Pepper Spray's Effects On A Suspect's Ability To Breathe
U.S. Department of JusticeOffice of Justice ProgramsNational Institute of JusticeNational Institute of JusticeResearchinBriefDecember 2001Issues and FindingsDiscussed in this Brief: Theeffect of oleoresin capsicum (OC),or pepper spray, on respiration,particularly when combined withpositional restraint. Researchersexposed 34 subjects to OC spray,both while sitting and in theprone maximal restraint position.Key issues: OC spray has gainedwide acceptance in law enforcement as a swift and effective wayto subdue violent and dangeroussuspects in the field with relatively little force. As its use hasincreased, however, OC spray hasbeen associated in the mediawith the deaths of a number ofsuspects in custody. Some haveargued that OC spray, when usedin combination with physicalrestraints, can lead to significantrespiratory compromise, includingasphyxiation and death. To testthis theory, researchers examinedthe respiratory effects of inhalingOC spray while in the sitting andrestraint positions and comparedthe results with those obtainedin the same two positions whensubjects inhaled a placebo spray.Key findings: OC exposure andinhalation do not result in a significant risk for respiratory compromise or asphyxiation, even whencombined with positional restraint.In the sitting position, OC sprayinhalation and exposure resultedin no respiratory compromise. Pepper Spray’s Effects on aSuspect’s Ability to BreatheBy Theodore C. Chan, Gary M. Vilke, Jack Clausen, Richard Clark, Paul Schmidt,Thomas Snowden, and Tom NeumanMost law enforcement agencies in theUnited States have authorized the use ofoleoresin capsicum (OC), or pepper spray,as a use-of-force option to subdue andcontrol dangerous, combative, or violentsubjects in the field. OC, with its abilityto temporarily incapacitate subjects, hasbeen credited with decreasing injuriesamong officers and arrestees by reducingthe need for more severe force options.Despite the success of OC spray, thereis growing concern about its safety, particularly when exposure is combined withpositional restraint. A number of arresteesexposed to OC, which induces coughing,gagging, and shortness of breath, havedied in custody—thus prompting the allegation that OC inhalation places individuals at risk for potentially fatal respiratorycompromise.1The National Institute of Justice (NIJ), inconjunction with the Office of CommunityOriented Policing Services (COPS), supported a study by medical researchersat the University of California–San Diegoto examine the combined effects of OCexposure and positional restraint on respiratory and pulmonary function among34 volunteer subjects recruited from alaw enforcement training academy.Research findings suggested that inhalation of OC spray does not pose a significantrisk to subjects in terms of respiratoryand pulmonary function, even when itoccurs with positional restraint. However,OC exposure did result in a small butstatistically significant increase in bloodpressure, the origin of which remainsunclear.What is OC spray?Oleoresin capsicum is the oily extractof the cayenne pepper plant. Exposure toOC irritates the skin, eyes, and mucousmembranes of the upper respiratory tract.These properties of the pepper plant havebeen known for centuries. In Japan, samurai warriors threw rice-paper bags filledwith pepper extracts at the eyes of theirenemies to cause temporary blindness.Chinese soldiers heated red peppers inhot oil to form an irritant smoke to beblown over enemy lines.In 1973, OC became available as anaerosol spray and was initially used byFBI personnel and U.S. mail carriers toincapacitate humans and animals on atemporary basis. During the late 1980s,it was widely adopted by law enforcement agencies nationwide and was madecontinued Support for this research was provided through a transfer of funds to NIJ fromthe Office of Community Oriented Policing Services.COMMUNITY ORIENTED POLICING SERVICESU.S. DEPARTMENT OF JUSTICE
ReIssues and Findings continuedThere was no evidence of abnormally low oxygen levels or abnormally high levels of carbon dioxide(CO2). In fact, the lower CO2 levels for this group suggest that OCspray may actually increase ventilation slightly.Researchers detected no difference between the OC and placebo groups in the restraint position.There was some decline in pulmonary function, but not enoughto be clinically significant. As inthe sitting position, OC seemedto increase ventilation. OC exposure did, however,result in an increase in bloodpressure, perhaps due to the discomfort and pain associated withOC. The clinical implications ofthis finding remain unknown. This study had a number oflimitations. First, not all of theconditions that occur when OCand restraint are employed in thefield could be reproduced in thelaboratory. Second, the effectsof prolonged sprays or repeatedexposures were not studied.Third, all of the subjects werecadets at the local police academy and were generally healthy.Fourth, the study did not investigate the long-term effects of OCexposure or the potential for complications from chronic occupational exposure to OC. Target audience: Law enforcement policymakers and practitioners, defense and prosecutionattorneys involved in OC spraycriminal and civil litigation, andmedical examiners.searchinavailable for use by the general public.Currently, hand-held canister spray models are produced and used in this country.These models produce an aerosol, liquidstream, or foam spray, with OC concentrations ranging from 1 to 10 percent.Pepper sprays are generally regardedas immediately effective, safer, and lesstoxic than other classic forms of tear gasor mace, such as chloroacetophenone (CN)or o-chlorobenzyildene malononitrile (CS).About this studyPrevious studies have examined thecough-inducing properties of capsaicin(the active ingredient of OC) spray, anda few have looked at the health effectsof OC in humans. In addition, some research has been conducted to determineif prone maximal restraint (the “hogtie”or “hobble” position) may lead to positional asphyxia (death caused by obstructed airways or other interference withbreathing resulting from body position).The study discussed in this Research inBrief is the first to investigate whetherOC exposure by itself or in combinationwith positional restraint resulted in respiratory compromise that could put individuals at risk for significant injury ordeath. The study also examined theeffects of OC spray/positional restrainton blood pressure and explored whetherthe health effects associated with OCexposure might be influenced by— Body weight and size. Asthma or other pulmonary disease. The use of respiratory inhalermedication. A history of smoking.Study subjectsThirty-seven individuals (training staffand cadets) from the San Diego Regional2BriefPublic Training Institute were recruitedand enrolled as subjects for the study.Two subjects were excluded at the outset:One had fractured his ribs and was unableto adequately perform pulmonary functiontesting; the other had a fractured armimmobilized in a cast, making it impossible to place him in the restraint position. A third subject was excluded afterfainting when his blood was drawn inthe first trial. He had been exposed tothe placebo spray in the sitting positionbut was never exposed to OC spray orrestrained at any time.Overall, 34 subjects (24 men and 10women) completed the study. The averageage was 31.7 years, with subjects rangingfrom 22 to 46 years. The average weightwas 79.1 kilograms (about 174 pounds),with subjects ranging from 52 to 107 kilograms (approximately 115 to 236 pounds).Seven subjects were classified as overweight (with a body mass index, or BMI,of more than 28 kg/m2), and eight subjectshad a history of smoking, lung disease,or respiratory inhaler medication use.Study designA randomized, crossover, controlled laboratory study on human subjects was performed, comparing the effects of OC sprayand a placebo spray followed by the sitting and restraint positions. The 34 subjects completed 136 separate trials (4trials per subject) of varying exposure andposition such that each served as his orher own control. Eight trials were excluded from analysis because the subjectdid not adequately inhale when exposedto OC spray. As a result, 128 separatetrials were analyzed for the purposes ofthis study.For the spirometric and pulmonary function testing data, an additional four trialswere excluded from the testing becauseit did not meet American Thoracic
ResSociety criteria for reproducibilityand variability.2 An additional two trials were excluded from the findings onarterial blood gas data because venousrather than arterial blood was sampled; one trial was excluded from thefindings on blood pressure data due tomechanical instrument error.earchinBemia (low levels of blood oxygenation),hypercapnia (increased carbon dioxidelevels), or hypoventilation (decreasedventilation of the lungs).3In this study, researchers found noevidence that OC exposure resultedin any additional change in respiratory function in the restraint position.riefIn both the OC and placebo groups,pulmonary function was restricted inthe restraint position, but measurements remained within the normalrange. Moreover, there were no statistical differences between the OCand placebo groups relative to thesedeclines (see exhibits 1 and 2).Study findingsSitting position. Researchers found noevidence that OC spray inhalation andexposure resulted in any respiratorycompromise in the sitting position.Statistically, there was no significantdifference in percent of predicted values for FVC (forced vital capacity—the amount of air that can be expelledfrom the lungs after a maximal inspiration) or FEV1 (the amount of air thata subject can forcibly expel in 1 second during a forced expiration test)between the OC and placebo groupsat 1.5 and 10 minutes after exposure.Clinically, values remained within thenormal range at 1.5 and 10 minutesafter OC exposure and inhalation(see exhibits 1 and 2).OC spray exposure did not result inany statistically significant differencesin blood oxygenation when comparedwith placebo in the sitting position.Blood oxygenation remained at clinically normal levels (see exhibit 3) andcarbon dioxide levels decreased afterexposure to OC spray. This small butsignificant finding suggests that ventilation actually increased after OC exposure (see exhibit 4).Restraint position. The findings ofthis study concerning the restraintposition are consistent with the authors’previous studies on respiratory function and restraint, which found thatrestraint led to declines in FVC andFEV1 but found no evidence of hypox-Exhibit 1. FVC by exposure and positionMean % predicted /restraint100806040200Baseline1.5 minutes10 minutesExhibit 2. FEV1 by exposure and positionMean % predicted C/restraint100806040200Baseline31.5 minutes10 minutes
ReseJust as in the sitting position, therewas no difference in oxygenation inthe restraint position between theOC and placebo groups (see exhibit 3).There was also no difference in carbondioxide levels between the two groupsin the restraint position, suggestingthat OC exposure had no adverse effecton ventilatory function in restrainedsubjects (see exhibit 4). Thus, OC aintOC/restraint1 minute5 minutes9 minutesABG* Arterial blood gas.Exhibit 4. Ventilation (CO2 levels) by exposure and positionEnd tidal CO2 (pCO2 for C/restraint1 minute5 minutes4035BaselineefMean arterial blood pressure, however,was significantly elevated after exposure to OC spray when compared toplacebo in both the sitting and restraintpositions. This difference, though small,persisted at 3, 6, and 9 minutes afterexposure (see exhibit 6). The reasonsfor this remain uncertain and may simply be related to the discomfort andpain associated with OC exposure.9630iCardiovascular effects. Exposure toOC spray resulted in a small increasein heart rate when compared with placebo. While statistically significant, thisdifference is probably of no clinicalimportance, since average heart rates98Baselinerfor all groups (regardless of exposureor position) remained well within normal limits (see exhibit 5).% Oxygen saturation (pO2 for ABG*)10090Blation had no effect on the pulmonaryfunction changes, oxygenation, or ventilation associated with restraint.Exhibit 3. Oxygenation by exposure and position92n9 minutesABG* Arterial blood gas.4Effects of body size and weight.Researchers found no evidence ofadditional restrictive pulmonary dysfunction in seven overweight subjectsin the sitting or even the restraint position with OC or placebo exposure. Inthis group, OC exposure did not leadto hypoxemia or hypoventilation ineither the sitting or restraint positionand actually seemed to improve oxygenation in the sitting position. Clearly,however, these conclusions must betempered by the small size of this subgroup and the fact that none of thesubjects were morbidly obese (BMIgreater than 32 kg/m2).Asthma, smoking, respiratory inhalermedication use. Researchers found noevidence that OC spray inhalation andexposure resulted in respiratory compromise in subjects with a history oflung disease, asthma, smoking, orrespiratory inhaler medication use.In this subgroup, OC exposure hadno effect on pulmonary function in thesitting or restraint positions. There wasalso no evidence of hypoxemia, hypercapnia, or hypoventilation after OCinhalation for this group in either thesitting or restraint positions. Yet whilethese results suggest that OC exposuredoes not result in respiratory dysfunction in those with potential respiratory
Resabnormalities, it is important to notethat this study cannot make definitiveconclusions due to the small numberof subjects (eight) in this subgroup.Study caveats and implicationsLimitations of this study. This studywas performed on human subjects in aclinical laboratory and did not attemptto replicate all the conditions that maybe encountered in the field. Field subjects are often in a state of extremeagitation and “excited delirium” as aresult of underlying psychiatric disease or intoxication from recreationaldrugs. Subjects are often involved inviolent physical struggles before, during, and after the use of OC spray orpositional restraint. There has beenspeculation that subjects in the fieldundergo extreme levels of exertionleading to exhaustion that may affectpulmonary function. Although previous studies have attempted to replicateexertion and struggle, it is unlikely thatall conditions that occur in the field—particularly the physiological and psychological effects of stress and trauma—can be reproduced in the laboratory.Moreover, as this study focused oninhalation exposure, all subjects woregoggles to reduce OC exposure to theeyes, which causes irritation and pain.Ocular OC exposure may exacerbatethe physiological stress of field subjects but was not assessed in this study.In addition, restrained subjects wereplaced on a medical examination tablerather than on a hard surface, as oftenoccurs in field settings.This study attempted to replicate OCexposure in the field as much as possible in the laboratory setting. In doingso, exact capsaicin dosing was not standardized. Rather, subjects, whose headswere placed in a 5' x 3' x 5' exposureearchinBbox, received a standard 1-second spraydirected from 5 feet away as dictatedby both manufacturer recommendations and local police policies regarding the use of OC. Spraying from lessthan 5 feet away does not allow foradequate aerosolization of OC and islikely to reduce the amount of inhalation exposure.riefExposure in the box was limited to5 seconds while in the laboratory.Although this may seem to be a shortperiod of time, spray in the field usually occurs in an open setting whereOC dissipates rapidly. Moreover, bycontaining the spray within the exposure box, it is likely that subjectswere exposed to a much higherExhibit 5. Heart rate by exposure and positionHeart rate (beats per tOC/restraint75706560Baseline1 minute5 minutes9 minutes* Arterial blood gasExhibit 6. Blood pressure by exposure and positionMean arterial pressure (MAP) tOC/restraint11511010510095Baseline* Arterial blood gas53 minutes6 minutes9 minutes
Resconcentration of capsaicin than mightoccur in the open air.This study did not examine repeatedOC spray exposures, which commonlyoccur in the field setting. Researchersused an aerosol form of OC spray, ratherthan the liquid or foam forms that arealso used by law enforcement agencies,because the aerosol form was morelikely to be inhaled than other formsand was thus more appropriate for astudy on the respiratory effects of OC.Although subjects were monitoredcarefully for 1 hour after each trial andwere checked by the research staff forsignificant adverse reactions, they werenot assessed for any delayed or longterm effects from exposure. Moreover,this study did not address issues regarding the potential for long-term complications from chronic occupationalexposure to OC.Finally, it is important to emphasizethe limited nature of the additionalanalyses performed on the subgroupsof subjects who were overweight orhad potential respiratory abnormalities. These groups were small in number and the analysis in this studylacked sufficient statistical power tomake any definite conclusive findings.Law enforcement implications. Studyfindings support the contention thatOC spray inhalation, even when combined with positional restraint, posesno significant risk to subjects in termsof respiratory and pulmonary function.Although capsaicin spray has beenstudied extensively, this study assessedpulmonary and respiratory functionafter exposure to a commercially available OC spray used by law enforcementagencies nationwide. OC exposure produced no evidence of pulmonary dysfunction, hypoxemia, or hypoventilationearchinBin either the sitting or restraint positions. These findings also applied to thegroups of overweight subjects and tothose with potential respiratory abnormalities. On the issue of in-custodydeaths, this study indicates that OCinhalation and exposure do not causesignificant respiratory injury andshould not lead to an increased riskof respiratory compromise, arrest, ordeath—thus lending credence to thelarge retrospective field studies thatAriefhave found little evidence that OCcauses significant respiratory injury.These findings will aid law enforcementagencies by providing data supportingthe safety of OC spray, even when usedin combination with positional restraint.First, they will provide law enforcementpersonnel some measure of comfort inthe knowledge that they are employingforce methods that have been testedand found safe in humans in clinicalGlossary of Medical Termsrterial blood gas (ABG) test:A test that analyzes arterial blood foroxygen, carbon dioxide, and pH. Itis used to test the effectiveness ofrespiration.Body mass index (BMI): One’s weight(in kilograms) divided by the square ofone’s height (in meters).End-tidal CO2: The partial pressureor maximal concentration of carbondioxide (CO2) at the end of anexhaled breath.Forced expiratory volume in 1 second (FEV1): The amount of air that asubject can forcibly expel in 1 secondduring a forced expiration test.Forced vital capacity (FVC): Theamount of air that can be expelled fromthe lungs after a maximal inspiration.Hypercapnia: The presence of excessiveamounts of carbon dioxide in the blood.Hypoventilation: Decreased ventilationof the lungs.Hypoxemia: Deficient oxygenation ofthe blood.Mean arterial blood pressure (MAP):The average value for arterial blood6pressure (systolic pressure plus diastolicpressure divided by 2).Percent of predicted values: Comparison of a specific person’s lung volume
or pepper spray, on respiration, particularly when combined with positional restraint. Researchers exposed 34 subjects to OC spray, both while sitting and in the prone maximal restraint position. Key issues:OC spray has gained wide acceptance in law enforce-ment as a swift and effective way
Spray finishing can be conducted in a spray booth, spray room, or spray area. Tuesday, February 14, 2017 Definitions Tuesday, February 14, 2017 Spray room: A spray room is a room in which spray-finishing operations not conducted in a spray booth are performed separately from other areas. 1910.94(c)(1)(iii)
PEPPER and Data Analytics for Skilled Nursing Facilities, Hospices and Inpatient Rehabilitation Facilities April 19, 2015 Kimberly Hrehor Program for Evaluating Payment Patterns Electronic Report Agenda What is PEPPER? Focus: Hospice PEPPER Focus: SNF PEPPER Focus: IRF PEPPER Review strategies to mitigate audit risk
Introduction to Thermal Spray Processing / 5 Thermal Spray Processes and Techniques Members of the thermal spray family of processes are typically grouped into three major categories: flame spray, electric arc spray, and plasma arc spray, with a number of subsets falling under each category. (Cold spray is a recent addition to the familyFile Size: 793KB
a properly selected spray angle, will tend to make more effective use of the spray as well as help minimize the dis-turbance effects of wind/draft condi-tions on the water spray patterns. Spray Patterns. The Design Spray Profiles for the nozzle spray angles of 65 to 180 degrees
coverage of spray patterns as calculated from the included spray angle of the spray and the distance from the nozzle orifice. Values are based on the assumption that the spray angle remains the same throughout the entire spray distance. In actual practice, the tabulated spray angle
*Feature ingredient: Thai chili pepper or bird’s eye pepper The Thai chili can be anywhere between ten to fifty times hotter than a jalapeño pepper while about one third to half the potency of a habanero pepper. The smaller peppers are hotter. The Thai pepper has a clean tas
Malaysia, 98% of pepper production comes from the state of Sarawak. The National Commodity Policy (2011-2020) targets to increase the pepper plantation area from the current 16,331 ha to 20,110 ha by year 2020. However, pepper diseases remain as a major challenge in the pepper industry. A great number of airborne fungi pathogen may contribute
In Abrasive Jet Machining (AJM), abrasive particles are made to impinge on the work material at a high velocity. The jet of abrasive particles is carried by carrier gas or air. The high velocity stream of abrasive is generated by converting the pressure energy of the carrier gas or air to its kinetic energy and hence high velocity jet. The nozzle directs the abrasive jet in a controlled manner .
