In an atmospheric HAZMAT release unprotected public dermal exposure is often of short duration, but with potential secondary exposure if not decontaminated promptly. Mass decontamination is resource intensive and needs to be justified. For many HAZMAT agents there is no evidence-base on which to provide guidance on decontamination, particularly for non-symptomatic worried well. It is important to understand the influence of street clothing and environmental and other factors. Ammonia is a common HAZMAT agent and was selected for in vitro human skin studies of absorption, penetration and off-gassing at test concentrations up to 2000 ppm, incorporating primary and secondary exposure combinations up to 60 min. Intact skin provided a good barrier to ammonia penetration. Heavy street clothing such as denim was found to act as an initial barrier to skin absorption but subsequently as a reservoir for secondary exposure, under variable temperature and humidity conditions. Rapid off-gassing was observed for lighter fabrics including polyester and cotton. The findings here have been summarized as a set of practical guidelines for emergency responders who are required to make decisions about ammonia decontamination including for non-symptomatic individuals. This evidence-based diagrammatic approach allows for specific actions based on different atmospheric ammonia concentrations and other parameters.
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