- Email: [email protected]
“Safety” of chemical batons
EDITORIAL
THE LANCET Volume 352, Number 9123
“Safety” of chemical batons Many police forces equip their officers with personal chemical weapons to supplement the more traditional baton or firearm. In mid-1996, UK police forces began to arm their officers with a spray canister containing the irritant CS (o-chlorobenzylidene malononitrile). With a product specifically designed to disable, safety is a relative term but there are concerns that the effects on the victim are not as benign as was thought. Because CS lingers, the use of CS can become an occupational-health issue for police officers, police doctors, and ambulance and accident-and-emergency personnel. Police doctors in Bedfordshire, UK, fearing the effects of secondary exposure, are reported to refuse to attend to prisoners in custody who have been sprayed. In addition, members of the public who are near the sprayed person at the time or soon afterwards may be affected. CS is a crystalline solid. As used by UK police forces, it is dissolved as 5% w/v in methylisobutylketone (MIBK) with nitrogen as a propellant (in the USA, one-fifth of this concentration of CS is deemed adequate). After spraying, CS solidifies on the skin and clothes. Acute effects include pain and discomfort in the eyes, leading to excessive lacrimation, blepharospasm, a burning sensation in the nose and throat, excessive nasal secretion and salivation, burning and constriction of the chest, sneezing, coughing, retching, and a burning or stinging feeling on the exposed skin. These acute effects start to wear off within 15 minutes as the victim is exposed to fresh air. Recommended management is to stand the sprayed person in a well-ventilated area (under fans or even outdoors), and to remove and seal clothing in plastic bags. Washing the face and eyes with water is specifically not advised. If the effects persist for 30 minutes, some recommend showering in water for at least 15 minutes. In the USA, troops use sodium metabisulphite solution as a wash, but there is little information about such a remedy in the UK. Advice to police officers transporting a prisoner sprayed with CS is to ride with vehicle windows open, and to use fans in custody areas to disperse residual CS on the victim. THE LANCET • Vol 352 • July 4, 1998
In a survey by the UK Channel 4 television programme Dispatches in 1996, only two of 34 people who had been sprayed said they had recovered within 15 minutes, and over half said they still felt effects a day later. There are reports of more chronic effects on the skin, including extensive blistering and burns, and damage to the eyes. A well-publicised case is the police officer in training with the CS spray who received almost 50% burns to his eyes. From France, there are reports of severe skin reactions: erythematous dermatitis on areas exposed to the spray, including vesicles, blisters, and crusts. Some patients had keratitis. In the UK, police officers have developed “dry eye” after a demonstration of CS sprays, and some officers have had skin reactions on the hands. What remains unclear is whether the unacceptable toxic effects are due to the solvent for CS; MIBK is used in paints and paint strippers. The official line (eg, from the Association of Chief Police Officers) is that CS sprays, when used as directed, are safe for the user and bystanders, and relatively safe as an incapacitant. However, not all police forces have introduced the current CS spray, largely because of concerns about safety. The Sussex force is studying another solvent and the Hertfordshire force is investigating an alternative agent, pelargonic acid vanillylamide (PAVA), a derivative of the pepper sprays used in the USA. Police officers in the front line believe that drawing a CS spray is a useful deterrent when confronted with a violent person and that any sideeffects from use of the spray are outweighed by the pacifying advantages of the product. It is equally clear that the safety profile of CS at 5% w/v dissolved in MIBK is under-investigated. Those who sanction official use of the spray are, given the safety data published to date, at risk of claims for damages from victims or third parties. It is right to question policy when safety remains in doubt. Until police authorities can publish or cite adequate safety studies, there should be a moratorium on the use of CS spray.
The Lancet 159
THE LANCET Volume 352, Number 9123
“Safety” of chemical batons Many police forces equip their officers with personal chemical weapons to supplement the more traditional baton or firearm. In mid-1996, UK police forces began to arm their officers with a spray canister containing the irritant CS (o-chlorobenzylidene malononitrile). With a product specifically designed to disable, safety is a relative term but there are concerns that the effects on the victim are not as benign as was thought. Because CS lingers, the use of CS can become an occupational-health issue for police officers, police doctors, and ambulance and accident-and-emergency personnel. Police doctors in Bedfordshire, UK, fearing the effects of secondary exposure, are reported to refuse to attend to prisoners in custody who have been sprayed. In addition, members of the public who are near the sprayed person at the time or soon afterwards may be affected. CS is a crystalline solid. As used by UK police forces, it is dissolved as 5% w/v in methylisobutylketone (MIBK) with nitrogen as a propellant (in the USA, one-fifth of this concentration of CS is deemed adequate). After spraying, CS solidifies on the skin and clothes. Acute effects include pain and discomfort in the eyes, leading to excessive lacrimation, blepharospasm, a burning sensation in the nose and throat, excessive nasal secretion and salivation, burning and constriction of the chest, sneezing, coughing, retching, and a burning or stinging feeling on the exposed skin. These acute effects start to wear off within 15 minutes as the victim is exposed to fresh air. Recommended management is to stand the sprayed person in a well-ventilated area (under fans or even outdoors), and to remove and seal clothing in plastic bags. Washing the face and eyes with water is specifically not advised. If the effects persist for 30 minutes, some recommend showering in water for at least 15 minutes. In the USA, troops use sodium metabisulphite solution as a wash, but there is little information about such a remedy in the UK. Advice to police officers transporting a prisoner sprayed with CS is to ride with vehicle windows open, and to use fans in custody areas to disperse residual CS on the victim. THE LANCET • Vol 352 • July 4, 1998
In a survey by the UK Channel 4 television programme Dispatches in 1996, only two of 34 people who had been sprayed said they had recovered within 15 minutes, and over half said they still felt effects a day later. There are reports of more chronic effects on the skin, including extensive blistering and burns, and damage to the eyes. A well-publicised case is the police officer in training with the CS spray who received almost 50% burns to his eyes. From France, there are reports of severe skin reactions: erythematous dermatitis on areas exposed to the spray, including vesicles, blisters, and crusts. Some patients had keratitis. In the UK, police officers have developed “dry eye” after a demonstration of CS sprays, and some officers have had skin reactions on the hands. What remains unclear is whether the unacceptable toxic effects are due to the solvent for CS; MIBK is used in paints and paint strippers. The official line (eg, from the Association of Chief Police Officers) is that CS sprays, when used as directed, are safe for the user and bystanders, and relatively safe as an incapacitant. However, not all police forces have introduced the current CS spray, largely because of concerns about safety. The Sussex force is studying another solvent and the Hertfordshire force is investigating an alternative agent, pelargonic acid vanillylamide (PAVA), a derivative of the pepper sprays used in the USA. Police officers in the front line believe that drawing a CS spray is a useful deterrent when confronted with a violent person and that any sideeffects from use of the spray are outweighed by the pacifying advantages of the product. It is equally clear that the safety profile of CS at 5% w/v dissolved in MIBK is under-investigated. Those who sanction official use of the spray are, given the safety data published to date, at risk of claims for damages from victims or third parties. It is right to question policy when safety remains in doubt. Until police authorities can publish or cite adequate safety studies, there should be a moratorium on the use of CS spray.
The Lancet 159