Clinical Features and Treatment

As mentioned, the three main chemical restraint compounds used by law enforcement for individual or crowd control are OC, CN, and CS. These agents are available in varying concentrations, with several vehicles, in aerosols or foams and in particulate form with dispersal devices. Some of these are listed in Table 1.

Essentially a means of less lethal chemical warfare, chemical crowd-control products are used as defensive agents to temporarily incapacitate individuals or disperse groups without requiring more forceful means. The clinical effects are short-lived once exposure has ended. These agents share common effects that include lacrimation, ocular irritation and pain, dermal irritation, blepharospasm, conjunctivitis, transient impairment of vision, and mild to moderate respiratory distress (11-13). Some corneal defects after exposure have been noted, but whether this is a direct tissue effect of the agent, the vehicle, or dispersant or a result of rubbing the ocular surface is unknown

(14). Contact dermatitis and periocular edema can also result. Other more severe effects, such as pulmonary edema, have been documented when concentrations are several hundred-fold above what produces intolerable symptoms or with trauma associated with the explosive device used to deliver the chemical agent (6,15).

All of these clinical effects produced by chemical crowd-control agents render the recipient temporarily unable to continue violent action or resist arrest. Because they all share a high safety ratio, are effective at low concentrations, and can be used without direct forceful contact by the law enforcement officer, they are ideal agents for control of either the individual offender or riot control. Because of their relative safety, these agents are generally excluded from international treaty provisions that address chemical weapons. The United States, England, Ireland, France, China, Korea, Israel, and Russia are just some examples of countries that use these compounds as riot control agents. The legal availability to law enforcement and the general public differs between countries; however, most can be easily obtained through international markets or ordered through the Internet.

Chemical restraint compounds differ from most agents because some, such as CS, are solid particles with low vapor pressures. They are usually dispersed as fine particles or in a solution. For large crowds, "bombs" have been developed that can be dropped from aerial positions producing wide dispersal of the compound. They are also formulated in grenades or canisters, which can be propelled by either throwing or with a projectile device. The most common method of dispersal is by individual spray cans that deliver a stream, spray, or foam containing the agent. These individual dispersal units were designed to render immediate incapacitation to an offender without the use of more forceful methods, thereby providing an extra means of control in the ladder of force used by law enforcement. Canisters containing a lower concentration of the active ingredient have been marketed to civilians for personal protection. There is no formal training for civilians on securing the devices, laws governing their use, deployment, or decontamination after exposure. This lack of training significantly increases the risk for exposure and adverse events to the users, the intended target, and bystanders.

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