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Durmaz K, Misbach M, Danoy A, Salvi JP, Bloch E, Bourrelly S, Verrier B, Sohier J. An innovative Fuller's earth-based film-forming formulation for skin decontamination, through removal and entrapment of an organophosphorus compound, paraoxon-ethyl. JOURNAL OF HAZARDOUS MATERIALS 2024; 470:134190. [PMID: 38593659 DOI: 10.1016/j.jhazmat.2024.134190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 03/28/2024] [Accepted: 03/30/2024] [Indexed: 04/11/2024]
Abstract
Organophosphorus compounds (OPs), such as VX, pose a significant threat due to their neurotoxic and hazardous properties. Skin decontamination is essential to avoid irreversible effects. Fuller's earth (FE), a phyllosilicate conventionally employed in powder form, has demonstrated decontamination capacity against OPs. The aim of this study was to develop a formulation that forms a film on the skin, with a significant OP removal capacity (>95 %) coupled with sequestration capabilities, favorable drying time and mechanical properties to allow for easy application and removal, particularly in emergency context. Various formulations were prepared using different concentrations of polyvinyl alcohol (PVA), FE and surfactants. Their removal and sequestration capacity was tested using paraoxon-ethyl (POX), a chemical that simulates the behavior of VX. Formulations with removal capacity levels surpassing 95 % were mechanically characterized and cell viability assays were performed on Normal Human Dermal Fibroblast (NHDF). The four most promising formulations were used to assess decontamination efficacy on pig ear skin explants. These formulations showed decontamination levels ranging from 84.4 ± 4.7 % to 96.5 ± 1.3 %, which is equivalent to current decontamination methods. These results suggest that this technology could be a novel and effective tool for skin decontamination following exposure to OPs.
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Affiliation(s)
- Kardelen Durmaz
- UMR 5305: Laboratoire de Biologie Tissulaire et d'Ingénierie Thérapeutique, CNRS/Université Claude Bernard Lyon 1, 8 avenue Rockefeller, 69008 Lyon, France
| | - Magaly Misbach
- UMR 5305: Laboratoire de Biologie Tissulaire et d'Ingénierie Thérapeutique, CNRS/Université Claude Bernard Lyon 1, 8 avenue Rockefeller, 69008 Lyon, France
| | - Alix Danoy
- UMR 5305: Laboratoire de Biologie Tissulaire et d'Ingénierie Thérapeutique, CNRS/Université Claude Bernard Lyon 1, 8 avenue Rockefeller, 69008 Lyon, France
| | - Jean-Paul Salvi
- UMR 5305: Laboratoire de Biologie Tissulaire et d'Ingénierie Thérapeutique, CNRS/Université Claude Bernard Lyon 1, 8 avenue Rockefeller, 69008 Lyon, France
| | - Emily Bloch
- UMR 7246: Laboratoire MADIREL, CNRS/Université Aix-Marseille, 52 avenue Escadrille Normandie - Niemen, 13013 Marseille, France
| | - Sandrine Bourrelly
- UMR 7246: Laboratoire MADIREL, CNRS/Université Aix-Marseille, 52 avenue Escadrille Normandie - Niemen, 13013 Marseille, France
| | - Bernard Verrier
- UMR 5305: Laboratoire de Biologie Tissulaire et d'Ingénierie Thérapeutique, CNRS/Université Claude Bernard Lyon 1, 8 avenue Rockefeller, 69008 Lyon, France
| | - Jerome Sohier
- UMR 5305: Laboratoire de Biologie Tissulaire et d'Ingénierie Thérapeutique, CNRS/Université Claude Bernard Lyon 1, 8 avenue Rockefeller, 69008 Lyon, France.
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Thors L, Wigenstam E, Qvarnström J, Wästerby P, Öberg L, Bucht A. Immediate dry decontamination using efficient absorbent materials is beneficial following skin exposure to low-volatile toxic chemicals. J Appl Toxicol 2024. [PMID: 38730557 DOI: 10.1002/jat.4627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 04/10/2024] [Accepted: 04/30/2024] [Indexed: 05/13/2024]
Abstract
In a chemical mass casualty incident requiring skin decontamination, dry removal using absorbent materials may be beneficial to enable immediate decontamination. The efficacy of absorbent materials has therefore been evaluated, alone or procedures including both dry and wet decontamination, following skin exposure to two low volatile toxic chemicals using an in vitro human skin penetration model. Additionally, removal using active carbon wipes was evaluated with or without the Dahlgren Decon solution. All dry decontamination procedures resulted in a significantly decreased skin penetration rate of the industrial chemical 2-butoxyethanol compared to the control without decontamination. Wet decontamination following dry absorption significantly improved the efficacy compared to dry removal alone. Dry decontamination post-exposure to the chemical warfare nerve agent VX showed no decontamination efficacy. However, dry and wet decontamination resulted in a decreased agent skin penetration rate during the last hour of the experiment. At -15°C, significantly reduced VX skin penetration rates were demonstrated for both dry decontamination alone and the dry and wet decontamination procedure. The Dahlgren Decon solution significantly reduced the amount of VX penetrating the skin, but the active carbon wipe alone did not impact the skin penetration rate. In conclusion, absorbent materials are beneficial for the removal of low-volatile chemicals from the skin, but the degree of efficacy varies between chemicals. Despite the variability, immediate dry decontamination using available absorbent materials prior to wet decontamination is recommended as a general procedure for skin decontamination. The procedure should also be prioritized in cold-weather conditions to prevent patient hypothermia.
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Affiliation(s)
- Lina Thors
- Swedish Defence Research Agency, CBRN Defence and Security, Umeå, Sweden
| | | | - Johanna Qvarnström
- Swedish Defence Research Agency, CBRN Defence and Security, Umeå, Sweden
| | - Pär Wästerby
- Swedish Defence Research Agency, CBRN Defence and Security, Umeå, Sweden
| | - Linda Öberg
- Swedish Defence Research Agency, CBRN Defence and Security, Umeå, Sweden
| | - Anders Bucht
- Swedish Defence Research Agency, CBRN Defence and Security, Umeå, Sweden
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Franken J, Mikler J. Reactive skin decontamination lotion (RSDL) safety with clinical antiseptics and hemostatic agents. Toxicol Lett 2024; 395:11-16. [PMID: 38484828 DOI: 10.1016/j.toxlet.2024.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 02/23/2024] [Accepted: 02/26/2024] [Indexed: 04/21/2024]
Abstract
Reactive skin decontamination lotion (RSDL) is a Health Canada approved product used by the Canadian Armed Forces for removal and inactivation of toxic chemicals on skin. Although it is considered very safe when used as directed, questions have been raised regarding whether topical RSDL in the medical setting will react exothermically with antiseptic compounds on the casualty's epidermis that could result in thermal burns. Benchtop experiments were conducted to investigate reactivity of RSDL with various antiseptic compounds or hemostatic agents. Temperature changes were closely monitored in three different volume ratios, 1:10, 1:1, and 10:1 over a time course of 16 minutes. Chlorine based bleaches versus RSDL were included as a positive control and were the only combination that exhibited a significant exothermic reaction capable of causing minor thermal burns. RSDL was also evaluated with antiseptic solution applied to swine epidermal tissue without observation of visual irritation; then in lacerated skeletal muscle tissue which resulted in no measured temperature change. The conclusion of this study is that antiseptics and hemostatic agents can be used as required on a patient decontaminated with RSDL as no exothermic reaction will occur.
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Affiliation(s)
- Jessica Franken
- Defence Research and Development Canada - Suffield Research Centre, Department of National Defence, Suffield, Alberta, Canada.
| | - John Mikler
- Defence Research and Development Canada - Suffield Research Centre, Department of National Defence, Suffield, Alberta, Canada
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Dalton C, Watkins R, Pritchard S, Graham S. Skin decontamination of Carfentanil in vitro. Toxicol Lett 2023; 388:56-63. [PMID: 37806367 DOI: 10.1016/j.toxlet.2023.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 09/28/2023] [Accepted: 10/05/2023] [Indexed: 10/10/2023]
Abstract
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.
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Affiliation(s)
- Christopher Dalton
- Chemical Biological and Radiological Division, Dstl Porton Down, Salisbury SP4 0JQ, UK.
| | - Rachel Watkins
- Chemical Biological and Radiological Division, Dstl Porton Down, Salisbury SP4 0JQ, UK
| | - Sarah Pritchard
- Chemical Biological and Radiological Division, Dstl Porton Down, Salisbury SP4 0JQ, UK
| | - Stuart Graham
- Chemical Biological and Radiological Division, Dstl Porton Down, Salisbury SP4 0JQ, UK
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Su H, Huang MZ, Shiea J, Lee CW. Thermal desorption ambient ionization mass spectrometry for emergency toxicology. MASS SPECTROMETRY REVIEWS 2022:e21784. [PMID: 35603997 DOI: 10.1002/mas.21784] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 12/17/2021] [Accepted: 01/21/2022] [Indexed: 06/15/2023]
Abstract
In the emergency department, it is important to rapidly identify the toxic substances that have led to acute poisoning because different toxicants or toxins cause poisoning through different mechanisms, requiring disparate therapeutic strategies and precautions against contraindicating actions, and diverse directions of clinical course monitoring and prediction of prognosis. Ambient ionization mass spectrometry, a state-of-the-art technology, has been proved to be a fast, accurate, and user-friendly tool for rapidly identifying toxicants like residual pesticides on fruits and vegetables. In view of this, developing an analytical platform that explores the application of such a cutting-edge technology in a novel direction has been initiated a research program, namely, the rapid identification of toxic substances which might have caused acute poisoning in patients who visit the emergency department and requires an accurate diagnosis for correct clinical decision-making to bring about corresponding data-guided management. This review includes (i) a narrative account of the breakthrough in emergency toxicology brought about by the advent of ambient ionization mass spectrometry and (ii) a thorough discussion about the clinical implications and technical limitations of such a promising innovation for promoting toxicological tests from tier two-level to tier one level.
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Affiliation(s)
- Hung Su
- Department of Chemistry, National Sun Yat-Sen University, Kaohsiung, Taiwan
| | - Min-Zong Huang
- Department of Chemistry, National Sun Yat-Sen University, Kaohsiung, Taiwan
| | - Jentaie Shiea
- Department of Chemistry, National Sun Yat-Sen University, Kaohsiung, Taiwan
- Department of Medicinal and Applied Chemistry, Kaohsiung Medical University, Kaohsiung, Taiwan
- Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chi-Wei Lee
- Institute of Medical Science and Technology, National Sun Yat-Sen University, Kaohsiung, Taiwan
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Danoy A, Durmaz K, Paoletti M, Vachez L, Roul A, Sohier J, Verrier B. Aqueous suspensions of Fuller's earth potentiate the adsorption capacities of paraoxon and improve skin decontamination properties. JOURNAL OF HAZARDOUS MATERIALS 2022; 425:127714. [PMID: 34896712 DOI: 10.1016/j.jhazmat.2021.127714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 11/02/2021] [Accepted: 11/03/2021] [Indexed: 06/14/2023]
Abstract
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.
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Affiliation(s)
- Alix Danoy
- UMR 5305: Laboratoire de Biologie Tissulaire et d'Ingénierie Thérapeutique, CNRS / Université Claude Bernard Lyon 1, Institut de Biologie et Chimie des Protéines, 7 passage du Vercors, 69367 Lyon Cedex 07, France
| | - Kardelen Durmaz
- UMR 5305: Laboratoire de Biologie Tissulaire et d'Ingénierie Thérapeutique, CNRS / Université Claude Bernard Lyon 1, Institut de Biologie et Chimie des Protéines, 7 passage du Vercors, 69367 Lyon Cedex 07, France.
| | - Margaux Paoletti
- UMR 5305: Laboratoire de Biologie Tissulaire et d'Ingénierie Thérapeutique, CNRS / Université Claude Bernard Lyon 1, Institut de Biologie et Chimie des Protéines, 7 passage du Vercors, 69367 Lyon Cedex 07, France
| | - Laetitia Vachez
- UMR 5305: Laboratoire de Biologie Tissulaire et d'Ingénierie Thérapeutique, CNRS / Université Claude Bernard Lyon 1, Institut de Biologie et Chimie des Protéines, 7 passage du Vercors, 69367 Lyon Cedex 07, France
| | - Annick Roul
- UMR 5305: Laboratoire de Biologie Tissulaire et d'Ingénierie Thérapeutique, CNRS / Université Claude Bernard Lyon 1, Institut de Biologie et Chimie des Protéines, 7 passage du Vercors, 69367 Lyon Cedex 07, France; Pôle Santé, Direction Générale de la Sécurité Civile et de la Gestion des Crises, Ministère de l'Intérieur Paris, France
| | - Jérôme Sohier
- UMR 5305: Laboratoire de Biologie Tissulaire et d'Ingénierie Thérapeutique, CNRS / Université Claude Bernard Lyon 1, Institut de Biologie et Chimie des Protéines, 7 passage du Vercors, 69367 Lyon Cedex 07, France
| | - Bernard Verrier
- UMR 5305: Laboratoire de Biologie Tissulaire et d'Ingénierie Thérapeutique, CNRS / Université Claude Bernard Lyon 1, Institut de Biologie et Chimie des Protéines, 7 passage du Vercors, 69367 Lyon Cedex 07, France
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Nair A, Yadav P, Behl A, Sharma RK, Kulshrestha S, Butola BS, Sharma N. Toxic blister agents: Chemistry, mode of their action and effective treatment strategies. Chem Biol Interact 2021; 350:109654. [PMID: 34634268 DOI: 10.1016/j.cbi.2021.109654] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 08/11/2021] [Accepted: 09/09/2021] [Indexed: 11/19/2022]
Abstract
Since their use during the First World War, Blister agents have posed a major threat to the individuals and have caused around two million casualties. Major incidents occurred not only due to their use as chemical warfare agents but also because of occupational hazards. Therefore, a clear understanding of these agents and their mode of action is essential to develop effective decontamination and therapeutic strategies. The blister agents have been categorised on the basis of their chemistry and the biological interactions that entail post contamination. These compounds have been known to majorly cause blisters/bullae along with alkylation of the contaminated DNA. However, due to the high toxicity and restricted use, very little research has been conducted and a lot remains to be clearly understood about these compounds. Various decontamination solutions and detection technologies have been developed, which have proven to be effective for their timely mitigation. But a major hurdle seems to be the lack of proper understanding of the toxicological mechanism of action of these compounds. Current review is about the detailed and updated information on physical, chemical and biological aspects of various blister agents. It also illustrates the mechanism of their action, toxicological effects, detection technologies and possible decontamination strategies.
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Affiliation(s)
- Ashrit Nair
- Department of Textile and Fibre Engineering, Indian Institute of Technology, New Delhi-110016, India
| | - Pooja Yadav
- Department of Medical Elementology and Toxicology, Jamia Hamdard, New Delhi, 110062, India
| | - Amanpreet Behl
- Department of Textile and Fibre Engineering, Indian Institute of Technology, New Delhi-110016, India
| | - Rakesh Kumar Sharma
- Saveetha Institute of Medical & Technical Sciences, 162, Poonamallee High Road Chennai, Tamil Nadu 600077, India
| | - Shweta Kulshrestha
- Dr. B.R. Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi-110029, India
| | - Bhupendra Singh Butola
- Department of Textile and Fibre Engineering, Indian Institute of Technology, New Delhi-110016, India.
| | - Navneet Sharma
- Department of Textile and Fibre Engineering, Indian Institute of Technology, New Delhi-110016, India.
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Immobilization of Mutant Phosphotriesterase on Fuller’s Earth Enhanced the Stability of the Enzyme. Catalysts 2021. [DOI: 10.3390/catal11080983] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Immobilization is a method for making an enzyme more robust in the environment, especially in terms of its stability and reusability. A mutant phosphotriesterase (YT PTE) isolated from Pseudomonas dimunita has been reported to have high proficiency in hydrolyzing the Sp and Rp-enantiomers of organophosphate chromophoric analogs and therefore has great potential as a decontamination agent and biosensor. This work aims to investigate the feasibility of using Fuller’s earth (FE) as a YT PTE immobilization support and characterize its biochemical features after immobilization. The immobilized YT PTE was found to show improvement in thermal stability with a half-life of 24 h compared to that of the free enzyme, which was only 8 h. The stability of the immobilized YT PTE allowed storage for up to 4 months and reuse for up to 6 times. The immobilized YT PTE showed high tolerance against all tested metal ions, Tween 40 and 80 surfactants and inorganic solvents. These findings showed that the immobilized YT PTE became more robust for use especially with regards to its stability and reusability. These features would enhance the future applicability of this enzyme as a decontamination agent and its use in other suitable industrial applications.
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Jacquet P, Rémy B, Bross RPT, van Grol M, Gaucher F, Chabrière E, de Koning MC, Daudé D. Enzymatic Decontamination of G-Type, V-Type and Novichok Nerve Agents. Int J Mol Sci 2021; 22:8152. [PMID: 34360916 PMCID: PMC8347808 DOI: 10.3390/ijms22158152] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 07/23/2021] [Accepted: 07/26/2021] [Indexed: 12/02/2022] Open
Abstract
Organophosphorus nerve agents (OPNAs) are highly toxic compounds inhibiting cholinergic enzymes in the central and autonomic nervous systems and neuromuscular junctions, causing severe intoxications in humans. Medical countermeasures and efficient decontamination solutions are needed to counteract the toxicity of a wide spectrum of harmful OPNAs including G, V and Novichok agents. Here, we describe the use of engineered OPNA-degrading enzymes for the degradation of various toxic agents including insecticides, a series of OPNA surrogates, as well as real chemical warfare agents (cyclosarin, sarin, soman, tabun, VX, A230, A232, A234). We demonstrate that only two enzymes can degrade most of these molecules at high concentrations (25 mM) in less than 5 min. Using surface assays adapted from NATO AEP-65 guidelines, we further show that enzyme-based solutions can decontaminate 97.6% and 99.4% of 10 g∙m-2 of soman- and VX-contaminated surfaces, respectively. Finally, we demonstrate that these enzymes can degrade ethyl-paraoxon down to sub-inhibitory concentrations of acetylcholinesterase, confirming their efficacy from high to micromolar doses.
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Affiliation(s)
- Pauline Jacquet
- Gene&GreenTK, 19–21 Boulevard Jean Moulin, 13005 Marseille, France; (P.J.); (B.R.); (F.G.)
| | - Benjamin Rémy
- Gene&GreenTK, 19–21 Boulevard Jean Moulin, 13005 Marseille, France; (P.J.); (B.R.); (F.G.)
| | - Rowdy P. T. Bross
- TNO Department CBRN Protection, Lange Kleiweg 137, 2288 GJ Rijswijk, The Netherlands; (R.P.T.B.); (M.v.G.)
| | - Marco van Grol
- TNO Department CBRN Protection, Lange Kleiweg 137, 2288 GJ Rijswijk, The Netherlands; (R.P.T.B.); (M.v.G.)
| | - Floriane Gaucher
- Gene&GreenTK, 19–21 Boulevard Jean Moulin, 13005 Marseille, France; (P.J.); (B.R.); (F.G.)
| | - Eric Chabrière
- Institut Hospitalo-Universitaire (IHU) Méditerranée Infection, Aix-Marseille Université, 13005 Marseille, France
- Institut de Recherche pour le Développement (IRD), Assistance Publique Hôpitaux de Marseille (APHM), Unité Microbe Evolution Phylogénie et Infection (MEPHI), 13005 Marseille, France
| | - Martijn C. de Koning
- TNO Department CBRN Protection, Lange Kleiweg 137, 2288 GJ Rijswijk, The Netherlands; (R.P.T.B.); (M.v.G.)
| | - David Daudé
- Gene&GreenTK, 19–21 Boulevard Jean Moulin, 13005 Marseille, France; (P.J.); (B.R.); (F.G.)
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Comparative efficacy of Reactive Skin Decontamination Lotion (RSDL): A systematic review. Toxicol Lett 2021; 349:109-114. [PMID: 34147606 DOI: 10.1016/j.toxlet.2021.06.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 05/19/2021] [Accepted: 06/15/2021] [Indexed: 11/21/2022]
Abstract
Due to threats posed by Chemical Warfare Agents (CWAs) and accidents with Toxic Industrial Chemicals (TICs), the need for highly effective skin decontamination remains relevant. Reactive Skin Decontamination Lotion (RSDL), composed of Dekon 139 and 2,3-butanedione monoxime, has been shown highly effective against CWAs and TICs. This systematic review compares RSDL efficacy to other decontaminating agents. Online search engines PubMed, Web of Science, and Embase were explored, and all literature containing quantitative data, comparing RSDL to other decontaminating agents, investigated. Year of publication, type of study (in vitro or in vivo), model (animal or human), toxin tested, and result of each relevant article were recorded. In total, 15 relevant papers, comprising a total of 18 experimental models, were identified. Nine studies concluded that RSDL was the most effective decontaminant tested against the toxin of interest. Four studies concluded that RSDL was not the most effective decontaminant tested against the toxin of interest. The remaining 5 studies concluded RSDL displayed similar efficacy to at least one of the other decontaminating agents tested against the toxin of interest. There is substantial evidence supporting the efficacy of RSDL as a decontaminating agent. However, there remains to be insufficient data on this important topic, and limitations on the usefulness of current data, when applied to the broad array of potential exposures.
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11
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Skin decontamination procedures against potential hazards substances exposure. Chem Biol Interact 2021; 344:109481. [PMID: 34051209 DOI: 10.1016/j.cbi.2021.109481] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 03/20/2021] [Accepted: 04/15/2021] [Indexed: 10/21/2022]
Abstract
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.
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Thors L, Wigenstam E, Qvarnström J, Bucht A. Efficient agent degradation within skin is important for decontamination of percutaneously exposed VX. Cutan Ocul Toxicol 2021; 40:95-102. [PMID: 33759679 DOI: 10.1080/15569527.2021.1902342] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
AIM OF THE STUDY Following percutaneous exposure to the nerve agent VX, the remaining intact agent within the skin after decontamination is of great concern. Consequently, this leads to prolonged agent release to the blood circulation resulting in sustained intoxication, which may complicate the medical management. The decontamination procedure used should therefore possess the ability for agent removal both on and within the skin. The efficacy of three decontamination procedures was evaluated by measuring VX and the primary degradation product ethyl methyl phosphonic acid (EMPA) penetrated through human skin and the amount remaining within the skin. MATERIALS AND METHODS Decontamination was initiated 5 min post-exposure to VX on human dermatomed skin. Experiments were conducted using an in vitro skin penetration model and the amount remaining within the skin was determined by combining the tape-stripping technique and acetylcholinesterase activity measurements. RESULTS In control experiments without decontamination, higher amounts of VX were recovered in the deeper layers of skin compared to EMPA, which was primarily located in the stratum corneum. Both Reactive Skin Decontamination Lotion (RSDL) and the RSDL training kit (TRSDL) significantly reduced the amount of VX within the skin and decreased the penetration through the skin. However, the degradation ability of RSDL was demonstrated to be beneficial by the reduction of intact agents remaining in the skin compared to TRSDL without agent degradation capability. Soapy water decontamination caused a "wash-in" effect of VX with decreased agent amounts within stratum corneum but increased the amount VX penetrated through the skin. CONCLUSION Efficient skin decontamination of VX requires skin decontaminants reaching deeper layers of the skin, and that both absorption and degradation properties are important. In addition, the "wash-in" effect by using soapy water may enhance VX release to the blood circulation.
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Affiliation(s)
- Lina Thors
- Swedish Defence Research Agency, CBRN Defence and Security, Umeå, Sweden
| | | | - Johanna Qvarnström
- Swedish Defence Research Agency, CBRN Defence and Security, Umeå, Sweden
| | - Anders Bucht
- Swedish Defence Research Agency, CBRN Defence and Security, Umeå, Sweden
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Collins S, James T, Carter H, Symons C, Southworth F, Foxall K, Marczylo T, Amlôt R. Mass Casualty Decontamination for Chemical Incidents: Research Outcomes and Future Priorities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3079. [PMID: 33802722 PMCID: PMC8002470 DOI: 10.3390/ijerph18063079] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 03/09/2021] [Accepted: 03/13/2021] [Indexed: 01/22/2023]
Abstract
Planning for major incidents involving the release of hazardous chemicals has been informed by a multi-disciplinary research agenda which has sought to inform all aspects of emergency response, but with a focus in recent years on mass casualty decontamination. In vitro and human volunteer studies have established the relative effectiveness of different decontamination protocols for a range of chemical agents. In parallel, a programme of research has focused on communicating with and managing large numbers of contaminated casualties at the scene of an incident. We present an accessible overview of the evidence underpinning current casualty decontamination strategies. We highlight where research outcomes can directly inform response planning, including the critical importance of beginning the decontamination process as soon as possible, the benefits of early removal of contaminated clothing, the evidence under-pinning dry and wet decontamination and how effective communication is essential to any decontamination response. We identify a range of priority areas for future research including establishing the significance of the 'wash-in' effect and developing effective strategies for the decontamination of hair. We also highlight several areas of future methodological development, such as the need for novel chemical simulants. Whilst considerable progress has been made towards incorporating research outcomes into operational policy and practice, we outline how this developing evidence-base might be used to inform future iterations of mass casualty decontamination guidance.
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Affiliation(s)
- Samuel Collins
- Chemicals and Environmental Effects Department, Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Didcot OX11 0RQ, UK;
| | - Thomas James
- Chemicals and Environmental Effects Department, Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Didcot OX11 0RQ, UK;
| | - Holly Carter
- COVID-19 Behavioural Science and Insights Unit, Public Health England, Public Health England, London SE1 8UG, UK; (H.C.); (C.S.); (R.A.)
| | - Charles Symons
- COVID-19 Behavioural Science and Insights Unit, Public Health England, Public Health England, London SE1 8UG, UK; (H.C.); (C.S.); (R.A.)
| | - Felicity Southworth
- Behavioural Science, Emergency Response Department Science & Technology, Health Protection Directorate, Public Health England, Porton SP4 0JG, UK;
| | - Kerry Foxall
- Toxicology Department, Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Didcot OX11 0RQ, UK; (K.F.); (T.M.)
| | - Tim Marczylo
- Toxicology Department, Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Didcot OX11 0RQ, UK; (K.F.); (T.M.)
| | - Richard Amlôt
- COVID-19 Behavioural Science and Insights Unit, Public Health England, Public Health England, London SE1 8UG, UK; (H.C.); (C.S.); (R.A.)
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College, London SE1 1UL, UK
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Dachir S, Cohen M, Buch H, Kadar T. Skin decontamination efficacy of sulfur mustard and VX in the pig model: A comparison between Fuller's earth and RSDL. Chem Biol Interact 2021; 336:109393. [PMID: 33508307 DOI: 10.1016/j.cbi.2021.109393] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 12/31/2020] [Accepted: 01/20/2021] [Indexed: 01/06/2023]
Abstract
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.
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Affiliation(s)
- Shlomit Dachir
- Department of Pharmacology, Israel Institute for Biological Research, Ness Ziona, Israel.
| | - Maayan Cohen
- Department of Pharmacology, Israel Institute for Biological Research, Ness Ziona, Israel
| | - Hillel Buch
- Department of Pharmacology, Israel Institute for Biological Research, Ness Ziona, Israel
| | - Tamar Kadar
- Department of Pharmacology, Israel Institute for Biological Research, Ness Ziona, Israel
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15
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In vitro human skin decontamination efficacy of MOF-808 in decontamination lotion following exposure to the nerve agent VX. Toxicol Lett 2020; 339:32-38. [PMID: 33370593 DOI: 10.1016/j.toxlet.2020.12.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 11/27/2020] [Accepted: 12/22/2020] [Indexed: 01/03/2023]
Abstract
Metal-organic frameworks (MOFs) have shown promising properties for removal of chemical warfare agents, in particular for material decontamination and functionalized fabrics. The MOF-properties could also be beneficial for skin decontamination, especially when exposed to highly toxic and low volatile nerve agents. In such exposures, efficient decontamination is crucial for adequate medical management. In the present study, seven zirconium-based MOFs were evaluated for their ability to degrade VX and subsequently tested in vitro for decontamination of VX on human dermatomed skin. Of the MOFs evaluated, MOF-808 showed the greatest ability to degrade VX in an alkaline buffer with complete degradation of VX within 5 min. PCN-777, Zr-NDC and NU-1000 displayed degradation half-lives of approximately 10 min. When including MOF-808 in a skin friendly carrier with slightly acidic pH, a decreased agent degradation rate was observed, requiring over 24 h to reach complete degradation. In skin decontamination experiments, MOF-808 enhanced the efficacy compared to the carrier alone, essentially by improved agent absorption. Adding MOF-808 to Reactive Skin Decontamination Lotion (RSDL) did not improve the high effectiveness of RSDL alone. The present study showed that including MOF in skin decontamination lotions could be beneficial. Further studies should include optimizing the particulates and formulations.
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16
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Ehrich M, Hinckley J, Werre SR, Zhou Z. Effects of polyhydroxyfullerenes on organophosphate-induced toxicity in mice. Toxicology 2020; 445:152586. [PMID: 32949634 DOI: 10.1016/j.tox.2020.152586] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 09/04/2020] [Accepted: 09/12/2020] [Indexed: 10/23/2022]
Abstract
Two polyhydroxyfullerenes, which decrease organophosphate (OP)-induced acetylcholinesterase (AChE) inhibition in vitro, were administered by the intraperitoneal (ip) route or applied topically at doses of 0.9-24 mg/kg to protect adult male mice from enzyme-inhibiting and behavioral effects indicative of OP toxicity resulting from exposure to 1.7 - 2 mg/kg diphosphorofluoridate (DFP) ip or 2.3 - 2.7 mg paraoxon topical. Dosing paradigms included OP-fullerene simultaneous administration by the ip route, and 20 min post-OP polyhydroxyfullerene treatment topically. Benefits of OP sequestration by the polyhydroxyfullerene were noted and were dependent on the OP compound as well as timing and route of the polyhydroxyfullerene treatment.
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Affiliation(s)
- Marion Ehrich
- Virginia-Maryland College of Veterinary Medicine, Virginia Tech, Blacksburg VA, United States.
| | - Jonathan Hinckley
- Virginia-Maryland College of Veterinary Medicine, Virginia Tech, Blacksburg VA, United States
| | - Stephen R Werre
- Virginia-Maryland College of Veterinary Medicine, Virginia Tech, Blacksburg VA, United States
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17
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Zhou Y, Gao Q, Zhang L, Zhou Y, Zhong Y, Yu J, Liu J, Huang C, Wang Y. Combining Two into One: A Dual-Function H5PV2Mo10O40@MOF-808 Composite as a Versatile Decontaminant for Sulfur Mustard and Soman. Inorg Chem 2020; 59:11595-11605. [DOI: 10.1021/acs.inorgchem.0c01392] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Yuanyuan Zhou
- State Key Laboratory of Chemical Resource Engineering, Institute of Chemistry, Beijing University of Chemical Technology, Beijing 100029, People’s Republic of China
| | - Qi Gao
- State Key Laboratory of Chemical Resource Engineering, Institute of Chemistry, Beijing University of Chemical Technology, Beijing 100029, People’s Republic of China
| | - Lijuan Zhang
- State Key Laboratory of Chemical Resource Engineering, Institute of Chemistry, Beijing University of Chemical Technology, Beijing 100029, People’s Republic of China
| | - Yunshan Zhou
- State Key Laboratory of Chemical Resource Engineering, Institute of Chemistry, Beijing University of Chemical Technology, Beijing 100029, People’s Republic of China
| | - Yuxu Zhong
- Toxicology and Medical Countermeasures, Institute of Pharmacology and Toxicology, Academy of Military Sciences PLA China, Beijing 100850, People’s Republic of China
| | - Jialin Yu
- State Key Laboratory of Chemical Resource Engineering, Institute of Chemistry, Beijing University of Chemical Technology, Beijing 100029, People’s Republic of China
| | - Jie Liu
- State Key Laboratory of Chemical Resource Engineering, Institute of Chemistry, Beijing University of Chemical Technology, Beijing 100029, People’s Republic of China
| | - Chengcheng Huang
- State Key Laboratory of Chemical Resource Engineering, Institute of Chemistry, Beijing University of Chemical Technology, Beijing 100029, People’s Republic of China
| | - Yong’An Wang
- Toxicology and Medical Countermeasures, Institute of Pharmacology and Toxicology, Academy of Military Sciences PLA China, Beijing 100850, People’s Republic of China
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18
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Thors L, Wigenstam E, Qvarnström J, Hägglund L, Bucht A. Improved skin decontamination efficacy for the nerve agent VX. Chem Biol Interact 2020; 325:109135. [DOI: 10.1016/j.cbi.2020.109135] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 04/21/2020] [Accepted: 05/12/2020] [Indexed: 11/17/2022]
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19
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Yu J, Gao Q, Zhang L, Zhou Y, Zhong Y, Yin J, Zhou Y, Tao F, Wang Y. A dual-function all-inorganic intercluster salt comprising the polycation ε-[Al 13O 4(OH) 24(H 2O) 12] 7+ and polyanion α-[PMo 10V 2O 40] 5- for detoxifying sulfur mustard and soman. Dalton Trans 2020; 49:8122-8135. [PMID: 32495804 DOI: 10.1039/d0dt01307b] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
ε-[Al13O4(OH)24(H2O)12]7+, which shares similarity with the phosphotriesterase active site ZnII-OH-ZnII, was specially chosen to interact with the cluster α-PMo10V2O405- to form a new three-dimensional intercluster, which crystallized in the monoclinic space group P21/m with Z = 2, for the decontamination of chemical warfare agents. The experimental results showed that 50 mg of the compound decontaminated 96.4% (within 120 min) and 99.5% (within 40 min) of sulfur mustard (HD) (4 μL) and soman (GD) (4 μL), respectively, in ambient conditions. The decontamination processes followed first-order reaction kinetics with a rate constant and half-life of 0.01234 min-1 and 56.15 min for HD and 0.1198 min-1 and 5.78 min for GD, respectively. It was concluded that the α-PMo10V2O405- moiety was responsible for the catalytic oxidation of HD into non-toxic sulfoxide, while the ε-[Al13O4(OH)24(H2O)12]7+ moiety was responsible for the catalytic hydrolysis of HD and GD into nontoxic hydrolysates. Besides, the compound showed notable efficacy for the decontamination of HD on guinea pig skin and of GD on Kunming mouse skin, indicating high potential for use in human skin protection and treatment.
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Affiliation(s)
- Jialin Yu
- State Key Laboratory of Chemical Resource Engineering, College of Chemistry, Beijing University of Chemical Technology, Beijing 100029, P. R. China.
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Connolly JM, Stevenson RS, Railer RF, Clark OE, Whitten KA, Lee-Stubbs RB, Anderson DR. Impairment of wound healing by reactive skin decontamination lotion (RSDL ®) in a Göttingen minipig ® model. Cutan Ocul Toxicol 2020; 39:143-157. [PMID: 32321319 DOI: 10.1080/15569527.2020.1751183] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Reactive Skin Decontamination Lotion (RSDL®) is an FDA-approved skin decontamination kit carried by service members for removal and neutralisation of vesicants and nerve agents. The RSDL kit, comprised of a lotion-impregnated sponge, was shown to be the superior medical decontamination device for chemical warfare agent (CWA) exposure on intact skin. In the event of a chemical exposure situation (i.e. terrorism, battlefield) physical injuries are probable, and preservation of life will outweigh the risk associated with application of RSDL to compromised skin. The purpose of this study was to quantify the rate and quality of wound healing in epidermal skin wounds treated with RSDL in a porcine model. Degree of wound healing was assessed using bioengineering methods to include ballistometry, colorimetry, evaporimetry, and high-frequency ultrasonography. Clinical observation, histopathology and immunohistochemistry were also utilised. All pigs received four bilateral superficial abdominal wounds via a pneumatic dermatome on their ventral abdomen, then were treated with the following dressings over a seven-day period: RSDL sponge, petroleum based Xeroform® gauze, 3 M™ Tegaderm™ Film, and 3 M™ Tegaderm™ Foam. Two additional non-wounded sites on the flank were used as controls. Two groups of pigs were then evaluated for a 21- or 56-day time period, representing short- and long-term wound-healing progression. Our findings indicated RSDL had a negative impact on wound-healing progression at both 21 and 56 days post-injury. Wounds receiving RSDL demonstrated a decreased skin elasticity, significant transepidermal water loss, and altered skin colouration and thickness. In addition, the rate of wound healing was delayed, and return to a functional skin barrier was altered when compared to non-RSDL-treated wounds. In conclusion, wound management care and clinical therapeutic intervention plans should be established to account for a prolonged duration of healing in patients with RSDL-contaminated wounds.
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Affiliation(s)
- Jessica M Connolly
- Veterinary Medicine and Surgery Department, Research Support Division, United States Army Medical Research Institute of Chemical Defense, Aberdeen Proving Ground, MD, USA
| | - Robert S Stevenson
- Pharmaceutical Sciences Department, Medical Toxicology Research Division, United States Army Medical Research Institute of Chemical Defense, Aberdeen Proving Ground, MD, USA
| | - Roy F Railer
- Laboratory Services Department, Research Support Division, United States Army Medical Research Institute of Chemical Defense, Aberdeen Proving Ground, MD, USA
| | - Offie E Clark
- Biochemistry and Physiology Department, Medical Toxicology Research Division, United States Army Medical Research Institute of Chemical Defense, Aberdeen Proving Ground, MD, USA
| | - Kimberly A Whitten
- Comparative Pathology Department, Research Support Division, United States Army Medical Research Institute of Chemical Defense, Aberdeen Proving Ground, MD, USA
| | - Robyn B Lee-Stubbs
- Institutional Animal Care and Use Office, United States Army Medical Research Institute of Chemical Defense, Aberdeen Proving Ground, MD, USA
| | - Dana R Anderson
- Biochemistry and Physiology Department, Medical Toxicology Research Division, United States Army Medical Research Institute of Chemical Defense, Aberdeen Proving Ground, MD, USA
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21
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Su H, Yeh IJ, Wu YH, Jiang ZH, Shiea J, Lee CW. Rapid identification of organophosphorus pesticides on contaminated skin and confirmation of adequate decontamination by ambient mass spectrometry in emergency settings. RAPID COMMUNICATIONS IN MASS SPECTROMETRY : RCM 2020; 34 Suppl 1:e8562. [PMID: 31461793 DOI: 10.1002/rcm.8562] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 08/13/2019] [Accepted: 08/21/2019] [Indexed: 06/10/2023]
Abstract
RATIONALE Dermal exposure to pesticides may cause severe intoxication and even result in a fatal outcome. To expedite rescue in the emergency department, it is mandatory to develop a point-of-care analytical method for immediate identification of pesticides on the skin of exposed personnel, and to perform immediate dermal decontamination to prevent further harm and optimize the chance for full clinical recovery. METHODS Four of the most commonly used highly toxic pesticides that contaminate the skin were rapidly characterized by thermal desorption electrospray ionization mass spectrometry. The technique was also applied to confirm the completeness of pesticide decontamination from the skin. Pesticide sampling, desorption, ionization, and detection altogether took less than 30 s. In addition, different fabrics of protective garments worn by farmers were assessed with this efficient ambient mass spectrometric technique for their protective capabilities against dermal exposure to pesticides, and scanning electron microscopy was used to observe their different microstructures. The decontaminating efficacies of different cleansing agents for these skin contaminants were also evaluated by this technical platform. RESULTS The repeatability of this method had a low relative standard deviation (<22%) for the detection of pesticides on the surface of swine skin. The detection limits of the pesticides in solution were found to be in the range of 3-20 ng/mL. Linearity was observed between the signal intensities and the concentrations of the four pesticides in solution within the range of 50 ng/mL to 50 μg/mL (R2 between 0.9921 and 0.9966). In addition, it was found that PVC fabric is optimal in preventing skin contamination by fenthion and detergent had the best efficiency for fenthion decontamination. CONCLUSIONS Since the whole analytical process is extremely fast, this technique allows early point-of-care identification of contaminating pesticides on the skin of exposed patients in the emergency room, as well as rapid assessment of the adequacy of decontamination.
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Affiliation(s)
- Hung Su
- Department of Chemistry, National Sun Yat-Sen University, Kaohsiung, Taiwan
| | - I-Jeng Yeh
- Department of Emergency Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yen-Hung Wu
- Department of Emergency Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Zong-Han Jiang
- Institute of Medical Science and Technology, National Sun Yat-Sen University, Kaohsiung, Taiwan
| | - Jentaie Shiea
- Department of Chemistry, National Sun Yat-Sen University, Kaohsiung, Taiwan
- Department of Medicinal and Applied Chemistry, Kaohsiung Medical University, Kaohsiung, Taiwan
- Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chi-Wei Lee
- Institute of Medical Science and Technology, National Sun Yat-Sen University, Kaohsiung, Taiwan
- Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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Etemad L, Moshiri M, Balali-Mood M. Advances in treatment of acute sulfur mustard poisoning - a critical review. Crit Rev Toxicol 2020; 49:191-214. [PMID: 31576778 DOI: 10.1080/10408444.2019.1579779] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Sulfur mustard (SM) is a blistering chemical warfare agent that was used during the World War I and in the Iraq-Iran conflict. The aim of this paper is to discuss and critically review the published results of experiments on the treatment of SM poisoning based on our clinical and research experience. The victims must remove from the contaminated zone immediately. The best solution for decontamination is large amounts of water, using neutral soap and 0.5% sodium hypochlorite. Severely intoxicated patients should be treated according to advanced life support protocols and intensive care therapy for respiratory disorders and the chemical burn. Sodium thiosulfate infusion (100-500 mg/kg/min) should be started up to 60 min after SM exposure. However, N-acetyle cysteine (NAC) is recommended, none of them acts as specific or effective antidote. The important protective and conservative treatment of SM-induced pulmonary injuries include humidified oxygen, bronchodilators, NAC as muculytic, rehydration, mechanical ventilation, appropriate antibiotics and respiratory physiotherapy as clinically indicated. Treatment of acute SM ocular lesions start with topical antibiotics; preferably sulfacetamide eye drop, continue with lubricants, and artificial tears. Treatment for cutaneous injuries include: moist dressing; preferably with silver sulfadiazine cream, analgesic, anti-pruritic, physically debridement, debridase, Laser debridement, followed by skin autologous split-thickness therapy as clinically indicated. The new suggested medications and therapeutic approaches include: anti-inflammatory agents, Niacinamide, Silibinin, Calmodulin antagonists, Clobetasol, full-thickness skin grafting for skin injuries; Doxycycline; Bevacizumab, and Colchicine for ocular injuries. Recommended compounds based on animal studies include Niacinamide, Aprotinin, des-aspartate-angiotensin-I, Gamma-glutamyltransferase, vitamin E, and vitamin D. In vitro studies revealed that Dimethylthiourea, L-nitroarginine, Methyl-ester, Sodium pyruvate, Butylated hydroxyanisole, ethacrynic acid, and macrolide antibiotics are effective. However, none of them, except macrolide antibiotics have been proved clinically. Avoidance of inappropriate polypharmacy is advisable.
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Affiliation(s)
- Leila Etemad
- Pharmaceutical Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences , Mashhad , Iran
| | - Mohammad Moshiri
- Medical Toxicology Research Center, Faculty of Medicine, Mashhad University of Medical Sciences , Mashhad , Iran
| | - Mahdi Balali-Mood
- Medical Toxicology and Drug Abuse Research Center, Birjand University of Medical Sciences , Birjand , Iran
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23
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Wang J, Li Y, Huang J, Li W, Luo Y, Sui X, Li J, Wang Y, Yang J. A protein nanocomposite for ultra-fast, efficient and non-irritating skin decontamination of nerve agents. NANOSCALE 2020; 12:4400-4409. [PMID: 32025678 DOI: 10.1039/c9nr09015k] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
In recent assassinations reported in London and Malaysia, nerve agents were used to cause death, by skin poisoning. Skin decontamination is the ultimate and most important defense against nerve agent poisoning, because no effective antidote currently exists. However, almost no existing material can achieve effective and rapid decontamination without irritating the skin. This study links proteins that exhibit no decontamination ability with polymers to form a nanocomposite. This creates a nanospace on the surface of the protein that attracts and traps organic molecules, effectively adsorbing the nerve agent Soman within several seconds, without irritating the skin. Analysis of the different components of proteins and polymers reveals that the decontamination efficiency is considerably affected by the thickness of the coated polymer. Moreover, the thickness of the layer is predominantly determined by the size and species of the core and the crosslinking method. Further in vivo experiments on rats poisoned with Soman verify the efficiency and safety of the nanocomposite. These results could be used to design and synthesize more multi-functional and effective decontamination materials.
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Affiliation(s)
- Jiapeng Wang
- State Key Laboratory of Toxicology and Medical Countermeasures, Institutes of Pharmacology and Toxicology, Academy of Military Medical Sciences, Beijing, 100850, China.
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24
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McGarry KG, Schill KE, Winters TP, Lemmon EE, Sabourin CL, Harvilchuck JA, Moyer RA. Characterization of Cholinesterases From Multiple Large Animal Species for Medical Countermeasure Development Against Chemical Warfare Nerve Agents. Toxicol Sci 2019; 174:124-132. [DOI: 10.1093/toxsci/kfz250] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Organophosphorus (OP) compounds, which include insecticides and chemical warfare nerve agents (CWNAs) such as sarin (GB) and VX, continue to be a global threat to both civilian and military populations. It is widely accepted that cholinesterase inhibition is the primary mechanism for acute OP toxicity. Disruption of cholinergic function through the inhibition of acetylcholinesterase (AChE) leads to the accumulation of the neurotransmitter acetylcholine. Excess acetylcholine at the synapse results in an overstimulation of cholinergic neurons which manifests in the common signs and symptoms of OP intoxication (miosis, increased secretions, seizures, convulsions, and respiratory failure). The primary therapeutic strategy employed in the United States to treat OP intoxication includes reactivation of inhibited AChE with the oxime pralidoxime (2-PAM) along with the muscarinic acetylcholine receptor antagonist atropine and the benzodiazepine, diazepam. CWNAs are also known to inhibit butyrylcholinesterase (BChE) without any apparent toxic effects. Therefore, BChE may be viewed as a “bioscavenger” that stoichiometrically binds CWNAs and removes them from circulation. The degree of inhibition of AChE and BChE and the effectiveness of 2-PAM are known to vary among species. Animal models are imperative for evaluating the efficacy of CWNA medical countermeasures, and a thorough characterization of available animal models is important for translating results to humans. Thus, the objective of this study was to compare the circulating levels of each of the cholinesterases as well as multiple kinetic properties (inhibition, reactivation, and aging rates) of both AChE and BChE derived from humans to AChE and BChE derived from commonly used large animal models.
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Affiliation(s)
| | | | | | - Erin E Lemmon
- Battelle Memorial Institute, Columbus, OH 43201, Ohio
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25
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Decontamination of Chemical Warfare Agents by Novel Oximated Acrylate Copolymer. Chem Res Chin Univ 2019. [DOI: 10.1007/s40242-019-9105-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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26
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Matar H, Pinhal A, Amer N, Barrett M, Thomas E, Hughes P, Larner J, Chilcott RP. Decontamination and management of contaminated hair following a CBRN incident. Toxicol Sci 2019; 171:269-279. [PMID: 31241158 PMCID: PMC6736418 DOI: 10.1093/toxsci/kfz145] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 06/06/2019] [Accepted: 06/17/2019] [Indexed: 11/14/2022] Open
Abstract
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.
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Affiliation(s)
- Hazem Matar
- Research Centre for Topical Drug Delivery and Toxicology, Department of Pharmacy, University of Hertfordshire, UK
| | - Andreia Pinhal
- Research Centre for Topical Drug Delivery and Toxicology, Department of Pharmacy, University of Hertfordshire, UK
| | - Nevine Amer
- Research Centre for Topical Drug Delivery and Toxicology, Department of Pharmacy, University of Hertfordshire, UK
| | - Mark Barrett
- Research Centre for Topical Drug Delivery and Toxicology, Department of Pharmacy, University of Hertfordshire, UK
| | - Elliot Thomas
- Research Centre for Topical Drug Delivery and Toxicology, Department of Pharmacy, University of Hertfordshire, UK
| | - Philip Hughes
- Research Centre for Topical Drug Delivery and Toxicology, Department of Pharmacy, University of Hertfordshire, UK
| | - Joanne Larner
- Research Centre for Topical Drug Delivery and Toxicology, Department of Pharmacy, University of Hertfordshire, UK
| | - Robert P Chilcott
- Research Centre for Topical Drug Delivery and Toxicology, Department of Pharmacy, University of Hertfordshire, UK
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In vitro human skin permeation and decontamination of diisopropyl methylphosphonate (DIMP) using Dermal Decontamination Gel (DDGel) and Reactive Skin Decontamination Lotion (RSDL) at different timepoints. Toxicol Lett 2018; 299:118-123. [DOI: 10.1016/j.toxlet.2018.09.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2018] [Revised: 08/30/2018] [Accepted: 09/28/2018] [Indexed: 11/18/2022]
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28
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Cao Y, Hui X, Zhu H, Elmahdy A, Maibach H. In vitro human skin permeation and decontamination of 2-chloroethyl ethyl sulfide (CEES) using Dermal Decontamination Gel (DDGel) and Reactive Skin Decontamination Lotion (RSDL). Toxicol Lett 2018; 291:86-91. [DOI: 10.1016/j.toxlet.2018.04.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 04/11/2018] [Accepted: 04/14/2018] [Indexed: 12/01/2022]
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29
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Lydon H, Hall C, Matar H, Dalton C, Chipman JK, Graham JS, Chilcott RP. The percutaneous toxicokinetics of VX in a damaged skin porcine model and the evaluation of WoundStat™ as a topical decontaminant. J Appl Toxicol 2017; 38:318-328. [PMID: 29023806 DOI: 10.1002/jat.3542] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Revised: 08/31/2017] [Accepted: 08/31/2017] [Indexed: 11/06/2022]
Abstract
This study used a damaged skin, porcine model to evaluate the in vivo efficacy of WoundStat™ for the decontamination of superficial, nerve agent-contaminated wounds. Anaesthetized animals were randomly assigned to either control (n = 7), no decontamination (n = 12) or WoundStat™ (n = 12) treatment groups. Pigs were exposed to a 5× LD50 dose of neat, radiolabelled S-[2-(diisopropylamino)ethyl]-O-ethyl methyl-phosphonothioate (VX; or equivalent volume of sterile saline for the control group) via an area of superficially damaged skin on the ear. WoundStat™ was applied at 30 seconds post-exposure to assigned animals. The VX contaminant (or saline) and decontaminant remained in place for the duration of the study (up to 6 hours). Physiological parameters and signs of intoxication were recorded during the exposure period. Skin and organ samples were taken post mortem for 14 C-VX distribution analyses. Blood samples were taken periodically for toxicokinetic and whole-blood acetylcholinesterase (AChE) activity analyses. VX exposure was accompanied by a rapid decrease in AChE activity in all animals, regardless of decontamination. However, decontamination significantly improved survival rate and time and reduced the severity of signs of intoxication. In addition, the distribution of 14 C-VX in key internal organs and post mortem blood samples was significantly lower in the WoundStat™ treatment group. This study demonstrates that WoundStat™ may be a suitable medical countermeasure for increasing both survival rate and time following VX exposure. The results also suggest that AChE activity is not a useful prognostic indicator.
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Affiliation(s)
- Helen Lydon
- CBRN & Chemical Toxicological Research Group, Centre for Radiation, Chemical and Environmental Hazards, Health Protection Agency (now Public Health England), Chilton, UK.,School of Biosciences, University of Birmingham, Edgbaston, UK
| | - Charlotte Hall
- CBRN & Chemical Toxicological Research Group, Centre for Radiation, Chemical and Environmental Hazards, Health Protection Agency (now Public Health England), Chilton, UK.,School of Biosciences, University of Birmingham, Edgbaston, UK
| | - Hazem Matar
- CBRN & Chemical Toxicological Research Group, Centre for Radiation, Chemical and Environmental Hazards, Health Protection Agency (now Public Health England), Chilton, UK.,Research Centre for Topical Drug Delivery and Toxicology, University of Hertfordshire, Hatfield, UK
| | - Christopher Dalton
- School of Biosciences, University of Birmingham, Edgbaston, UK.,Defence Science & Technology Laboratory, Porton, UK
| | - J Kevin Chipman
- School of Biosciences, University of Birmingham, Edgbaston, UK
| | - John S Graham
- Medical Toxicology Branch Analytical Toxicology Division, U.S. Army Medical Research Institute of Chemical Defense, Aberdeen Proving Ground, MD, 21010, USA
| | - Robert P Chilcott
- CBRN & Chemical Toxicological Research Group, Centre for Radiation, Chemical and Environmental Hazards, Health Protection Agency (now Public Health England), Chilton, UK.,Research Centre for Topical Drug Delivery and Toxicology, University of Hertfordshire, Hatfield, UK
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30
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Jiang A, Maibach H. Dermatotoxicology of sulfur mustard: Historical perspectives from World War I. J Appl Toxicol 2017; 38:108-112. [PMID: 28929511 DOI: 10.1002/jat.3524] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 08/15/2017] [Accepted: 08/16/2017] [Indexed: 11/09/2022]
Abstract
Sulfur mustard has been used as a chemical warfare agent for the past century. After its introduction by the Germans in World War I, investigators quickly began studying its impact on the human body including its deleterious effects on skin. This review focuses on two groups in particular who conducted experiments from 1917 to 1918: the United States Army at the American University Experiment Station Laboratories and Torald Sollmann at Western Reserve University. Through this work, these researchers proved far ahead of their time by anticipating dermatologic phenomena not described in the literature until later in the twentieth century. These include regional variation of percutaneous penetration, effect of vehicle on penetration and predicting immunologic contact urticaria. The work conducted by these researchers set the groundwork for much of twentieth century dermatotoxicology.
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Affiliation(s)
- Austin Jiang
- University of Cincinnati College of Medicine, Cincinnati, OH, 45267, USA
| | - Howard Maibach
- University of California, San Francisco, San Francisco, CA, 94143, USA
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31
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Thors L, Koch M, Wigenstam E, Koch B, Hägglund L, Bucht A. Comparison of skin decontamination efficacy of commercial decontamination products following exposure to VX on human skin. Chem Biol Interact 2017; 273:82-89. [DOI: 10.1016/j.cbi.2017.06.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Revised: 05/15/2017] [Accepted: 06/05/2017] [Indexed: 10/19/2022]
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32
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Roul A, Le CAK, Gustin MP, Clavaud E, Verrier B, Pirot F, Falson F. Comparison of four different fuller's earth formulations in skin decontamination. J Appl Toxicol 2017; 37:1527-1536. [DOI: 10.1002/jat.3506] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Revised: 05/31/2017] [Accepted: 06/15/2017] [Indexed: 01/19/2023]
Affiliation(s)
- Annick Roul
- Université Lyon 1, UMR 5305 - CNRS/UCBL1, LBTI Lyon; France
- Laboratoire de galénique industrielle (LGI) ISPB UCBL1 Lyon; France
- Direction Générale de la Sécurité Civile et de la Gestion des Crises, Ministère de l'intérieur; Paris France
| | - Cong-Anh-Khanh Le
- Université Lyon 1, UMR 5305 - CNRS/UCBL1, LBTI Lyon; France
- Laboratoire de galénique industrielle (LGI) ISPB UCBL1 Lyon; France
| | | | - Emmanuel Clavaud
- Service départemental d'incendie et de secours de la Savoie; Saint Alban-Leysse France
| | | | - Fabrice Pirot
- Université Lyon 1, UMR 5305 - CNRS/UCBL1, LBTI Lyon; France
- Laboratoire de galénique industrielle (LGI) ISPB UCBL1 Lyon; France
| | - Françoise Falson
- Université Lyon 1, UMR 5305 - CNRS/UCBL1, LBTI Lyon; France
- Laboratoire de galénique industrielle (LGI) ISPB UCBL1 Lyon; France
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33
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Hall CA, Lydon HL, Dalton CH, Chipman JK, Graham JS, Chilcott RP. The percutaneous toxicokinetics of Sulphur mustard in a damaged skin porcine model and the evaluation of WoundStat™ as a topical decontaminant. J Appl Toxicol 2017; 37:1036-1045. [DOI: 10.1002/jat.3453] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Revised: 01/12/2017] [Accepted: 01/17/2017] [Indexed: 11/11/2022]
Affiliation(s)
- Charlotte A. Hall
- CBRN & Chemical Toxicological Research Group, Centre for Radiation; Chemical and Environmental Hazards, Health Protection Agency; Chilton UK
- School of BioSciences; University of Birmingham; Birmingham UK
| | - Helen L. Lydon
- CBRN & Chemical Toxicological Research Group, Centre for Radiation; Chemical and Environmental Hazards, Health Protection Agency; Chilton UK
- School of BioSciences; University of Birmingham; Birmingham UK
| | | | | | - John S. Graham
- Medical Toxicology Branch Analytical Toxicology Division; US Army Medical Research Institute of Chemical Defense; Aberdeen Proving Ground; MD 21010 USA
| | - Robert P. Chilcott
- CBRN & Chemical Toxicological Research Group, Centre for Radiation; Chemical and Environmental Hazards, Health Protection Agency; Chilton UK
- Research Centre for Topical Drug Delivery and Toxicology; University of Hertfordshire; Hatfield UK
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Poirier L, Jacquet P, Elias M, Daudé D, Chabrière E. [Decontamination of organophosphorus compounds: Towards new alternatives]. ANNALES PHARMACEUTIQUES FRANÇAISES 2017; 75:209-226. [PMID: 28267954 DOI: 10.1016/j.pharma.2017.01.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Revised: 01/16/2017] [Accepted: 01/24/2017] [Indexed: 01/20/2023]
Abstract
Organophosphorus coumpounds (OP) are toxic chemicals mainly used for agricultural purpose such as insecticides and were also developed and used as warfare nerve agents. OP are inhibitors of acetylcholinesterase, a key enzyme involved in the regulation of the central nervous system. Chemical, physical and biological approaches have been considered to decontaminate OP. This review summarizes the current and emerging strategies that are investigated to tackle this issue with a special emphasis on enzymatic remediation methods. During the last decade, many studies have been dedicated to the development of biocatalysts for OP removal. Among these, recent reports have pointed out the promising enzyme SsoPox isolated from the archaea Sulfolobus solfataricus. Considering both its intrinsic stability and activity, this hyperthermostable enzyme is highly appealing for the decontamination of OP.
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Affiliation(s)
- L Poirier
- Inserm, CNRS, IRD, URMITE, Aix Marseille université, Marseille, France
| | - P Jacquet
- Inserm, CNRS, IRD, URMITE, Aix Marseille université, Marseille, France
| | - M Elias
- Department of Biochemistry, Molecular Biology and Biophysics & Biotechnology Institute, University of Minnesota, St. Paul, MN 55108, États-Unis
| | - D Daudé
- Gene&GreenTK, faculté de médecine, 27, boulevard Jean-Moulin, 13385 Marseille cedex 5, France.
| | - E Chabrière
- Inserm, CNRS, IRD, URMITE, Aix Marseille université, Marseille, France; Gene&GreenTK, faculté de médecine, 27, boulevard Jean-Moulin, 13385 Marseille cedex 5, France.
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35
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Thors L, Lindberg S, Johansson S, Koch B, Koch M, Hägglund L, Bucht A. RSDL decontamination of human skin contaminated with the nerve agent VX. Toxicol Lett 2017; 269:47-54. [PMID: 28179194 DOI: 10.1016/j.toxlet.2017.02.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Revised: 01/30/2017] [Accepted: 02/04/2017] [Indexed: 11/19/2022]
Abstract
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.
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Affiliation(s)
- L Thors
- Swedish Defence Research Agency, Division of CBRN Defence and Security, Umeå, Sweden.
| | - S Lindberg
- Swedish Defence Research Agency, Division of CBRN Defence and Security, Umeå, Sweden
| | - S Johansson
- Swedish Defence Research Agency, Division of CBRN Defence and Security, Umeå, Sweden
| | - B Koch
- Swedish Defence Research Agency, Division of CBRN Defence and Security, Umeå, Sweden
| | - M Koch
- Swedish Defence Research Agency, Division of CBRN Defence and Security, Umeå, Sweden
| | - L Hägglund
- Swedish Defence Research Agency, Division of CBRN Defence and Security, Umeå, Sweden
| | - A Bucht
- Swedish Defence Research Agency, Division of CBRN Defence and Security, Umeå, Sweden; Department of Public Health and Clinical Medicine, Unit of Respiratory Medicine, Umeå University, Umeå, Sweden
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36
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Spiandore M, Piram A, Lacoste A, Prevost P, Maloni P, Torre F, Asia L, Josse D, Doumenq P. Efficacy of scalp hair decontamination following exposure to vapours of sulphur mustard simulants 2-chloroethyl ethyl sulphide and methyl salicylate. Chem Biol Interact 2016; 267:74-79. [PMID: 27492218 DOI: 10.1016/j.cbi.2016.07.018] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 07/11/2016] [Accepted: 07/13/2016] [Indexed: 11/18/2022]
Abstract
Chemical warfare agents are an actual threat and victims' decontamination is a main concern when mass exposure occurs. Skin decontamination with current protocols has been widely documented, as well as surface decontamination. However, considering hair ability to trap chemicals in vapour phase, we investigated hair decontamination after exposure to sulphur mustard simulants methyl salicylate and 2-chloroethyl ethyl sulphide. Four decontamination protocols were tested on hair, combining showering and emergency decontamination (use of Fuller's earth or Reactive Skin Decontamination Lotion RSDL®). Both simulants were recovered from hair after treatment, but contents were significantly reduced (42-85% content allowance). Showering alone was the least efficient protocol. Concerning 2-chloroethyl ethyl sulphide, protocols did not display significant differences in decontamination efficacy. For MeS, use of emergency decontaminants significantly increased showering efficacy (10-20% rise), underlining their usefulness before thorough decontamination. Our results highlighted the need to extensively decontaminate hair after chemical exposure. Residual amounts after decontamination are challenging, as their release from hair could lead to health issues.
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Affiliation(s)
| | - Anne Piram
- Aix-Marseille Univ, CNRS, LCE, Marseille, France.
| | - Alexandre Lacoste
- Bataillon des Marins-Pompiers (BMPM) de Marseille, 13303 Marseille, France
| | | | | | - Franck Torre
- Institut Méditerranéen de Biodiversité et d'Ecologie Marine et continentale (IMBE), Aix-Marseille Université, CNRS, IRD, Avignon Université, Faculté de Saint Jérôme, Case 421, 13397 Marseille Cedex 20, France
| | | | - Denis Josse
- Service Départemental d'Incendie et de Secours des Alpes-Maritimes (SDIS06), 06271 Villeneuve-Loubet Cedex, France
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37
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Pickering emulsions for skin decontamination. Toxicol In Vitro 2016; 34:45-54. [DOI: 10.1016/j.tiv.2016.03.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Revised: 02/05/2016] [Accepted: 03/10/2016] [Indexed: 11/19/2022]
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38
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Tazrart A, Bolzinger MA, Moureau A, Molina T, Coudert S, Angulo JF, Briancon S, Griffiths NM. Penetration and decontamination of americium-241 ex vivo using fresh and frozen pig skin. Chem Biol Interact 2016; 267:40-47. [PMID: 27234047 DOI: 10.1016/j.cbi.2016.05.027] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2016] [Revised: 04/21/2016] [Accepted: 05/20/2016] [Indexed: 12/12/2022]
Abstract
Skin contamination is one of the most probable risks following major nuclear or radiological incidents. However, accidents involving skin contamination with radionuclides may occur in the nuclear industry, in research laboratories and in nuclear medicine departments. This work aims to measure the penetration of the radiological contaminant Americium (241Am) in fresh and frozen skin and to evaluate the distribution of the contamination in the skin. Decontamination tests were performed using water, Fuller's earth and diethylene triamine pentaacetic acid (DTPA), which is the recommended treatment in case of skin contamination with actinides such as plutonium or americium. To assess these parameters, we used the Franz cell diffusion system with full-thickness skin obtained from pigs' ears, representative of human skin. Solutions of 241Am were deposited on the skin samples. The radioactivity content in each compartment and skin layers was measured after 24 h by liquid scintillation counting and alpha spectrophotometry. The Am cutaneous penetration to the receiver compartment is almost negligible in fresh and frozen skin. Multiple washings with water and DTPA recovered about 90% of the initial activity. The rest remains fixed mainly in the stratum corneum. Traces of activity were detected within the epidermis and dermis which is fixed and not accessible to the decontamination.
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Affiliation(s)
- A Tazrart
- Laboratoire de RadioToxicologie, CEA/DRF/iRCM, Bruyères le Châtel, Arpajon, France; Université de Lyon, F-69008, Lyon, France; Laboratoire de Dermopharmacie et Cosmétologie, Laboratoire d'Automatique et de Génie des Procédés (LAGEP), UMR CNRS 5007, 8, Avenue Rockefeller, 69373 Lyon Cedex 08, France
| | - M A Bolzinger
- Université de Lyon, F-69008, Lyon, France; Laboratoire de Dermopharmacie et Cosmétologie, Laboratoire d'Automatique et de Génie des Procédés (LAGEP), UMR CNRS 5007, 8, Avenue Rockefeller, 69373 Lyon Cedex 08, France
| | - A Moureau
- Laboratoire de RadioToxicologie, CEA/DRF/iRCM, Bruyères le Châtel, Arpajon, France
| | - T Molina
- Laboratoire de RadioToxicologie, CEA/DRF/iRCM, Bruyères le Châtel, Arpajon, France
| | - S Coudert
- Laboratoire de RadioToxicologie, CEA/DRF/iRCM, Bruyères le Châtel, Arpajon, France
| | - J F Angulo
- Laboratoire de RadioToxicologie, CEA/DRF/iRCM, Bruyères le Châtel, Arpajon, France
| | - S Briancon
- Université de Lyon, F-69008, Lyon, France; Laboratoire de Dermopharmacie et Cosmétologie, Laboratoire d'Automatique et de Génie des Procédés (LAGEP), UMR CNRS 5007, 8, Avenue Rockefeller, 69373 Lyon Cedex 08, France
| | - N M Griffiths
- Laboratoire de RadioToxicologie, CEA/DRF/iRCM, Bruyères le Châtel, Arpajon, France.
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Jacquet P, Daudé D, Bzdrenga J, Masson P, Elias M, Chabrière E. Current and emerging strategies for organophosphate decontamination: special focus on hyperstable enzymes. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2016; 23:8200-18. [PMID: 26832878 DOI: 10.1007/s11356-016-6143-1] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Accepted: 01/20/2016] [Indexed: 06/05/2023]
Abstract
Organophosphorus chemicals are highly toxic molecules mainly used as pesticides. Some of them are banned warfare nerve agents. These compounds are covalent inhibitors of acetylcholinesterase, a key enzyme in central and peripheral nervous systems. Numerous approaches, including chemical, physical, and biological decontamination, have been considered for developing decontamination methods against organophosphates (OPs). This work is an overview of both validated and emerging strategies for the protection against OP pollution with special attention to the use of decontaminating enzymes. Considerable efforts have been dedicated during the past decades to the development of efficient OP degrading biocatalysts. Among these, the promising biocatalyst SsoPox isolated from the archaeon Sulfolobus solfataricus is emphasized in the light of recently published results. This hyperthermostable enzyme appears to be particularly attractive for external decontamination purposes with regard to both its catalytic and stability properties.
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Affiliation(s)
- Pauline Jacquet
- Aix Marseille Université, URMITE, UM63, CNRS 7278, IRD 198, INSERM 1095, Marseille, France
| | - David Daudé
- Gene&GreenTK, Faculté de Médecine, 27 boulevard Jean Moulin, Cedex 5, Marseille, 13385, France
| | - Janek Bzdrenga
- Aix Marseille Université, URMITE, UM63, CNRS 7278, IRD 198, INSERM 1095, Marseille, France
| | - Patrick Masson
- Neuropharmacology Laboratory, Kazan Federal University, Kazan, 420008, Russia
| | - Mikael Elias
- Department of Biochemistry, Molecular Biology and Biophysics & Biotechnology Institute, University of Minnesota, St. Paul, MN, 55108, USA
| | - Eric Chabrière
- Aix Marseille Université, URMITE, UM63, CNRS 7278, IRD 198, INSERM 1095, Marseille, France.
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40
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Matar H, Guerreiro A, Piletsky SA, Price SC, Chilcott RP. Preliminary evaluation of military, commercial and novel skin decontamination products against a chemical warfare agent simulant (methyl salicylate). Cutan Ocul Toxicol 2015; 35:137-44. [PMID: 26339920 DOI: 10.3109/15569527.2015.1072544] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Rapid decontamination is vital to alleviate adverse health effects following dermal exposure to hazardous materials. There is an abundance of materials and products which can be utilised to remove hazardous materials from the skin. In this study, a total of 15 products were evaluated, 10 of which were commercial or military products and five were novel (molecular imprinted) polymers. The efficacies of these products were evaluated against a 10 µl droplet of (14)C-methyl salicylate applied to the surface of porcine skin mounted on static diffusion cells. The current UK military decontaminant (Fuller's earth) performed well, retaining 83% of the dose over 24 h and served as a benchmark to compare with the other test products. The five most effective test products were Fuller's earth (the current UK military decontaminant), Fast-Act® and three novel polymers [based on itaconic acid, 2-trifluoromethylacrylic acid and N,N-methylenebis(acrylamide)]. Five products (medical moist-free wipes, 5% FloraFree™ solution, normal baby wipes, baby wipes for sensitive skin and Diphotérine™) enhanced the dermal absorption of (14)C-methyl salicylate. Further work is required to establish the performance of the most effective products identified in this study against chemical warfare agents.
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Affiliation(s)
- Hazem Matar
- a Department of Pharmacy , University of Hertfordshire , Hatfield , UK
| | - Antonio Guerreiro
- b Department of Chemistry , University of Leicester , Leicester , UK , and
| | - Sergey A Piletsky
- b Department of Chemistry , University of Leicester , Leicester , UK , and
| | - Shirley C Price
- c Faculty of Health and Medical Sciences , University of Surrey , Guildford , UK
| | - Robert P Chilcott
- a Department of Pharmacy , University of Hertfordshire , Hatfield , UK
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41
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Comparison of Selected Methods for Individual Decontamination of Chemical Warfare Agents. TOXICS 2014. [DOI: 10.3390/toxics2020307] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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42
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Evidence-based patient decontamination: an integral component of mass exposure chemical incident planning and response. Disaster Med Public Health Prep 2014; 8:260-266. [PMID: 24867089 DOI: 10.1017/dmp.2014.41] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Decontaminating patients who have been exposed to hazardous chemicals can directly benefit the patients' health by saving lives and reducing the severity of toxicity. While the importance of decontaminating patients to prevent the spread of contamination has long been recognized, its role in improving patient health outcomes has not been as widely appreciated. Acute chemical toxicity may manifest rapidly-often minutes to hours after exposure. Patient decontamination and emergency medical treatment must be initiated as early as possible to terminate further exposure and treat the effects of the dose already absorbed. In a mass exposure chemical incident, responders and receivers are faced with the challenges of determining the type of care that each patient needs (including medical treatment, decontamination, and behavioral health support), providing that care within the effective window of time, and protecting themselves from harm. The US Department of Health and Human Services and Department of Homeland Security have led the development of national planning guidance for mass patient decontamination in a chemical incident to help local communities meet these multiple, time-sensitive health demands. This report summarizes the science on which the guidance is based and the principles that form the core of the updated approach.
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Sun JH, Sun PP, Zheng W, Han S, Ying Y, Liu HY, Zhang C, Zhao BQ, Zuo GM, Lu H, Zhong YX. Skin decontamination efficacy of potassium ketoxime on rabbits exposed to sulfur mustard. Cutan Ocul Toxicol 2014; 34:1-6. [DOI: 10.3109/15569527.2014.880454] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Stehle R, Schulreich C, Wellert S, Gäb J, Blum MM, Kehe K, Richardt A, Lapp A, Hellweg T. An enzyme containing microemulsion based on skin friendly oil and surfactant as decontamination medium for organo phosphates: Phase behavior, structure, and enzyme activity. J Colloid Interface Sci 2014; 413:127-32. [DOI: 10.1016/j.jcis.2013.09.027] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2013] [Revised: 09/06/2013] [Accepted: 09/07/2013] [Indexed: 10/26/2022]
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Rolland P, Bolzinger MA, Cruz C, Josse D, Briançon S. Hairy skin exposure to VX in vitro: Effectiveness of delayed decontamination. Toxicol In Vitro 2013; 27:358-66. [DOI: 10.1016/j.tiv.2012.08.014] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2012] [Revised: 08/07/2012] [Accepted: 08/08/2012] [Indexed: 11/16/2022]
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Abstract
INTRODUCTION Mobile decontamination units are intended to be used at the accident site to decontaminate persons contaminated by toxic substances. A test program was carried out to evaluate the efficacy of mobile decontamination units. OBJECTIVE The tests included functionality, methodology, inside environment, effects of wind direction, and decontamination efficacy. METHODS Three different types of units were tested during summer and winter conditions. Up to 15 test-persons per trial were contaminated with the imitation substances Purasolve ethyl lactate (PEL) and methyl salicylate (MES). Decontamination was carried out according to standardized procedures. During the decontamination trials, the concentrations of the substances inside the units were measured. After decontamination, substances evaporating from test-persons and blankets as well as remaining amounts in the units were measured. RESULTS The air concentrations of PEL and MES inside the units during decontamination in some cases exceeded short-term exposure limits for most toxic industrial chemicals. This was a problem, especially during harmful wind conditions, i.e., wind blowing in the same direction as persons moving through the decontamination units. Although decontamination removed a greater part of the substances from the skin, the concentrations evaporating from some test-persons occasionally were high and potentially harmful if the substances had been toxic. The study also showed that blankets placed in the units absorbed chemicals and that the units still were contaminated five hours after the end of operations. CONCLUSIONS After decontamination, the imitation substances still were present and evaporating from the contaminated persons, blankets, and units. These results indicate a need for improvements in technical solutions, procedures, and training.
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Misik J, Jost P, Pavlikova R, Vodakova E, Cabal J, Kuca K. A comparison of decontamination effects of commercially available detergents in rats pre-exposed to topical sulphur mustard. Cutan Ocul Toxicol 2012; 32:135-9. [DOI: 10.3109/15569527.2012.730087] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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In vitro study to determine decontamination of 3,5-dichloro-2,4,6-trifluoropyridine (DCTFP) from human skin. Food Chem Toxicol 2012; 50:2496-502. [DOI: 10.1016/j.fct.2012.03.069] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2011] [Revised: 03/22/2012] [Accepted: 03/24/2012] [Indexed: 11/21/2022]
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Mikler J, Tenn C, Worek F, Reiter G, Thiermann H, Garrett M, Bohnert S, Sawyer T. Immobilization of Russian VX skin depots by localized cooling: Implications for decontamination and medical countermeasures. Toxicol Lett 2011; 206:47-53. [DOI: 10.1016/j.toxlet.2011.05.1047] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2011] [Accepted: 05/30/2011] [Indexed: 10/18/2022]
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The therapeutic use of localized cooling in the treatment of VX poisoning. Toxicol Lett 2011; 204:52-6. [DOI: 10.1016/j.toxlet.2011.04.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2011] [Revised: 04/06/2011] [Accepted: 04/11/2011] [Indexed: 11/23/2022]
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