In today’s modern world, it’s difficult to avoid exposure to toxic chemicals. Chemical weapons are largely prohibited by the Chemical Weapons Convention (CWC), a treaty that outlaws their production and use. Although almost all nations have signed this treaty, the risk of chemical attacks by terror organizations and industrial accidents still exist.
A SHORT HISTORY OF CHEMICAL ATTACKS
In a previous article, we discussed the use of lethal chemicals dating back to the first poison-tipped arrow. Historical examples of natural and man-made substances used to cause mass casualties abound: The ancient Greeks, for example, commonly poisoned the water supply of besieged cities and, on occasion, would use sulfur fumes on defending forces. During the French conquest of Algeria in the 1840s, French troops trapped 1,000 Berber tribesmen into a cave and used smoke to kill them.
The invention of tear gas in 1912 came just in time for World War I. From 1914-1918, both sides used chlorine, sulfur mustard, and phosgene. Tens of thousands of artillery shells filled with these substances were employed throughout the duration, causing 1.3 million chemical casualties and close to 100,000 deaths.
Aside: A young Adolf Hitler was temporarily blinded by a gas attack in 1918.
Although the League of Nations ratified a chemical weapon ban in 1925, Benito Mussolini used mustard gas on Ethiopians during Italy’s invasion in 1935-6. Although not used on the battlefield in World War II, poison gas killed millions of civilians during the holocaust.
Later in the twentieth century, incendiary chemicals like napalm and herbicides like Agent Orange caused deaths and long-term ill effects. Several incidents of chemical weapon use in the Middle East were reported later still.
Attacks have been rare since the Chemical Weapons Convention went into effect in 1997. Exceptions include attacks by Syria against civilian targets in 2013 and 2017.
CATEGORIES OF CHEMICAL AGENTS
The response to a chemical emergency depends on the substance involved. Each agent has a different effect on the human body. The list includes:
- Acids: Chemicals that burn or corrode people’s skin, eyes, and mucus membranes (lining of the nose, mouth, throat, and lungs) on contact.
- Blister agents (also called “vesicants”): Chemicals that severely blister the eyes, respiratory tract, and skin on contact.
- Blood agents: Poisons that affect the body by being absorbed into the blood.
- Choking agents: Chemicals that cause irritation or swelling of the respiratory tract.
- Incapacitating agents: Drugs that that cause an altered mental state or unconsciousness.
- Long-acting anticoagulants: Poisons that prevent blood from clotting properly, leading to hemorrhage.
- Metals: Agents that consist of metallic poisons.
- Nerve agents: Chemicals that work by preventing the nervous system from working properly.
- Organic solvents: Agents that damage the tissues of living things by dissolving fats and oils.
- Riot control agents: Highly irritating agents sometimes used by law enforcement for crowd control or by individuals for protection (e.g., pepper spray).
- Toxic alcohols: Poisonous alcohols that can damage the heart, kidneys, and nervous system.
- Vomiting agents: Chemicals that cause nausea and vomiting.
WHAT TO DO IN CHEMICAL EMERGENCIES
Chemical accidents or attacks, such as an overturned tanker truck or a terror event, may render an area dangerous. Common sense dictates evacuation as the wisest course of action. This is not only to prevent physical contact but also to avoid noxious fumes that may be carried by the winds. Given the wide range of chemicals, be sure to seek and rapidly act upon the advice of local emergency departments for the specific event.
Evacuation may involve going to an emergency shelter. If so, notify others of your plan of action and take additional supplies and medications that the municipality may not have in sufficient quantities. Know what their policy is regarding pets. The schools your children attend will have their own plan of action for chemical emergencies; be aware of their disaster protocols. It may be more dangerous to try to bring them home.
SHELTER IN PLACE?
Some chemical emergencies could make going outdoors risky. Leaving might put you in harm’s way. Sheltering in place is a way to protect yourself until help arrives. Sheltering in a vehicle, however, is a last resort, as vehicles aren’t airtight enough to protect you from noxious fumes.
If you can’t evacuate the area, choose a room with as few windows and doors as possible. A room with a water supply (a connecting bathroom, perhaps) is best. Some gases sink to the floor, so a second-story room is preferable. Notice how different this strategy is from most natural disaster plans, where a basement might be the safest area in the home.
Shut all outside doors and windows as soon as you are aware of the emergency. Locking and taping them will make a better seal against the chemical. Turn off air conditioners, fans, and heaters. Close the fireplace damper, vents, and any place that air can enter from outside.
Go into the designated safe room and shut the door. Turn on the radio and keep a cell phone available. If it is necessary to drink water, drink safely-stored water, not water from the tap. If you run out of water, you can drink from a toilet tank (but not from the bowl).
HAZARDOUS CHEMICAL EXPOSURE
Some types of chemical exposure involve direct contact. As many substances (especially in liquid or solid form) can penetrate clothing and be absorbed through the skin, it will be necessary to remove and safely dispose of contaminated clothing. A thorough body wash with soap and water is then needed to both protect the victim and medical personnel. The faster this is accomplished, the more effective the decontamination.
When taking off chemical-drenched clothing, avoid pulling it over your head. Cut it off instead. When removing clothing from others, make every effort to avoid touching contaminated areas without hand protection (rubber gloves), tongs, or other methods that avoid contact with skin. Place all “dirty” items in a biohazard bag and seal it.
Eye damage from chemical exposure can be severe. Remove any contact lenses and rinse eyes with clean water for 10-15 minutes. Hold the eyelids away from the eyeball while moving the eye in all directions. Wash eyeglasses with soap and water.
With any luck, a chemical emergency will last only a few hours. Despite this, your shelter should have the usual basics:
- -A good first aid kit
- -Flashlights, battery-powered radio, and extra batteries for both
- -A means of communication
- -Food and bottled water. Store at least 1 gallon of water per person in plastic bottles as well as non-perishable foods with a long storage life.
- -Towels and plastic sheeting. You may have to cut sheeting to fit your windows, doors, and vents. Duct tape can be used to form a better seal.
Of course, this is the absolute minimum necessary for a short-term event. Longer-term disasters require much more. In modern times, call 911 or your local poison control center.
MATERIALS NEEDED FOR CHEMICAL SPILLS
Some specialized materials not normally included in medical kits are useful for chemical spills. They include:
- Rubber or other chemically-resistant gloves, aprons, and boots
- Brooms & dustpans
- Safety goggles
- Gas masks (Note: N95 and other respirator masks, while excellent to protect against infectious diseases, are insufficient to protect against most noxious chemicals and gases)
- Plastic spatulas
- Plastic hazardous material bags
- 5-gallon buckets with lids
- Drum liners
- Baking Soda (useful for gasoline spills)
- Vermiculite (useful for package spills)
Note: This source suggests that a 1:1:1 mixture of unscented kitty litter, sodium bicarbonate and sand is good for most chemical spills including solvents, acids and bases.
Joe Alton MD
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