Hydrofluoric acid (HF) is a weak acid that can deeply penetrate human skin and is used across several industries. The toxicity of the fluoride ion is well characterized but there are few objective decontamination studies. This review is meant to summarize the literature available for human application.

The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) were used to guide methodology and reporting. A comprehensive literature search was performed using the databases PubMed, Web of Science, Embase, Scopus, ScienceDirect, and Ovid Medline in July of 2023 using the terms (“HF” AND “decontamination” AND “animal” AND “human”). Studies in the English language were included if they quantified HF decontamination using in vivo or ex vivo models. Studies were excluded if they were expansions of the initial study by the same author. A total of 734 records were screened by title and abstract by one independent researcher. 80 articles were then screened for full text eligibility, with five included in the final review. Any discrepancies were settled by a third researcher.

All studies selected were ex-vivo models in the human skin (4/5) or eye (1/5). No study selected examined fluoride elimination in the airway. Nosé et al 2017 used enucleated human cornea and optical coherence tomographic imaging to show that structural damage in the mannitol group is reduced versus the NaCl wash and HF unwashed groups. Studies by Dennerlein et al 2018, Burgher et al 2011, and Mathieu et al 2010 examining the skin explants found that Hexafluorine® was the superior decontaminant compared with calcium gluconate, polyethylene glycol, and water. Vijayan et al 2021 found that timing of the application of decontamination agents appears to be a more significant variable compared to the choice of agent used and using a pH adjusting buffer promoted decontamination efficacy. This study examined the efficacy of water vs Hexafluorine® vs calcium gluconate vs magnesium gluconate.

The available literature demonstrates that Hexafluorine® or calcium gluconate is the best skin decontaminant and as such is mainstay in clinical practice. More studies are needed, however, to elucidate decontamination strategies in the airway, another common route of HF entry.

References and Resources

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