Mass Casualty Acute Pepper Spray Inhalation Respiratory Effect Severity

Authors: B. Michelle Sweeting

Abstract:

Pepper spray use has gained momentum since 1992 and although the active ingredient is readily available, it is considered a weapon with restricted use in many regions, including The Bahamas. In light of controversy in the literature regarding the severity of presenting respiration complaints among individuals postacute exposure of pepper spray inhalation, this descriptive case series study was conducted to assess the respiratory status of persons evaluated during a mass casualty in The Bahamas. Parameters noted were patients- demographics and respiration severity determined via clinical examination findings, disposition and follow-up review of the 20 persons. Their most common complaint was difficulty breathing post exposure. Two required admission and stayed for <24 hours uneventfully. All cases remained without residual complaints upon follow-up. Results showed that although respiration difficulty was perceived as the most detrimental of presenting complaints, it was noted to be mostly subjective with benign outcome.

Keywords: Acute Pepper Spray Inhalation, Capsaicinoids, Oleoresin Capsicum, Pepper spray, Respiratory severity severity.

Digital Object Identifier (DOI): doi.org/10.5281/zenodo.1055825

References:

[1] T. C. Chan, G. M. Vilke, J. Clausen, R. F. Clark, P. Schmidt, T. Snowden, and T. Neuman, "The effects of oleoresin capsicum ÔÇÿpepper- spray inhalation on respiratory function." Journal of Forensic Science, vol. 47, no. 2, pp. 299-304, 2002.
[2] J. J. Oh, R. Yong, R. Ponampalam, V. Anantharman, and S. H. Lim, "Mass casualty incident involving pepper spray exposure: impact on the emergency department and management of casualties Hong Kong." Journal of Emergency Medicine, vol. 17, no. 4, pp. 352-359, 2010.
[3] R. G. Christensen, and D. E. Frank, Preliminary investigation of oleoresin capsicum. Office of Law Enforcement Standards, National Institute of Standards and Technology, National Institute of Justice; 1995 Report No. 100-95.
[4] P. Montaque, Chemical Composition of Pepper Sprays. 2009.
[5] C. G. Smith, and W. Stopford, "Health Hazards of Pepper Spray." NCMJ, vol. 60, no. 5, pp. 268-274, 1999.
[6] R. W. Fuller, "Pharmacology of inhaled capsaicin in humans." Respir Med., vol. 85, Suppl. A, pp. 31-4, 1991.
[7] W. Johnson, "Final Report on the Safety Assessment of Capsicum Annuum Extract, Capsicum Annuum Fruit Extract, Capsicum Annuum Resin, Capsicum Annuum Fruit Powder, Capsicum Frutescens Fruit, Capsicum Frutescens Fruit Extract, Capsicum Frutescens Resin, and Capsaicin." International Journal of Toxicology, vol. 26, Suppl. 1, pp. 3-106, 2007.
[8] D. F. Billmire, C. Vinocur, M. Ginda, N. B. Robinson, H. Panitch, H. Friss, D. Rubenstein, and J. F. Wiley, "Pepper-spray-induced respiratory failure treated with extracorporeal membrane oxygenation." Pediatrics, vol. 98, no. 5, pp. 961-3. 1996.
[9] C. H. Steffee, P. E. Lantz, L. M. Flannagan, R. L. Thompson, and D. R. Jason, "Oleoresin capsicum (pepper) spray and ÔÇÿn custody deaths-." Am J Forensic Med Path, vol. 16, pp. 185-92. 1995.
[10] W. A. Watson, K. R. Stremel, and E. J. "Oleoresin capsicum (capstun) toxicity from aerosol exposures." Ann Pharmacotherapy, vol. 30, pp. 733-5. 1996.
[11] J. Granfield, J. Onnen, and C. S. Petty, Pepper spray and in-custody deaths. Executive Brief. Science & Technology. Washington DC: International Association of Chiefs of Police, 1994.
[12] D. Ross, and B. Siddle, Use of force policies and training recommendations: based on the medical implications of oleoresin capsicum. St. Louis: PPCT Research Review, 1996.
[13] C. A. Reilly, J. L. Taylor, D. L. Lanza, B. A. Carr, D. J. Crouch, and G. S. Yost, "Capsaicinoids Cause Inflammation and Epithelial Cell Death through Activation of Vanilloid Receptors." Toxicol. Sci, vol. 73, no. 1, pp. 170-181, 2003.
[14] B. Veronesi, M. Oortgiesen, J. Roy, J. D. Carter, S. A. Simon, and S. H. Gavett, "Vanilloid (capsaicin) receptors influence inflammatory sensitivity in response to particulate matter." Toxicol. Appl. Pharmacol, vol. 169, pp. 66-76, 2000.
[15] D. M. McDonald, "Infections intensify neurogenic plasma extravasation in the airway mucosa." Amer Rev Resp Dis, vol. 146, pp. S40-4, 1992.
[16] The American Civil Liberties Union of Southern California. Pepper spray update: more fatalities, more questions. 1995.
[17] R. Busker, H. P. M. van Helden, "Toxicologic Evaluation of Pepper Spray as a Possible Weapon for the Dutch Police Force: Risk Assessment and Efficacy." American Journal of Forensic Medicine & Pathology, vol. 19, no. 4, pp. 309-316, 1998.
[18] E. Seyhan, N. Mert, and H Mert, "The Effect of Pepper Gas (OC) on Some Biochemical Parameters in Rats." KafkasUniv Vet FakDerg, vol. 18, no. 2, pp. 259-266, 2012.