EXPOSURE TO ‘TEAR GAS’ (CROWD CONTROL AGENTS) IN PREGNANCY

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(Date of issue: December 2017, Version: 2)

This is a UKTIS monograph for use by health care professionals. For case-specific advice please contact UKTIS on 0344 892 0909. To report an exposure please download and complete a pregnancy reporting form. Please encourage all women to complete an online reporting form.

Summary

Agents used for crowd control such as CS gas, CR gas, CN gas, and pepper sprays, including PAVA, are potent, rapidly incapacitating sensory irritants and lacrimators.  They cause irritation of the mucous membranes of the eyes, nose, mouth and throat that is short-lived, usually resolving spontaneously within 15-30 minutes.  Systemic toxicity, although rare, is occasionally observed after CN exposure, especially at high concentrations.  CS gas, CR gas and CN gas are often formulated to include organic solvents that allow their dispersal as aerosols.  CS gas is the crowd control agent most widely used by UK police forces, although PAVA spray is also used on occasion as an alternative.

There are very limited preclinical and human data available concerning acute exposure to CS gas in pregnancy, and no available data for CR gas, CN gas, or pepper sprays.  Available data on CS gas used for crowd control do not indicate an association with adverse effects on the fetus but are too limited to exclude an increased risk.  Significant systemic toxicity is generally not expected following exposure to crowd control agents (other than expected lacrimatory effects), but patients with pre-existing medical conditions such as asthma or cardiovascular disorders may be at risk of systemic effects.  If treatment is required, pregnant women should be treated as for the non-pregnant patient.

Exposure to crowd control agents at any stage of pregnancy would not usually be regarded as medical grounds for termination of pregnancy.  However, other risk factors may be present in individual cases which may independently increase the risk of adverse pregnancy outcome.  Clinicians are reminded of the importance of consideration of such factors when performing case specific risk assessments.  Where exposure to crowd control agents has occurred even in the absence of maternal toxicity, enhanced fetal monitoring may be warranted, particularly in cases associated with maternal hypoxia or signs of systemic toxicity.  Discussion with UKTIS is recommended in all cases of exposure.                
      
This document is regularly reviewed and updated. Only use full UKTIS monographs downloaded directly from TOXBASE.org to be sure you are using the most up-to-date version. The summaries of these monographs are openly available on UKTIS.org.

This is a summary of the full UKTIS monograph for health care professionals and should not be used in isolation. The full UKTIS monograph and access to any hyperlinked related documents is available to health care professionals at www.toxbase.org.

If you have a patient with exposure to a drug or chemical and require assistance in making a patient-specific risk assessment, please telephone UKTIS on 0344 892 0909 to discuss the case with a teratology specialist.

If you would like to report a pregnancy to UKTIS please click here to download our pregnancy reporting form. Please encourage all women to complete an online reporting form.

Disclaimer: Every effort has been made to ensure that this monograph was accurate and up-to-date at the time of writing, however it cannot cover every eventuality and the information providers cannot be held responsible for any adverse outcomes of the measures recommended. The final decision regarding which treatment is used for an individual patient remains the clinical responsibility of the prescriber. This material may be freely reproduced for education and not for profit purposes within the UK National Health Service, however no linking to this website or reproduction by or for commercial organisations is permitted without the express written permission of this service. This document is regularly reviewed and updated. Only use UKTIS monographs downloaded directly from TOXBASE.org or UKTIS.org to ensure you are using the most up-to-date version.