Monday, February 27, 2012

CA - REGION: Residents' sudden deaths linked to abuse of 'air duster' products, officials say..

OFF THE WIRE
North County Times
Dr. Iain McIntyre, chief toxicologist at the county medical examiner's office, says the number of bodies that test positive for the gas found in air duster products is on the rise.
A recent trend of sudden deaths after people intentionally inhaled "air duster" electronics-cleaning products to get high has prompted county scientists to write an academic paper drawing attention to the apparent drug abuse in San Diego County.
The 25-page paper describes 17 deaths reported in the last five years countywide, including two North County residents who died last year. All 17 people tested positive for 1,1-difluoroethane, the compressed volatile gas the products shoot out at high pressure to remove dust from electronics without touching them or leaving behind moisture.
The gas is listed as a cause of death in 13 of the cases, and investigators found at least one can of the cleaning products near 14 of the bodies.
County scientists have identified a possible upward trend in the number of deaths attributed annually to the dangerous practice of inhaling, or "huffing," air duster products, such as Blast Away, for a brief euphoric high, said Dr. Iain McIntyre, chief toxicologist at the county medical examiner's office.
Concerned, McIntyre and two colleagues set out to share what they know about 1,1-difluoroethane-related deaths in San Diego County.
"There are dangers out there, and when we find something of significance we try to alert not just the community, but the scientific community as well," McIntyre said.
He said the paper has been accepted for publication in a scientific journal, and it's expected to go to print later this year. McIntyre co-wrote the paper with Deputy Medical Examiner Dr. Christopher Swalwell, and Chris Vance, a criminalist with the San Diego County Sheriff's Department.
A growing concern?
Two North County residents were among the five 1,1-difluoroethane-related deaths recorded countywide in 2011, McIntyre said. They were the only North County residents of the 17 people who died suddenly from the products between Jan. 1, 2007 and Dec. 31, 2011.
A 34-year-old Oceanside man who had no significant health problems beyond obesity, and who did not smoke, drink or use illicit drugs was found dead in his mother's home Aug. 29 with a bag over his head, according to the man's autopsy report. A can of Blast Away brand air duster was on a nearby vanity.
Investigators ruled his death an accident, caused by acute 1,1-difluoroethane intoxication, according to the report.
A Rancho Penasquitos woman, 24, was found dead April 5 on the floor next to her bed in her room at her aunt's home, a can of Ativa-brand compressed air on her dresser, according to her autopsy report. Her medical history included prescription drug abuse, mental illness, and she had admitted to huffing air duster about a week before her death.
Investigators ruled her death an accident caused by the combined effects of 1,1-difluoroethane, and the prescription drugs pseudoephedrine, amphetamine and fluoxetine, according to the report.
The number of bodies that tested positive for the gas appears to be on the rise, suggesting abuse of the products could be growing more common, McIntyre said.
He said one person tested positive for the gas in 2007, three in 2008, five in 2009, three in 2010 and five in 2011.
So far this year, three people examined by the medical examiner's office have tested positive for the gas, McIntyre said. The cases were open Wednesday, and investigators had not determined whether the gas caused the deaths.
"It's not a lot in terms of overall numbers, but it's given as a cause of death in 13 cases," McIntyre said. "If you weren't looking for the drug, you wouldn't have found the cause of death."
Awareness is key
The San Diego County medical examiner's office has been looking for the substance during routine alcohol screening, but other county coroners and medical examiner's offices have not, McIntyre said. He said he and his colleagues wanted to promote screening for the gas because abuse of the seemingly innocent air duster products could be easy to overlook.
The products, which are sold widely at electronics stores and other retailers for about $6 per 12-ounce can, may not stand out as potentially illicit drugs the way pills and dried plant products would in settings such as homes and offices, officials said.
"People have cans at home; you wouldn't necessarily suspect it would be a cause of death," McIntyre said.
Incidental inhalation during normal use of the products rarely causes health problems because little is ingested and the body can quickly expel the gas when breathing normally, McIntyre said.
When there are high concentrations of the gas in blood and eye fluid after death, it suggests that use was intentional and recent enough that the person stopped breathing before they could expel the gas from the body, according to the research paper.
Direct intentional exposure to the gas can kill users suddenly, whether they are huffing it for the first time or 30th time, said Dr. Lee Cantrell, interim director of San Diego division of the California Poison Control System. It can cause sudden death by competing with oxygen for space in users' lungs, suffocating them, or causing fatal cardiac arrhythmia.
Cantrell didn't have statistics on hand detailing the number of inhalant-related calls to the poison control system, but he said calls about abuse and misuse of air duster products are not rare.
If users don't die right away and continue to abuse the products, they can suffer brain damage by depriving their brains of oxygen, Cantrell said.
Cumulative damage to the brain and other organs can have serious, irreversible consequences.
"There's more than one way this stuff can kill you," he said.