QNB: Incapacitating Agent

White crystalline solid.

QNB is an incapacitating agent and has been considered historically for use as a chemical warfare agent. A very potent drug, QNB causes confusion and hallucinations; it also affects circulation, digestion, salivation, sweating, and vision. Impairments caused by QNB are generally temporary and unlikely to be fatal; however, they can be severe if exposure is large enough.

• Indoor Air: QNB can be released into indoor air as a fine powder or liquid spray (aerosol).
• Water: QNB can be used to contaminate water.
• Food: QNB can be used to contaminate food.
• Outdoor Air: QNB can be released into outdoor air as a fine powder or liquid spray (aerosol).
• Agricultural: If QNB is released into the air as a fine powder or liquid spray (aerosol), it has the potential to contaminate agricultural products.

QNB can be absorbed into the body by inhalation, ingestion, skin contact, or eye contact. Inhalation and ingestion are important routes of exposure for the solid. Skin and eye contact are routes of exposure when QNB is mixed with a liquid solvent that would enhance absorption.

First Responders should use a NIOSH-certified Chemical, Biological, Radiological, Nuclear (CBRN) Self Contained Breathing Apparatus (SCBA) with a Level A protective suit when entering an area with an unknown contaminant or when entering an area where the concentration of the contaminant is unknown. Level A protection should be used until monitoring results confirm the contaminant and the concentration of the contaminant.
NOTE: Safe use of protective clothing and equipment requires specific skills developed through training and experience.

Select when the greatest level of skin, respiratory, and eye protection is required. This is the maximum protection for workers in danger of exposure to unknown chemical hazards or levels above the IDLH or greater than the AEGL-2.

• A NIOSH-certified CBRN full-face-piece SCBA operated in a pressure-demand mode or a pressure-demand supplied air hose respirator with an auxiliary escape bottle.
• A Totally-Encapsulating Chemical Protective (TECP) suit that provides protection against CBRN agents.
• Chemical-resistant gloves (outer).
• Chemical-resistant gloves (inner).
• Chemical-resistant boots with a steel toe and shank.
• Coveralls, long underwear, and a hard hat worn under the TECP suit are optional items.

Select when the highest level of respiratory protection is necessary but a lesser level of skin protection is required. This is the minimum protection for workers in danger of exposure to unknown chemical hazards or levels above the IDLH or greater than AEGL-2. It differs from Level A in that it incorporates a non-encapsulating, splash-protective, chemical-resistant splash suit that provides Level A protection against liquids but is not airtight.

• A NIOSH-certified CBRN full-face-piece SCBA operated in a pressure-demand mode or a pressure-demand supplied air hose respirator with an auxiliary escape bottle.
• A hooded chemical-resistant suit that provides protection against CBRN agents.
• Chemical-resistant gloves (outer).
• Chemical-resistant gloves (inner).
• Chemical-resistant boots with a steel toe and shank.
• Coveralls, long underwear, a hard hat worn under the chemical-resistant suit, and chemical-resistant disposable boot-covers worn over the chemical-resistant suit are optional items.

Select when the contaminant and concentration of the contaminant are known and the respiratory protection criteria factors for using Air Purifying Respirators (APR) or Powered Air Purifying Respirators (PAPR) are met. This level is appropriate when decontaminating patient/victims.

• A NIOSH-certified CBRN tight-fitting APR with a canister-type gas mask or CBRN PAPR for air levels greater than AEGL-2.
• A NIOSH-certified CBRN PAPR with a loose-fitting face-piece, hood, or helmet and a filter or a combination organic vapor, acid gas, and particulate cartridge/filter combination or a continuous flow respirator for air levels greater than AEGL-1.
• A hooded chemical-resistant suit that provides protection against CBRN agents.
• Chemical-resistant gloves (outer).
• Chemical-resistant gloves (inner).
• Chemical-resistant boots with a steel toe and shank.
• Escape mask, face shield, coveralls, long underwear, a hard hat worn under the chemical-resistant suit, and chemical-resistant disposable boot-covers worn over the chemical-resistant suit are optional items.

Select when the contaminant and concentration of the contaminant are known and the concentration is below the appropriate occupational exposure limit or less than AEGL-1 for the stated duration times.

• Limited to coveralls or other work clothes, boots, and gloves.

• QNB lightly attacks aluminum and anodized aluminum after 3 months at 160°F (71°C). It has no effect on steel or stainless steel after 3 months.
• Contact with metals may evolve flammable hydrogen gas.

• When heated, aerosols may form explosive mixtures with air, presenting an explosion hazard indoors, outdoors, and in sewers.
• Containers may explode when heated.

• QNB is combustible.
• The agent may burn but does not ignite readily.
• Fire may produce irritating, corrosive, and/or toxic gases.
• The agent may be transported in a molten form.
• For small fires, use dry chemical, carbon dioxide, or water spray.
• For large fires, use dry chemical, carbon dioxide, alcohol-resistant foam, or water spray. Move containers from the fire area if it is possible to do so without risk to personnel. Dike fire control water for later disposal; do not scatter the material.
• For fire involving tanks or car/trailer loads, fight the fire from maximum distance or use unmanned hose holders or monitor nozzles. Do not get water inside containers. Cool containers with flooding quantities of water until well after the fire is out. Withdraw immediately in case of rising sound from venting safety devices or discoloration of tanks. Always stay away from tanks engulfed in fire.
• Run-off from fire control or dilution water may be corrosive and/or toxic, and it may cause pollution.
• If the situation allows, control and properly dispose of run-off (effluent).

• If a tank, rail car, or tank truck is involved in a fire, isolate it for 0.5 mi (800 m) in all directions; also consider initial evacuation for 0.5 mi (800 m) in all directions.
• Small spills (involving the release of approximately 52.83 gallons (200 liters) or less), when used as a weapon
• First isolate in all directions: 100 ft (30 m).
• Then protect persons downwind during the day: 0.2 mi (0.1 km).
• Then protect persons downwind during the night: 0.3 mi (0.5 km).
• Large spills (involving quantities greater than 52.83 gallons (200 liters)), when used as a weapon
• First isolate in all directions: 200 ft (60 m).
• Then protect persons downwind during the day: 0.3 mi (0.5 km).
• Then protect persons downwind during the night: 1.2 mi (2.0 km).

• Aerosol is heavier than air. It will spread along the ground and collect and stay in poorly-ventilated, low-lying, or confined areas (e.g., sewers, basements, and tanks).
• Hazardous concentrations may develop quickly in enclosed, poorly-ventilated, or low-lying areas. Keep out of these areas. Stay upwind.
• QNB is stable in most solvents, with a half-life of 3 to 4 weeks in moist air.
• QNB is extremely persistent in soil and water and on most surfaces.
• QNB is stable and is not degraded by heat.

• OSHA: Not established/determined
• NIOSH: Not established/determined

• • AIR MATRIX
    No references were identified for this sampling matrix for this agent.
  • OTHER
    No references were identified for this sampling matrix for this agent.
  • SOIL MATRIX
    No references were identified for this sampling matrix for this agent.
  • SURFACES
    No references were identified for this sampling matrix for this agent.
  • WATER
    Byrd GD, Paule RC, Sander LC, Sniegoski LT, White EV, Bausum HT [1992]. Determination of 3-quinuclidinyl benzilate (QNB) and its major metabolites in urine by isotope dilution gas chromatography-mass spectrometry. J Anal Toxicol 16(3):182-187.Byrd GD, Sniegoski LT, White E [1988]. Determination of 3-quinuclidinyl benzilate in urine. J Resear Natl Bur Stand 93(3):293-295.Halamek E, Kobliha ZI [1993]. Investigation of the conditions of extraction of ion-associates of 3-quinuclidinyl benzilate with acidic dyes. Collect Czech Chem Commun 58(2):315-319.Lee JT, Palk CH, Klesewetter DO, Park SG, Eckelman WC [1994]. The analysis of (rr), (rs), (sr), and (ss) 4-fluoroalkyl derivatives of 3-quinuclidinyl benzilate (qnb) in-vivo. J Nucl Med Suppl S 35(5):53.

    Rakin D, Markov V, Mijovic D, Zupanc S [1979]. Qualitative and quantitative methods for detection of compounds of the 3-quinuclidinyl benzilate type. Naucno-Teh Pregl 29(1):3-10.

    Skalican Z, Kobliha Z, Halamek E [1995]. Ion-associates of alkaloids and synthetical psychopharmaca with cresol red. Anal Ltrs 28(7):1223-1235.

    Soucek J, Belicky L, Havel J, Halova J [1993]. Study of the conditions for the extraction of toxic organic-bases and methods for their determination. 2. Extraction of ion associates of 3-quinuclidinyl benzilate and diethyl lysergamide with azo dyes and sulfophthaleins. Collect Czech Chem Commun 58(6):1337-1344.

    Zhou YX, Ci YX [1998]. Preparation and analytical application of polyclonal antibodies against 3-quinuclidinyl benzilate. Fenxi Ceshi Xuebao 17(1):26-28.

    Zhou YX, Li QY, Jin ZY, Lou YH [2000]. Determination of nerve agents VX, BZ and their degradation products by GC with atomic-emission detection. Fenxi Ceshi Xuebao 19(3):79-81.

Signs and symptoms of QNB toxicity are delayed but long lasting, regardless of route of exposure. The size of the dose and route of exposure to QNB determine time to onset, time to peak effect, time to recovery, and potency of toxic effect. Signs and symptoms generally begin between 30 minutes and 4 hours post-exposure. However, toxicity following skin exposure may be delayed in onset as long as 20 to 36 hours. Peak effect is 4 to 8 hours for most routes of exposure. Full recovery is expected after 3 to 4 days.

Acetylcholine is a neurotransmitter (a chemical that transmits signals from one nerve to the next) in both the central and peripheral nervous systems. QNB works by blocking the acetylcholine receptor of the nerve on the “receiving end” of the signal. By this mechanism, QNB prevents the normal transmission of nerve signals in both the central and peripheral nervous systems. The resulting peripheral nervous system effects due to QNB exposure are known as the “anticholinergic toxidrome.”

• • • See Inhalation Exposure.
    • If liquid containing QNB is splashed in the eye, irritation and inflammation of the membranes (conjunctivitis) may occur.

• • • See Inhalation Exposure.

• • • Mild to moderate intoxication: “Anticholinergic toxidrome” of elevated body temperature (hyperthermia), dry mouth (xerostomia), dry skin, low urine output, flushing (redness) of skin, dilated pupils (mydriasis), inability to focus on near objects, blurred vision, and rapid heart rate (later a normal or slow heart rate). Other effects include disorientation, altered level of consciousness, misperceptions and difficulty in interpretation (delusions, hallucinations), poor judgment and insight (denial of illness), short attention span, distractibility, impaired short-term memory, slurred speech, involuntary repetition of behaviors (perseveration), loss of coordination (ataxia), variability in behavior (e.g., between quiet and restless states), and muscle weakness.
    • Severe intoxication: Dose-dependent decrease in consciousness level (drowsiness through sedation to stupor and coma), hallucinations and combative agitation, serious alterations in heart rhythm (cardiac arrhythmias), and serious alterations in levels of ions in biological fluids (electrolyte disturbances).

• See Inhalation Exposure.

The purpose of decontamination is to make an individual and/or their equipment safe by physically removing toxic substances quickly and effectively. Your Incident Commander will provide you with decontaminants specific for the agent released or the agent believed to have been released.

The following are recommendations to protect the first responders from the release area:

• • • Position the decontamination corridor upwind and uphill of the hot zone.
    • The warm zone should include two decontamination corridors. One decontamination corridor is used to enter the warm zone and the other for exiting the warm zone into the cold zone. The decontamination zone for exiting should be upwind and uphill from the zone used to enter.
    • Decontamination area workers should wear appropriate PPE. See the PPE section of this card for detailed information.
    • A solution of detergent and water (which should have a pH value of at least 8 but should not exceed a pH value of 10.5) should be available for use in decontamination procedures. Soft brushes should be available to remove contamination from the PPE.
    • Labeled, durable 6-mil polyethylene bags should be available for disposal of contaminated PPE.

The following methods can be used to decontaminate an individual:

• • • Decontamination of First Responder:
      • Begin washing PPE of the first responder using soap and water solution and a soft brush. Always move in a downward motion (from head to toe). Make sure to get into all areas, especially folds in the clothing. Wash and rinse (using cold or warm water) until the contaminant is thoroughly removed.
      • Remove PPE by rolling downward (from head to toe) and avoid pulling PPE off over the head. Remove the SCBA after other PPE has been removed.
      • Place all PPE in labeled durable 6-mil polyethylene bags.
    • Decontamination of Patient/Victim:
      • Remove the patient/victim from the contaminated area and into the decontamination corridor.
      • Remove all clothing (at least down to their undergarments) and place the clothing in a labeled durable 6-mil polyethylene bag.
      • Thoroughly wash and rinse (using cold or warm water) the contaminated skin of the patient/victim using a soap and water solution. Be careful not to break the patient/victim’s skin during the decontamination process, and cover all open wounds.
      • Cover the patient/victim to prevent shock and loss of body heat.
      • Move the patient/victim to an area where emergency medical treatment can be provided.

Treatment of QNB poisoning largely consists of supportive care: use of intravenous fluids and appropriate cooling measures to address elevated core body temperature and judicious use of sedation using benzodiazepines. Severe toxicity may require the use of physostigmine in a hospital setting.

Some military references suggest the use of physostigmine to temporarily increase synaptic acetylcholine concentrations. Physostigmine poses its own risks of side effects and interactions with other drugs and should only be used by persons familiar with its safe use.

• • • Immediately remove the patient/victim from the source of exposure.
    • Immediately wash eyes with large amounts of tepid water for at least 15 minutes.
    • Do not allow the patient/victim to rub eyes.
    • Monitor the patient/victim for signs of whole-body (systemic) effects.
    • If signs of whole-body (systemic) poisoning appear, see the Inhalation section for treatment recommendations.
    • Seek medical attention immediately.

• • • Immediately remove the patient/victim from the source of exposure.
    • Ensure that the patient/victim has an unobstructed airway.
    • Do not induce vomiting (emesis).
    • See the Inhalation section for first aid recommendations.
    • Seek medical attention immediately.

• • • Immediately remove the patient/victim from the source of exposure.
    • Evaluate respiratory function and pulse.
    • Ensure that the patient/victim has an unobstructed airway.
    • If shortness of breath occurs or breathing is difficult (dyspnea), administer oxygen.
    • Assist ventilation as required. Always use a barrier or bag-valve-mask device.
    • If breathing has ceased (apnea), provide artificial respiration.
    • Monitor for exceptionally high body temperature (hyperthermia).
    • If body temperature is elevated above 102°F (39°C), initiate immediate and vigorous cooling (as for heatstroke), using 72° to 75°F (22° to 24°C) water and air circulation (fanning), wet cloths and air circulation, or maximum exposure to air in a shaded area with maximum air circulation. Do not use ice for skin cooling.
    • Give fluids sparingly.
    • Manage dryness and coating of the mouth and lips using moist swabs and small amounts of petroleum jelly.
    • Monitor for skin abrasions caused by repetitive movements.
    • Remove potentially harmful items, including cigarettes, matches, medications, and small items that could be accidentally ingested, from the patient/victim’s possession.
    • Consider loose restraint of disoriented or agitated patient/victims.
    • Consider separation of affected individuals into small groups to minimize potential crowd control problems.
    • Seek medical attention immediately.

• • • Immediately remove the patient/victim from the source of exposure.
    • See the Decontamination section for patient/victim decontamination procedures.
    • See the Inhalation section for first aid recommendations.
    • Seek medical attention immediately.

In a patient/victim with marked agitation and/or exceptionally high body temperature (hyperthermia) clotting studies (e.g., prothrombin time, activated partial thromboplastin time, and international normalized ratio) are recommended.

Widespread formation of clots in the blood vessels (disseminated intravascular coagulation) is a potential complication in a patient/victim with marked agitation and/or exceptionally high body temperature (hyperthermia).

Information is unavailable about the carcinogenicity, developmental toxicity, or reproductive toxicity from chronic or repeated exposure to QNB.

• • • Consult with the Incident Commander regarding the agent dispersed, dissemination method, level of PPE required, location, geographic complications (if any), and the approximate number of remains.
    • Coordinate responsibilities and prepare to enter the scene as part of the evaluation team along with the FBI HazMat Technician, local law enforcement evidence technician, and other relevant personnel.
    • Begin tracking remains using waterproof tags.

• • • Wear PPE until all remains are deemed free of contamination.
    • Establish a preliminary (holding) morgue.
    • Gather evidence, and place it in a clearly labeled impervious container. Hand any evidence over to the FBI.
    • Remove and tag personal effects.
    • Perform a thorough external evaluation and a preliminary identification check.
    • See the Decontamination section for decontamination procedures.
    • Decontaminate remains before they are removed from the incident site.

The following methods can be used to decontaminate the environment/spillage disposal:

• Do not touch or walk through the spilled agent if at all possible. However, if you must, personnel should wear the appropriate PPE during environmental decontamination. See the PPE section of this card for detailed information.
• Keep combustibles (e.g., wood, paper, and oil) away from the spilled agent.
• Use water spray to reduce aerosols or divert aerosol cloud drift. Avoid allowing water runoff to contact the spilled agent.
• Do not direct water at the spill or the source of the leak.
• Stop the leak if it is possible to do so without risk to personnel.
• Prevent entry into waterways, sewers, basements, or confined areas.
• Isolate the area until aerosol has dispersed.
• Ventilate the area.

Agents can seep into the crevices of equipment making it dangerous to handle. The following methods can be used to decontaminate equipment:

• Not established/determined