The Hong Kong Government must come

clean about tear gas

With most city neighborhoods exposed, officials need to clarify
health risks
Kevin K.C. Hung, Emily Y.Y. Chan and Colin A. Graham

Nikkei Asian Review

NOVEMBER 20, 2019 14:00 JST

The Hong Kong police force has deployed more than 9,000 rounds of tear gas
in the city since June in responding to antigovernment protests.

An estimated 88% of Hong Kong's population resides in affected areas of the

crowded city. Of particular concern has been the deployment of tear gas in
high-risk enclosed areas such as underground train stations as well as in
locations adjacent to vulnerable populations, such as around schools and
retirement homes.

On Nov. 18, tear gas was fired near a major hospital close to Hong Kong
Polytechnic University where police were battling protesters. Elective
operations had to be canceled, ambulances diverted patients to other hospitals
and staff reported discomfort after breathing the gas.

The extensive use of chemical irritants in Hong Kong's densely populated

neighborhoods and the lack of government-led cleansing and
decontamination procedures has generated mounting public concerns about
potential short and long-term health effects.
The chemical agents used for crowd control, including chlorobenzylidene
malononitrile, or CS, the defining component of tear gas, are all designed to
cause immediate incapacitation to exposed persons. They vary in their potency
but are in common use because of the big difference for each between an
incapacitating dose and a lethal dose.

Yet cases of long-term disability or even death from exposure to these

chemicals have been documented worldwide. The organic solvents used to
dissolve CS can cause skin burns and liver damage, particularly when used in
confined spaces.

The intentional incapacitating effects on the respiratory system from these

agents can also trigger acute and potentially lethal attacks of asthma or
bronchitis in susceptible people, particularly in the hot and humid subtropical
environment of Hong Kong.

Such biological effects can be intensified in specific deployment conditions

and be affected by manufacturer-specific product characteristics as well as
usage after the agents' official expiration date. Venezuelan professor Monica
Krauter has found that expired tear gas can degrade into more toxic chemicals,
including cyanide oxide and phosgene, with the potential to cause heart, brain,
nerve or lung damage depending on exposure.

The Hong Kong police have not released detailed information of the type of
agents they are deploying. The force previously imported tear gas from British
and American suppliers, but with those supply sources in potential jeopardy
over human rights concerns, officials have confirmed new purchases from
manufacturers in mainland China.

Some police have said the Chinese tear gas canisters produce denser smoke
and can more quickly incapacitate targets. Recently, a journalist repeatedly
exposed to tear gas during his front-line reporting was diagnosed with
chloracne, a hallmark effect of dioxin exposure.

This has sparked further concern about environmental contamination. Dioxin

and related compounds are highly toxic pollutants that the U.S.
Environmental Protection Agency categorizes as likely human carcinogens.
These compounds do not easily degrade in the environment or the body. The
police have confirmed that their tear gas rounds may contain dioxin yet there
has been no government-led effort to comprehensively assess the
environmental impact on affected areas.
The police have confirmed that their tear gas rounds may contain dioxin.   © Reuters

Members of the public, as well as front-line health care providers and

volunteers providing medical aid, are becoming increasingly concerned about
the gas's impact. City health authorities recently issued public guidelines on
how to deal with tear gas exposure, highlighting first-aid measures for those
exposed, breastfeeding advice, steps to reduce indoor contamination and
other home cleaning tips.

The guidelines, however, acknowledge that there is a lack of scientific data on

the longer-term effects of tear gas exposure. There is thus an urgent need to
provide monitoring for exposed individuals to uphold the safety of Hong Kong
neighborhoods and ensure appropriate treatment. The accurate gathering of
information and its timely dissemination can help protect the health of the
public.

Rumors about toxic compounds in Hong Kong neighborhoods risk damage to

public trust in the city's governance. The government should be open and
transparent about the chemical composition of the crowd-control agents in
police use.
Monitoring and provision of adequate information and updates can help to
debunk myths that incite further disquiet as well as protect the health of Hong
Kong people. As the neighborhoods of Hong Kong have become real-life mini-
laboratory experiments about the long-term public health consequences of
tear gas, the government must demonstrate its commitment to protect
citizens' well-being and minimizing unnecessary risks to their health.

Kevin K.C. Hung is an assistant professor of emergency medicine at the

Chinese University of Hong Kong. Emily Y.Y. Chan is a professor of public
health at the school. Colin A. Graham is a professor of emergency medicine
there.