECD) in vitro toxicology protocol with human donor skin, this article reports on two common and odorous chemicals, hydrogen sulphide and phosphine. Results show that undamaged human skin provides a good barrier to hydrogen sulphide (up to 800 ppm) and phosphine (up to 1000 ppm) penetration for up to 30 min exposures, with little variability in the presence of clothing or in elevated temperature and humidity conditions. A practical guideline template for skin decontamination has been developed, and implications of the research for first responders are outlined.

Proposed human stratum corneum water domain in chemical absorption

Compounds with varying physical and chemical properties may have different affinities to the stratum corneum (SC) and/or its intercellular lipids, keratin protein, and possible water domains. To better understand the mechanism of percutaneous absorption, we utilized 21 carbon-14 labeled chemicals, with wide hydrophilicity (log P = -0.05 to 6.17), and quantified their absorption/adsorption properties for a short incubation time (15 min) with regards to intact SC membrane, delipidized SC membrane and SC lipid. A facile method was developed for SC/lipid absorption, providing a more equivalent procedure and comparable data. SC lipid absorption of chemical solutes positively correlated with the octanol/water partition coefficient (log P). Differences between the percent dose of chemical absorption to intact SC and the total percent dose contributed by the protein and lipid domains suggest the possibility and significance of a water domain. Absorption rate experiments showed a longer lag time for intact SC than for delipidized SC or SC lipid, suggesting that the water domain may delay chemical binding to protein and lipid domains, and may be a factor in the resistance of many chemicals to current decontamination methods. Copyright © 2015 John Wiley & Sons, Ltd.

Current concepts for oil decontamination of crush injuries: a review

This anecdotal, non-systematic review serves to explore the principles and methods of effective oil decontamination from cutaneous wounds, particularly crush injuries. The current expansion of the petroleum industry is necessary to meet increasing world demands for oil. Most stages of oil refining and applications involve significant injury risks, particularly for crush injuries that become contaminated with petroleum compounds. A literature review regarding a standard of care for effective cutaneous oil decontamination is lacking. Based on case reports, animal models, and in vitro studies identified in our expert opinion review, standard water and soap cleansing may not be an appropriate approach. Instead, the principle of ‘like dissolves like’ guides the use of lipophilic, petroleum-derived solvents to attract and subsequently dissolve the petroleum contaminant from the skin injury. Limitations include paucity of and dated literature sources regarding the topic as well as no models specifically addressing crush injuries. Our literature review found that oil decontamination of cutaneous injuries may be best accomplished with oil-based cleansers. Certainly, this topic has significant importance for the potentially carcinogenic petroleum compounds that pervade virtually every aspect of modern human life.

Howard I. Maibach: Extraordinary Leadership in Integrating Key Concepts Underpinning Our Understanding of Percutaneous Absorption and Occupational Dermatology

The purpose of the present article is to briefly highlight some contributions of Prof. Howard I. Maibach to the field of dermatology. After a few introducing remarks regarding Howard's personal career, the article specifically reviews contributions to the understanding of percutaneous absorption and to occupational dermatology. He and his companions/coworkers established and introduced experimental prerequisites to better study and understand percutaneous absorption - both in vitro and in vivo. Not less influential was his contribution to occupational dermatology acting as a founding member of the International Contact Dermatitis Research Group and coinaugurating the North American Contact Dermatitis Group. These groups have been very active ever since. As an academic teacher, he inspired young colleagues to perform original research work and to establish their own working groups. He has done this most successfully with many fellows who worked with him over the years, and who are now leading departments or companies dedicated to dermatological research all over the world. Probably this is his most important and lasting achievement.