Epidemiology of Inhalant Abuse - Archives - National Institute on ...

Therefore, to prevent misuse, a small modification to the valve could
limit access to the propellant (D. Roberts, British Aerosol Manufacturers’
Association, personal communication, 1990). Gas canisters that have a
screw-on valve require the possession <strong>of</strong> an appliance to gain access to
the contents.
Disposable cigarette lighter refills are attractive to misusers because the
butane gas is accessible without use <strong>of</strong> an appliance. Anecdotal reports
suggest that cigarette lighter refills most <strong>of</strong>ten are used by clenching the
plastic nozzle between the teeth and pressing to release the gas. If the
cylinder inadvertently is tipped up, very cold fluid (below -40°C) rather
than gas is expelled. This can cause pulmonary edema or even death
from vagal inhibition (Shepherd 1989). Modification <strong>of</strong> the valve on
cigarette lighter refills should be considered to reduce this practice.
<strong>Abuse</strong> <strong>of</strong> disposable cigarette lighters themselves, although <strong>of</strong>ten referred
to, is unlikely because they contain very little gas (typically 4 ml <strong>of</strong>
liquid) and the flow rate is restricted. The flammability <strong>of</strong> butane gives
rise to the risk <strong>of</strong> bums resulting from misuse, usually when an
intoxicated youngster decides to smoke and sniff butane at the same time
(Scerri et al. 1992). Elliott (1991) reports cold bums (i.e., frostbite) <strong>of</strong>
the mouth <strong>of</strong> a soldier who had inhaled a propellant containing propane
and dichlorodifluoromethane (FC 12).
The international control <strong>of</strong> the manufacture <strong>of</strong> halogenated compounds
suspected <strong>of</strong> depleting stratospheric ozone (table 1) will necessitate
changes in the formulation <strong>of</strong> some products abused by inhalation.
Typewriter correction fluids, as well as cleaning and degreasing agents,
will no longer contain 1, 1, 1-trichloroethane, which is relatively safe
during chronic occupational exposure. It can be expected that the more
toxic trichloroethylene and, perhaps, dichloromethane will be substituted
in some applications. On the positive side, bromochlorodifluoromethane
(BCF, FC 12B1) probably will be replaced by carbon dioxide in fire
extinguishers.
Based on mortality data and anecdotal reports, gasoline is not commonly
misused in the United Kingdom, in contrast to the United States, where
gasoline vied with glue as the top “ever used” product in the 1991
<strong>National</strong> Household Survey on Drug <strong>Abuse</strong> (Sharp 1992). It perhaps is
more understandable that populations such as native Australians (Brady
1991) and the aboriginal populations <strong>of</strong> some other countries (Smart
1988), who do not have access to consumer products, should use this, the
only readily available volatile compound. The hazard from lead additives
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