Effects of incapacitant spray deployed in the restraint and arrest of detainees in the Metropolitan Police Service area, London, UK: a prospective study
- 222 Downloads
- 8 Citations
Abstract
Purpose
In the United Kingdom (UK) police restraint and control of detainees is undertaken by assorted means. Two types of incapacitant spray (IS) are approved by the UK Home Office for use: CS (o-chlorobenzylidine malononitrile, dissolved in an organic solvent—methyl iso-butyl ketone and pelargonic acid vanillyamide (PAVA). The aim of this study was to document the effects of incapacitant sprays, by symptom assessment and medical examination, within a few hours of deployment.
Methods
A detailed proforma was produced to explore the nature of the arrest, the nature of exposure to the incapacitant spray, the type of incapacitant spray, the symptoms experienced and the medical findings.
Results
99 proformas were completed. 74 % were completed by detainees and 26 % were completed by police officers. 88 % were exposed to CS spray, the remainder to PAVA spray. The mean time of assessment after exposure was 2.8 ± 2.33 h (mean ± SD). The most frequent sites of IS contact were the face and scalp (n = 78), and exposure to the left and right eyes (n = 32). The most common symptoms were: painful eyes (n = 68); red eyes (n = 58); runny nose (n = 59); lacrimation (n = 55); nasal discomfort (n = 52); skin irritation (n = 49); and skin burning (n = 45). The most common medical findings were: conjunctival erythema (n = 34); skin erythema (n = 21); and rhinorrhea (n = 20).
Conclusions
Symptoms and signs of exposure to IS lasted longer than was expected (a mean of 2.8 h). Approximately 30 % of those exposed had ocular effects and 20 % had skin effects. The findings of this study will enable the guidelines on the expected effects and duration of symptoms resulting from exposure to incapacitant sprays to be reviewed and suggestions for their management to be refined.
Keywords
Irritant spray Incapacitant spray Restraint Use of force Police custody CS spray PAVA sprayNotes
Acknowledgments
We thank the forensic physicians and custody nurse practitioners who completed the proforma in the study.
References
- 1.Association of Chief Police Officers of England. Wales and Northern Ireland. Guidance on the use of incapacitant spray. ACPO. 2009. www.acpo.police.uk. Accessed 17 Aug 2013.
- 2.Payne-James JJ. Restraint injuries and crowd control agents. In: Rogers DJ, Norfolk GA, Stark MM, editors. Good practice guidelines for forensic medical examiners. Royal Military Police. Oxford: GPG Editors; 2009.Google Scholar
- 3.Faculty of Forensic & Legal Medicine. Incapacitant sprays: clinical effects and management: recommendations for healthcare professionals (Forensic Physicians, Custody Nurses and Paramedics). 2010. http://fflm.ac.uk/upload/documents/1265990238.pdf. Accessed 4 Sept 2013.
- 4.Carron P-N, Yersin B. Management of the effects of exposure to tear gas. BMJ. 2009;338:1554–8.CrossRefGoogle Scholar
- 5.Karaman E, Erturan S, Duman C, Yaman M, Duman GU. Acute laryngeal and bronchial obstruction after CS (o-chlorobenzylidenemalononitrile) gas inhalation. Eur Arch Otorhinolaryngol. 2009;266:301–4.PubMedCrossRefGoogle Scholar
- 6.Hardwicke J, Satti U. Facial burns after exposure to CS spray. Injury Extra. 2006;37:133–4.CrossRefGoogle Scholar
- 7.Agrawal Y, Thornton D, Phipps A. CS gas-completely safe? A burn case report and literature review. Burns. 2009;35:895–7.PubMedCrossRefGoogle Scholar
- 8.Southward RD. Cutaneous burns from CS incapacitant spray. Med Sci Law. 2000;41:74–7.Google Scholar
- 9.Davey A, Moppett IK. Postoperative complications after CS spray exposure. Anaesthesia. 2004;59:1219–20.PubMedCrossRefGoogle Scholar
- 10.Watson K, Rycroft R. Unintended cutaneous reactions to CS spray. Contact Dermat. 2005;53:9–13.CrossRefGoogle Scholar
- 11.Horton D, Burgess P, Rossiter S, Kaye W. Secondary contamination of emergency department personnel from o-chlorobenzylidene malononitrile exposure. Ann Emerg Med. 2005;45:655–8.PubMedCrossRefGoogle Scholar
- 12.Worthington E, Nee Patrick A. CS-exposure—clinical effects and management. J Accid Emerg Med. 1999;16:168–70.PubMedCentralPubMedCrossRefGoogle Scholar
- 13.Fraunfelder F. Is CS gas dangerous? BMJ. 2000;320:458–9.PubMedCrossRefGoogle Scholar
- 14.Rappert B. Health and safety in policing: lessons from the regulations of CS sprays in the UK. Soc Sci Med. 2003;56:1269–78.PubMedCrossRefGoogle Scholar
- 15.Weir E. The health impact of crowd control agents. CMAJ. 2001;164:1889–90.PubMedCentralPubMedGoogle Scholar
- 16.Department of Health. 2007. https://www.gov.uk/government/publications/police-use-of-cs-spray. Accessed 14 Aug 2013.
- 17.Karagama Y, Newton J, Newbegin C. Short-term and long-term physical effects of exposure to CS spray. J R Soc Med. 2003;96:172–4.PubMedCentralPubMedCrossRefGoogle Scholar
- 18.Euripidou E, MacLehose R, Fletcher A. An investigation into the short term and medium term health impacts of personal incapacitant sprays. A follow up of patients reported to the National Poisons Information Service. Emerg Med J. 2004;21:548–52.PubMedCrossRefGoogle Scholar
- 19.Varma S, Holt PJ. Severe cutaneous reaction to CS gas. Clin Exp Dermatol. 2001;26:248–50.PubMedCrossRefGoogle Scholar
- 20.Shambhu S, Kurtis R. Allergic contact dermatitis due to CS spray. Emerg Med J. 2011;28:345.PubMedCrossRefGoogle Scholar
- 21.Viala B, Blomet J, Mathieu L, Hall AH. Prevention of CS “tear gas” eye and skin effects and active decontamination with Diphoterine: preliminary studies in 5 French Gendarmes. J Emerg Med. 2005;29:5–8.PubMedCrossRefGoogle Scholar
- 22.Department of Health, London. Committees on Toxicity, mutagenicity, and carcinogenicity of chemicals in food, consumer products, and the environment. Statement on 2-chlorobenzylidene malononitrile (CS) and CS spray. 1999. http://cot.food.gov.uk/pdfs/csgas.pdf. Accessed 5 Sept 2013.