Hybrid in vitro diffusion cell for simultaneous evaluation of hair and skin decontamination: temporal distribution of chemical contaminants

Matar, Hazem; Amer, Nevine; Kansagra, Sneha; Pinhal, Andreia; Thomas, Elliot; Townend, Scott; Larner, Joanne; Chilcott, Robert P.

doi:10.1038/s41598-018-35105-z

Cited by 8 publications

(15 citation statements)

References 22 publications

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“…This was shown not only directly, by the much smaller quantities of methyl salicylate measured in back swabs, but also indirectly, by the significantly smaller amounts of contaminant recovered from the washcloths and towels used in the technical decontamination phase and the lower vapor concentrations of MS in the decontamination unit when protocols were combined. Moreover, the higher (16-fold) relative recoveries of methyl salicylate from hair in relation to scalp skin of control (untreated) volunteers were in good agreement with previous studies, confirming that hair protects the underlying scalp skin (13,32).…”

Section: Discussionsupporting

confidence: 88%

“…In this regard, the data obtained from skin swabs and secondary hazardous materials succeeded in achieving this objective. Previous work by our group has addressed the temporal importance of decontamination (1,32). Moreover, this present study is in agreement with previous work performed under more realistic environmental conditions and response times (13).…”

Section: Limitationssupporting

confidence: 92%

“…Dosing was therefore deemed considered reflective of a spray exposure and comparisons could subsequently be made between different decontamination protocols. Dry decontamination, LPS and technical decontamination, following current US emergency personnel guidance (4, 31), were then compared to the proposed improved procedures derived from in vitro hair and skin decontamination studies (10,32) and other human volunteer trials incorporating an initial dry decontamination step (12,13).…”

Section: Discussionmentioning

confidence: 99%

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Efficacy of Different Hair and Skin Decontamination Strategies with Identification of Associated Hazards to First Responders

Larner

Durrant

Hughes

et al. 2019

Prehospital Emergency Care

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Prompt disrobing and minimization of time to casualty decontamination are key to the effective treatment of individuals exposed to toxic chemicals. Established procedures for mass casualty decontamination that involve the deployment of equipment for showering with water (such as the ladder pipe system [LPS] and technical decontamination) necessarily introduce a short, but critical delay. The purpose of this study was to investigate the effectiveness of dry and wet decontamination approaches (individually and in combination) for removing a chemical warfare agent simulant from the hair and skin of human volunteers. A secondary aim was to quantify potential hazards arising from the decontamination processes. Volunteers were exposed to the simulant (mixture of methyl salicylate, fluorophore [curcumin] and mineral oil) as an aerosol within a custom-built dosing chamber. Three decontamination protocols (dry, LPS and technical decontamination) were applied in various sequences. The efficacy of the protocols was evaluated by whole-body fluorescent imaging and measurement of residual simulant recovered from the hair, skin, decontamination materials and air samples using liquid chromatography and thermal desorption gas chromatography. Dry decontamination before LPS or technical decontamination produced significant reductions in methyl salicylate skin contamination. The greatest reductions were seen with the Triple Protocol (dry, then LPS, then technical decontamination). Secondary sources of contamination (e.g. off-gassing of vapor and residue on wash cloths/towels) decreased following dry decontamination. The introduction of dry decontamination prior to wet forms of decontamination offers a simple strategy to initiate treatment at a much earlier opportunity, with a corresponding improvement in clinical outcomes. Our results confirm the value of a "Triple Protocol" response strategy based on the integration of dry and wet decontamination procedures. 3 Importantly, we highlight how these combined protocols may reduce toxicological risks downstream in the operational process.

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Section: Discussionsupporting

confidence: 88%

Section: Limitationssupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

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Efficacy of Different Hair and Skin Decontamination Strategies with Identification of Associated Hazards to First Responders

Larner

Durrant

Hughes

et al. 2019

Prehospital Emergency Care

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“…Hair curtains (swatches) were assembled using 3 different visual hair types: thin (brown), dyed blonde, and thick (dark brown or black). The hair swatches/curtains were prepared as previously described by Matar et al (2018).…”

Section: Methodsmentioning

confidence: 99%

“…Hair decontamination studies have found that the efficacy of the decontamination protocols employed for skin decontamination may not apply in the case of hair decontamination, particularly for more lipophilic compounds such as methyl salicylate (MS) and phorate (PHR) (Matar et al , 2018). Thus, there is a need to investigate the potential dangers of hazardous chemicals that are bound or otherwise retained within the hair shaft after decontamination protocols have been completed.…”

mentioning

confidence: 99%

Decontamination and Management of Contaminated Hair following a CBRN or HazMat Incident

Matar

Pinhal

Amer

et al. 2019

Toxicological Sciences

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This in vitro study evaluated the “triple protocol” of dry decontamination, the ladder pipe system (a method for gross decontamination), and technical decontamination for the decontamination of hair following chemical contamination. First, we assessed the efficacy of the 3 protocols, alone or in combination, on excised porcine skin and human hair contaminated with either methyl salicylate (MS), phorate (PHR), sodium fluoroacetate (SFA), or potassium cyanide (KCN). A second experiment investigated the residual hair contamination following decontamination with the triple protocol at different intervals postexposure. In a third experiment, hair decontaminated after exposure to MS or PHR was evaluated for off-gassing. Though skin decontamination was highly effective, a substantial proportion (20%–40%) of the lipophilic compounds (MS and PHR) remained within the hair. The more water-soluble contaminants (SFA and KCN) tended to form much smaller reservoirs within the hair. Interestingly, substantial off-gassing of MS, a medium volatility chemical, was detectable from triple-decontaminated hair up to 5 days postexposure. Overall, the decontamination strategies investigated were effective for the decontamination of skin, but less so for hair. These findings highlight the importance of contaminated hair serving as a source of potential secondary contamination by contact or inhalation. Therefore, consideration should be given to the removal of contaminated hair following exposure to toxic chemicals.

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A review of the efficacy of easily accessible dry decontaminants for human chemical contamination

Nandamuri

Feschuk

Maibach

2022

J of Applied Toxicology

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Soap and water are often considered the gold standard for dermal decontamination.However, recent systematic reviews have shown that these methods often result in incomplete decontamination and may even induce contaminant absorption due to the "wash-in" effect. Therefore, it is important to gain insight on other decontamination methods. A literature search was done using PubMed to find experimental studies relating to dry decontamination performed with readily available items. Seven studies met eligibility criteria, and the study model, dry decontaminant, method of dry decontamination, method of analyzing decontamination, and main conclusions from each study were extracted, summarized, and compared. Important conclusions include that all studies investigated found that dry decontamination yielded decreases in contamination. In addition, it was shown by multiple studies that not only the decontaminant, but the manner in which it is used (method used [blotting, rubbing, etc.], amount used, and whether decontamination instructions are provided to exposed individuals) is vital to success. Finally, in all four studies that investigated wet and dry decontamination combination protocols, combinations were more efficacious than dry decontamination alone. However, this means that dry improvised decontamination can be performed while waiting for the deployment and arrival of further formal decontaminants. These conclusions deserve consideration in the event that universal decontamination guidelines are designed. However, more studies are required in order to draw definitive conclusions regarding the important topic of dermal decontamination.

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Hybrid in vitro diffusion cell for simultaneous evaluation of hair and skin decontamination: temporal distribution of chemical contaminants

Cited by 8 publications

References 22 publications

Efficacy of Different Hair and Skin Decontamination Strategies with Identification of Associated Hazards to First Responders

Efficacy of Different Hair and Skin Decontamination Strategies with Identification of Associated Hazards to First Responders

Decontamination and Management of Contaminated Hair following a CBRN or HazMat Incident

A review of the efficacy of easily accessible dry decontaminants for human chemical contamination

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