Friday, June 12, 2015

The growing trend of Chemical-Detergent Suicide; Implications for EMS Personnel



It is considered a fast and painless method to die.









Written by Fuxa, Gary

A trend in the method of committing suicide is continuing to grow in the United States and it poses a viable threat to first responders. This method does not involve firearms, knives or medications, but rather common household products. When mixed together, they can produce one of the most toxic gases known to man: Hydrogen Sulfide.   It is considered a fast and painless method to die.

This method evolved in Japan in the late 2000s and is known as “chemical suicide” or “detergent suicide.” Since that time and due to this method, deaths in Japan have been estimated to be in the hundreds by some officials. It is believed that the first chemical suicides were carried out in the United States in 2008.

What is Hydrogen Sulfide?

Hydrogen sulfide (H2S) is a colorless gas that is heavier than air. It is produced in nature by the decomposition of organic materials. It is also known as sewer gas, sour gas, sulfane, and stink damp. H2S can be found in sewers, swamps, and in the air around petroleum producing locations. It can also be produced chemically by mixing certain household chemicals together. It is water-soluble and, in low concentrations, there is a distinct odor often described as “rotten eggs.” It is flammable and has a half-life of 37 hours. 

One of the most dangerous characteristics of hydrogen sulfide gas is that a person’s sense of smell can be inhibited after just few minutes of exposure to low concentrations. Because of this, first responders may not be aware of its presence or may unknowingly wander farther into higher concentrations.

Effects of Exposure

Some of the effects of contamination to people can be inflammation of the respiratory system, difficulty breathing, rapid or slow heart beat, sweating, delirium, headache, sensitivity to light, blueness of skin due to depleted oxygen in the blood stream, and drowsiness. Hydrogen sulfide can be deadly in higher concentrations. The maximum allowable safe concentration according to OSHA is 20 parts per million (PPM). 

Consider some possible effects when exposed to different levels. At 100 PPM, the loss of smell after a few minutes, respiratory irritation, drowsiness, and death can occur after 48 hours. At 500-700 PPM, the loss of consciousness and possible death after 30 minutes. At 1000-2000 PPM, the immediate loss of consciousness and death. To put things in perspective, one part per million would be equivalent to one minute in two years, or one penny in $10,000.

Easy to Make

The method of artificially producing hydrogen sulfide involves mixing chemicals containing hydrochloric acid with compounds that contains a sulfur product. When mixed in a small, confined area such as a closet, very high concentrations of gas can be achieved. Many of these compounds can be found in easily obtainable household products. Some common household products containing acid are toilet bowl and disinfectant cleaners, and some tile and stone cleaning products. 

Sulfur containing products can include dandruff shampoos, some types of paints, spackling, and pesticides/fungicides. Only a few ounces of each is needed to produce enough gas to fill a small confined area such as a car interior or small closet with the equivalency of 1,000 PPM of Hydrogen Sulfide gas in just a few seconds. An important thing to note is that while it only takes a small amount to produce concentrations high enough to cause death, mixing large amounts will produce an extremely hazardous and deadly environment.  

Remember the half-life number of 37 hours? Take a confined atmosphere of say 1,000 PPM, with no environmental interference, after 37 hours, half of the product has decomposed, leaving 500 PPM. After another 37 hours, again half the product is lost, leaving 250 PPM. The gas can last a very long time and still be deadly. Colder weather can extend the half-life, prolonging the lethality even more. 

Warning Signs

Most of the suicides take place in a small confined area such as a vehicle interior or a small closet. In most reported cases thus far, warning notes and Hazmat placards have been placed on the outside or inside of doors and on windows which warn those who approach that poisonous gases are present. 

One danger to first responders is that the resulting chemical reaction can produce by-products such as water (condensation) or a chemical fog, which can distort or deteriorate the notes left as warnings. The chemical reaction will often create brightly colored substances (if mixing containers are present). 

Sometimes the doors may be sealed with tape on the inside to keep the gas from escaping. If notes or placards are placed on the outside, elements such as wind, rain or snow may destroy them. As a result, first responders cannot depend on these warning signs, as they can become rendered unreadable, especially if placed on the inside of the car window. 

Anyone who enters a scene without taking proper precautions can quickly become a victim. How many times has it happened where first responders are sent to an unresponsive subject in a vehicle? With these types of suicides in mind, we can’t afford to blindly extract the person out of the vehicle. Can you imagine opening the door to an environment that is 1,000-2,000 PPM and getting a lung full of hydrogen sulfide gas? 

There have been reports of first responders and civilians overcome and injured due to opening a door to a vehicle where poisonous gases were present. In one incident, snow had distorted the warning note. In another, no notes were attached to the vehicle. Remember these types of incidents are not exclusive to vehicles; they can occur anywhere there is a confined space. Just a small amount of gas is needed to make an environment deadly. Fortunately, I could not find any deaths to first responders or civilians due to these actions.

Use Proper Tactics

There are some hazard signs to look for, though. In most cases, the products (in their original containers) are mixed while inside the enclosed environments. Mixing containers can be almost anything, plastic buckets, pots, water jugs, or even the center or passenger-side glove boxes. There may be mixing tools such as spoons or sticks. There may be receipts for the products in plain view. 

Upon arriving on the scene, a threat assessment needs to be done. Is the vehicle occupied? Is the person inside responsive? Are there notes warning of poisonous gases? Is there a distinct odor of rotten eggs? Is there condensation on the inside of the vehicle? Are mixing buckets, utensils or household chemical containers present? If none of these are present, then it is most likely not a chemical suicide. However, if any of the listed clues are present, then precautions should be taken.

It would also be advantageous to have communications personnel trained to recognize the signs of chemical suicides. Dispatchers can relay valuable information to responding officers. They can also warn callers not to approach or extract persons who may have attempted chemical suicide. When dealing with a suspected chemical suicide, responders should utilize Level 1 SCBN gear, as well as have the jurisdiction’s hazardous materials unit respond. 

There may be instances where a large area will need to be evacuated. This will need to be determined during your assessment. Wind speed and direction are important factors that must be considered prior to an evacuation. If confined areas need to be ventilated, it is critical to determine that no one will be affected by the vapors before doing so. There was an instance in Japan where an apartment building was evacuated due to the gas sinking (remember hydrogen sulfide is heavier than air) into other rooms. Numerous victims were taken to the hospital. 

Responders should utilize public address systems to awaken victims if it is possible that they are sleeping. If no response is noted, then a thorough reconnaissance should be conducted before entering and assisting the victim. If the victim appears to be awake, have them come to you. Anyone exposed to hazardous vapors should be decontaminated with soap and water. First aid/CPR should be carried out with proper personal protective equipment (PPE) as gases can be present in the lungs and may be “gassed out” as a result of first aid efforts. 

Contaminated clothing should be bagged. The dangerous gases can also accumulate in clothing so caution should be used during their handling. Deceased victims should be confined to sheets or tarps rather than body bags as again the gases may release from the body and, if in a confined space, a high level may accumulate. Anyone in close vicinity may be overcome. Hospitals should also be advised, if victims are transported to their facility, so that they may take the proper protocols for handling this type of situation.

More Common

Chemical suicides are becoming more commonplace in our society. It is critical that first responders adapt to this method of suicide for their own protection. Educate personnel on the dangers of chemical suicides. Perform a thorough assessment of the scene, look for clues that would indicate the presence of hazardous materials, use personal protective gear, use proper techniques when handling exposures, and notify the proper agencies to dispose of hazardous materials.
Source: http://www.hendonpub.com