Pediatric Tear Gas Poisoning in Southern Israel: Clinical Characteristics and Outcomes.

BACKGROUND

Pepper spray and tear gas are chemical irritants causing ocular, dermal, and respiratory injury. Data specific to pediatric emergency department (PED) presentations remain limited.

OBJECTIVES

To characterize the epidemiology, clinical presentation, and short-term outcomes of chemical irritant exposure in children presenting to a tertiary PED.

METHODS

We conducted a retrospective cohort study of patients aged 0-18 years of age presenting to a single tertiary PED between 2016 and 2024 following civilian-grade chemical irritant exposure. Cases were identified using ICD-9 codes and free-text electronic medical records search. Demographic characteristics, clinical findings, treatment, and disposition were analyzed using descriptive statistics.

RESULTS

We included 84 pediatric patients (median age 12.5 years, IQR 6.0-15.6; 69.0% male). Exposures occurred most commonly at home (44.0%) and school (36.9%). Ocular involvement was common. Superficial punctate keratitis was identified in 54.5% of patients who underwent fluorescein examination by ophthalmologist (21.5% of the total cohort). Respiratory and dermal symptoms were mild and self-resolving. No severe complications were documented; 96.4% were discharged home.

CONCLUSIONS

Civilian-grade chemical irritant exposures in children were predominantly self-limited and managed successfully with conservative ED care, supporting decontamination-based protocols while highlighting home and school settings as priorities for prevention.