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

FIGURE 9. United Kingdom VSA-related deaths: Method <strong>of</strong> misuse
by product.
Contact <strong>of</strong> the perioral region with adhesive contaminating the bag
probably is responsible for “glue sniffers rash” (Meredith et al. 1989).
Liquids commonly are inhaled directly from the original containers or
poured into empty containers such as bleach bottles before use. It
probably is observation <strong>of</strong> this practice by adults that gives rise to many
rumors <strong>of</strong> bleach sniffing. However, this bizarre practice has been
documented (Raferty 1980). Vapor from liquids also may be inhaled
after pouring them onto a handkerchief or sleeve. Aerosols sometimes
are inverted and sprayed directly into the mouth (figure 1), used to inflate
plastic bags, or, more rarely, bubbled through water to scrub out the
nonrespirable components. Deaths have occurred when children have
done this in the bath; the semiconscious child falls forward and drowns.
Cigarette lighter refills are misused by clenching the nozzle between the
teeth, and pressing on the can to discharge the contents directly into the
mouth, as discussed above.
PLACES WHERE SUBSTANCES ARE ABUSED
In 1991, 39 percent <strong>of</strong> VSA-related deaths occurred when sniffing took
place at home; 11 percent at the home <strong>of</strong> a friend; 3 percent in an
institution (e.g., school or residential home): 42 percent in a public place;
and 2 percent at work. The location was not reported in 3 percent <strong>of</strong>
cases (figure 10). It perhaps is surprising that over half <strong>of</strong> the deaths
222