Chemical Burns, Proper Treatment of An "anti-antidote" plea

May 25, 2012 - Chemical Burns, Proper Treatment of An "anti-antidote" plea. S. M. MacCutcheon. Ind. Eng. Chem. , 1958, 50 (5), pp 81A–82A. DOI: 10.1...
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by S. M. MacCutcheon Dow Chemical Co.

SAFETY A

W O R K B O O K

F E A T U R E

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Chemical Burns, Proper Treatment of An "anti-antidote" plea

I F the backward statement of this month's column title gains one extra reader who will accept the recom­ mendations outlined, we will have accomplished our purpose. If the admitted corny approach in the subheading sells one laboratory or production supervisor on the use of water, water, and more water following a chemical contact ex­ posure, writing up the material will be worth while. O n e or two points should be m a d e early in the discussion. First, we are talking about holding an acci­ dental injury to the lowest possible degree of severity. T h e accident has occurred ; we are talking injury prevention, or better, injury severity reduction. Second, we are discussing the immediate, first-aid, plant-scene measures to be taken. We are not indicating medical measures in the treatment of chemical contact ex­ posures. Fallacy of Specific Antidotes

T h e use of specific antidotes for specific chemical exposures was still somewhat in vogue over a score of years ago. Neutralizing agents were felt to be a necessary first step follow­ ing contact with chemical agents. T h e r e are several basic faults in this approach to immediate emergency treatment. 1. The antidote or neutralizep was very seldom on hand when the exposure occurred. 2. Even if available, the antidote was often not in sufficient quantity to handle the case at hand. 3. A long history of improperly labeled or mistakenly grabbed "anti­ dotes" brought disfavor to this general method of treatment. An example of this is the vinegar bottle (used to neu­ tralize caustic on the skin) inadvertently

replaced by full strength or glacial acetic acid. 4. The heat of reaction set up follow­ ing the application of a neutralizer often negated the intended effect and in fact did more harm than good. 5. The use of solvents to aid in the removal of an offending chemical often resulted in the solution being more read­ ily absorbed through the skin. This was particularly true following a gross ex­ posure when a decidedly ineffective amount of solvent was available. The one-time use of alcohol on phenol burns was an example of this point. Water, the Universal Antidote

T h e five points listed above show clearly why and how the general idea of antidotes and neutralizers fell into disrepute. Industrial medi­ cal, safety, and hygiene personnel have for m a n y years carried out in­ tensive educational programs to gain acceptance of water, WATER only, and lots of W A T E R as a universal treatment for any and all chemical contact exposures. W e admit that sooner or later an exception may turn u p . However, to date no bona fide exception is recognized when considering a true chemical contact exposure. For all known materials, the use of any substance other than water is either not indicated, is impractical from an availability point of view, or is in fact dangerous. T o use the medical vernacular, water is the material of choice. In addition we have touched briefly on the need for speed in the applica­ tion of water. S P E E D IS ESSEN­ T I A L . Another page on this phase of the topic could not add anything to the three-word phrase. Quantity is a second important factor. T h e only way to be sure of having enough is to be fairly certain that you are using too much. Total I/EC

quantity is of course a function of a m o u n t and time. In this connec­ tion, the Manufacturing Chemists' Association Medical Advisory Com­ mittee has repeatedly advised the following procedure in case of in­ jurious chemicals contacting the eyes, "Eyes should be washed out immediately with copious amounts of flowing water. T h e washing should continue for at least 15 minutes." Removal of contaminated clothing is an additional very important point in treatment of chemical ex­ posures. T h e degree to which this point is adhered to is often dependent on the a m o u n t of the material in­ volved. A gross spill of a chemical will be followed by immmediate and complete removal of clothing prior to or during the use of a safety shower. O n the other h a n d an apparently negligible contamination of clothing, particularly footwear, will often end disastrously unless removal and thor­ ough washing follow as a routine measure. I n all cases of this nature,

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82 A

Methods of furnishing the water are naturally of concern in carrying out the prescribed treatment. W a t e r from a fire hose or service hose will do everything for the m a n that water from any other source will do. There are obvious drawbacks to this method, and a more refined means lies in the provision of properly located safety showers and eye foun­ tains. M a n y types of showers a n d fountains are on the market. T h e accompanying photograph shows a home-designed example of each of these pieces of safety equipment. Points to keep in mind in obtaining and installing these " w a t e r sources" may be briefly cataloged as follows : 1. Locate in relation to hazardous nature of chemical handling operation. 2. If eye hazard is paramount, the fountain alone may be adequate. 3. If general hazard is present, the safety shower may fill the bill for "gen­ eral" plus eye washing. 4. A holding tank, where necessary and feasible, will temper the water tem­ perature, thus decreasing employee dis­ comfort when the shower or fountain is used. 5. Maintenance of the shower or fountain station is critical. Periodic checks to ensure proper operation (including freedom from line sediment) are particularly important. M a n y phases of safety program­ ming are constantly bucking h u m a n frailties. T h e proper treatment of chemical burns is no exception. Knowledge of proper procedures on the part of medical, safety, or man­ agement personnel is not enough. Understanding and acceptance by supervisory and employee personnel arc necessary. Until understanding mid acceptance are gained, chemicalcontact exposures will continue to result in unnecessary suffering and disability. Employee education is the obvious answer. I n my personal experience, I know of no one point that seems to d e m a n d more constant repetition than this general topic of immediate complete treatment of chemical burns with water. A plant safety standard covering

INDUSTRIAL AND ENGINEERING CHEMISTRY

the subject is the recommended first step. Following m a n a g e m e n t a p ­ proval of the standard, employee education can be carried out through normal safety meeting or employee training channels. Experience shows that a n annual review of the material with every plant employee is not overdoing it. T h e major points in the treatment of chemical contact exposures are : • Chemical antidotes should not be used as emergency first aid meas­ ures. • W a t e r should be used immediately to remove the offending chemi­ cal. S P E E D IS E S S E N T I A L . Water has a degree of solvent ac­ tion with many chemicals. More significantly, large quantities of water provide a mechanical washing or removal action with all chemicals. • T h e a m o u n t of water used is important. Continued flooding of the affected area is necessary. I n the case of eyes, washing should be continued for a m i n i m u m of 15 minutes. • Contaminated clothing, including shoes, should be removed im­ mediately. Removal during wash­ ing is approved if this will ensure an earlier start of the washing procedure. • Medical attention is essential following the prescribed emer­ gency first aid treatment. This is particularly true with regard to eye injuries. • Safety showers and eye fountains are the two most generally recog­ nized methods of furnishing water. Proper placement and mainte­ nance are key points in furnishing these items. • Employee education on a manage­ ment approved standard or policy is necessary to ensure immediate proper action at the time of an incident.

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