Citation

Sen JPB, Sandhu R, Bland S. BJA Educ. 2021; 21(4): 126-132.

Copyright

(Copyright © 2021, Elsevier Publishing)

DOI

10.1016/j.bjae.2020.11.005

PMID

33777410

Abstract

Chemical incidents are defined by the WHO as the uncontrolled release of a toxic substance, potentially resulting in harm to public health and the environment. The cause of a chemical incident can be an unintentional release of hazardous material (HAZMAT) as a result of an industrial or transportation accident, or a deliberate release attributable to terrorism or act of war, often described as a chemical, biological, radiological or nuclear (CBRN) incident. In the UK, there has been an increase in the use of caustic substances (acids or alkalis) as a targeted assault.

Tragically, the use of chemicals in deliberate acts of terrorism and warfare is not new with incidents in World War 1 demonstrating the devastating effects of chlorine, phosgene and sulphur mustard gas.In more recent history, chemical weapons have been used in major cities in civilian attacks, such as the use of sarin in Syria from 2013 and the Salisbury nerve agent incident in the UK in 2018. The increased use of chemical agents in acts of terrorism has led to guidance from Public Health England supporting the clinical management and health protection in CBRN incidents, and international guidelines from the North Atlantic Treaty Organization.

Domestically, the use of chemicals, particularly caustic substances, in violent assaults has increased dramatically in the UK, with 501 attacks reported in 2018. The majority of these incidents have occurred in London, and unlike in other countries, these incidents appear to be gang-related with victims and perpetrators mostly male. In these attacks, the target is often the victim's face to cause maximal disfigurement by scarring and deformity, bringing long-term physical and psychological damage....

Language: en

Keywords

violence; safety; terrorism; burns; chemical; warfare