Abstract

Aim of the study

Following percutaneous exposure to the nerve agent VX, the remaining intact agent within the skin after decontamination is of great concern. Consequently, this leads to prolonged agent release to the blood circulation resulting in sustained intoxication, which may complicate the medical management. The decontamination procedure used should therefore possess the ability for agent removal both on and within the skin. The efficacy of three decontamination procedures was evaluated by measuring VX and the primary degradation product ethyl methyl phosphonic acid (EMPA) penetrated through human skin and the amount remaining within the skin.

Materials and methods

Decontamination was initiated 5 min post-exposure to VX on human dermatomed skin. Experiments were conducted using an in vitro skin penetration model and the amount remaining within the skin was determined by combining the tape-stripping technique and acetylcholinesterase activity measurements.

Results

In control experiments without decontamination, higher amounts of VX were recovered in the deeper layers of skin compared to EMPA, which was primarily located in the stratum corneum. Both Reactive Skin Decontamination Lotion (RSDL) and the RSDL training kit (TRSDL) significantly reduced the amount of VX within the skin and decreased the penetration through the skin. However, the degradation ability of RSDL was demonstrated to be beneficial by the reduction of intact agents remaining in the skin compared to TRSDL without agent degradation capability. Soapy water decontamination caused a “wash-in” effect of VX with decreased agent amounts within stratum corneum but increased the amount VX penetrated through the skin.

Conclusion

Efficient skin decontamination of VX requires skin decontaminants reaching deeper layers of the skin, and that both absorption and degradation properties are important. In addition, the “wash-in” effect by using soapy water may enhance VX release to the blood circulation.

中文翻译：

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皮肤内有效的药剂降解对于经皮暴露的 VX 的净化很重要

摘要

研究目的

在经皮暴露于神经毒剂 VX 后，去污后皮肤内剩余的完整毒剂是非常令人担忧的。因此，这导致药物释放到血液循环中的时间延长，导致持续中毒，这可能使医疗管理复杂化。因此，所使用的去污程序应具有去除皮肤表面和皮肤内的试剂的能力。通过测量 VX 和主要降解产物乙基甲基膦酸 (EMPA) 穿透人体皮肤以及留在皮肤内的量来评估三种去污程序的功效。

材料和方法

在人皮肤上暴露于 VX 后 5 分钟开始去污。使用体外皮肤渗透模型进行实验，并通过结合胶带剥离技术和乙酰胆碱酯酶活性测量来确定皮肤内剩余的量。

结果

在没有去污的对照实验中，与主要位于角质层中的 EMPA 相比，在更深层的皮肤中回收了更多的 VX 。活性皮肤去污乳液 (RSDL) 和 RSDL 培训套件 (TRSDL) 均显着降低了皮肤内 VX 的含量并降低了皮肤渗透率。然而，与没有试剂降解能力的 TRSDL 相比，RSDL 的降解能力通过减少残留在皮肤中的完整试剂而被证明是有益的。肥皂水去污导致 VX 的“洗入”效应，角质层内的药剂量减少，但 VX 渗透皮肤的量增加。

结论

VX 的有效皮肤去污需要皮肤去污剂到达皮肤的更深层，并且吸收和降解特性都很重要。此外，使用肥皂水的“冲洗”效果可能会促进 VX 释放到血液循环中。