Chemical Riot Control Agents A Narrative Review for Prehospital Providers
Main Article Content
Abstract
NEED TO ADD
Article Details

This work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License.
Publishing in IJOP allows authors to keep their copyright while giving IJOP unrestricted copyright permissions. Articles published in IJOP use Creative Common Attribution 4.0 International (CC BY-ND 4.0) licensing. This license requires that re-users give credit to the creator. It allows re-users to copy and distribute the material in any medium or format in unadapted form only, even for commercial purposes. Additional terms apply and can be accessed here.
Publishing in IJOP also allows authors to have contracts for non-exclusive distribution of the Journal's published version of the article, such as posting to an institutional repository or publication in a book, on the condition that the original publication in the original layout format in IJOP is retained and acknowledged.
We permit and encourage authors to post the articles they published in IJOP on their affiliated websites. This helps share the information, encourages citation in other works, and promotes scholarly discourse in the spirit of open access.
References
2-Chloroacetophenone. (2000, January). Environmental Protection Agency. https://www.epa.gov/sites/default/files/2016-09/documents/2-chloroacetophenone.pdf
Agrawal, Y., Thornton, D., & Phipps, A. (2009). CS gas--completely safe? A burn case report and literature review. Burns, 35(6), 895–897. https://doi.org/10.1016/j.burns.2008.06.007
Aktan, A. O. (2013). Tear gas is a chemical weapon, and Turkey should not use it to torture civilians. BMJ (Clinical Research Ed.), 346, f3801. https://doi.org/10.1136/bmj.f3801
Bessac, B. F., Sivula, M., von Hehn, C. A., Caceres, A. I., Escalera, J., & Jordt, S.-E. (2009). Transient receptor potential ankyrin 1 antagonists block the noxious effects of toxic industrial isocyanates and tear gases. FASEB Journal, 23(4), 1102–1114. https://doi.org/10.1096/fj.08-117812
Billmire, D. F., Vinocur, C., Ginda, M., Robinson, N. B., Panitch, H., Friss, H., Rubenstein, D., & Wiley, J. F. (1996). Pepper-spray-induced respiratory failure treated with extracorporeal membrane oxygenation. Pediatrics, 98(5), 961–963. https://doi.org/10.1542/peds.98.5.961
Blain, P. G. (2003). Tear gases and irritant incapacitants. 1-chloroacetophenone, 2-chlorobenzylidene malononitrile and dibenz[b,f]-1,4-oxazepine. Toxicological Reviews, 22(2), 103–110. https://doi.org/10.2165/00139709-200322020-00005
CDC. (2024, September 6). Riot Control Agents. Chemical Emergencies. https://www.cdc.gov/chemical-emergencies/chemical-fact-sheets/riot-control-agents.html
Chemical, biological, radiological, and nuclear (CBRN) respiratory protection handbook. (2018). U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health. https://doi.org/10.26616/NIOSHPUB2018166
Coleman, C. N., Bader, J. L., Koerner, J. F., Hrdina, C., Cliffer, K. D., Hick, J. L., James, J. J., Mansoura, M. K., Livinski, A. A., Nystrom, S. V., DiCarlo-Cohen, A., Marinissen, M. J., Wathen, L., Appler, J. M., Buddemeier, B., Casagrande, R., Estes, D., Byrne, P., Kennedy, E. M., … Hatchett, R. (2019). Chemical, Biological, Radiological, Nuclear, and Explosive (CBRNE) Science and the CBRNE Science Medical Operations Science Support Expert (CMOSSE). Disaster Medicine and Public Health Preparedness, 13(5–6), 995–1010. https://doi.org/10.1017/dmp.2018.163
El Zahran, T., Mostafa, H., Hamade, H., Mneimneh, Z., Kazzi, Z., & El Sayed, M. J. (2021). Riot-related injuries managed at a hospital in Beirut, Lebanon. The American Journal of Emergency Medicine, 42, 55–59. https://doi.org/10.1016/j.ajem.2020.12.084
Executive Orders. (2016, August 15). National Archives. https://www.archives.gov/federal-register/codification/executive-order/11850.html
Frey, A. S., Maniscalco, P. M., & Holstege, C. P. (2022). Chemical Agents Encountered in Protests. Emergency Medicine Clinics of North America, 40(2), 365–379. https://doi.org/10.1016/j.emc.2022.01.007
Haar, R. J., Iacopino, V., Ranadive, N., Weiser, S. D., & Dandu, M. (2017). Health impacts of chemical irritants used for crowd control: A systematic review of the injuries and deaths caused by tear gas and pepper spray. BMC Public Health, 17(1), 831. https://doi.org/10.1186/s12889-017-4814-6
Henry, J. (1998). CS “gas” is not a gas. Journal of Accident & Emergency Medicine, 15(5), 365. https://doi.org/10.1136/emj.15.5.365-c
Hotchkins, P., & Clapham, S. (2024, November). Scheduled chemicals and riot control agents: A visual guide. Organisation for the Prohibition of Chemical Weapons. https://www.opcw.org/sites/default/files/documents/science-for-diplomats/107%20Scheduled%20chemicals%20and%20riot%20control%20agents.pdf
Hu, H., Fine, J., Epstein, P., Kelsey, K., Reynolds, P., & Walker, B. (1989). Tear Gas—Harassing Agent or Toxic Chemical Weapon? JAMA, 262(5), 660–663. https://doi.org/10.1001/jama.1989.03430050076030
Jones, L. A., Tandberg, D., & Troutman, W. G. (1987). Household treatment for “chile burns” of the hands. Journal of Toxicology. Clinical Toxicology, 25(6), 483–491. https://doi.org/10.3109/15563658708992651
Karagama, Y. G., Newton, J. R., & Newbegin, C. J. R. (2003). Short-term and long-term physical effects of exposure to CS spray. Journal of the Royal Society of Medicine, 96(4), 172–174. https://doi.org/10.1258/jrsm.96.4.172
Major stadium disasters over recent decades. (2024, December 2). Reuters. https://www.reuters.com/world/major-stadium-disasters-over-recent-decades-2024-12-02
Morrone, A., Sacerdoti, G., Franco, G., Corretti, R., & Fazio, M. (2005). Tear gas dermatitis. Clinical and Experimental Dermatology, 30(4), 447–448. https://doi.org/10.1111/j.1365-2230.2005.01801.x
Motevalli, M. (2025). Comparative Analysis of Systematic, Scoping, Umbrella, and Narrative Reviews in Clinical Research: Critical Considerations and Future Directions. International Journal of Clinical Practice, 2025(1), 9929300. https://doi.org/10.1155/ijcp/9929300
Oaks, L. W., Dorman, J. E., & Petty, R. W. (1960). Tear gas burns of the eye. Archives of Ophthalmology (Chicago, Ill.: 1960), 63, 698–706. https://doi.org/10.1001/archopht.1960.00950020700013
Olajos, E. J., & Salem, H. (2001). Riot control agents: Pharmacology, toxicology, biochemistry and chemistry. Journal of Applied Toxicology, 21(5), 355–391. https://doi.org/10.1002/jat.767
Prehospital Trauma Life Support (10th ed.). (2023). National Association of Emergency Medical Technicians.
Preparing for, Protecting Against, and Treating Tear Gas and Other Chemical Irritant Exposure: A Protestor’s Guide. (n.d.). PHR. Retrieved January 19, 2026, from https://phr.org/our-work/resources/preparing-for-protecting-against-and-treating-tear-gas-and-other-chemical-irritant-exposure-a-protesters-guide
Region 11 Chicago EMS System. (2024). RIOT CONTROL AGENTS – BLS/ALS. https://chicagoems.org/wp-content/uploads/2024/08/ALS_BLS_Riot-Control-Agents_8_15_24.pdf
Schep, L. J., Slaughter, R. J., & McBride, D. I. (2015). Riot control agents: The tear gases CN, CS and OC-a medical review. Journal of the Royal Army Medical Corps, 161(2), 94–99. https://doi.org/10.1136/jramc-2013-000165
Smith, J., & Greaves, I. (2002). The use of chemical incapacitant sprays: A review. The Journal of Trauma, 52(3), 595–600. https://doi.org/10.1097/00005373-200203000-00036
Sommer, S., & Wilkinson, S. M. (1999). Exposure-pattern dermatitis due to CS gas. Contact Dermatitis, 40(1), 46–47. https://doi.org/10.1111/j.1600-0536.1999.tb05976.x
Torgrimson-Ojerio, B. N., Mularski, K. S., Peyton, M. R., Keast, E. M., Hassan, A., & Ivlev, I. (2021). Health issues and healthcare utilization among adults who reported exposure to tear gas during 2020 Portland (OR) protests: A cross-sectional survey. BMC Public Health, 21(1), 803. https://doi.org/10.1186/s12889-021-10859-w
Vaca, F. E., Myers, J. H., & Langdorf, M. (1996). Delayed pulmonary edema and bronchospasm after accidental lacrimator exposure. The American Journal of Emergency Medicine, 14(4), 402–405. https://doi.org/10.1016/S0735-6757(96)90060-1
Viala, B., Blomet, J., Mathieu, L., & Hall, A. H. (2005). Prevention of CS “tear gas” eye and skin effects and active decontamination with Diphoterine: Preliminary studies in 5 French Gendarmes. The Journal of Emergency Medicine, 29(1), 5–8. https://doi.org/10.1016/j.jemermed.2005.01.002
Weigernd, Dennis. A. (1969). Cutaneous Reaction to the Riot Control Agent CS. Military Medicine, 134(6), 437–440. https://doi.org/10.1093/milmed/134.6.437
Wilder, J. M., Mangipane, L. S., Atwood, T., Kochnev, A., Smith, T., & Vongraven, D. (2023). Efficacy of bear spray as a deterrent against polar bears. Wildlife Society Bulletin, 47(1), e1403. https://doi.org/10.1002/wsb.1403
Winslow, J. E., Hill, K. D., & Bozeman, W. P. (2006). 163: Determination of Optimal Methods of Decontamination After Tear Gas and subPepper Spray Exposure. Annals of Emergency Medicine, 48(4), 51. https://doi.org/10.1016/j.annemergmed.2006.07.617
Wiyono, L., Kresnadi, I., Munir, A. S., Tannuardi, M., & Mirtha, L. T. (2023). Improving public safety in events of mass gathering: The 2022 Kanjuruhan Stadium Disaster in Indonesia. Public Health Challenges, 2(4), e139. https://doi.org/10.1002/puh2.139