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Cornelissen AS, van den Berg RM, Langenberg JP, van Grol M, Bross R, Pittman J, Cochrane L, Savransky V. Effective skin decontamination with RSDL® (reactive skin decontamination lotion kit) following dermal exposure to a Novichok class nerve agent. Chem Biol Interact 2024; 395:111001. [PMID: 38641146 DOI: 10.1016/j.cbi.2024.111001] [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: 03/07/2024] [Revised: 03/30/2024] [Accepted: 04/07/2024] [Indexed: 04/21/2024]
Abstract
In recent years, various poisoning incidents have been reported, involving the alleged use of the so-called Novichok agents, resulting in their addition to the Schedule I list of the Organisation for the Prohibition of Chemical Warfare (OPCW). As the physicochemical properties of these agents are different from the 'classical' nerve agents, such as VX, research is needed to evaluate whether and to what extent existing countermeasures are effective. Here, we evaluated the therapeutic potential of RSDL® (Reactive Skin Decontamination Lotion Kit) for the neutralization of percutaneous toxicity caused by Novichok agents, both in vitro and in vivo. Experiments showed the three selected Novichok agents (A230, A232, A234) could be degraded by RSDL lotion, but at a different rate. The half-life of A234, in the presence of an excess of RSDL lotion, was 36 min, as compared to A230 (<5 min) and A232 (18 min). Following dermal exposure of guinea pigs to A234, application of the RSDL kit was highly effective in preventing intoxication, even when applied up until 30 min following exposure. Delayed use of the RSDL kit until the appearance of clinical signs of intoxication (3-4 h) was not able to prevent intoxication progression and deaths. This study determines RSDL decontamination as an effective treatment strategy for dermal exposure to the Novichok agent A234 and underscores the importance of early, forward use of skin decontamination, as rapidly as possible.
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Affiliation(s)
- Alex S Cornelissen
- TNO Defence, Safety and Security, CBRN Protection, Rijswijk, the Netherlands
| | | | - Jan P Langenberg
- TNO Defence, Safety and Security, CBRN Protection, Rijswijk, the Netherlands
| | - Marco van Grol
- TNO Defence, Safety and Security, CBRN Protection, Rijswijk, the Netherlands
| | - Rowdy Bross
- TNO Defence, Safety and Security, CBRN Protection, Rijswijk, the Netherlands
| | - John Pittman
- Emergent BioSolutions Inc., Gaithersburg, MD, USA
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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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Bloch-Shilderman E, Nili U, Nahum V, Smolkin B, Ashkenazi N. "Catch-up" therapy: combining antidotal treatment with dermal application of AHA following percutaneous VX poisoning in the domestic swine. Arch Toxicol 2023; 97:2771-2783. [PMID: 37610476 DOI: 10.1007/s00204-023-03574-5] [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: 06/13/2023] [Accepted: 08/02/2023] [Indexed: 08/24/2023]
Abstract
Low-volatility organophosphorus chemical warfare agents (OP CWAs) are cholinesterase inhibitors which easily absorb into the skin, leading to the formation of a dermal depot from which they slowly enter the bloodstream. This leads to sustained cholinergic hyperstimulation, which if untreated may lead to death. However, current available countermeasures are not adequate to neutralize the agent residing in the dermal depot. Accordingly, we evaluated the efficacy of the potassium salt of acetohydroxamic acid (880 mg/ml in DMSO/H2O 1:4, AHAK), as a potential "catch-up" therapy lotion intended to neutralize the dermal depot, by penetrating the skin and decomposing it before it reaches the bloodstream. To that end, we compared the clinical outcome following skin surface decontamination combined with antidotal treatment, to that following the same antidotal treatment combined with dermal application of AHAK at the site of VX exposure, against percutaneous poisoning by a lethal neat dose (4 mg/kg) of the low-volatility nerve agent VX, in an unanesthetized swine model. Following skin surface decontamination and antidotal treatment, recurrence of intoxication signs and a prolonged recovery time were observed. In contrast, similar antidotal treatment combined with dermal application of AHAK significantly reduced intoxication signs recurrences and accordingly medical supervision duration needed, paralleled by a significantly faster recovery of whole blood cholinesterase activity. An initial evaluation demonstrated the safety of prolonged whole-body AHAK application. Hence, the AHAK lotion may act as an efficient "catch-up" therapy against percutaneous poisoning by low-volatility OP CWAs, improving the clinical outcome and reducing the burden on medical staff.
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Affiliation(s)
- Eugenia Bloch-Shilderman
- Department of Pharmacology, IIBR-Israel Institute for Biological Research, P.O. Box 19, 7410001, Ness Ziona, Israel.
| | - Uri Nili
- Department of Pharmacology, IIBR-Israel Institute for Biological Research, P.O. Box 19, 7410001, Ness Ziona, Israel
| | - Victoria Nahum
- Department of Organic Chemistry, IIBR-Israel Institute for Biological Research, P.O. Box 19, 7410001, Ness Ziona, Israel
| | - Boris Smolkin
- Department of Organic Chemistry, IIBR-Israel Institute for Biological Research, P.O. Box 19, 7410001, Ness Ziona, Israel
| | - Nissan Ashkenazi
- Department of Organic Chemistry, IIBR-Israel Institute for Biological Research, P.O. Box 19, 7410001, Ness Ziona, Israel.
- Department of Chemical Sciences, Ariel University, 4070000, Ariel, Israel.
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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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Thors L, Wigenstam E, Qvarnström J, Larsson A, Lindberg S, Öberg L, Rattfelt-Nyholm J, Bucht A. Comparison of skin decontamination strategies in the initial operational response following chemical exposures. Toxicol In Vitro 2023; 87:105539. [PMID: 36539105 DOI: 10.1016/j.tiv.2022.105539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 12/03/2022] [Accepted: 12/15/2022] [Indexed: 12/23/2022]
Abstract
In mass casualty incidents including hazardous chemical skin exposure, decontamination is the primary intervention to avoid systemic uptake of the toxic compound. The protocol needs to be both simple and efficient to enable a rapid response and avoid delay of patient management. In the present study, decontamination strategies included in the initial operational response were evaluated following human skin exposure in vitro to four different contaminants. Results demonstrated that the efficacy of selected decontamination procedures was highly dependent on the chemical contaminant used. Dry removal of the sulfur mustard simulant methyl salicylate prior to wet decontamination was found beneficial compared to wet decontamination alone. Rapidly initiated wet decontamination was more efficient compared to dry and wet removal of the industrial chemical 2-butoxyethanol and the nerve agent tabun. Following VX-exposure, all wet decontamination procedures resulted in increased agent penetration compared to the control. In conclusion, challenges in establishing simple and efficient decontamination procedures for a broad-spectrum of chemicals have been demonstrated. The impact of including a dry removal step during decontamination was evidently agent specific. Despite the variation in efficacy, immediately initiated dry removal may facilitate patient management until wet decontamination resources are available and to reduce the risk of secondary contamination.
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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
| | - Andreas Larsson
- Swedish Defence Research Agency, CBRN Defence and Security, Umeå, Sweden
| | - Sandra Lindberg
- 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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Thors L, Wästerby P, Wigenstam E, Larsson A, Öberg L, Bucht A. Do cold weather temperatures affect the efficacy of skin decontamination? J Appl Toxicol 2021; 42:961-969. [PMID: 34850419 DOI: 10.1002/jat.4265] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 10/18/2021] [Accepted: 10/30/2021] [Indexed: 01/06/2023]
Abstract
Skin decontamination in cold weather temperatures might be challenging due to the aggravating circumstances. However, no information is available on the efficacy of commonly used procedures in winter conditions. Therefore, the efficacy of the reactive skin decontamination lotion (RSDL) and soapy water decontamination following skin exposure to the nerve agent VX was evaluated at three ambient air temperatures (-5°C, -15°C and room temperature). Experiments were performed in vitro using human dermatomed skin. The ability of RSDL to degrade VX at the three different air temperatures was separately evaluated. The ambient air temperature in experiments without decontamination did not influence the penetration rate of VX through skin. RSDL decontamination was highly efficient in removing VX from skin when performed in all three ambient temperatures, despite the slower agent degradation rate of VX at the lower temperatures. Decontamination with soapy water at RT resulted in an increased skin penetration of VX compared with the control without decontamination; however, in colder temperatures the VX skin penetration was similar to the corresponding control without decontamination. At RT, dry removal prior to washing with soapy water did not improve decontamination of VX compared with washing solely with soapy water. This study demonstrated high efficacy of RSDL decontamination following skin exposure to VX also at cold temperatures. The previously reported 'wash-in' effect of soapy water on VX skin penetration was reduced at cold temperatures. Altogether, this study found a scientific basis to establish guidelines for skin decontamination of chemical casualties at cold weather temperatures.
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Affiliation(s)
- Lina Thors
- Swedish Defence Research Agency, CBRN Defence and security, Umeå, Sweden
| | - Pär Wästerby
- Swedish Defence Research Agency, CBRN Defence and security, Umeå, Sweden
| | | | - Andreas Larsson
- 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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Chiang C, Kashetsky N, Feschuk A, Burli A, Law RM, Maibach HI. Efficacy of water-only or soap and water skin decontamination of chemical warfare agents or simulants using in vitro human models: A systematic review. J Appl Toxicol 2021; 42:930-941. [PMID: 34665468 DOI: 10.1002/jat.4251] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 09/20/2021] [Accepted: 09/23/2021] [Indexed: 11/06/2022]
Abstract
Water-only or water and soap are widely recommended as preferred solutions for dermal decontamination. However, limited efficacy data exist. We summarized experimental studies evaluating in vitro efficacy of water-only or soap and water in decontaminating chemical warfare agents (CWA) or their simulants from human skin models. Embase, Covidence®, MEDLINE, PubMed, Web of Science, and Google Scholar were searched for articles using water-only or soap and water decontamination methods for removal of CWA/CWA simulants in in vitro human skin models. Data extraction was completed from seven studies, yielding seven contaminants. Water-only decontamination led to partial decontamination in all skin samples (100%, n = 81/81). Soap and water decontamination led to partial decontamination in all skin samples (100%, n = 143/143). Four studies found decontamination to either paradoxically enhance absorption of contaminants or their penetration rates, known as the "wash-in" effect. Despite recommendations, water-only or water and soap decontamination were found to yield partial decontamination of CWA or their simulants in all human in vitro studies. Thus, more effective decontaminating agents are needed. Some studies demonstrated increased or faster penetration of chemicals following decontamination, which could prove deadly for agents such as VX, although these findings require in vivo validation. Heterogeneity in experimental setups limits interstudy comparison, and it remains unclear when water-only or water and soap are ideal decontaminants, which requires more studies. Pending manuscripts will summarize in vivo human and animal efficacy data. International harmonized efficacy protocol should enable more efficient public health decisions for evidence-based public health decisions.
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Affiliation(s)
- Chavy Chiang
- School of Medicine and Dentistry, University of Rochester, Rochester, New York, USA
| | - Nadia Kashetsky
- Faculty of Medicine, Memorial University, St. John's, Newfoundland & Labrador, Canada
| | - Aileen Feschuk
- Faculty of Medicine, Memorial University, St. John's, Newfoundland & Labrador, Canada
| | - Anuk Burli
- School of Medicine and Dentistry, University of Rochester, Rochester, New York, USA
| | - Rebecca M Law
- Faculty of Medicine, Memorial University, St. John's, Newfoundland & Labrador, Canada.,School of Pharmacy, Memorial University, St. John's, Newfoundland & Labrador, Canada
| | - Howard I Maibach
- Department of Dermatology, University of California San Francisco, San Francisco, California, USA
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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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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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Towards catch-up therapy: evaluation of nucleophilic active pharmaceutical ingredients for the treatment of percutaneous VX poisoning, in-vial and in-vitro studies. Int J Pharm 2021; 603:120689. [PMID: 33965544 DOI: 10.1016/j.ijpharm.2021.120689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 04/28/2021] [Accepted: 05/04/2021] [Indexed: 11/23/2022]
Abstract
Dermal exposure to low volatility organophosphorus chemical warfare agents (OP CWA) poses a great risk to the exposed person. Due to their lipophilic nature, these compounds rapidly absorb into the skin, leading to the formation of a "dermal reservoir" from which they slowly enter the bloodstream causing prolonged intoxication. Traditionally, strategies to counter the toxicity of such substances consist of chemical decontamination/physical removal of the residual agent from the skin surface (preferably as soon as possible following the exposure) and administration of antidotes in the case of intoxication signs. Hence, these strategies are unable to counter a substantial amount of the agent, which accumulates inthe dermal reservoir. More than a decade ago, the concept of a "catch-up therapy" intended to neutralize the dermal reservoir was suggested. Herein, we describe examples of potential "catch-up therapy" lotions - vehicles designed to deliver small nucleophilic molecules into the skin and potentially decompose the remaining CWA before it reaches the blood stream. Eleven nucleophilic compounds, based on approved drugs, were initially screened. They were then tested in various binary solutions, for their detoxification efficacy and degradation ability towards lipophilic OP CWA models such as dibutylphosphofluoridate and o-nitro-phenyl diphenyl phosphate, as well as the nerve agent VX, by means of kinetic 31P NMR and UV-Vis spectroscopy. Of these, the potassium and diethyl ammonium salts of acetohydroxamic acid (AHAK and AHA DEA) in (DMSO/H2O 1:4) were found to be the most active nucleophiles, hydrolyzing VX in practical time scales (t1/2 = 5.28 and 6.78 min, respectively). The vehicle solution DMSO/H2O 1:4 promoted the penetration of substantial amounts of AHA K and AHA DEA through excised pig skin in in-vitro studies, suggesting that such formulations may serve as useful CWA nucleophilic scavengers for both on and within -skin detoxification. These findings may pave the way to a more efficacious treatment against low volatility OP CWA percutaneous poisoning.
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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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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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Collins S, James T, Southworth F, Davidson L, Williams N, Orchard E, Marczylo T, Amlôt R. Human volunteer study of the decontamination of chemically contaminated hair and the consequences for systemic exposure. Sci Rep 2020; 10:20822. [PMID: 33257756 PMCID: PMC7705014 DOI: 10.1038/s41598-020-77930-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 11/18/2020] [Indexed: 02/03/2023] Open
Abstract
The decontamination of exposed persons is a priority following the release of toxic chemicals. Efficacious decontamination reduces the risk of harm to those directly affected and prevents the uncontrolled spread of contamination. Human studies examining the effectiveness of emergency decontamination procedures have primarily focused on decontaminating skin, with few examining the decontamination of hair and scalp. We report the outcome of two studies designed to evaluate the efficacy of current United Kingdom (UK) improvised, interim and specialist mass casualty decontamination protocols when conducted in sequence. Decontamination efficacy was evaluated using two chemical simulants, methyl salicylate (MeS) and benzyl salicylate (BeS) applied to and recovered from the hair of volunteers. Twenty-four-hour urinary MeS and BeS were measured as a surrogate for systemic bioavailability. Current UK decontamination methods performed in sequence were partially effective at removing MeS and BeS from hair and underlying scalp. BeS and MeS levels in urine indicated that decontamination had no significant effect on systemic exposure raising important considerations with respect to the speed of decontamination. The decontamination of hair may therefore be challenging for first responders, requiring careful management of exposed persons following decontamination. Further work to extend these studies is required with a broader range of chemical simulants, a larger group of volunteers and at different intervention times.
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Affiliation(s)
- Samuel Collins
- Chemical and Environmental Effects Department, Centre for Radiation, Chemicals and Environmental Hazards, Public Health England, Didcot, Oxfordshire, UK.
| | - Thomas James
- Chemical and Environmental Effects Department, Centre for Radiation, Chemicals and Environmental Hazards, Public Health England, Didcot, Oxfordshire, UK
| | - Felicity Southworth
- Behavioural Science Team, Emergency Response Department Science and Technology, Public Health England, Porton Down, UK
| | - Louise Davidson
- Behavioural Science Team, Emergency Response Department Science and Technology, Public Health England, Porton Down, UK
| | - Natalie Williams
- Behavioural Science Team, Emergency Response Department Science and Technology, Public Health England, Porton Down, UK
| | - Emily Orchard
- Behavioural Science Team, Emergency Response Department Science and Technology, Public Health England, Porton Down, UK
| | - Tim Marczylo
- Toxicology Department, Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Didcot, Oxfordshire, UK
| | - Richard Amlôt
- Behavioural Science Team, Emergency Response Department Science and Technology, Public Health England, Porton Down, UK
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Cao Y, Hui X, Maibach HI. Effect of superabsorbent polymers (SAP) and metal organic frameworks (MOF) wiping sandwich patch on human skin decontamination and detoxification in vitro. Toxicol Lett 2020; 337:7-17. [PMID: 33197554 DOI: 10.1016/j.toxlet.2020.11.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 10/27/2020] [Accepted: 11/04/2020] [Indexed: 11/18/2022]
Abstract
Most chemical warfare agents partition rapidly into stratum corneum (SC) and subsequently slowly diffuse through - or are retained in the membrane. Since chemicals can interact with SC components during the process, skin decontamination poses a challenging yet important problem. To address these issues, we have developed a new method in combination with wet and dry decon technologies with new materials for emergency or delayed contamination scenarios. An in vitro human skin diffusion system was employed to model various dermal exposures of radiolabeled chemical warfare simulants, followed by surface decontamination with metal organic frameworks (MOFs), super-absorbent polymers (SAP), and/or dermal decontamination gel (DDGel). All samples measured for radioactive recovery and acetylcholinesterase activity to ascertain relative decon efficacy. Results demonstrated powerful water absorption of SAP, strong catalysis of UiO-66 MOF, and decon enhancement of pre-wetting surface contaminants. SAP had no interfering interactions with MOF yet provided additional benefits as porosity and reactivity that allowed for fast liquidized chemical transportation, absorption, and degeneration. We then designed a cotton-based SAP/MOF patch that worked cooperatively in decontamination and detoxification. Together with pre-wet, SAP/MOF wipe, and DDGel applications, maximum effect was observed in early and/or extended dermal exposure, and no "wash-in" effect occurred.
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Affiliation(s)
- Yachao Cao
- Department of Dermatology, School of Medicine, University of California San Francisco, 2340 Sutter Street, N461, San Francisco, CA 94143-0989, USA; School of Mechanical Engineering, Hebei University of Science and Technology, No. 26 Yuxiang Street, Shijiangzhuang, Hebei, 050018 PR China
| | - Xiaoying Hui
- Department of Dermatology, School of Medicine, University of California San Francisco, 2340 Sutter Street, N461, San Francisco, CA 94143-0989, USA.
| | - Howard I Maibach
- Department of Dermatology, School of Medicine, University of California San Francisco, 2340 Sutter Street, N461, San Francisco, CA 94143-0989, USA
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Thors L, Öberg L, Forsberg E, Wigenstam E, Larsson A, Bucht A. Skin penetration and decontamination efficacy following human skin exposure to fentanyl. Toxicol In Vitro 2020; 67:104914. [DOI: 10.1016/j.tiv.2020.104914] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 06/04/2020] [Accepted: 06/11/2020] [Indexed: 10/24/2022]
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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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Hoffmann A, Fingerle V, Noll M. Analysis of Tick Surface Decontamination Methods. Microorganisms 2020; 8:microorganisms8070987. [PMID: 32630152 PMCID: PMC7409031 DOI: 10.3390/microorganisms8070987] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 06/19/2020] [Accepted: 06/29/2020] [Indexed: 11/23/2022] Open
Abstract
Various microbial pathogens have been found in ticks such as Ixodes ricinus. However, most studies assessed tick microbiomes without prior decontamination of the tick surface, which may alter the results and mislead conclusions regarding the composition of the tick-borne microbiome. The aim of this study was to test four different decontamination methods, namely (i.) 70% ethanol, (ii.) DNA Away, (iii.) 5% sodium hypochlorite and (iv.) Reactive Skin Decontamination Lotion (RSDL), which have been previously reported for tick surface and animal or human skin decontamination. To test the efficiency of decontamination, we contaminated each tick with a defined mixture of Escherichia coli, Micrococcus luteus, Pseudomonas fluorescens, dog saliva and human sweat. No contamination was used as a negative control, and for a positive control, a no decontamination strategy was carried out. After nucleic acid extraction, the recovery rate of contaminants was determined for RNA and DNA samples by qPCR and tick-borne microbiome analyses by bacterial 16S rRNA and 16S rRNA gene amplicon sequencing. Ticks treated with 5% sodium hypochlorite revealed the lowest number of contaminants followed by DNA Away, RSDL and 70% ethanol. Moreover, tick microbiomes after 5% sodium hypochlorite decontamination clustered with negative controls. Therefore, the efficiency of decontamination was optimal with 5% sodium hypochlorite and is recommended for upcoming studies to address the unbiased detection of tick-borne pathogens.
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Affiliation(s)
- Angeline Hoffmann
- Institute for Bioanalysis, Department of Applied Sciences, Coburg University of Applied Sciences and Arts, 96450 Coburg, Germany;
| | - Volker Fingerle
- Bavarian Health and Food Safety Authority (LGL), National Reference Center for Borrelia, 85764 Oberschleißheim, Germany;
| | - Matthias Noll
- Institute for Bioanalysis, Department of Applied Sciences, Coburg University of Applied Sciences and Arts, 96450 Coburg, Germany;
- Correspondence: ; Tel.: +49-9561-317-645
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Amend N, Niessen KV, Seeger T, Wille T, Worek F, Thiermann H. Diagnostics and treatment of nerve agent poisoning—current status and future developments. Ann N Y Acad Sci 2020; 1479:13-28. [DOI: 10.1111/nyas.14336] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 02/25/2020] [Accepted: 03/05/2020] [Indexed: 12/20/2022]
Affiliation(s)
- Niko Amend
- Bundeswehr Institute of Pharmacology and Toxicology Munich Germany
| | - Karin V. Niessen
- Bundeswehr Institute of Pharmacology and Toxicology Munich Germany
| | - Thomas Seeger
- Bundeswehr Institute of Pharmacology and Toxicology Munich Germany
| | - Timo Wille
- Bundeswehr Institute of Pharmacology and Toxicology Munich Germany
| | - Franz Worek
- Bundeswehr Institute of Pharmacology and Toxicology Munich Germany
| | - Horst Thiermann
- Bundeswehr Institute of Pharmacology and Toxicology Munich Germany
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21
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de Bruin-Hoegée M, de Koning MC, Cochrane L, Joosen MJ. Contact transfer risk from fentanyl-contaminated RSDL® Kit. Toxicol Lett 2020; 319:237-241. [DOI: 10.1016/j.toxlet.2019.11.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Revised: 11/09/2019] [Accepted: 11/11/2019] [Indexed: 02/06/2023]
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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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Hybrid in vitro diffusion cell for simultaneous evaluation of hair and skin decontamination: temporal distribution of chemical contaminants. Sci Rep 2018; 8:16906. [PMID: 30443008 PMCID: PMC6237820 DOI: 10.1038/s41598-018-35105-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Accepted: 10/22/2018] [Indexed: 01/12/2023] Open
Abstract
Most casualty or personnel decontamination studies have focused on removing contaminants from the skin. However, scalp hair and underlying skin are the most likely areas of contamination following airborne exposure to chemicals. The aim of this study was to investigate the interactions of contaminants with scalp hair and underlying skin using a hybrid in vitro diffusion cell model. The in vitro hybrid test system comprised “curtains” of human hair mounted onto sections of excised porcine skin within a modified diffusion cell. The results demonstrated that hair substantially reduced underlying scalp skin contamination and that hair may provide a limited decontamination effect by removing contaminants from the skin surface. This hybrid test system may have application in the development of improved chemical incident response processes through the evaluation of various hair and skin decontamination strategies.
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Matar H, Price SC, Chilcott RP. Further studies of the efficacy of military, commercial and novel skin decontaminants against the chemical warfare agents sulphur Mustard, Soman and VX. Toxicol In Vitro 2018; 54:263-268. [PMID: 30347232 DOI: 10.1016/j.tiv.2018.10.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 09/25/2018] [Accepted: 10/19/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND/AIMS Following an incident involving toxic chemicals, deployment of countermeasures before the arrival of specialised services at the scene may provide a "therapeutic" window in which to mitigate skin absorption. METHODS Five potential candidates (itaconic acid, N,N'-methylenebisacrylamide, 2-trifluoromethylacrylic acid, fuller's earth and Fast-Act®) previously found effective against a simulant (methyl salicylate) were evaluated against a 10 μL droplet of 14C-sulphur mustard (HD), soman (GD) or VX applied to the surface of porcine skin mounted on static skin diffusion cells. RESULTS All the decontaminants applied to the skin 5 min post exposure achieved a marked reduction in the amount of 14C contaminant remaining within the skin at 24 h. Itaconic acid significantly (p < .05) reduced the amount of 14C-HD, GD and VX remaining in the skin at 24 h. Additionally, 2-trifluoromethylacrylic acid significantly reduced the amount of 14C-HD, whilst fuller's earth significantly reduced the amounts of 14C-HD and VX recovered within the skin at 24 h. CONCLUSION All of the products evaluated in this study performed well in reducing the dermal absorption of all the chemical warfare agents tested.
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Affiliation(s)
- Hazem Matar
- Centre for Radiation, Chemical and Environmental Hazards, Health Protection Agency (now Public Health England), Chilton, Oxfordshire OX11 0RQ, United Kingdom; Research Centre for Transdermal Drug Delivery and Toxicology, Department of Pharmacy, University of Hertfordshire, Hatfield, United Kingdom
| | - Shirley C Price
- Vice Provost Office, Senate House, University of Surrey, Guildford, United Kingdom
| | - Robert P Chilcott
- Centre for Radiation, Chemical and Environmental Hazards, Health Protection Agency (now Public Health England), Chilton, Oxfordshire OX11 0RQ, United Kingdom; Research Centre for Transdermal Drug Delivery and Toxicology, Department of Pharmacy, University of Hertfordshire, Hatfield, United Kingdom..
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