Hi I'm Wendy Zukerman and you're listening to Science Vs from Gimlet. We’re now two weeks into the protest movement sparked by the death of George Floyd. The protests started in Minneapolis, where he was killed by a police officer, but it quickly caught on around the country...and then spread around the world[1].
It’s now a global movement with thousands taking to the streets, from Amsterdam to Paris[2]
What’s his name George Floyd what’s his name George Floyd
Protestors gathering from city to city, doing exactly what researchers for months have urged them not to do
Despite stay at home orders and social distancing rules,[3] hundreds of thousands of people have come out[4] - to make a stand against police using force against Black people. And police are coming down hard. They’ve used tear gas. They’ve been corralling protesters into tight spaces - and they’ve arrested thousands[5], putting people on crowded buses, and later into holding cells[6]. Many public health experts are watching all of this and worrying it will cause a spike in coronavirus cases.[7]
And so today we're going to look at what the protests might mean for the pandemic and we’ll hear how protesters who do go out can protect themselves, not just from the virus but also from tear gas.
To tell you the truth - I had expected doctors and infectious disease researchers to call for the protests to stop. But actually, it’s been the opposite.[8][9][10][11] Doctors have staged sit ins to support the protesters[12]. Hundreds of doctors and public health experts signed an open letter saying the protests "must be supported”[13]. And finally, American Public Health Association - which represents 50,000 researchers - has said "We stand by the millions of people across the country and around the world who have come together"[14]. And this seems like a paradox right? The same people that told us to social distance - are now ok with this? So we’re going to dig into it.
To start, we called up Dr Cassandra Pierre[15], she's an infectious disease physician at Boston Medical Center, and a hospital epidemiologist
WZ You’ve been treating patients, you're running a study into why healthcare workers sometimes get coronavirus… how are you going?
Well I'm also a Black woman and so it's been rough, it's been a lot of the things
WZ: What's the worst case that could happen here after these protests?
CP Oh the worst case would be that we would have another huge spike in the very communities that have already been hard hit and that those communities would continue the cycle of infection while the rest of the country moves on and then becomes truly an issue that is segregated, so that would be the worse case scenario
WZ Orright I wish I hadn't asked you about the worst case scenario - that is bleak
CP I'm sure I could even get more dystopian if you'd like but I think that's enough
WZ What do you think is actually likely to happen?
CP Yeah, I think there are going to be areas where we do see some spikes. At the same time we're having reopenings or different phases of reopenings in different states[16] and so those two factors could create significant spikes. My infectious prevention side is shrieking! I am really worried that we'd see a second wave of infection[17][18]
If there is a spike, it's expected to start popping up in the next few weeks... as symptoms start to show up and people get tested So.. if that is the case … and the protests could spread this coronavirus even more - why are so many public health researchers on board?
CP Yeah, the reason they are in favour of this is because the cause is objectively just, there's just no way around it. The public health authorities that are supporting this have for years, maybe not long maybe not strongly enough, but have for years decried structural racism as a driver of chronic health concerns… transmissible infectious diseases[19]
And you can see this connection between experiencing racism and having health problems in the data. Just to start - if you look at almost every metric of health in the US, Black Americans - fare worse off than white Americans. [20][21][22] Their life expectancy is several years less than white people[23]. Babies who are Black are twice as likely to die before they turn 1 compared to white babies.[24] And Black Americans have higher rates of certain diseases like diabetes[25][26] and heart disease…[27] They're also being hit extra hard by Covid.
WZ How bad has covid been for the Black community
CP It's been devastating, so you have settings like Louisiana where people of colour make up 30% of the population but 70% of Covid related deaths[28], it is absolutely devastating. We've had multiple generations - fathers and sons dying in the same hospital. Some of my colleagues have commented I haven't taken care of someone who hasn’t been a person of colour
And a big report from the National Academies of Sciences published a couple of years ago concluded that a big driver for these gaps between the health of blacks and whites in America: is racism[29].[30][31]. They wrote it follows people ‘from womb to tomb[32].’”
And so while it might seem hypocritical, to support and condone these protests - the protests are speaking to an issue that is actively worsening the health of communities in which we also fear covid, it's all part and parcel unfortunately of the same underlying structural issue in our country.
And we heard this from many academics that we reached out to… one told us that when it comes to these protests and the pandemic - we have public health squaring off against public health. So Cassandra? She protested. And she was thinking about these big structural things that need to change. But she was also thinking about two little things. Her kids, they're just toddlers...
Those toddler twins are boys so I'm really worried about their future, they're 2 and yes they're two so there's a bit of time, I don't kid myself that by the time they're age, or by the time they're Tamir Rice's age in 10 years, that we'll have wrapped this up um so I really felt like it was important to lend my voice
Cassandra wasn't just thinking about her boys during the protest, though. She's a doctor too - so she was also thinking about how she could best stay safe from coronavirus
I was wearing a surgical mask… constantly monitoring my distance, thinking from the left from the right… in front of you behind you, you don't want to tell people to back up, it's just not the spirit of why you're going there I danced around, flitted around as much as I could around to remain 3 to 6 feet separated from people. It's really difficult to do and so once I felt like I could not longer do that I did unfortunately have to leave after half an hour as much as I wanted to stay
We asked Cassandra what else people should do to stay safe if they’re thinking of protesting. She says if you're feeling sick, don't go. If you live with someone who is in a high risk category… someone older, or who has diabetes[33] - seriously think about if you can isolate yourself when you get back from the protests.
If you are going… Cassandra says - put on a mask… it may reduce the risk of spreading droplets… but as we've talked about on the show before, they're not a silver bullet
Yeah, Masks are not sufficient; they're one component of the package that we need, but alone they're not enough.
Cassandra says protesters might want to try protecting their eyes[34][35] - from droplets getting in … she recommended swimming goggles, or even wraparound sunglasses.[36]
But then there's the cheering and the shouting. One study found that speaking loudly can release 10 times the droplets of talking quietly[37] .
Are there other things that protesters could be doing instead… ? Like banging drums?
I fully intend the next protest I got to bring some drums, tambourines, maybe not a wind instrument…
WZ No Vuvuzelas?
CP haha yeah that will just disperse the respiratory droplets,
Yeah that would be amazing, most of what i'm saying is in an ideal world, there is a lot of pain there's a lot of grief, that I feel and I know other feels … and that needs to a catharsis and often that’s in a vocal manner. People are going to want to shout it's what protests are about, so if you can, if you're going to be shouting, try to be as careful as possible
Cassandra also had a few thoughts on what the police could do to make things safer. Basically, they shouldn’t be corralling people into small spaces[38]. And if they’re arresting people, they should try to space them apart on buses and in jail cells.
There's really poor ventilation compared to outdoor open protests and so the likelihood of transmission if someone is sick is higher in those situations
Of course - coronavirus isn't the only risk to people's health at the protests. Like, police have been using tear gas on crowds all over the country.[39] On Sunday, cops sprayed it onto protesters in Seattle - even after the city banned it[40][41].. And so for people who are thinking of going to demonstrations in the US … they might run into this stuff. So what does tear gas do to you? And can you protect yourself from it? That’s after the break
BREAK:
Welcome back. We've just heard how protesters can try to protect themselves from coronavirus. Now we want to talk about how protesters can protect themselves from another big problem they may face: tear gas. To start I called up … someone who's kind of an expert here. Because he’s been tear gassed a few times - amid protests that have lasted for over a year in Hong Kong.[42] And his name is well..
WZ: So firstly what should i call you? -02
103: guys usually call me 103 so 103 is probably ok
WZ: 103 great.
103 is a chemist by training, he didn’t want us to use his name. He got exposed to tear gas last year - he was at this big protest at a university in Hong Kong …
I feel it in my throat first and I feel it as first some kind of a scratchy feeling, like there is something itchy and you just want to cough. And then I feel it in my eyes. So then your eyes start to water, you want to blink it off but it doesn't really go away and if you get into thicker clouds of it, your eyes just water so much that you can't really see.
103 started coughing … and was struggling to breathe … but he couldn't get away from the gas…
103: By now you are breathing a lot more so then you start coughing uncontrollably
WZ: How long did it last, the pain?
103: Maybe 10 15 minutes
So what is this chemical - that hurts so bad and then goes away after 15 minutes? And what exactly is it doing to our body… ? For this we went to Rohini Haar[43], an emergency medicine physician in Oakland California. Who specialises in tear gas. She's so well known that when 103 found out I was chatting to her - he told me to say hello. So I did.
WZ: hi from the Chemist from Hong Kong
RH: Oh! That's hilarious - yes it's a very small world of people studying these weapons. It’s funny because their use is so widespread, so prevalent
Rohini told us that when you see those big plumes being sprayed over crowds… it could be a few different kinds of chemicals[44]… one is called 2-Chlorobenzalmalononitrile[45] or for short:
RH: CS gas, but sometimes there’s pepper spray, or synthetic versions of pepper in there[46][47], or successors of CS[48]
WZ: Successors? So scientists are still working out the best tear gas?
RH: I'm not sure I'd call them scientists - but maybe manufacturers are creating more potent and longer lasting versions.
WZ: We call it a gas is it a gas?
RH: So CS is not a gas it's a powder. Mummy! Hold on one second Can I have my shorts?… check in your drawer and can you close the door. I looked… !! you have to leave now. Love you! Bye
WZ: What was the desperate need for something?
RH: She needs shorts!
WZ We all need our shorts sometimes
RH: Yeah!! Anyway where was I?
WZ: you were telling us it's not a gas
RH: So it's not a gas it's actually a powder
Rohini says that the powder often gets squished into these canisters, that can get fired out onto crowds…[49] The canisters heat up and then release the powder as an aerosol[50] …
RH: And so eventually though it explodes in the air, it will kind of drop down
When these tiny little particles come down - you can’t really see them landing on you. But from here the chemicals - whether it's CS, or pepper spray… they’ll bind to these proteins on our body, in places like our eyes and skin[51][52][53].… and that sends a message to your brain that's interpreted as PAIN. It's the same reason[54] chili can hurt your eyes or nose when it gets in there[55].
This is not your average habanero[56] [57]- I mean these agents are designed to be uncomfortable and irritating enough that people who are really motivated to be on the streets and protest disappear yknow?
And the pain kicks in fast. Within 20 to 60 seconds of getting exposed[58]. But it usually doesn’t last long. The chemicals are designed to break down pretty quickly. And so for most people - once they remove the powder[59] the pain should go away within around 20 minutes or so[60]. Like it did for 103.
It’s not just pain you have to worry about, though. A couple of years ago, Rohini did a big review…[61] of around 5,000 people who suffered injuries from tear gas and pepper spray… whether it was getting exposed during a protest or sprayed directly by a cop during an arrest[62]. And she found that around 75% of the injuries[63] weren't serious - there were sore throats.[64] … and headache, injuries to eye and skin.[65] [66] And although some symptoms might last a couple of weeks - they usually go away on their own.[67][68]
RH: The vast majority of injuries are minor, like don't require medical attention
But Rohini found that some people got serious injuries. Like very serious.
WZ: In your review there were about 60 people who became disabled? How does that happen with tear gas?
RH: From the tear gas canister, Like hitting someone's head or neck or eye
As the canisters get fired into the crowd and hit someone in the eyes it can lead to blindness[69]. Already one protester in Indiana last week lost his eye this way[70]. In Rohini's review one person was hit in the head and left in a vegetative state[71]; 13 people lost the use of their limbs.
RH: There's a couple of case reports I think from Hong Kong where there were so many canisters fired that they actually burned people's legs[72] because the canisters themselves you know people couldn’t get away from where the canisters were on the ground
WZ: Oh my gosh
RH: It's not new news that crowd control weapons are not harmless…
Now, there might be circumstances where it makes sense for a cop to use pepper spray in a one on one situation with a violent suspect - and a report from the Department of Justice found that pepper spray can be safer than batons or Tasers[73]. But Rohini says the issue is when these types of chemicals are used for the wrong reasons - and in a crowd.
RH: The problem is that many people are exposed to tear gas, it's such an an indiscriminate weapon, so when you fire it into a crowd you can't target it at the 5 people who are violent, you’re firing it at everybody there whether that’s grandma or little five year old joey they're all being tear gassed at the same time. In the Chemical Weapons Convention with the UN, these irritants are banned they're essentially chemical weapons[74]
WZ: Oh wow and yet, in the US in 2020 we just seeing them used
RH: Right so in war and conflict generally the military is not allowed to use these weapons, but they are permitted for use by civilian police specifically for defence[75] or public safety protection, that's ostensibly what they're supposed to be used for
Firing tear gas in the middle of the pandemic has also led to concerns that it could help spread the disease. It can make people cough… so if you have someone with coronavirus getting tear gassed- they could spread it around more. Some researchers are also worried that it could make people's symptoms worse[76]. As you can imagine - there's no science on tear gas and this coronavirus. But one thing is for sure… you want to avoid this stuff. In the time of a pandemic or not.
And so our final question is if you're planning to head to a protest where you think the cops might spray tear gas… what can you do? I asked 103, the anonymous protest from Hong Kong - what he’s learned. He said one big thing is protecting your eyes.
WZ: i have glasses- would they protect me or do anything?
103: Glasses would absolutely not protect you from anything if they’re not airtight then teargas can come through
The gas or powder gets through the sides. It's not enough. 103 also says that contact lenses are a big no-no.
103: Because once the gas gets on your contact lenses they get lodged in there[77].
The powder can get stuck in between your lens and eyeball. Now there's some talk online that this can make you permanently blind. Rohini told me that was unlikely, but it could hurt like hell and maybe cause some damage. So no contacts. The solution of choice in Hong Kong?
103: If you have swimming goggles they're a good choice.
Goggles.. the same thing Cassandra recommended to protect you from coronavirus droplets. So yeah…move over bandanas… there’s a new hot accessory in town. Swimming Goggles Also if your water bottle was open when the tear gas was sprayed… just bin it. It's contaminated. And can give you diarrhea[78]. And if you do get exposed to tear gas. How do you stop the pain? There's a lot of ideas about what you can do. And Rohini - who's worked with people exposed to tear gas all around the world. She’s heard everything.
RH: Like honestly everywhere in the world everyone has their different home remedies. I’ve heard in the U.S. a lot of milk and baking soda, in other places, I've seen saturating your masks in coca cola, or if you’re being exposed like smelling onions to counteract it.[79], but I don't know if there's any studies that would prove that any of them work more than the other… or any of them work.
Rohini says the best thing you can do is wash off the powder as soon as possible… get it off your skin and out of your eyes … using saline solution[80] or water.
RH: It's about the copious irrigation of water like a lot of water not just a little bit.
WZ: You're literally just trying to push all the powder away
RH: Yeah essentially just washing it away
And you'll also need to wash your clothes… the powder will stick to it. 103 told me that popping it a regular wash worked for most protestors… but his pro tip was adding a bit of borax in there too. He reckons the high pH of Borax[81] helps break down the tear gas faster. But 103 also told me that from what he’s seen in Hong Kong… regular people can't win against the cops, or the military.
103: Getting away is probably the only solution. You need to run away safely, right? and I think about the protective gear to buy some time.
We're fighting two public health crises here at once … and we don’t know what’s going to happen. But chances are, even after this pandemic is over - this other crisis - that the protesters are fighting for - it'll still be hanging around.
That’s Science Vs.
This episode has 81 citations in it - if you want to know more about anything that we've talked about on this show, please head to the show notes, and then click on the link to the transcript. And if you want to listen to any great podcasts and learn more about race and racism we recommend heading over to 1619, Reveal and Code Switch… Lots of great reporting going on there.
CITATIONS
This episode was produced by me, Wendy Zukerman, and Sinduja Srinivasan with help from Rose Rimler, Meryl Horn, Michelle Dang and Mathilde Urfalino. We’re edited by Blythe Terrell with help from Caitlin Kenney. Fact checking by Lexi Krupp. Mix and sound design by Peter Leonard. Music written by Peter Leonard, Marcus Bagala, Emma Munger, and Bobby Lord. A huge thanks to all the researchers we got in touch with for this episode, including Professor Nina Harawa, Professor Vincent Racaniello, Professor Peter Katona, Professor Wafaa El-Sadr, Dr Anne Paxton, Dr Abram Wagner, Dr Sumit Mohan, Dr Jon Zelner, Dr Joshua Petrie, Dr Jesse Jacob, Dr Matthew C Freeman, Dr Amelia Boeheme, Dr Mohammed K Ali, Dr Ryan Malosh, Quentin Leclerc, Dr Aubree Gordon, Dr. Dustin Duncan, Dr. Maureen Miller, Dr Manuela Orjuela-Grimm and Claire Garrido-Ortega. And special thanks to Diane Wu, Rose E. Reid, the Zukerman family, and Joseph Lavelle Wilson.
[1] MAY 26: Protests in Minneapolis begin, and the police use tear gas to break them up.
NYT: Tens of thousands turned out in Australia, Britain, France, Germany and other nations … From Paris to Berlin — as in demonstrations this past week in Japan, Sweden and Zimbabwe — people around the world once again turned out in solidarity with Americans protesters
[4] June 1: “Tens of thousands of protesters began another week of demonstrations and disturbances on Monday night”
June 3: Los Angeles: estimated 10,000 people packing Civic Center streets.
June 4: New York City: tens of thousands
June 5: Houston: organizers estimated attendance at 60,000
June 7: More than 10,000 people poured into the nation’s capital on the ninth day of protests over police brutality
https://www.nytimes.com/2020/06/06/us/protests-today-police-george-floyd.htm
Around the world: Tens of thousands reported each in: UK Germany Australia Canada New Zealand
[6] “Many people arrested for curfew violation were packed onto buses for several hours with no ability to socially distance… In Milwaukee, detainees have been taken from one crowded setting to another — buses, vans, staging areas and the district station.”
[7]Science Vs reached out to many academics, the ~20 who responded who were concerned about this
[11] "WHO fully supports equality and the global movement against racism. We reject discrimination of all kinds. We encourage all those protesting around the world to do so safely.
[12] https://twitter.com/gradydoctor/status/1268956035051593734?s=20; “
“More than 500 physicians, nurses and staff from across departments at Grady Memorial Hospital knelt Friday as part of a “White Coats for Black Lives” demonstration first organized by Emory University medical students on social media.”
[13] Protests against systemic racism, which fosters the disproportionate burden of COVID-19 on Black communities and also perpetuates police violence, must be supported. [CTL F for MD, RN and MPH]
[14] tps://apha.org/news-and-media/news-releases/apha-news-releases/2020/apha-calls-out-police-violence
[16]“In Las Vegas, casinos are reopening. In New York City, long the center of the coronavirus outbreak in the United States, as many as 400,000 workers on Monday can begin returning to construction jobs, manufacturing sites and retail stores as the city enters the first phase of its reopening.”
[17] In Philadelphia - On September 28 1918, the city held the Fourth Liberty Loan Drive, which was designed to encourage the purchase of bonds to fund the war effort. It was the largest parade in the city’s history and contributed to a swift spreading of the virus. Within a week of the parade, sickness and death overwhelmed city services. In the first ten days after the parade, more than a thousand Philadelphians lay dead, and estimates suggest that over two hundred thousand people had fallen ill
[18] This article on 1918 Pandemic "Despite the clear correlation between the parades and pandemic explosions, they still continued to occur."
[20] Certain disparities were particularly marked for specific racial/ethnic groups: for Latinos, suboptimal health status and teeth condition, uninsurance, and problems getting specialty care; for African Americans, asthma, behavior problems, skin allergies, speech problems, and unmet prescription needs
[21] (1998-2016) racial and ethnic disparities in hospitalizations from chronic ambulatory care sensitive conditions (ACSCs) have increased resulting in over 430,000 excess hospitalizations among non-Hispanic Blacks compared to non-Hispanic Whites
[22] blacks fared worse than whites in both health status and insurance coverage
[23] In 2014, the life expectancy for African American males was 72.0 years, while that for white males was 76.5 years and that for Latino males was 79.2 years. In the same year, life expectancy was 78.1 years for African American females, 81.1 years for white females, and 84.0 years for Latina females (Arias, 2016).
[24] Tragically, infant mortality—the number of deaths under 1 year of age per 1,000 live births—is much higher in certain populations. In 2013, among non-Hispanic whites, 5.06 infants of every 1,000 live births died before their first birthday; among African Americans, that rate was double, at 11.1 per 1,000
In 2016, infant mortality rates for “Non-Hispanic black: 11.4”; “Non-Hispanic white: 4.9” according to CSC
[26] African American adults are 60 percent more likely than non-Hispanic white adults to have been diagnosed with diabetes by a physician.
[28] In Chicago and Louisiana, about 70% of COVID-19 deaths involve black individuals, although black people make up only 30% of the population. In Michigan and New York City we're also seeing this pattern.
[29] https://pubmed.ncbi.nlm.nih.gov/15566445/: Compared to whites, African Americans have been found to have greater morbidity and mortality from HIV. Adjusting for patient characteristics only, African-American patients with white providers received protease inhibitors significantly later than African-American patients with African-American providers (median 461 days vs. 342 days respectively; P < .001) and white patients with white providers (median 461 vs. 353 days respectively; P= .002)
[30]Logistic-regression analysis indicated that women (odds ratio, 0.60; 95 percent confidence interval, 0.4 to 0.9; P=0.02) and blacks (odds ratio, 0.60; 95 percent confidence interval, 0.4 to 0.9; P=0.02) were less likely to be referred for cardiac catheterization than men and whites, respectively. Analysis of race–sex interactions showed that black women were significantly less likely to be referred for catheterization than white men
[31] And this can't be explained by income - "African Americans had greater odds of obesity at all levels of income and educational attainment" .."African Americans who were college graduates and those with incomes greater than or equal to $100,000 had more than twice the odds of diabetes as their white counterparts."
[34] Although there is a low prevalence of SARS-CoV-2 in tears, it is possible to transmit via the eyes.
[35] the eye is neither a preferred organ of human CoV infection nor a preferred gateway of entry for human CoVs for infecting the respiratory tract. However, pathogens that the ocular surface is exposed to might be transported to nasal and nasopharyngeal mucosa by constant tear rinsing through the lacrimal duct system and then cause respiratory tract infection.
[36] systematic review and meta-analysis to investigate the optimum distance for avoiding person-to-person virus (COVID-19, SARS, or MERS): Eye protection (included visors, faceshields, and goggles, among others) also was associated with less infection
[37] This study found that raising your voice increased "the particle emission rate". "Speaking loudly yielded on average a 10-fold increase in the emission rate compared to speaking the same series of words quietly."
[38] The protesters had not seen that riot police had flooded the plaza behind them, boxing them in. The maneuver was a law enforcement tactic called kettling. The police encircle protesters so that they have no way to exit from a park, city block or other public space, and then charge in and make arrests.
All over the country this week, police officers have surrounded protesters—and then refused to let them leave.
[39] June 1: Atlanta, Georgia; June 3 (early morning): Washington, DC; June 1 and June 3: Huntsville, Alabama
[40]https://www.forbes.com/sites/jemimamcevoy/2020/06/08/seattle-police-use-tear-gas-against-protestors-despite-city-ban/#73d5cb05b4bc
https://twitter.com/chaseburnsy/status/1269891485941460992?s=20
[41] Seattle mayor, police chief agree to ban use of tear gas on protesters amid ongoing demonstrations
[42] The protests in Hong Kong against an extradition law started June 9, 2020.
[44] Today, the most commonly used lacrimating agents are chloroacetophenone (CN), o-chloro-benzylidene malononitrile (CS), and oleoresin capsicum (OC)
[46] Some police officers are using a chemical called OC - pepper spray.
[47] https://militaryhealth.bmj.com/content/161/2/94.long 2-Chloroacetophenone (CN), o-chlorobenzylidene malonitrile (CS) and oleoresin capsicum (OC) are common riot control agents.
[48] E.G., CR http://aei.pitt.edu/5538/1/5538.pdf Individually these weapons are becoming more powerful, for example each new riot agentis more powerful than the one it replaces. Thus CS is nearly 20 times more powerful than the CN it replaced; CR is more than 30 times more powerful than CN and the newest and most aggressively marketed agent OC, (See Fig.11 ), the most powerful of them all (Chart 3)
[49] Canisters and grenades, on the other hand, are considered much more serious uses of force because they produce indiscriminate chemical clouds that can affect everyone in their path. Large canisters are sprayed like fire extinguishers; smaller ones are fired like grenades. Both are used to subdue and disperse crowds.
[50] Though commonly referred to as “tear gas,” the active compounds are not actually gases but solids. … grenades and canisters use a powdered form blended with a pyrotechnic mixture that can be aerosolized for dispersion as a smoke or fog. (You can read more here: How Stuff Works “A typical tear gas grenade contains a host of additional chemicals for heat dispersal of the irritant. When the solid CS powder heats up, it vaporizes into an easily dispersed aerosol”)
[51] The different formulations of tear gases were all found to act on transient receptor potential (TRP) channels. One TRP subtype is TRPA1, which is heavily expressed in nociceptors. Stimulation of TRPA1 causes a sensation of scalding heat and pain, which is why it is thought to help detect body temperature
In pepper spray: TRPV1 is found in peripheral sensory nerves and is present in all organs, including the skin, conjunctiva, cornea, and the mucous membranes of the upper and lower airways….
In addition to pain, the TRPA1 and TRPV1 receptors are common pathways for inflammatory signaling.
[52] CS, CN, and CR gases have been found to be 10000 times more potent on TRP receptors than other natural agonists. Among the traditional tear gasses, CR is the most potent TRPA1 agonist.[13] Other agonists of TRPA1 are temperature greater than 43 degrees C (109 degrees F), low pH and allyl isothiocyanate, the pungent compound in mustard and garlic.[13][1]
[53] TRP channels in eye tissues: https://pubmed.ncbi.nlm.nih.gov/26818117/
[54] These physiological effects can be considered as an extreme form of the lacrimation observed with the exposure to the known TRPA1 agonists present in garlic and onions
[55] Capsaicin is the active component in pepper spray. Similar to traditional riot control agents, capsaicin’s target is a vanilloid TRP target called TRPV1.
Oleoresin capsicum (OC) is the active agent in pepper spray, which is an oily concentrated extract from plants of the genus Capsicum, more commonly referred to as the chili pepper.
[56] Figure 1, average Habanero 253,000 Scoville Heat Units.
Compare with Pepper Spray: In table 4 (up to 900,000 Scoville Heat Units) And keep in mind the amount you would be exposed to is a lot more
[57] OC for nonlethal weapon formulas can differ in potency from 16,000 Scoville Heat Units (S.H.U) to 1.5 million units, with a 5-10% solution generally recommended as an effective dose
[58] Table 1 http://www.dickyricky.com/Medicine/Papers/2009_06_27%20BMJ%20Management%20of%20the%20effects%20of%20exposure%20to%20tear%20gas.pdf
[59] In humans, the half-life of CS, 2-chlorobenzaldehyde, and 2-chlorobenzyl malononitrile was found to be 5, 15, and 660 seconds [11 minutes]
[60] Tear gas and pepper spray: In the vast majority of cases after removal from the exposure, resolution of symptoms will occur within 10 to 20 minutes.
[63] There were 9261 documented injuries, with multiple injuries occurring in each individual. In total, 6878 (74.2%) of the injuries were categorized as mild, 1582 (17%) were moderate injuries, and 865 (8.7%) were severe injuries
[64] https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-017-4814-6#Sec2 Minor injuries were transient symptoms that may not be present on physical exam or are expected side effects of chemical irritants, such as blepharospasm, lacrimation, mild respiratory distress, sore throat, or nausea.
[65] https://www.ncbi.nlm.nih.gov/books/NBK544263/ In most cases, symptoms are self-limited and resolve spontaneously within 10 to 30 minutes after removal from the source.[6] Cough and shortness of breath may persist, especially of patients have intrinsic lung disease...Runny nose and salivation may last for about 12 hours, and headaches can remain for up to 24 hours.
[66] https://militaryhealth.bmj.com/content/161/2/94.long “Following inhalation, effects can include a stinging or burning sensation in the nose, tightness and pain in the chest, sore throat, sporadic breath holding, dyspnoea, coughing, sneezing and difficulty breathing.. Other less specific symptoms may include headache, fever, syncope, dizziness and tachycardia
[67] https://sci-hub.tw/10.1177/096032719601500601 “ The most common complaints were burns (52%), cough (38%), headache (29%), shortness of breath (21%), chest pain (19%), sore throat (15%) and fever (13%).” See figure 2- some patients still have cough, shortness of breath 3 weeks later
[68] https://www.atsjournals.org/doi/abs/10.1164/ajrccm-conference.2014.189.1_MeetingAbstracts.A3142
Conference abstract- “The median duration of symptoms were for respiratory difficulty 2 days, cough 15 days, sputum 14 days, hemoptysis 14 days, chest pain 15 days, nasal discharge 13 days… The symptoms were reported to last 2-15 days in contrast to previous knowledge about the effects of crowd control agents.”
[69] Levine and Stahl a studied 14 eyes from 13 men enucleated after close range explosive injuries. The five eyes that were enucleated within 2 months after the insult all displayed “intense, suppurative, necrotizing keratitis” and coagulative necrosis with iridocyclitis….“the majority of severe ocular injuries were caused by the explosive force rather than the chemical itself.”
[70]https://www.journalgazette.net/news/local/police-fire/20200531/indiana-tech-student-loses-eye-during-saturdays-protest
[71] These included globe ruptures and blindness (four people), traumatic brain injury resulting in a persistent vegetative state (one person), limb amputations (three people), and functional loss of limbs (10 people).
[72] August 10, 2019, Hong Kong (new york times): reporting on a man in a train station hit by tear gas can “two of the canisters went through gaps in the barrier, hitting him in the stomach and on the right arm...Five days after the episode, he still had a clear burn mark, bruising and swelling”; August 14, 2019 (time): Sven-Eric Jordt, an associate professor at Duke University School of Medicine says “The China-made tear gas cartridges have caused severe burn injuries and even melted the asphalt of the roads.”; “November 2, 2019, Hong Kong: “A paramedic lost consciousness when one of the canisters exploded upon hitting his back, causing serious burns, City Broadcasting Channel (CBC), an independent media run by City University of Hong Kong, reported on Nov. 2”
[73] Several studies found that when agencies adopted the use of pepper spray, they subsequently had large declines in assaults on officers and declines in officer and suspect injury rates, and associated injuries were usually minor.
[74] Chemical Weapons Convention text: The updated agreement prohibited members from using "riot control agents as a method of warfare." That convention explicitly defined “riot control” gases as chemicals "which can produce rapidly in humans sensory irritation or disabling physical effects which disappear within a short time following termination of exposure,". Note, “Law enforcement including domestic riot control purposes” falls under “Purposes Not Prohibited Under this Convention”, meaning that countries are permitted to use riot control agents, including tear gas, in domestic, riot control, contexts. The full text of the 1993 Convention can be found here.
[75] In the end, a compromise was reached under which States Parties are to declare to the OPCW the RCAs they possess for law enforcement purposes. Though use is allowed for these purposes, it is prohibited as a method of warfare
[76] Recruits had a significantly higher risk (risk ratio = 2.44; 95% confidence interval = 1.74, 3.43) of being diagnosed with ARI following exposure to CS compared to the period of training preceding exposure,
[77] Contact lenses and contaminated clothing should be removed and discarded,as they may retain particles. Effects of CS on the eyes: (discussing this review paper) Of the 90 cases reported, 57% showed ocular effects such as lacrimation, blepharospasm, eye pain, conjunctivitis, and reduced vision. Effects of pepper spray (OC) on the eyes: Pepper sprays are not completely safe, as there have been a number of reports of ocular complications from OC. In humans, exposure to OC led to transient reduction in corneal sensitivity, focal epithelial cell damage and necrosis, limbal ischemia, pseudopterygion, corneal neovascularization and temporary corneal epithelial swelling.
[79] Home remedies circulating around the internet include milk, coke, or even Maalox dissolved in water
[80] A curious case report of 23 people who got sprayed in a nightclub found saline helped.