Summary

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.