Chemical Hazards In Law Enforcement

Fabrice Czarnecki. M.D.

From Clinics In Occupational and Environmental Medicine

Volume 3, Issue 3, Pages 443-456

Clandestine drug laboratories
 

The clandestine drug laboratory is a nationwide phenomenon that involves significant health hazards to law enforcement officers. Most of these laboratories manufacture methamphetamine, which is an easy drug to produce, even with limited knowledge of chemistry. Methamphetamine is an illegal stimulant that can be made with simple, over-the-counter ingredients. Other drugs manufactured in clandestine laboratories include sodium gamma hydroxybutyrate, lysergic acid diethylamide, methcathinone, methylenedioxymethamphetamine (ecstasy), and phencyclidine [1,2].

Most clandestine laboratories in the United States are located in the Midwest and Western states, but they have become more common in the rest of the country. They can be found in a variety of locations, from a university or industrial chemical lab, to a remote cabin, hotel room, van, or trailer. In 1993, 270 clandestine laboratories were seized in the United States, primarily in the West and Southwest. In 2001, approximately 8000 methamphetamine laboratories were seized and reported to the National Clandestine Laboratory Database at the El Paso Intelligence Center [1,2].

Every police officer should be trained to recognize a clandestine drug laboratory. Some signs include ammonia or other unusual odors, a large number of glass containers (used to separate methamphetamine from byproducts), and specific chemicals (eg, lye, ammonia, rubbing alcohol, ephedrine). In most cases, an unprepared officer should leave the environment of the laboratory and call for the appropriate response. If officers recognize a laboratory, they should get out (if possible), avoid turning any switch on or off, avoid eating or drinking anything, be aware of booby traps and hostile suspects, secure the scene, and call a specialized drug laboratory team. Only trained officers should make entry and should wear personal protective equipment (PPE).

Occupational hazards

A survey of 46 law enforcement chemists and 13 clandestine drug laboratory investigation team members found that responding to an active laboratory was associated with a 7- to 15-fold increased risk of illness, compared with the risk associated with other assignments that did not involve active laboratories [3]. Most illness symptoms were headache and respiratory, mucous membrane, and skin irritation. Inhalation was the main source of exposure. Modern procedures that involve respiratory protection should decrease the risk for inhalation.

The reported long-term effects that are caused by exposure to clandestine drug laboratories mostly describe effects on the respiratory system. There are anecdotal reports of elevated liver transaminase levels. A study of 40 California drug laboratory investigators showed an average annual decline in forced expiratory volume in 1 second (FEV1) of 64.0 mL/y, with a median decline of 40.0 mL/y [4]. The absence of respiratory protection was associated with a more rapid annual decline in FEV1. No significant changes in liver transaminase level, hemoglobin level, and white cell count were seen. A slight decrease of the platelet count was observed.

The Nazi Cold Labs method is a common and simple way to manufacture methamphetamine from ephedrine or pseudoephedrine [5]. The hazardous chemicals that are used in this process include solvents, ammonia, sodium metal, and sulfuric acid. Ammonia is used in the anhydrous form, which is caustic, explosive, and toxic. It can cause chemical burns of the skin and the eyes, acute respiratory failure with bronchiectasis and obliterative bronchiolitis, and chronic obstructive lung disease. The solvents, typically alcohols or hydrocarbons, can be volatile, inflammable, and toxic. Sodium metal commonly is stored in kerosene and ignites in contact with water. Sulfuric acid can cause chemical burns. Hydrogen chloride is a byproduct of methamphetamine synthesis and can cause persistent lung damage.

The red phosphorous method is another common way to manufacture methamphetamine from ephedrine or pseudoephedrine [5]. The chemicals that are used include solvents, iodine, sodium hydroxide, sulfuric acid, and hypophosphorus acid. Sodium hydroxide usually comes from common drain-opening formulations available at supermarkets and hardware stores and is caustic. An important toxic hazard of the red phosphorous method is the production of phosphine gas as a byproduct. Phosphine can cause pulmonary edema, myocardial injury, and potentially lethal toxicity. In 1996, the Los Angeles County Sheriff's Department reported three fatalities caused by phosphine inhalation during an attempted synthesis of methamphetamine [6]. One case report described a forensic specialist who was exposed to phosphine at approximately 2.7 ppm for 20 to 30 minutes during the investigation of a methamphetamine laboratory [7]. The forensic specialist was not wearing any respiratory protection and developed dizziness, cough, headache, and diarrhea within a few hours. Pulmonary symptoms persisted for several days.

Other dangerous chemicals found in clandestine laboratories include hydrochloric acid, phenylacetic acid, benzene, cyanide, and carbon monoxide [5]. Hydrochloric acid and phenylacetic acid are skin and respiratory irritants. Benzene is a carcinogen. It can cause drowsiness, dizziness, headache, and unconsciousness after an acute exposure and cause anemia with chronic exposure. Cyanide is toxic through inhalation, ingestion, and skin contact. Cyanide can cause dizziness, headache, nausea, vomiting, seizures, apnea, and death.

Besides toxicity from chemical exposures, fires and explosions create additional hazards in clandestine laboratory operations [5]. Many laboratories are found during the investigation of a fire. Booby traps, poor electrical connections, common inflammable solvents, and hydrogen cause fires and explosions. Criminals place booby traps in their laboratories for protection against the police and competing criminals. Officers should be looking for trip wires and deadfalls. When entering a suspected clandestine drug laboratory, electrical switches should not be turned on or off because they could be booby trapped or linked to a cooling circuit that is controlling a chemical reaction [5].

PPE

Only properly trained and equipped officers should knowingly enter a clandestine drug laboratory. The Clandestine Laboratory Training Unit of the Drug Enforcement Administration (DEA) offers training programs that meet Occupational Safety and Health Administration (OSHA) standards for working with respiratory protection. Current regulations mandate that law enforcement officers receive at least 24 hours of hazardous chemical handling training before entering a clandestine drug laboratory [8]. Officers also should attend refresher training every year.

The DEA conducts a 40-hour Basic Clandestine Laboratory Certification School and an Advanced Site Safety Officer School. Students who graduate from the DEA course receive more than $2000 in specialized safety equipment, including Nomex fire-resistant ballistic vests (DuPont, Wilmington, DE); Nomex fire-resistant jackets, pants, and gloves; chemical resistant boots; air-purifying respirators; chemical testing equipment; explosion-proof flashlights; chemical-resistant clothing; and goggles [9].

When entering a clandestine laboratory, officers should wear appropriate PPE [10]. Depending on the risk assessment, air sampling, and previous intelligence, officers can choose level B or level C PPE, as defined by OSHA, as cutaneous and respiratory protections are necessary (these levels of PPE are discussed in the article by Leiken et al elsewhere in this issue). The atmosphere should be monitored remotely, before entering the suspect location, for oxygen level, toxicity, and lower explosive limit.

Officers should wear fire-resistant uniforms, usually made of Nomex, and eye protection. Heat exhaustion may become an issue because of the ballistic vests and heavy tactical equipment. To prevent heat injury, officers should be rotated frequently and allowed to rest. Officers should train with PPE on a regular basis, because PPE tends to impair vision and dexterity. Defensive tactics, firearms training, building searches, and tactical entries should be practiced while wearing PPE.

Medical surveillance

OSHA mandates a medical surveillance program for employees working with a respirator and for employees dealing with hazardous waste operations [11]. An initial medical evaluation is necessary to determine whether the officer is physically able to work with a respirator. Physical examinations are required before beginning the clandestine laboratory assignment and then once a year. The examinations can be more or less frequent, as decided by the examining physician, but should be performed at least every 2 years and after each injury or exposure. Officers with asthma, chronic lung disease, coronary artery disease, and liver disease should undergo a thorough evaluation by a physician who is knowledgeable in these conditions to determine if the officers safely can participate in clandestine laboratory operations. The following tests are recommended for use during the initial medical examination:

• Complete blood cell count

• Liver function tests

• Urinalysis

• Pulmonary function tests with FEV1

• Electrocardiography

• Exercise stress test, depending on cardiac risk factors

The examining physician can order these tests after the initial examination, according to the officer's symptoms and known exposures.

With appropriate preparation, training, use of PPE, and medical oversight, clandestine drug laboratory operations should be relatively safe. Although there is a significant potential for injury and illness, the DEA has not seen any long-term lung or liver disease (R. Waite, personal communication, 2002).


Chemical agents used in law enforcement
Oleoresin capsicum

Oleoresin capsicum (OC) is a natural oily compound that is extracted from cayenne pepper. It has been used in warfare for several centuries. Around 2000 BC in China, armies would burn red pepper to produce a suffocating smoke. The US Postal Service has used OC as a dog repellent since 1961. The first law-enforcement OC aerosol, commonly called pepper spray, was manufactured in 1973.

OC contains several active ingredients called capsaicinoids [12], which include capsaicin, dihydrocapsaicin, nordihydrocapsaicin, homodihydrocapsaicin, homocapsaicin, and nonivamide. Capsaicin, the main capsaicinoid, is a crystalline alkaloid (8-methyl-N-vanillyl-6-nonenamide; C18H27NO3) and is approved by the Food and Drug Administration as a topical treatment for pain from rheumatoid arthritis, osteoarthritis, zoster, and diabetic neuropathy. Capsaicin also has been used in the treatment of chronic rhinitis [12,13].

Effects of OC aerosols

OC is an inflammatory agent that causes pain, erythema, and edema. Its effects as an aerosol are immediate, and it is safer and more effective than other riot-control agents [13,14].

Cutaneous and mucous membrane effects

OC aerosols cause a transient inflammation of the skin and mucous membranes, usually associated with a burning sensation and erythema [13,14].


Ocular effects

OC aerosols cause severe eye pain, conjunctivitis, blepharospasm, and lacrimation. Once a subject is sprayed with OC, fighting abilities are decreased mostly from difficulty with vision that is caused by eye inflammation [12–15].

Respiratory effects

The respiratory effects of OC include coughing and shortness of breath, without other objective findings [13,14,16]. One study found no significant differences in forced vital capacity, FEV1, oxygen, and CO2 levels between a group exposed to OC and a placebo group [16]. Another study found a transient (less than 60 seconds) decrease of airway conductance after capsaicin inhalation, with no difference in magnitude or duration observed between normal subjects and those with asthma [17].

Psychologic effects

Psychologic effects are critical to law enforcement applications. Most subjects, when they do not have a strong goal to fight the effects of OC, tend to panic after exposure. The fear of blindness and suffocation can be overwhelming. Subjects might be unable to function or fight, and some might fall to the ground in a fetal position [13].

OC does not stop a determined assailant. Most police officers, who are exposed in training and especially if they have been well prepared for the effects of OC and given a task to achieve after the exposure, tend to perform well despite the discomfort caused by OC. It seems that having a strong goal is the critical factor that allows people to fight through the effects of OC. Officers deploying OC should be aware that criminals can resist OC. This agent does not replace firearms, impact weapons, defensive tactics, and other defense and control tools. It should not be used in a deadly force situation. Some people seem to be naturally immune to the effects of OC: The usual estimation is that OC is effective on 80% to 85% of the population [13].

OC also is used as a defense against bears and dogs. Trained dogs, when given a specific task before being sprayed, have been shown to withstand OC. Like humans, they can use a strong goal to overcome the effects of OC.

Most of the effects of OC last for less than 45 minutes, with an average duration of about 30 minutes. A mild conjunctivitis can persist for several hours. Rarely, a corneal abrasion has been observed after exposure to OC aerosols, but this effect resolved within 24 hours without treatment [15]. Studies found an incidence of corneal abrasion of up to 10% [18,19]. A study of 47 subjects, only found punctate epithelial erosions, without abrasion [20]. The exact cause of the corneal abrasion after OC exposure is unknown. Solvents, the pressure of the spray, or the rubbing of eyes after exposure, in addition to OC, have been suggested as possible causes.

OC has an established track record of safety. It is used widely by police agencies in the United States and other countries. No death has ever been proved to be caused by OC exposure [14,21,22]. In 1994, the International Association of Chiefs of Police published a report on in-custody death after OC exposure [22]. The report concluded that OC was not the cause of death in any of the cases. Deaths after OC exposure are usually the consequence of excited delirium, a condition that is characterized by extreme agitation, hyperthermia, rhabdomyolysis, renal failure, and hyperkalemia. The chronic use of excitant drugs, mostly cocaine, causes excited delirium.

OC spray selection

The pungency of chili peppers is measured in Scoville heat units (SHU) [12,13]. The original pungency testing was performed using a panel of five experienced subjects who tasted the spices. The American Spice Trade Association, using high-pressure liquid chromatography, designed a modern, more reliable method. Most law enforcement sprays have a pungency of 500,000 to 2 million SHU. One brand has sprays with 5.3 million SHU. Hotter sprays (with more SHU) tend to have faster effects.

Another characteristic of OC aerosol is the concentration of capsicum [13], which varies from 2% to 17%. Most law enforcement sprays have a concentration of 5% to 10%. A higher concentration generally means longer-lasting effects, which is not necessarily desirable. The concentration of capsaicin, the main active ingredient, is not the same as the capsicum concentration, which is stated on the label of the canister. The capsicum concentration is a poor indicator of the efficiency of the aerosol. The concentration of capsaicin would be a better indicator, but it is rarely available [12]. The National Institute of Justice is financing research that would help determine the exact composition of available pepper sprays and standardize formulations.

Some OC aerosols use an alcohol-containing solution. These formulations should not be sprayed near an open flame. Once a subject has been sprayed with an alcohol-based aerosol, a taser or an electric stun gun should not be used, because the risk for burns is significant.

OC aerosols offer different dispersion shapes, depending on the application. The cone is effective on the eyes, respiratory system, and mucous membranes, and its risk for secondary exposure is high. The stream is more target specific and is more effective in high winds, and the risk for secondary exposure is low. The foam is best for indoor use, especially in a crowded environment, because the secondary exposure is minimal. The fogger deploys a cloud of OC under high pressure, with the goal of affecting everybody in a large area.

OC decontamination

Soap and baby shampoo can be used to remove OC oily compounds from the face and hands, mainly to prevent secondary recontamination [13,14]. Milk, soda, baby shampoo, sugar solutions, water, and commercial decontaminants have been used, and no one method has been proven to be superior to another. Some OC trainers believe that commercial decontaminants are not superior to water and fresh air. Water, fresh air, and time seem to be the best agents that ease the pain. Once the inflammation starts, no decontaminant can stop it. The goal of the decontamination process is to remove the OC from the skin to prevent future recontamination.

A person who has been sprayed should be brought to a hospital if the symptoms persist for longer than 45 minutes or if the person requests it. Emergency medical services (EMS) should be called if signs of distress are observed (eg, loss of consciousness, difficulty breathing, chest pain) [13].

Exposure to OC during training

A controversial issue in police training is whether officers should be exposed to OC. Although it is safe for healthy individuals, some police departments do not expose their officers to OC. Other departments have officers perform job-related tasks after exposure, like restraining or disarming a suspect or shooting a firearm.

Officers are likely to be exposed to OC in the field and should know in advance how they can function after exposure. Assaults on police officers with pepper spray have occurred. Cross-contamination is common and occurs when officers deploy OC in a closed environment. Exposure during training helps officers react in a positive way if they experience significant OC exposure during an actual fight. Criminals can use OC to incapacitate officers to obtain access to their firearms. Training should address that issue. Previous OC exposure might be the best way to achieve successful firearm retention during an actual attack, when coupled with firearm-retention techniques and mental conditioning.

Panic has an important role in the human reaction to OC, and previous exposure decreases panic levels. Training helps officers overcome that panic and fear, which can result in an inability to protect themselves if sprayed with OC. Previous exposure is probably the best way to show officers that they can control their panic reaction.

Other reasons to expose officers include acceptability and liability. Spraying officers shows the community that OC is not dangerous and may not necessarily constitute excessive use of force or police brutality. The knowledge about the effects of OC help officers articulate in court their use of force escalation, possibly up to deadly force, when they are assaulted with OC. If they know from personal experience what happens when exposed to OC, it would be easier to justify the actions they took to defend themselves from a suspect who threatened them with OC. Officers can explain that OC is not a magic bullet and that suspects may require more force to arrest them if OC has failed.

Personal experience might increase the confidence in OC use. Such knowledge improves officers' understanding of the effectiveness of OC as a defense and an arrest tool and its strengths and weaknesses.

Officers and suspects benefit when officers participate in a live OC training exercise, which is an excellent way to learn decontamination procedures. Officers learn what steps to follow to help in the decontamination of suspects. Because they experience the discomfort caused by OC, officers also learn to feel empathy toward these suspects.

During a training session, the OC canister should be kept at a safe distance from the person being sprayed, as recommended by the manufacturer (usually 3 feet), to avoid eye damage caused by the pressure of the aerosol [13,14]. Officers should wait a sufficient amount of time (ie, at least 4 hours to allow the conjunctivitis to subside) after being sprayed before driving a car. The officers carefully should wash their hands and face and change exposed clothes to avoid secondary contamination while driving. Instructors should be ready to help officers decontaminate themselves, as necessary. A medical plan includes on-site medical supplies, quick access to 911 and EMS, and the presence of trained cardiopulmonary resuscitation and first aid personnel.

There is anecdotal evidence that OC is not dangerous in asthmatics. According to a leading OC trainer, several hundreds of asthmatic officers have been sprayed in training, without any side effect (R. Ouellette, personal communication, 2001). OC is contraindicated during an acute asthma exacerbation. Pregnant officers should be allowed to opt out of OC exposure during training. Other contraindications might be articulated by the officer's personal physician, which may raise several questions: Should that officer be issued pepper spray considering the definitive risk for cross-contamination? How would that officer react if other officers deploy OC near him or her?

The author's recommendation, as a physician and a pepper-spray instructor, is to encourage OC exposure during training, because it is safe and useful for officers. Whether it should be optional or mandatory has to be answered by the legal department as an OSHA issue and a use-of-force issue. If officers are not exposed directly to OC, they should at least watch a film showing the effects of pepper spray.

Other riot gases

Omega-chloroacetophenone (CN) was the original active ingredient used in self-defense sprays [13,14]. It was developed in 1869 and has been used as a riot-control gas since the late 1920s. CN usually is defined as an irritant agent. This aerosolized solid is effective within a few seconds and has a LCt50 (concentration of chemical agent that will kill by inhalation 50% of an exposed population) of 14,000 mg·min/m3. Exposure to CN can cause lacrimation, shortness of breath, skin inflammation, and nausea. CN relies mostly on pain compliance and might be less effective on intoxicated and agitated subjects. CN cross-contamination is a major issue, because CN particles can remain airborne for some time after deployment. CN can cause severe dermatitis, necrotizing keratitis, suppurative iridocyclitis, and a potentially deadly pulmonary edema. It is not used commonly in law enforcement in the United States.

o-chlorobenzylidene malonitrile (CS) is a common riot-control gas that has been used by the US military since 1960 [13,14]. It was developed in 1928 and initially was used as a riot-control gas in 1956 in Cyprus by the British military. CS usually is defined as a tear gas. This aerosolized solid is effective within 20 to 60 seconds and has an LCt50 of 25,000 mg·min/m3 and a LD50 of 200 mg/kg. Exposure to CS can cause lacrimation, persistent coughing, nasal discharge, shortness of breath, skin inflammation, and nausea. Law enforcement applications of CS include crowd-control situations where the goal is to displace a crowd, rather than “knock its members to the ground”, when OC might be more appropriate. CS is the most popular chemical self-defense spray in Europe for police and civilian markets, but more European police agencies are switching to OC.

Chemical agents have been used by law enforcement for about 80 years. Compared with other agents, OC has proved to have superior effectiveness, reliability, and most importantly, safety for officers and suspects. Although the issues of exposure during training and decontamination remain unsolved, OC has been established as a standard nonlethal weapon in US law enforcement.

Lead exposure

Police officers are exposed to lead mostly during firearms training. In countries where gasoline is contains lead, traffic enforcement can be another significant source of lead exposure for police officers [23]. Fingerprint powders are another source of exposure [24]. The following section addresses the issue of lead exposure on police ranges and how to mitigate it.

Metabolism

Inorganic lead is absorbed by inhalation and ingestion [25]. The blood absorption of inhaled lead is approximately 30% to 40%, depending on particle size and interindividual variation. The absorption of lead through ingestion is approximately 5% to 15%. The latter figure increases to up to 50% in pregnant women and children. Most circulating lead (≥95%) is bound to erythrocytes. Lead then is deposited to bones and soft tissues. Bones contain about 90% of the total content of lead in the body. The half-life of lead is 1 to 3 months in blood and soft tissues and 10 to 25 years in bones. Lead is excreted mainly through the kidneys and gastrointestinal tract. Breast milk is another excretion route, and the lead concentration in breast milk is associated with the concentration in blood.

Toxicology

Hematologic effects

A mild-to-moderate anemia is a common toxic effect of lead in adults [25,26]. The anemia is usually normocytic and normochromic with a chronic exposure, but could be microcytic and hypochromic in the early course of the disease. The mechanism of anemia is double: Lead inhibits the synthesis of hemoglobin, and it decreases the life span of circulating erythrocytes.

Neurologic effects

Lead encephalopathy resulting from occupational exposure is rare [25,26]. The symptoms in the early stages of the disease include fatigue, subtle behavioral changes, memory impairment, depression, headache, and tremor. Severe cases progress to drowsiness, convulsions, and coma. Chronic lead exposure in childhood causes cognitive deficits, low IQ scores, and hearing loss. Peripheral nervous system damage is more common in adults. The symptoms of lead neuropathy include muscle and joint pain, fatigue, and tremor. Paralysis, typically of the extensor muscles of the hand, is a late finding.

Renal effects

Lead nephropathy results from a combination of proximal tubule damage, interstitial fibrosis, and vascular changes [25,26]. Chronic lead exposure has been associated with gout. So-called “saturnine gout” is related to the tubular damage and the consequent underexcretion of uric acid. Lead nephropathy is rare and results from heavy exposure lasting at least 10 years.

Other effects

Gastrointestinal symptoms of lead toxicity include loss of appetite, abdominal pain, and constipation or diarrhea [25,26]. Hypertension can occur, and cerebrovascular deaths seem to be more frequent with heavy exposure to lead. Decreased fertility has been observed in female and male workers. Lead exposure during pregnancy can cause spontaneous abortion, premature delivery, preeclampsia, and decreased birth weight [26,27].

Treatment

The treatment of lead poisoning starts with removing the source of exposure. Chelation usually is indicated in adults with blood lead levels greater 80 μg/dL and in children with levels greater than 40 μg/dL [25]. Chelating agents include ethylenediamine tetra-acetic acid (EDTA) and 2,3-dimercaptosuccinic acid. OSHA prohibits the use of chelating agents to prevent elevated blood lead levels.

Medical surveillance

The OSHA action level for inorganic lead concentration in the air is 30 μg/m3, when workers are not wearing respirators [28]. The OSHA permissible exposure limit (PEL) is 50 μg/m3 averaged over an 8-hour workday. When the action level is reached, the following steps have to be taken: air monitoring every 6 months, employee training, medical surveillance, and biologic monitoring of exposed personnel exposed for more than 30 d/y. When the PEL is reached, the air has to be monitored every 3 months.

Workers who are exposed to the OSHA action level (30 μg/m3) for more than 30 d/y should be tested for blood lead and zinc protoporphyrin (ZPP) levels every 6 months. If the blood lead level is less than 40 μg/dL, there are no further requirements. If the blood lead level is greater than 40 μg/dL of whole blood, the worker should get a complete physical, with hemoglobin and hematocrit determinations, peripheral blood smear, blood urea nitrogen, and serum creatinine, urinalysis, and be tested for lead every 2 months until 2 consecutive levels are less than 40 μg/dL. The worker should be completely removed from any lead exposure if the average blood lead level is greater than 50 μg/dL and be tested every month until 2 consecutive levels are less than 40 μg/dL.

ZPP is believed to be an indicator of exposure to lead over the past 4 months. Elevated ZPP results are seen in iron deficiency, the anemia of chronic disease, and in chronic lead poisoning, typically when the blood lead is greater than 25 μg/dL. The OSHA standard does not specify action levels for ZPP.

In addition to specific requirements in the OSHA lead standard, the following steps should be considered when an employee has a blood lead level greater than 25 μg/dL:

• Immediate testing of each employee for blood lead and ZPP levels

• Air sampling

• Professional inspection of the range by an industrial hygienist

• Improvement of the air ventilation system

• Professional cleaning of range

Lead exposure in police ranges

Shooting ranges can expose police officers to airborne lead particles during firearms training. Police officers have to qualify with their issued firearms on a regular basis, usually two to four times a year, to demonstrate proficiency. Beyond regular qualification, some agencies require or encourage additional firearms training. Some officers shoot on their own time or for practice, hunting, or competition.

The routes of lead contamination include inhalation, ingestion, and cross-contamination. The officer can inhale lead dust coming from the primer (the small explosive located at the base of the shell casing) or inhale lead particles caused by friction of a lead bullet passing through the barrel. The lead dust also settles on the skin, clothing, face, and hands of the shooter. Ingestion occurs through the deposition of lead dust on the officer's hands and face, especially facial hair. Lead can contaminate clothing, especially shoes, and food and beverages left in or near the shooting area. The clothes worn at the range could contaminate the family of the officer if they are brought home [26].

Only vacuum cleaning should be used, preferably with a vacuum cleaner equipped with a high-efficiency particulate air filter [26]. Sweeping and brushing might cause the lead particles to become airborne and should be avoided.

Prevention of lead poisoning in police ranges

Several steps can be taken to reduce the exposure to lead in police ranges. The precautions should be more stringent with full-time range workers and possibly less stringent with occasional visitors, such as police recruits, officers who come for in-service training, and part-time firearms instructors. OSHA mandates monitoring for employees who spend at least 30 d/y in a lead-contaminated environment [28].

Full-time range workers include firearms instructors and support personnel. The exposure risk for the cleaning staff is high, but the risk for gunsmiths and clerical personnel can be variable. The authors recommend baseline blood lead testing and a complete blood count before employees at risk for exposure begin working at the range. Workers who work in the lead-contaminated area should be tested for blood lead levels at least every 6 months.

Engineering modifications and a better design of the range decrease the level of exposure. An industrial hygienist can provide regular professional inspections of the range. The change rooms and washing rooms should be separate from the firing range. Engineering modifications include improved ventilation and exhaust systems. The airflow should go downrange, away from shooters. The goal is to insure that the breathing zones of the workers (18-inch radius) have a lead concentration of less than 30 μg/m3.

Police officers should receive training to reduce the exposure to lead. Full-time range workers may need additional training. The reproductive dangers of lead should be explained to male and female officers. Once a pregnancy is known, pregnant officers should not be required to participate in firearms training because of the increased risks for spontaneous abortion, premature delivery, preeclampsia, and decreased birth weight [27]. The fetus could be exposed during the earliest part of the pregnancy, before the pregnancy is known. Pregnant and lactating officers should be offered alternatives to live-fire training [27].

Male and female officers who plan to have children in the near future should be careful to reduce their lead exposure and should keep their blood lead levels under 30 μg/dL [29].

No one should be allowed to eat, drink, or smoke on the range [26]. No food, beverages, or tobacco products should be allowed on or near the range. Officers should wash their hands and face carefully after shooting and after manipulation or cleaning firearms, especially before eating, drinking, or smoking. Officers should avoid touching their mouths or applying lipstick or lip balm while on the range.

To avoid contaminating their families, officers should change and shower as soon they arrive home. Officers should wear different shoes at the range and at home. Clothing worn at the range should be washed at the range or separated from the family wash. These precautions are important if officers live with small children or pregnant women. Cleaning firearms may expose officers and their families to lead. Such cleaning should be performed at the range, while taking the precautions required when shooting.

Full-time range workers may want to take extra steps to protect themselves and their families. Air-purifying respirators, protective clothing, and gloves can be used when cleaning the range. Range workers also can change clothes, including shoes, and take a shower before leaving the range.

The ammunition design, such as totally metal-jacketed bullets and lead-free primers, can be useful to decrease lead exposure. One study showed that the use of totally copper-jacketed bullets reduced airborne lead levels by a factor of 21 in the personal breathing zone of the shooters [30].

Using lead-free ammunition, with lead-free primers, is the best way to avoid lead exposure. Lead-free ammunition is more expensive and not used widely, but more training facilities are adopting them. Some firearms instructors train officers with service ammunition (ie, the ammunition issued for street use) rather than with training ammunition. No lead-free service ammunition is available, but most, if not all, of firearms training can be accomplished with lead-free training ammunition. Progressive law enforcement agencies should consider using only lead-free ammunition during training, especially in indoor ranges. Outdoor ranges might be safer than indoor ranges, but still require some precautions. Significant lead exposure has been found in uncovered outdoor ranges [31].

Lead probably remains the main toxic chemical in the law enforcement profession. Lead exposure is a complex issue, but proper planning can keep it under control, using a combination of engineering improvements, hygiene, and education of the officers. In the future, lead-free ammunition should become the standard in police training.

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a The Gables Group, Inc., 1172 South Dixie Highway, Coral Gables, FL 33146, USA
b Family Health Center, Franklin Square Hospital Center, 9101 Franklin Square Drive, Suite 205, Baltimore, MD 21237, USA
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* Family Health Center, Franklin Square Hospital Center, 9101 Franklin Square Drive, Suite 205, Baltimore, MD 21237

doi: 10.1016/s1526-0046(03)00075-x

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