Abstract
The UK Initial Operational Response (IOR) to chemical incidents includes improvised decontamination procedures, which use readily available materials to rapidly reduce risk to potentially exposed persons. A controlled, cross-over human volunteer study was conducted to investigate the effectiveness of improvised dry and wet decontamination procedures on skin, both alone, and in sequence. A simulant contaminant, methyl salicylate (MeS) in vegetable oil with a fluorophore was applied to three locations (shoulder, leg, arm). Participants then received no decontamination (control) or attempted to remove the simulant using one of three improvised protocols (dry decontamination; wet decontamination; combined dry and wet decontamination). Simulant remaining on the skin following decontamination was quantified using both Gas Chromatography Tandem Mass Spectrometry (GC-MSMS) for analysis of MeS and UV imaging to detect fluorophores. Additionally, urine samples were collected for 24 hours following application for analysis of MeS. Significantly less simulant was recovered from skin following each improvised decontamination protocol, compared to the no decontamination control. Further, combined dry and wet decontamination resulted in lower recovery of simulant when compared to either dry or wet decontamination alone. Irrespective of decontamination protocol, significantly more simulant remained on the shoulders compared to either the arms or legs, suggesting that improvised decontamination procedures are less effective for difficult to reach areas of the body. There was no effect of decontamination on excreted MeS in urine over 24 hours. Overall, findings indicate that improvised decontamination is an effective means of rapidly removing contaminants from skin, and combinations of improvised approaches can increase effectiveness in the early stages of decontamination and in the absence of specialist resources at an incident scene. However, the variable control and consistency of improvised decontamination techniques means that further intervention is likely to be needed, particularly for less accessible areas of the body.
Highlights
In the event of a chemical incident, rapid decontamination of the people exposed is essential to minimise injury, prevent loss of life, and inhibit the uncontrolled spread of contamination
Improvised decontamination may be followed by interim wet decontamination set-up using Fire and Rescue Service (FRS) frontline equipment, followed by structured mass decontamination showering following the arrival of specialist decontamination units [1]
More simulant was removed from the skin when both improvised dry and wet decontamination were conducted in sequence compared to individually
Summary
In the event of a chemical incident, rapid decontamination of the people exposed is essential to minimise injury, prevent loss of life, and inhibit the uncontrolled spread of contamination. The purpose of IOR is to equip non-specialist frontline responders with strategies to rapidly reduce the risk to potentially contaminated people, via: evacuation from hazardous areas, removal of contaminated clothing, and improvised dry and wet decontamination protocols using any available materials. Improvised decontamination involves dry and/or wet procedures to remove contaminants from the body, using readily available materials [1]. According to IOR guidance, dry decontamination should be conducted in the first instance where a non-caustic chemical is suspected potentially followed by improvised wet decontamination. If signs and symptoms of a caustic chemical are apparent, improvised wet decontamination should be conducted as the default measure. Improvised wet decontamination can be administered using any available water source, typically following a ‘rinse-wipe-rinse’ (RWR) procedure [1]. Improvised decontamination may be followed by interim wet decontamination set-up using Fire and Rescue Service (FRS) frontline equipment, followed by structured mass decontamination showering following the arrival of specialist decontamination units [1]
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