CS tear gas intoxication - Chem-Bio-Rad Suspicion
Riot control agents are not considered chemical warfare agents as defined by the Geneva Convention of 1925, and they are utilized by police forces worldwide.
Tear gas is disseminated as a smoke or large particle mist via spray can, tank, grenade, or larger bombs.
CS, CN, and CR primarily affect the eyes, causing temporary blindness due to lacrimation and blepharospasm. They also produce conjunctival redness; mouth, nose, and throat irritation; cough; chest tightness; and sneezing. In raw or abraded skin, lacrimators can cause burning and erythema. Under the conditions of high temperature, high humidity, and high concentration, they can cause second-degree burns with erythema and vesication. The effects of these agents are felt on contact and, once the agent is removed, dissipate within 15-30 minutes. The effects of OC are usually limited to runny nose and watery eyes.
*LCt50 (L = lethal, C = concentration of vapor [mg/m3], t = exposure time [minutes]) is the concentration of a chemical agent exposure by inhalation that causes death in 50% of unprotected people.
T59.3X4A – Toxic effect of lacrimogenic gas, undetermined, initial encounter
84419005 – Tear gas toxic effect
Differential Diagnosis & Pitfalls
- Vesicant exposure (mustard, lewisite, phosgene oxime) – With mustard gas, pain does not occur until hours later when vesicles form, which have a "string of pearls" appearance and then later coalesce. With lewisite, pain begins within minutes of exposure, and blisters begin 2-3 hours later.
- Adamsite, another riot control agent, has a 30-minute delay of onset and, when released in higher concentrations, may cause vomiting.
- Hydrazine poisoning
- Pulmonary agent poisoning
- Hydrogen fluoride
- Hydrogen sulfide
- Ricin or abrin poisoning
- Staphylococcal enterotoxin B (SEB)
- Trichothecene (T-2) mycotoxin poisoning