Design and characterisation of a novel in vitro skin diffusion cell system for assessing mass casualty decontamination systems

Matar, Hazem; Larner, Joanne; Kansagra, Sneha; Atkinson, Karen; Skamarauskas, John; Amlôt, Richard; Chilcott, Robert P.

doi:10.1016/j.tiv.2014.01.001

Cited by 16 publications

(18 citation statements)

References 25 publications

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“…water) may be alternatively carried out with adsorptive powders (i.e. talcum, flour, FE), also called dry decontamination (Chilcott, ; Matar et al, ). In our study we have investigated the adsorptive properties of FE in vitro in function of the three parameters: (1) time; (2) amount of FE; and (3) 4‐CP concentration in aqueous solutions.…”

Section: Discussionmentioning

confidence: 99%

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Comparison of four different fuller's earth formulations in skin decontamination

Roul

Gustin

et al. 2017

J of Applied Toxicology

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Industrial accidents, wars and terrorist threats are potential sources of skin contamination by highly toxic chemical warfare agents and manufacturing compounds. We have compared the time-dependent adsorption capacity and decontamination efficiency of fuller's earth (FE) for four different formulations for the molecular tracer, 4-cyanophenol (4-CP), in vitro and ex vivo using water decontamination as standard. The adsorption capacity of FE was assessed in vitro for 4-CP aqueous solutions whereas decontamination efficiency was investigated ex vivo by tracking porcine skin 4-CP content using attenuated total reflectance Fourier transform infrared spectroscopy. Decontamination was performed on short time, exposed porcine skin to 4-CP by application of FE: (1) as free powder; (2) loaded on adhesive tape; (3) on powdered glove; or (4) in suspension. Removal rate of 4-CP from aqueous solutions correlates with the amount of FE and its contact time. Decontamination efficiency estimated by the percentage of 4-CP recovery from contaminated porcine skin, achieved 54% with water, ranged between ~60 and 70% with dry FE and reached ~90% with FE suspension. Successful decontamination of the FE suspension, enabling a dramatic reduction of skin contamination after a brief exposure scenario, appears to be rapid, reliable and should be formulated in a new device ready to use for self-application.

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Section: Discussionmentioning

confidence: 99%

“…water) may be alternatively carried out with adsorptive powders (i.e. talcum, flour, FE), also called dry decontamination (Chilcott, 2014;Matar et al, 2014). In our study we have investigated (Oubagaranadin et al, 2007).…”

Section: Discussionmentioning

confidence: 99%

Comparison of four different fuller's earth formulations in skin decontamination

Roul

Gustin

et al. 2017

J of Applied Toxicology

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“…This concentration was based on a series of pilot tests designed to identify the optimum solution of the two substances in combination that would allow effective recovery of the simulant from the skin of volunteers, and visualisation of the simulant using UV-illuminated photography. This solution has been used successfully in a previous study of emergency decontamination [8]. Methyl salicylate has a long history of use in human volunteer studies and is used as a simulant for the chemical warfare agent sulphur mustard [9].…”

Section: Methodsmentioning

confidence: 99%

Volunteer trials of a novel improvised dry decontamination protocol for use during mass casualty incidents as part of the UK’S Initial Operational Response (IOR)

et al. 2017

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Previous studies have demonstrated that rapid evacuation, disrobing and emergency decontamination can enhance the ability of emergency services and acute hospitals to effectively manage chemically-contaminated casualties. The purpose of this human volunteer study was to further optimise such an “Initial Operational Response” by (1) identifying an appropriate method for performing improvised skin decontamination and (2) providing guidance for use by first responders and casualties. The study was performed using two readily available, absorbent materials (paper towels and incontinence pads). The decontamination effectiveness of the test materials was measured by quantifying the amount of a chemical warfare agent simulant (methyl salicylate) removed from each volunteer’s forearm skin. Results from the first study demonstrated that simulant recovery was lower in all of the dry decontamination conditions when compared to matched controls, suggesting that dry decontamination serves to reduce chemical exposure. Blotting in combination with rubbing was the most effective form of decontamination. There was no difference in effectiveness between the two absorbent materials. In the following study, volunteers performed improvised dry decontamination, either with or without draft guidelines. Volunteers who received the guidance were able to carry out improvised dry decontamination more effectively, using more of the absorbent product (blue roll) to ensure that all areas of the body were decontaminated and avoiding cross-contamination of other body areas by working systematically from the head downwards. Collectively, these two studies suggest that absorbent products that are available on ambulances and in acute healthcare settings may have generic applicability for improvised dry decontamination. Wherever possible, emergency responders and healthcare workers should guide casualties through decontamination steps; in the absence of explicit guidance and instructions, improvised dry decontamination may not be performed correctly or safely.

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“…Four of the test materials were then selected for evaluation regarding their efficacy in decontamination. For this purpose we used a bespoke ex vivo diffusion cell system containing pig skin, which has previously been described and validated for assessment of skin decontamination systems [ 17 ]. The association between the initial absorption capability of each material and its usefulness in decontamination was evaluated retrospectively.…”

Section: Methodsmentioning

confidence: 99%

Evaluation of absorbent materials for use as ad hoc dry decontaminants during mass casualty incidents as part of the UK’s Initial Operational Response (IOR)

et al. 2017

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The UK’s Initial Operational Response (IOR) is a revised process for the medical management of mass casualties potentially contaminated with hazardous materials. A critical element of the IOR is the introduction of immediate, on-scene disrobing and decontamination of casualties to limit the adverse health effects of exposure. Ad hoc cleansing of the skin with dry absorbent materials has previously been identified as a potential means of facilitating emergency decontamination. The purpose of this study was to evaluate the in vitro oil and water absorbency of a range of materials commonly found in the domestic and clinical environments and to determine the effectiveness of a small, but representative selection of such materials in skin decontamination, using an established ex vivo model. Five contaminants were used in the study: methyl salicylate, parathion, diethyl malonate, phorate and potassium cyanide. In vitro measurements of water and oil absorbency did not correlate with ex vivo measurements of skin decontamination. When measured ex vivo, dry decontamination was consistently more effective than a standard wet decontamination method (“rinse-wipe-rinse”) for removing liquid contaminants. However, dry decontamination was ineffective against particulate contamination. Collectively, these data confirm that absorbent materials such as wound dressings and tissue paper provide an effective, generic capability for emergency removal of liquid contaminants from the skin surface, but that wet decontamination should be used for non-liquid contaminants.

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Design and characterisation of a novel in vitro skin diffusion cell system for assessing mass casualty decontamination systems

Cited by 16 publications

References 25 publications

Comparison of four different fuller's earth formulations in skin decontamination

Comparison of four different fuller's earth formulations in skin decontamination

Volunteer trials of a novel improvised dry decontamination protocol for use during mass casualty incidents as part of the UK’S Initial Operational Response (IOR)

Evaluation of absorbent materials for use as ad hoc dry decontaminants during mass casualty incidents as part of the UK’s Initial Operational Response (IOR)

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