![]() Keywords included hydrogen sulfide, antidote, chemical attack, chemical suicide, sulfide, countermeasure, hydrogen sulfide countermeasure, hydrogen sulfide pathophysiology, hydrogen sulfide death, hydrogen sulfide exposure, and hydrogen sulfide animal model. In the several articles referenced in this manuscript, the terms “countermeasure,” “antidote,” and “treatment” seem to be used interchangeably.Ī review of the literature was performed and relevant publications were identified by searching the following databases: MEDLINE, Embase, Cochrane Library, Web of Science, and Ovid MEDLINE. ![]() ![]() For the purposes of this manuscript, the term “countermeasure” refers to a treatment modality for hydrogen sulfide. We performed a review of the literature focusing on reports on the mechanism of toxicity, clinical presentation, and current developments of a H 2S countermeasure. Furthermore, an ideal antidote is one that is readily available, stable, and easy to store. An ideal countermeasure is one that is effective and can be easily administered in a small volume (i.e., intramuscularly). With the potential for exposure in multiple environmental, occupational, and chemical attack scenarios, the need for an effective countermeasure is evident. Ĭurrently, there are no FDA-approved antidotes for H 2S poisoning. After reviewing such documents, the Department of Homeland Security reported “that the chemical reactions described in the manuals are viable and would yield hydrogen sulfide…”. Its use as a weapon has been documented in several terrorist training manuals including The Mujahideen Poisons Handbook. That same year, the Transportation Security Administration (TSA) sent out a Security Awareness Message warning of the potential threat of H 2S use in an attack. In 2017, a terror plot to create an improvised device to release H 2S was revealed by Australian authorities. Its availability and deadly effects make it a favorable candidate for use by terrorist groups. ĭue to its lethality and ease of production, H 2S is considered a high priority chemical threat in industry and as a potential chemical weapon. In a 2004 report on 52 deaths related to H 2S exposure, Hendrickson and colleagues emphasized the need for proper education and training on H 2S safety. These exposures often result in multiple victims as bystanders and first responders attempt to rescue the first victim. Multiple occupational exposures resulting in rapid toxicity and a sudden but reversible loss of consciousness described as “knockdown” are reported in the Environmental Protection Agency (EPA) Toxicological Review on Hydrogen Sulfide. Occupational exposures can occur in industrial settings including tanning, pulp and paper processing, and rayon manufacturing. With the growing number of chemical suicides from H 2S reported in the USA, the New York State Office of Homeland Security received an advisory note from the Department of Homeland Security titled “Hydrogen Sulfide: A Potential First Responder Hazard” outlining the poison’s effects and clues on identifying potential incident sites to prevent secondary exposures. reported 43 victims of H 2S suicide incidents, 12 of which resulted from secondary exposures of first responders and employees at the coroner’s office. reported on 45 deaths from chemical suicide involving H 2S with injuries to first responders from 1999 to 2007. In these scenarios, the production of the hydrogen sulfide is rapid and in enclosed environments, such as a car or a small room, can reach deadly concentrations. It has been reported as a means of suicide by combining sulfur-containing household chemicals and acid cleaners to produce the gas. After carbon monoxide, it is the most common cause of occupational gas exposure deaths, particularly in the oil and gas, sanitation, fishing, and farming industries. ![]() Volcanoes and sulfur springs are areas where significant amounts of H 2S can be found as well. Hydrogen sulfide (H 2S) is found in petroleum, natural gas, and decaying organic matter.
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