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Sodium Hypochlorite - Medical Countermeasures Database

1. Name of Chemical Defense therapeutic agent/device

Sodium hypochlorite

2. Chemical Defense therapeutic area(s)

    — including key possible uses

Decontamination of sulfur mustard and nerve agents such as soman, tabun, sarin, cyclosarin and VX

3. Evidence-based medicine for Chemical Defense

    — including efficacy and safety

A. Summary

Structure

HSDB. Sodium Hypochlorite

Mechanism of action

• Application of fresh 0.5% sodium hypochlorite solution inactivates G agents (tabun, sarin, soman, and cylcosarin) and VX by chemical hydrolysis and inactivates VX by oxidative chlorination.

Niven AS, Roop SA; Inhalational exposure to nerve agents. Respiratory Care Clinics of North America, 2004 Mar;10(1):59-74. [PubMed Citation]

• A typical mode of HD decontamination by hypochlorite oxidants is oxidation of the electron-rich heteroatom, sometimes followed by rearrangement to form less-toxic chemical species. Nuclear chlorination is known to occur on phenols and other aromatic compounds exposed to hypochlorite or other chlorine-based oxidants.

Salter WB, Owens JR, Wander JD. Methyl salicylate: a reactive chemical warfare agent surrogate to detect reaction with hypochlorite. Applied Materials and Interfaces, 2011;3:4262-67. [PubMed Citation]

• Saponification reaction: Sodium hypochlorite acts as an organic and fat solvent degrading fatty acids, transforming them into fatty acid salts (soap) and glycerol (alcohol), which reduces the surface tension of the remaining solution.

• Neutralization reaction: Sodium hypochlorite neutralizes amino acids forming water and salt.

• Chloramination reaction: With the exit of hydroxyl ions, there is a reduction of pH. Hypochlorous acid, a substance present in sodium hypochlorite solution, when in contact with organic tissue acts as a solvent, releases chlorine that, combined with the protein amino group, forms chloramines. Hypochlorous acid (HOCl-) and hypochlorite ions (OCl-) lead to amino acid degradation and hydrolysis.

Estrela C, Estrela CR, Barbin EL, Spano JC, Marchesan MA, Pecora JD. Mechanism of action of sodium hypochlorite. Brazilian Dental Journal, 2002;13(2):113-7. [PubMed Citation]

• Methyl salicylate (MeS) has a rich history as an inert physical simulant for the chemical warfare agents sulfur mustard and soman, where it is used extensively for liquid- and vapor-permeation testing. Here the authors demonstrate possible utility of MeS as a reactivity simulant for chlorine-based decontaminants. In these experiments MeS was reacted with sodium hypochlorite varying stoichiometry, temperature, reaction time, and pH. No colored oxidation products were observed; however, chlorination of the aromatic ring occurred ortho (methyl 3-chlorosalicylate) and para (methyl 5-chlorosalicylate) to the position bearing the -OH group in both the mono- and disubstituted forms. The monosubstituted para product accumulated initially, and the ortho and 3,5-dichloro products formed over the next several hours. Yields from reactions conducted below pH 11 declined rapidly with decreasing pH. Reactions run at 40 ⁰C produced predominantly para substitution, while those run at 0 ⁰C produced lower yields of ortho- and parasubstituted products. Reactions were also carried out on textile substrates of cotton, 50/50 nylon-cotton, and a meta aramid. The textile data broadly reproduced reaction times and stoichiometry observed in the liquid phase, but are complicated by physical and possibly chemical interactions with the fabric. These data indicate that, for hypochlorite-containing neutralizing agents operating at strongly alkaline pH, one can expect MeS to react stoichiometrically with the hypochlorite it encounters. This suggests utility of MeS in lieu of such highly hazardous surrogates as monochloroalkyl sulfides as a simulant for threat scenarios involving the stoichiometric decomposition of sulfur mustard. Specifically, the extent of coverage of the simulant on a fabric by the neutralizing agent can be directly measured. Similar reactivity toward other halogen oxidizing agents is likely but remains to be demonstrated.

Salter WB, Owens JR, and Wander JD. Methyl salicylate: a reactive chemical warfare agent surrogate to detect reaction with hypochlorite. ACS Appl. Mater. Interfaces 2011 Nov; 3(11):4262-7. [PubMed Citation]

Summary of clinical and non-clinical studies

Sodium hypochlorite, commonly known as bleach, is a chemical used in applications ranging from household cleaning to the decontamination of chemical warfare agents (CWAs). As a decontaminant agent, sodium hypochlorite has been used and tested specifically to neutralize or remove traces of blister or nerve agents on skin, military equipment, or in soils near weapons storage and destruction facilities. In a skin decontamination study, guinea pigs were challenged with soman and then left untreated or topically treated with 0.5% bleach (sodium or calcium hypochlorite), Reactive Skin Decontamination Lotion, the M291 Skin Decontamination Kit, Skin Exposure Reduction Paste Against Chemical Warfare Agents, or 1% soapy water 2 minutes later (Braue et al., 2011). After a 24-hour observation period, protective ratios ([PRs]; median lethal dose [LD₅₀] of the treatment group/LD₅₀ of the untreated group) were calculated to determine efficacy. PRs for 0.5% bleach, soapy water, and control were 2.6, 2.2, and 1.0, respectively; the respective LD₅₀ values were 29 mg/kg, 24 mg/kg, and 11 mg/kg. Bleach and soapy water offered only modest (2<PR<5) protection against soman and were not statistically different from each other. Another skin decontamination study found that 0.5% and 2.5% sodium hypochlorite induced dermotoxicity in sulfur mustard-exposed guinea pigs (20 mg/kg, 2-minute intra-wound exposure), and bleeding from the wound site immediately after decontamination with 2.5% sodium hypochlorite in 50% of the animals (Gold et al., 1994). In animals that were not exposed to sulfur mustard, sodium hypochlorite, which has highly alkaline properties that can potentially damage cells by chemical or physicochemical disruption, induced lesions that were more severe than those flushed with water or not decontaminated. Therefore sodium hypochlorite may induce skin injury leading to undesired complications when it is used for wound decontamination.

Sodium hypochlorite was effective in removing CWAs from soils (Amos et al., 1994). After soils of varying textures (loamy sand to sandy clay loam) were spiked with 5 mg/g or 20 mg/g of sulfur mustard or soman and treated with 1% sodium hypochlorite, total residual sulfur mustard and soman were consistently less than 3% and 4.6%, respectively. In contrast, treatment of the contaminated soils with a single wash of plain water resulted in total residual sulfur mustard and soman ranging from 8% to 26%. Sodium hypochlorite was more effective than sodium carbonate and sodium hydroxide in cleaning mustard-contaminated soil. The efficacy of four decontamination formulations or CWA removal from typical indoor surfaces was evaluated through bench-scale testing (Love et al., 2011). Sodium hypochlorite (0.5%) with trisodium phosphate was not effective in CWA decontamination of nonporous and nonpermeable surfaces (glass and stainless steel) compared to other decontamination technologies. Aqueous-based sodium hypochlorite was not as effective as solvent-based formulations in CWA decontamination of permeable polymers (latex-painted wallboard and vinyl floor tile). However, sodium hypochlorite outperformed solvent-based decontamination technologies in penetrating polar surfaces (concrete). These findings suggest that sodium hypochlorite is an effective CWA decontaminant in selective settings, but because of varying effectiveness, a range of technologies may be required for CWA decontamination.

B. Link to clinical studies

Studies involving multiple populations

• Since 1993, the New York State Department of Health, funded by the Agency for Toxic Substances and Disease Registry, has collected data about non-petroleum hazardous substances releases through the Hazardous Substances Emergency Events Surveillance (NYHSEES) project. This study investigates risk factors for hazardous substances releases that may result in public health consequences such as injury or reported health effects. The 6428 qualifying events that occurred during the 10-year-period of 1993-2002 involved 8838 hazardous substances, 842 evacuations, more than 75,419 people evacuated, and more than 3120 people decontaminated. These events occurred both at fixed facilities (79%) and during transport (21%). The causative factors most frequently contributing to reported events were equipment failure (39%) and human error (33%). Five of the 10 chemicals most frequently associated with injuries were also among the 10 chemicals most frequently involved in reported events: sulfuric acid, hydrochloric acid, ammonia, sodium hypochlorite, and carbon monoxide... (Class IV)

Welles WL, Wilburn RE, Ehrlich JK, Floridia CM. New York hazardous substances emergency events surveillance: learning from hazardous substances releases to improve safety. Journal of Hazardous Materials 2004 Nov;115(1-3):39-49. [PubMed Citation]

C. Link to non-clinical (e.g., animal) studies

Adult animal studies

• Objective: This report, the second in a series of five, directly compares the efficacy of Reactive Skin Decontamination Lotion (RSDL), the M291 Skin Decontamination Kit (SDK), 0.5% bleach (sodium or calcium hypochlorite solution), 1% soapy water, and Skin Exposure Reduction Paste Against Chemical Warfare Agents (SERPACWA) in the haired guinea pig model following exposure to soman (GD). Methods: In all experiments, guinea pigs were close-clipped and given anesthesia. In the decontamination experiments, the animals were challenged with GD and decontaminated after a 2-minute delay for the standard procedure or at longer times for the delayed-decontamination experiments. Positive control animals were challenged with GD in the same manner as the treated animals, except that they received no treatment. All animals were observed during the first 4 hours and again at 24 hours after exposure for signs of toxicity and death. The protective ratio (PR, defined as the median lethal dose (LD50) of the treatment group divided by the LD50 of the untreated positive control animals) was calculated from the derived probit dose-response curves established for each treatment group and nontreated control animals. SERPACWA was applied as a thin coating (0.1 mm thick), allowed to dry for 15 minutes, and challenged with GD. After a 2-hour challenge, any remaining GD was blotted off the animal, but no additional decontamination was done. Significance in this report is defined as p < 0.05. Neat (undiluted) GD was used to challenge all animals in these studies. Results: In the standard 2-minute GD decontamination experiments, the calculated PRs for RSDL, 0.5% bleach, 1% soapy water, and M291 SDK were 14, 2.7, 2.2, and 2.6, respectively. RSDL was by far the most effective decontamination product tested and significantly better than any of the other products. Bleach, soapy water, and the M291 SDK provided equivalent and modest protection. Since only RSDL provided at least good protection (PR > 5), it was the only decontamination product evaluated for delayed decontamination. In the GD delayed decontamination experiments, the calculated LT50 (the delayed-decontamination time at which 50% of the animals die in the test population following a 5-LD50 challenge) value for RSDL was only 4.0 minutes. Conclusions: Several conclusions can be drawn from this study: 1) Reactive Skin Decontamination Lotion provided superior protection against GD compared with the other products tested; 2) The 0.5% bleach solution, the 1% soapy water solution, and the M291 SDK were less effective than RSDL, but still provided modest (2 < PR < 5) protection against GD; 3) Reactive Skin Decontamination Lotion, the best product tested, did not provide significant protection against GD when decontamination was delayed for more than 3 minutes; 4) Skin Exposure Reduction Paste Against Chemical Warfare Agents provided significant, but modest, protection against GD; 5) There was good correlation between using the rabbit model and the guinea pig model for decontamination efficacy evaluations; and 6) Soman (GD) is an agent of real concern because it is very difficult to decontaminate and the effects ofexposure are difficult to treat.

Braue EH Jr, Smith KH, Doxzon BF, Lumpkin HL, Clarkson ED. Efficacy studies of Reactive Skin Decontamination Lotion, M291 Skin Decontamination Kit, 0.5% bleach, 1% soapy water, and Skin Exposure Reduction Paste Against Chemical Warfare Agents, part 2: guinea pigs challenged with soman. Cutaneous and Ocular Toxicology, 2011 Mar; 30(1): 29-37. [Pub Med Citation]

• Hypochlorite solutions are thought to be efficacious when used to topically decontaminate intact skin. However, few studies have examined the efficacy of decontamination of chemically contaminated wounds. Therefore, we the authors compared the decontamination efficacy of sodium hypochlorite (0.5% and 2.5% solutions), calcium hypochlorite (0.5% and 2.5% solutions) and sterile water to untreated controls in wounds exposed to sulfur mustard (HD) . Anesthetized euthymic hairless guinea pigs (EHGP) (n=6) were exposed to 20 mg/kg (approximately 0.4 LDs,) HD in a full-thickness 8 mm surgical biopsy skin defect (i.e., wound). Each animal was subsequently decontaminated, after a two-minute intra-wound exposure to liquid HD, with nothing or one of the decontamination solutions. Decontamination efficacy was determined by the visual grading of the HD-traumatized wound lesion and by comparison of the expected HD-induced leukocyte suppression. Leukocyte suppression was inconsistent in all animals; therefore, the visual grading was the only viable evaluation method. No significant differences were observed among wounds decontaminated with any of the solutions. However, the skin surrounding nondecontaminated (but exposed) control animals showed the least visual pathology. The lesions induced following decontamination are presumed to be due to the mechanical flushing of HD onto the peri lesional skin, or by chemical damage induced by the solution, or HD-solution interaction...

Gold MB, Bongiovanni R, Scharf BA, Gresham VC, Woodward CL. Hypochlorite solution as a decontaminant in sulfur mustard contaminated skin defects in the euthymic hairless guinea pig. Drug And Chemical Toxicology 1994 Nov;17(4):499-527. [PubMed Citation]

Other non-clinical studies

• Bench-scale testing was used to evaluate the efficacy of four decontamination formulations on typical indoor surfaces following exposure to the liquid chemical warfare agents sarin (GB), soman (GD), sulfur mustard (HD), and VX. Residual surface contamination...was periodically measured for up to 24 h after applying one of four selected decontamination technologies [0.5% bleach solution with trisodium phosphate, Allen Vanguard Surface Decontamination Foam (SDFTM), U.S. military Decon GreenTM, and Modec Inc. and EnviroFoam Technologies Sandia Decontamination Foam (DF-200)]. All decontamination technologies tested, except for the bleach solution, performed well on nonporous and nonpermeable glass and stainless-steel surfaces. However, chemical agent residual contamination typically remained on porous and permeable surfaces, especially for the more persistent agents, HD and VX. Solvent-based Decon GreenTM performed better than aqueous-based bleach or foams on polymeric surfaces, possibly because the solvent is able to penetrate the polymer matrix. Bleach and foams out-performed Decon Green for penetrating the highly polar concrete surface. Results suggest that the different characteristics needed for an ideal and universal decontamination technology may be incompatible in a single formulation and a strategy for decontaminating a complex facility will require a range of technologies.

Love AH, Bailey CG, Hanna ML, Hok S, Vu AK, Reutter DJ, Raber E. Efficacy of liquid and foam decontamination technologies for chemical warfare agents on indoor surfaces. Journal of Hazardous Materials 2011 Nov;196:115- 122. [PubMed Citation]

• Several simple processes have been studied for the destruction of chemical agents, soman and mustard, on soils. A double wash or an extended single wash with water was effective in removing mustard and soman from soil; addition of either anionic or cationic surfactant did not improve removal efficiency. Soils with higher organic carbon content were more difficult to decontaminate. The most effective chemical process for the removal of mustard was treatment with hypochlorite; treatment with Na2CO3, or NaOH were almost as effective as hypochlorite in cleaning mustard contaminated soil. Soman was removed most effectively by treatment with Na2C03. Overall the most efficient process for the destruction of both mustard and soman was treatment with Na2C03 solution.

Amos D, Leake B. Clean-up of chemical warfare agents on soils using simple washing or chemical treatment processes. Journal of Hazardous Materials 1994;39:107-17.

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4. Pharmacokinetic and toxicokinetics data

    — including children-, pregnancy-, geriatric-, and obesity-related data

• No data available at this time.

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5. Current FDA/EUA approved indications and dosing

    — including children-, pregnancy-, geriatric-, and obesity-related data, and Emergency Use Authorization (EUA)

Emergency Use Authorization (FDA/CDC)

No Emergency Use Authorization for Sodium Hypochlorite has been issued from the Food and Drug Administration under section 564 of the Federal Food, Drug and Cosmetic Act (FD&C Act) (21 U.S.C. 360bbb-3), amended by the Project Bioshield Act of 2004 (public Law 108-276).

[DHHS/FDA; Emergency Preparedness and Response-Counterterrorism and Emerging Threats (12/01/2011)]

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6. Current available formulations/shelf life

Storage

• Store at room temperature.

Product label: DAKINS FULL (sodium hypochlorite) solution [Century Pharmaceutical, Inc.] Last revised: April 2010 [DailyMed]

 

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7. Current off label utilization and dosing

    — including children-, pregnancy-, geriatric-, and obesity-related data

Adult

NOTE: THIS DRUG HAS NOT BEEN FOUND BY FDA TO BE SAFE AND EFFECTIVE, AND THIS LABELING HAS NOT BEEN APPROVED BY FDA.

• Sodium Hypochlorite 0.50% (Antimicrobial)

Infections of the skin and tissue (pre and post surgery): apply once daily for lightly to moderately exudative wounds.  Apply twice daily for highly exudative or highly contaminated wounds. Protect intact skin with a moisture barrier ointment or skin sealant as needed.

Cuts, abrasions and skin ulcers: apply once daily for lightly to moderately exudative wounds.  Apply twice daily for highly exudative or highly contaminated wounds. Protect intact skin with a moisture barrier ointment or skin sealant as needed.

Product label: DAKINS FULL (sodium hypochlorite) solution [Century Pharmaceutical, Inc.] Last revised: April 2010 [DailyMed]

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8. Route of Administration/Monitoring

• Pour on or apply to affected area. For wound management, use as an irrigant, cleanser, or the wetting agent for a wet-to-moist dressing.

Product label: DAKINS FULL (sodium hypochlorite) solution [Century Pharmaceutical, Inc.] Last revised: April 2010 [DailyMed]

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9. Adverse effects

• NOTE: THIS DRUG HAS NOT BEEN FOUND BY FDA TO BE SAFE AND EFFECTIVE, AND THIS LABELING HAS NOT BEEN APPROVED BY FDA.

Product label: DAKINS FULL (sodium hypochlorite) solution [Century Pharmaceutical, Inc.] Last revised: April 2010 [DailyMed]

• Sodium and calcium hypochlorite are extremely corrosive and can cause severe damage to the eyes and skin. They have been assigned to Toxicity Category I, indicating the highest degree of toxicity, for these acute effects. No subchronic or chronic studies on sodium and calcium hypochlorite are needed, due to their simple chemical nature and structure. In the presence of oxygen, these compounds react easily with organic matter and convert readily into sodium chloride (table salt) and calcium chloride (road salt). Widely used in disinfecting water supplies for nearly a century, the hypochlorites have been proven safe and practical to use.

USEPA R.E.D. FACTS - Sodium and Calcium Hypochlorite Salts. 738-F-91-108 Sep 1991.

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10. Contraindication(s)

• Stop use and ask a doctor if redness, irritation, swelling or pain persists or increases.

• Do not use if sensitive to chlorine compounds.

Product label: DAKINS FULL (sodium hypochlorite) solution [Century Pharmaceutical, Inc.] Last revised: April 2010 [DailyMed]

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11. Clinical studies in progress

    — including relevant ones and any others highlighting possible adverse effects and other effects/issues

• No data available at this time.

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12. Non-clinical studies in progress

    — including relevant ones and any others highlighting possible adverse effects and other effects/issues

• No data available at this time.

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13. Needed studies for Chemical Defense clinical indication

    — including pharmacokinetics, safety, efficacy, pregnancy, breastfeeding, and review panel recommendations

• No data available at this time.

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14. Needed studies for non Chemical Defense clinical indications

    — including review panel recommendations

• No data available at this time.

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15. Study-related ethical concerns

    — including review panel recommendations

• No data available at this time.

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16. Global regulatory status

U.S.

• In 1957, under the authority of the Federal Insecticide, Fungicide, and Rodenticide Act (FIFRA), sodium hypochlorite (bleach) was registered for use as an antimicrobial pesticide. As a sanitizer or disinfectant to kill bacteria, fungi, and viruses, sodium hypochlorite is approved for use in households, food processing plants, agricultural settings, animal facilities, hospitals, and human drinking water supplies.

• Bleach containing products not claiming to sanitize or disinfect, are not a registered pesticide. These bleach containing products are often sold as a laundry additive or as an all-purpose cleaner.

USEPA: Anthrax spore decontamination using bleach (sodium hypochlorite). Last revised: May 2012.

• Sodium and calcium hypochlorite, better known as bleach, are widely used compounds whose chemical and toxicological properties are extensively documented in published literature. These chemicals were first registered for use as pesticides in 1957. EPA issued a Registration Standard for sodium and calcium hypochlorite in February 1986. The Agency concluded that no additional scientific data would be necessary to register or reregister products that contain sodium hypochlorite from 5.25% to 12.5%, or calcium hypochlorite from 65% to 70%, as long as the products contain no other active ingredients, contain no inert ingredients other than water, and bear Toxicity Category I labeling. EPA still supports these basic findings.

USEPA R.E.D. FACTS - Sodium and Calcium Hypochlorite Salts. 738-F-91-108 Sep 1991.

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17. Other potentially useful information

• Under Section 18 of FIFRA, the EPA "may exempt any Federal or State agency from any provision of this Act if the Administrator determines that emergency conditions exist which require such exemption." To respond as rapidly as possible to the bioterrorism attacks, the Agency decided in 2001 to develop and issue the crisis exemptions itself.

• Subsequently, EPA issued several crisis exemptions at different times permitting the limited sale, distribution, and use of EPA registered bleach products for use against Bacillus anthracis spores at a number of contaminated facilities such as:

  Capitol Hill,

  USPS Processing and Distribution Centers at Brentwood (Washington, D.C.) and

  Hamilton (Trenton, NJ),

  Department of State, General Services Administration, and

  Broken Sound Boulevard, Boca Raton, FL.

• Under these crisis exemptions, registered bleach products could only be sold or distributed to employees of federal, state, or local government agencies, and the U.S. Postal Service.

USEPA: Anthrax spore decontamination using bleach (sodium hypochlorite). Last revised: May 2012

• A gas chromatograph coupled with an atomic emission detector was used to identify and to determine the products formed on oxidation of sulfur mustard. The oxidation rate and the resulting oxidates were studied in relation to oxidant type and reaction medium parameters. Hydrogen peroxide, sodium hypochlorite, sodium perborate, potassium monopercarbonate, ammonium peroxydisulfate, potassium peroxymonosulfate (oxone), and tert-butyl peroxide were used as oxidants. Oxidations were run in aqueous media or in solvents of varying polarities. The oxidation rate was found to be strongly related to oxidant type: potassium peroxymonosulfate (oxone) and sodium hypochlorite were fastacting oxidants; sodium perborate, hydrogen peroxide, ammonium peroxydisulfate, and sodium monopercarbonate were moderate oxidants; tert-butyl peroxide was the slowest-acting oxidant. In non-aqueous solvents, the oxidation rate was strongly related to solvent polarity. The higher the solvent polarity, the faster the oxidation rate. In the acid and neutral media, the mustard oxidation rates were comparable. In the alkaline medium, oxidation was evidently slower. A suitable choice of the initial oxidant-to-mustard concentration ratio allowed to control the type of the resulting mustard oxidates. As the pH of the reaction medium was increased, the reaction of elimination of hydrogen chloride from mustard oxidates becomes more and more intensive.

Popiel S, Witkiewicz Z, Szewczuk A. The GC/AED studies on the reactions of sulfur mustard with oxidants. Journal of Hazardous Materials 2005 Aug;123:94-111. [PubMed Citation]

• The N95 filtering facepiece respirator (FFR) is commonly used to protect individuals from infectious aerosols. Health care experts predict a shortage of N95 FFRs if a severe pandemic occurs, and an option that has been suggested for mitigating such an FFR shortage is to decontaminate and reuse the devices. Before the effectiveness of this strategy can be established, many parameters affecting respiratory protection must be measured: biocidal efficacy of the decontamination treatment, filtration performance, pressure drop, fit, and toxicity to the end user post treatment. This research effort measured the amount of residual chemicals created or deposited on six models of FFRs following treatment by each of 7 simple decontamination technologies. Measured amounts of decontaminants retained by the FFRs treated with chemical disinfectants were small enough that exposure to wearers will be below the permissible exposure limit (PEL). Toxic byproducts were also evaluated, and two suspected toxins were detected after ethylene oxide treatment of FFR rubber straps. The results provide encouragement to efforts promoting the evolution of effective strategies for decontamination and reuse of FFRs.

Salter WB, Kinney K, Wallace WH, Lumley AE, B.K. Heimbuch BK, Wander JD. Analysis of residual chemicals on filtering facepiece respirators after decontamination. Journal of Occupational and Environmental Hygiene 2010 Aug;7(8): 437-45. [PubMed Citation]

• This study was designed to determine how easily methamphetamine can be removed from clothing and building materials, utilizing different cleaning materials and methods. The study also addressed the penetration of methamphetamine into drywall and the ability of paints to encapsulate the methamphetamine on drywall. Clothing and building materials were contaminated in a stainless steel chamber by aerosolizing methamphetamine in a beaker heater. The amount of methamphetamine surface contamination was determined by sampling a grid pattern on the material prior to attempting to clean the materials. After cleaning, the materials were again sampled, and the degree of decontamination noted. We found that household clothing and response gear worn by first responders was easily decontaminated using a household detergent in a household washing machine. A single wash removed over 95% of the methamphetamine from these materials. The study also indicated that methamphetamine-contaminated, smooth nonporous surfaces can be easily cleaned to below detectable levels using only mild cleaners. More porous surfaces such as plywood and drywall were unlikely to be decontaminated to below regulatory levels even with three washes using a mild cleaner. This may be due to methamphetamine penetration into the paint on these surfaces. Evaluation of methamphetamine contamination on drywall indicated that approximately 40% of the methamphetamine was removed using a wipe, while another 60% remained in the paint layer. Stronger cleaners such as those with active ingredients including sodium hypochlorite or quaternary ammonia and commercial decontamination agents were more effective than mild detergent-based cleaners and may reduce methamphetamine contamination to below regulatory levels. Results from the encapsulation studies indicate that sprayed on oil-based paint will encapsulate methamphetamine on drywall and plywood surfaces up to 4.5 months, while latex paints were less effective.

Serrano KA, Martyny JW, Kofford S, Contreras JR, Van Dyke MV. Decontamination of clothing and building materials associated with the clandestine production of methamphetamine. Journal of Occupational and Environmental Hygiene 2012;9(3): 185-97. [PubMed Citation]

• Handling of genotoxic compounds commonly used in cancer chemotherapy generates contaminated wastes that require decontamination before disposal. Chemical methods are an alternative and/or a complement to incineration for the treatment of wastes and spills. Method: As part of a program initiated by the International Agency for Research on Cancer (IARC), 3 chemical methods readily available in the hospital environment -sodium hypochlorite (NaOCl, 5.25%), hydrogen peroxide (H2O2, less, or equal to 30%) and Fenton reagent (FeCl2, 2H2O; 0.3 g in 10 ml H2O2, 30%) are being tested for the degradation of a total of 32 antineoplastic agents. The efficiency of degradation was monitored by high-pressure liquid chromatography. The mutagenicity of the degradation residues were tested by the Ames test using tester strains Salmonella typhimurium TA 97a, TA 98, TA 100, and TA 102 with and without an exogenous metabolic activation system. Results: The first results obtained for the degradation of cyclophosphamide, ifosfamide, and melphalan have been published in this journal. The present manuscript reports the results of the investigation of a series of six anthracyclines (aclarubicin, daunorubicin, doxorubicin, epirubicin, idarubicin, and pirarubicin) commonly used in chemotherapy treatment. Pharmaceutical preparations corresponding to the most concentrated administration solutions in either NaCl (0.9%) or dextrose (5%) were inactivated by oxidation volume/volume with each of the methods for at least 1 h. Complete degradation into nonmutagenic residues of all the tested compounds was observed after 1 h for the NaOCl (5.25%) treatment as previously reported for the first study. Conclusion: Sodium hypochlorite (5.25%) is an efficient reagent for the chemical degradation of the nine drugs tested thus far.

Castegnaro M, De Meo M, Laget M, Michelon J, Garren L, Sportouch MH, Hansel S. Chemical degradation of wastes of antineoplastic agents. 2: Six anthracyclines: idarubicin, doxorubicin, epirubicin, pirarubicin, aclarubicin, and daunorubicin. Int Arch Occup Environ Health 1997;70(6):378-84 [PubMed Citation]

Solubilities: 29.3 g/100 g (0 deg C) in water

HSDB. Sodium Hypochlorite

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18. Publications

Amos D, Leake B. Clean-up of chemical warfare agents on soils using simple washing or chemical treatment processes. Journal of Hazardous Materials 1994;39:107-17.

Braue EH Jr, Smith KH, Doxzon BF, Lumpkin HL, Clarkson ED. Efficacy studies of Reactive Skin Decontamination Lotion, M291 Skin Decontamination Kit, 0.5% bleach, 1% soapy water, and Skin Exposure Reduction Paste Against Chemical Warfare Agents, part 2: guinea pigs challenged with soman. Cutaneous and Ocular Toxicology, 2011 Mar; 30(1): 29-37. [PubMed Citation]

Castegnaro M, De Meo M, Laget M, Michelon J, Garren L, Sportouch MH, Hansel S. Chemical degradation of wastes of antineoplastic agents. 2: Six anthracyclines: idarubicin, doxorubicin, epirubicin, pirarubicin, aclarubicin, and daunorubicin. Int Arch Occup Environ Health 1997;70(6):378-84 [Pub Med Citation]

[DHHS/FDA; Emergency Preparedness and Response-Counterterrorism and Emerging Threats (12/01/2011)]

Estrela C, Estrela CR, Barbin EL, Spano JC, Marchesan MA, Pecora JD. Mechanism of action of sodium hypochlorite. Brazilian Dental Journal, 2002;13(2):113-7. [PubMed Citation]

Gold MB, Bongiovanni R, Scharf BA, Gresham VC, Woodward CL. Hypochlorite solution as a decontaminant in sulfur mustard contaminated skin defects in the euthymic hairless guinea pig. Drug And Chemical Toxicology 1994 Nov;17(4):499-527. [PubMed Citation]

HSDB. Sodium Hypochlorite

Love AH, Bailey CG, Hanna ML, Hok S, Vu AK, Reutter DJ, Raber E. Efficacy of liquid and foam decontamination technologies for chemical warfare agents on indoor surfaces. Journal of Hazardous Materials 2011 Nov;196:115- 122. [PubMed Citation]

Niven AS, Roop SA; Inhalational exposure to nerve agents. Respiratory Care Clinics of North America, 2004 Mar;10(1):59-74. [PubMed Citation]

Popiel S, Witkiewicz Z, Szewczuk A. The GC/AED studies on the reactions of sulfur mustard with oxidants. Journal of Hazardous Materials 2005 Aug;123:94-111. [PubMed Citation]

Product label: DAKINS FULL (sodium hypochlorite) solution [Century Pharmaceutical, Inc.] Last revised: April 2010 [DailyMed]

Salter WB, Kinney K, Wallace WH, Lumley AE, B.K. Heimbuch BK, Wander JD. Analysis of residual chemicals on filtering facepiece respirators after decontamination. Journal of Occupational and Environmental Hygiene 2010 Aug;7(8): 437-45. [PubMed Citation]

Salter WB, Owens JR, Wander JD. Methyl salicylate: a reactive chemical warfare agent surrogate to detect reaction with hypochlorite. Applied Materials and Interfaces, 2011;3:4262-67. [PubMed Citation]

Serrano KA, Martyny JW, Kofford S, Contreras JR, Van Dyke MV. Decontamination of clothing and building materials associated with the clandestine production of methamphetamine. Journal of Occupational and Environmental Hygiene 2012;9(3): 185-97. [PubMed Citation]

USEPA: Anthrax spore decontamination using bleach (sodium hypochlorite). Last revised: May 2012.

USEPA R.E.D. FACTS - Sodium and Calcium Hypochlorite Salts. 738-F-91-108 Sep 1991.

Welles WL, Wilburn RE, Ehrlich JK, Floridia CM. New York hazardous substances emergency events surveillance: learning from hazardous substances releases to improve safety. Journal of Hazardous Materials 2004 Nov;115(1-3):39-49. [PubMed Citation]

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19. Web sites

NIH CounterACT Program (HHS/NIH)

NIH RePORTER (HHS/NIH)

ClinicalTrials.gov (HHS/NIH)

PubMed (HHS/NIH)

DailyMed (HHS/NIH)

Record last updated 1/2/2013