American Thoracic Society calls for moratorium on tear gas use during COVID-19 pandemic

The American Thoracic Society issued a statement calling for a moratorium on the use of tear gas and chemical agents against protestors participating in demonstrations, citing potential for respiratory injury and spread of viral illnesses.

“The use of chemical crowd control agents is outlawed in the time of war,” Juan C. Celedón, MD, DrPH, ATSF, president of ATS, said in a press release. “They cause significant short- and long-term respiratory health injury and likely propagate the spread of viral illnesses, including COVID-19.”

The ATS notes that recent research has identified chronic bronchitis, compromised lung function and acute lung injury as consequences of exposure to tear gas such as 2-chlorobenzalmalononitrile (CS) and pepper oil used in exploding shells and grenades.

The ATS is also concerned that the use of tear gas may affect COVID-19 transmission. For example, a person with asymptomatic COVID-19 exposed to tear gas would be unable to keep a safe distance from others, which increases the risk for transmission to others. It has been demonstrated that airborne tear gas exposure also endangers uninvolved persons and medical personnel exposed when treating protestors due to chemical contamination of clothing and equipment. During the COVID-19 pandemic, this increases risk for COVID-19 transmission because protective masks exposed to tear gas will need to be discarded.

The ATS highlighted several recent studies to support its concerns.

In a study by Hout and colleagues, U.S. military recruits exposed to tear gas during training had an increased likelihood of developing respiratory diseases including influenza, pneumonia and bronchitis because chemicals in tear gas, such as CS, can degrade the lungs’ antiviral defenses. This may also apply to COVID-19, according to the statement.

“Current events in the U.S. provide evidence of tear gas escalation domestically. Inadequate training, monitoring and accountability in use of these weapons contribute to misuse and risk of injury. If used at all, tear gas should be a last resort,” according to the statement.

Questions remain about the health effects of exposure to tear gas and other chemical agents. The ATS notes that more research is needed, as most studies were conducted decades ago in young, healthy male participants or based on military research. Said studies do not address the potential health effects for vulnerable populations exposed during protests and demonstrations such as children, older adults and those with underlying health conditions.

“Based on the lack of crucial research, the escalation of tear gas use by law enforcement, and the likelihood of compromising lung health and promoting the spread of COVID-19, the American Thoracic Society calls for a moratorium on CS tear gas and [oleoresin capsicum] pepper weapons use,” Celedón said.

References:

• Hout J, et al. Mil Med. 2014;doi:10.7205/MILMED-D-13-00514.
• Parry J. BMJ. 2019;doi:10.1136/bmj.l5136.