Acid attack bystanders can make a real difference if they act fast, say experts

In London, the Metropolitan Police recorded almost 300 acid attacks in 2010, after which numbers decreased to 162 in 2012, but demonstrated a steep increase since 2014. There were 454 attacks in 2016, up from 261 in 2015.

Already 2017 has seen a big increase in acid attacks in the UK, relative to 2016. And, whereas in the past most of the attacks were related to robberies, corrosive substances now seem to be a replacement for carrying knives.

Recent figures obtained by the BBC from the Metropolitan Police show that men are twice as likely to be victims of attacks -- and many of these attacks have been linked to gang related violent crimes.

Yet the authors point out that currently in the UK, carrying corrosive substances is legal with no restrictions on volume or strength, although a change in legislation is being considered.

In 2002, after similar attacks, Bangladesh banned the open sale of acid and imposed stringent punishment of offenders, which saw the number of attacks fall by 15-20% a year. India and Cambodia have since implemented legislation to combat acid attacks but have yet to introduce laws restricting the ease and availability of acid.

The authors say that bystanders who come to the aid of the victim of an attack "can have an important role in minimising further injury." For example, removing contaminated clothing and washing off the acid with copious amounts of water can minimise scarring and need for surgical reconstruction.

Once in the emergency department, ongoing treatment and specialist review is vital to limit long term physical and emotional effects, they add.

The rising incidence of acid attacks is an evolving challenge to law enforcement, write the authors. Current legislation is being reviewed and may need to be fast tracked to ensure that carrying corrosive substances becomes a criminal offence, they add.

They suggest that "public education is needed on how to deal with these injuries, as immediate treatment can substantially improve the outcome." Similarly, ambulance service responders and health professionals in emergency departments "must have clear guidance on immediate steps to minimise secondary harm and training on how to deal with these devastating, life changing attacks."