Toxic Effects of Tear Gas on an Infant Following Prolonged Exposure

Abstract

A 4-month-old male infant developed pneumonitis following a prolonged exposure to tear gas (CS or orthochlorobenzylidene malononitrile). The patient had a persistent leukocytosis (white blood cell count 20,000 to 30,000/cu mm) with predominance of lymphocytes on peripheral blood smear and had a slow resolution of the pneumonitis radiologically. A discussion of the toxicity of the two most widely used tear gases\p=m-\chlo-roacetophenone (CN) and CS\p=m-\onthe respiratory system indicates that both agents are capable of inducing severe clinical toxicity dependent upon the concentration of the gas.Tear gases which have been used by local law enforcement agencies in the United States for many years are now being used more frequently. The two tear gases most commonly used are chloroacetophenone (US Army designation CN) and orthochlorobenzylidene malononitrile (US Army designation CS). Recently an infant of 4 months of age who was exposed to CS tear gas for a pro¬ longed duration developed pneu¬ monitis and was hospitalized. Report of a CaseA normal four-month-old white infant was exposed to CS gas for two to three hours. He was kept in a house into which police fired CS tear gas canisters in order to subdue a disturbed adult. Immediately upon being taken from the house, the pa¬ tient was seen in the emergency room. He was initially observed to have copious na¬ sal and oral secretions, sneezed and coughed frequently, and required suctioning to relieve upper airway obstruction. On physical examination, the infant was irri¬ table; there were watery secretions in the nose and throat, but there was no cyanosis or skin erythema. Temperature was 98 F (36.8 C) rectally; there were 26 respirations per minute, and pulse rate was 166 beats per minute. His conjunctivae were slightly injected. The lungs were clear to ausculta¬ tion and percussion. The heart rate was in¬ creased but regular and there was no mur¬ mur or abnormal sound on auscultation. The abdomen was distended but there was no visceromegaly or mass. Findings on neurological examination were within nor¬ mal limits. The following laboratory data were obtained: hemoglobin level, 8.6 gm/100 ml; hematocrit value 27.5%; and white blood cell count, 47,000/cu mm; with 64% segmented neutrophils, 23% band forms, 9% lymphocytes, and 3% monocytes. Electrolytes were normal. The blood urea nitrogen value was 21 mg/100 ml; serum glutamic oxaloacetic transaminase value 32 units/100 ml (normal, 8 to 40 units); and lactic dehydrogenase value, 860 units/100 ml (normal, less than 500 units). The chest roentgenogram on admission was clear. An ECG was within normal limits. On the sec¬ ond hospital day, the child had an episode of cyanosis which improved following suctioning. Examination revealed the infant to be in severe respiratory distress with suprasternal retraction and grunting res¬ pirations. There were wheezes and rales bilaterally in the posterior lung fields. The skin in the malar region now had devel¬ oped the changes of a first-degree burn. The liver was palpable 4 cm below t...

The comparative acute mammalian toxicity of 1-chloroacetophenone (CN) and 2-chlorobenzylidene malononitrile (CS)

“…Sublethal exposures to moderately high concentrations of CS or CN may produce localised inflammation in the bronchopulmonary mucosa which resolves, but in some instances may act as a focus for the development of a secondary respiratory infection. Such a human case has been described for a prolonged non-lethal exposure to CS by Park and Giammona (1972), and highlights the necessity for clinical observation and investigation of anyone exposed to very high concentrations of irritant smoke, particularly if prolonged.…”

The effect of o-Chlorobenxylidene Malononitrite (CS) to military personals healthfuring NBC training

“…Studies on volunteers indicate that exposure to about 0.5 to 1 mg/m 3 CS for 90 minutes in an exposure chamber produced symptoms of tightness in the chest and in some cases difficulty in breathing was experienced, particularly upon initial exposure [8]. Subjects were able to tolerate exposure at these levels throughout the 90 minutes' duration of this experiment.…”

“…In [12] tested the ability for human to work in a CS contaminated environment for duration of two weeks, whereby it is found that test subject accuracy decreases due to symptoms of respiratory failure. In [8] reported the case of a previously there is a negative relationship between the variables studies. It is found that FVC reading collected in this research will decreases as the duration of exposure to CS increases.…”

Riot control agents: pharmacology, toxicology, biochemistry and chemistry

“…Regarding adverse effects on reproductive function and pregnancy, the Himsworth Committee 404 concluded that CS exposure had not significantly affected reproductive physiology; however, meaningful epidemiological studies were not conducted to address more fully the issue of reproductive risks. The potential adverse effects in the very young following exposure to CS was addressed also by Park and Giammona, 407 who have described the effects of CS in a 4-month-old infant after prolonged exposure. The infant manifested severe respiratory distress and symptoms included copious nasal and oral secretions, sneezing and coughing and obstruction of the upper airways.…”