Abstract and Introduction
Introduction: A suicide trend that involves mixing household chemicals to produce hydrogen sulfide or hydrogen cyanide, commonly referred to as a detergent, hydrogen sulfide, or chemical suicide is a continuing problem in the United States (U.S.). Because there is not one database responsible for tracking chemical suicides, the actual number of incidents in the U.S. is unknown. To prevent morbidity and mortality associated with chemical suicides, it is important to characterize the incidents that have occurred in the U.S.
Methods: The author analyzed data from 2011–2013 from state health departments participating in the Agency for Toxic Substances and Disease Registry's National Toxic Substance Incidents Program (NTSIP). NTSIP is a web-based chemical incident surveillance system that tracks the public health consequences (e.g., morbidity, mortality) from acute chemical releases. Reporting sources for NTSIP incidents typically include first responders, hospitals, state environmental agencies, and media outlets. To find chemical suicide incidents in NTSIP's database, the author queried open text fields in the comment, synopsis, and contributing factors variables for potential incidents.
Results: Five of the nine states participating in NTSIP reported a total of 22 chemical suicide incidents or attempted suicides during 2011–2013. These states reported a total of 43 victims: 15 suicide victims who died, seven people who attempted suicide but survived, eight responders, and four employees working at a coroner's office; the remainder were members of the general public. None of the injured responders reported receiving HazMat technician-level training, and none had documented appropriate personal protective equipment.
Conclusion: Chemical suicides produce lethal gases that can pose a threat to responders and bystanders. Describing the characteristics of these incidents can help raise awareness among responders and the public about the dangers of chemical suicides. Along with increased awareness, education is also needed on how to protect themselves.
In 2007, Japan documented the first reports of chemical or detergent suicides, and 2,000 such suicides have been reported there since then. Around the same time, incidents of chemical suicide, also known as detergent or hydrogen sulfide suicide, were reported in the United States (U.S.).[2–4] Internet websites provide detailed instructions on how to commit suicide by mixing household chemicals usually to produce hydrogen sulfide or hydrogen cyanide gas in an enclosed space.[1,2] Hydrogen sulfide is a colorless gas that is heavier than air, has a sweetish taste, and smells like rotten eggs. Hydrogen cyanide gas has a faint, bitter almond odor and bitter burning taste. High-level exposure to either chemical could result in immediate death.[3,5]
Because no one database is responsible for tracking chemical suicides in the U.S., the actual number of incidents is unknown. In 2011, using National Vital Statistics System (NVSS) and Google searches, Reedy, Schwartz, and Morgan found that 30 chemical suicides occurred in the U.S. from 2008–2010. Medical examiners confirmed the chemical suicides found in the NVSS. In 2011, using chemical surveillance systems the Agency for Toxic Substance and Disease Registry (ATSDR) reported 10 chemical suicide incidents; however, this report focused only on incidents that occurred in vehicles. The report also showed that chemical suicides were a threat not only to the person committing suicide, but to responders and innocent bystanders as well. Both reports indicated that their findings were most likely underestimates of the true frequency of chemical suicide incidents.[4,6]
Our report updates ATSDR's chemical suicide data by including three additional years of surveillance data (2011–2013) and other locations where chemical suicide incidents occurred. Through describing the characteristics of these incidents, we hope to raise awareness about potential exposure risks to responders and bystanders from chemical suicides incidents so that recommendations for preventative actions can be made to avoid exposure and exposure-related injuries associated with chemical suicides.
Western J Emerg Med. 2016;17(6):680-683. © 2016 Western Journal of Emergency Medicine