Adamsite (DM): Vomiting Agent

Light green to yellow crystals (solid) at room temperature. When dispersed by heat, fine particulate smoke; canary yellow when concentrated, colorless when diluted with air.

Adamsite (DM) is a vomiting compound that has been used as a riot-control agent (military designation, DM). It is released as an aerosol. Adverse health effects due to exposure to adamsite (DM) are generally self-limited and do not require specific therapy. Most adverse health effects resolve within 30 minutes. Exposure to large concentrations of adamsite (DM), or exposure to adamsite (DM) within an enclosed space or under adverse weather conditions, may result in more severe adverse health effects, serious illness, or death.

• Indoor Air: Adamsite (DM) can be released into indoor air as fine particles (aerosol).
• Water: Adamsite (DM) is not soluble in water and cannot be used to contaminate water.
• Food: Not established/determined
• Outdoor Air: Adamsite (DM) can be released into outdoor air as fine particles (aerosol).
• Agricultural: If adamsite (DM) is released into the air as fine particles (aerosol), it has the potential to contaminate agricultural products.

Adamsite (DM) can affect the body through inhalation, ingestion, skin contact, or eye contact. Ingestion is an uncommon route of exposure.

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.

• Adamsite (DM) corrodes iron, bronze, and brass.
• Contact with metals may evolve flammable hydrogen gas.

• Containers may explode when heated.

• Adamsite (DM) is non-combustible.
• The agent itself does not burn, but it may decompose upon heating to produce corrosive and/or toxic fumes.
• Fire may produce irritating, corrosive, and/or toxic gases.
• The agent may be an oxidant, and it may ignite combustibles (wood, paper, oil, clothing, etc.).
• 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: 200 ft (60 m).
• Then protect persons downwind during the day: 0.2 mi (0.4 km).
• Then protect persons downwind during the night: 0.7 mi (1.2 km).
• Large spills (involving quantities greater than 52.83 gallons (200 liters)), when used as a weapon
• First isolate in all directions: 600 ft (180 m).
• Then protect persons downwind during the day: 1.4 mi (2.3 km).
• Then protect persons downwind during the night: 3.2 mi (5.2 km).

• Aerosol may collect and stay in 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.

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

• AIR MATRIX
  No references were identified for this sampling matrix for this agent.
• OTHER
  Schoene K, Steinhanses J, Bruckert HJ, König A [1992]. Speciation of arsenic-containing chemical warfare agents by gas chromatographic analysis after derivatization with thioglycolic acid methyl ester. J Chromatogr A 605(2):257-262.
• SOIL MATRIX
  Haas R, Schmidt TC, Steinbach K, von Low E [1998]. Chromatographic determination of phenylarsenic compounds. Fresenius J Anal Chem 361(3):313-318.Schoene K, Bruckert HJ, Jürling H, Steinhanses J [1996]. Derivatization of 10-chloro-5,10-dihydrophenarsazine (Adamsite) for gas chromatographic analysis. J Chromatogr A 719(2):401-409.Vermeer H, Lourens R, Bickelhaupt F [1975]. An investigation of the structure of the so-called phenarsazine: Mass spectroscopical evidence for the thermal formation of phenarsazine. Tetrahedron 31(20):2529-2535.
• SURFACES
  No references were identified for this sampling matrix for this agent.
• WATER
  Haas R, Schmidt TC, Steinbach K, von Low E [1988]. Chromatographic determination of phenylarsenic compounds. Fresenius J Anal Chem 361(3):313-318.

The short-term effects of adamsite (DM) exposure begin 2 to 4 minutes after the onset of exposure. Prolonged whole-body (systemic) effects may last for 1 to 2 hours. Inhalation of DM in an outdoor environment results in adverse health effects that usually resolve in 20 minutes to 2 hours, leaving no residual effects. Inhalation of DM in an indoor environment may produce serious illness or death.

Exposure to adamsite (DM) causes rapid onset irritation of the eyes, upper airway, and skin and also nausea and vomiting (emesis). Whole-body (systemic) effects are more prolonged, lasting for several hours after exposure. If concentrations are low, initial symptoms may resemble those of a severe cold.

• Irritation and burning, tear production (lacrimation), spasmodic blinking (blepharospasm), swelling of the blood vessels that supply the membranes lining the eye (conjunctival injection), necrosis of the corneal epithelium.

• Not established/determined

• Short-term effects: Upper respiratory tract irritation in nose and sinuses, burning in throat, chest tightness and pain, uncontrollable and violent coughing and sneezing, greatly increased nasal secretions and oral secretions.
• Whole-body (systemic) effects: Nausea, vomiting (emesis), abdominal cramps, diarrhea, feeling of generalized weakness (malaise), headache, mental depression, and chills.

• Dermal exposures to low concentrations of adamsite (DM) are likely to produce short-lived skin redness (erythema) and irritation. Exposure to higher concentrations of adamsite (DM) can result in more severe, longer-lasting redness, itching, and swelling possibly followed by blister (vesicle) formation. More severe skin irritation may require symptomatic treatment.

The purpose of decontamination is to make an individual and/or their equipment safe by physically removing toxic substances quickly and effectively. Care should be taken during decontamination, because absorbed agent can be released from clothing and skin as a gas. 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.

The effects of exposure to vomiting agents under usual outdoor conditions generally are self-limited, disappearing in 20 minutes to 2 hours, and require no specific therapy other than symptomatic relief. Exposure to large concentrations of adamsite (DM), or exposure to adamsite (DM) within an enclosed space or under adverse weather conditions, may result in more severe adverse health effects, serious illness, or death and may require supportive measures for symptomatic complaints of eye, skin, and airway irritation.

There is no antidote for adamsite (DM) toxicity.

• Immediately remove the patient/victim from the source of exposure.
• Immediately wash eyes with large amounts of tepid water for at least 15 minutes.
• Provide symptomatic relief.
• Seek medical attention immediately.

• Immediately remove the patient/victim from the source of exposure.
• Provide symptomatic relief.
• 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.
• Gargling may provide symptomatic relief.
• Seek medical attention immediately.

• Immediately remove the patient/victim from the source of exposure.
• May require the use of soothing compounds such as calamine, camphor, or mentholated creams.
• See the Decontamination section for patient/victim decontamination procedures.
• Seek medical attention immediately.

A small minority (fewer than 1%) of people will experience serious, prolonged adverse health effects following adamsite exposure. Those seeking medical attention will generally have complaints relating to ocular, airway, and/or skin irritation. Patient/victims with severe or prolonged adverse health effects should be observed until effects abate.
Eyes should be carefully examined for retained foreign bodies and irrigated with water or saline. Use of topical antibiotics and eye solutions to relieve irritation should be used and referral to an ophthalmologist is suggested.
Use of oxygen and bronchodilators (if bronchospasm is present) may be necessary in patients with underlying respiratory disease.
More persistent and severe skin irritation may require the use of soothing compounds such as calamine, camphor, or mentholated creams. Large blisters, if present, should be debrided and irrigated several times daily. Use of a topical dermal antibiotic is recommended.

Not established/determined

Information is unavailable about the carcinogenicity, developmental toxicity, or reproductive toxicity of chronic or repeated exposure to adamsite (DM).

• 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 vapors or divert vapor 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, and turn leaking containers so that gas rather than liquid escapes.
• Prevent entry into waterways, sewers, basements, or confined areas.
• Isolate the area until gas 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