Chemical Exposures Associated with Methamphetamine Labs: Implications for Children

1. Chemical Exposures Associated with Methamphetamine Labs: Implications for Children by John Martyny, Ph.D., CIH National Jewish Medical and Research Center

2. Methamphetamine “Truisms” • The chemicals used are just household chemicals and will not hurt anyone. • If it doesn’t hurt the cooks, it can’t hurt anyone else. • As long as you don’t smell a chemical odor, everything will be OK. • Exposures only last for a short time and therefore will not hurt anyone. • Exposures are usually below current standards and do not present a hazard for anyone.

3. What is a Meth Lab?

5. Is there a concern for adults? • University of Washington Studies • 17% of law enforcement chemists report illness. • Irritation symptoms occur in investigators that do not wear proper PPE. • Most symptoms occur in the processing phase. • Reported Cases • Phosphine exposure in a law enforcement officer • Skin and pulmonary irritation in law enforcement officers. • Questionnaire Results • 52% of officers attending training sessions reported symptoms at previous laboratory investigations.

6. What about kids? • What are the potential exposures to children associated with methamphetamine labs?

7. Meth Labs and Children • About 30-35% of labs seized are residences with children • Elevated sensitivity in children: • Physiologic status (higher rates of growth, metabolism, respiration, and development) • Behaviors(hand-to-mouth and increased contact with physical environment) • 35% - 55% of children removed from meth labs test positive for meth • 10% of children removed from homes of heavy users test positive for meth

8. The Project

9. Project Sponsors • Colorado Department of Public Safety • U.S. Dept. of Justice • Colorado Methamphetamine Program • Colorado Alliance for Drug Endangered Children • National Institutes of Occupational Safety and Health (NIOSH) • North Metro Drug Task Force • Tri-County Health Department • National Jewish Medical and Research Center

10. Pre-Sampling at Colorado Springs Police Department

11. Meth Lab Responses - Inactive • Responded to suspected clandestine laboratories. • Hotel Rooms • Homes • Apartments • Vehicles • Mobile Homes

13. Red P Cook at a Home

14. Red P Cook at a Motel

15. The “Birch” or “Nazi” Method

16. New Mexico Methamphetamine Cook

17. Nazi Lab in Dallas, TX

19. Results of Exposure Study

20. Definitions • Threshold Limit Value (TLV) • 8 hour time-weighted average (TWA) • Occupational exposures only • Ceiling Value • A concentration that should not be exceeded during any part of the working exposure. • Short Term Exposure Limit (STEL) • Not to be exceeded for a 15 minute TWA • Immediately Dangerous to Life and Health (IDLH)

21. Questions???? • Would you enter an area without PPE where a chemical was reported to be at the TLV? • Would you allow your children to enter an area where a chemical was reported to be at the TLV?

22. Phosphine • Symptoms • Severe pulmonary irritant • Nausea, vomiting, diarrhea, chest tightness, cough, headache, may be caused by exposures as low as 10 ppm • Pulmonary edema has caused death. • Implicated in deaths at Meth Labs. • Current Exposure Standards • TLV = 0.3 ppm • STEL = 1 ppm • IDLH = 50 ppm • Invisible with slight fish or garlic odor.

23. Phosphine Exposure Levels • In Red “P” and Hypophosphorous cooks. • Ranges from ND to 3.5 ppm (10 x the TLV of 0.3 ppm) • In the area of the cook in a home it averaged 0.94 ppm. • Phosphine may be present in the “death bag” at high concentrations. • The cook temperature and water content may have a significant effect on the amounts of phosphine generated.

24. Iodine • Iodine – Airborne • Irritant of the eyes, mucous membranes, and skin. • May cause chest tightness and difficulty breathing. • Levels of 1.63 ppm will cause eye irritation in all exposed within 5 minutes. • Skin rash due to hypersensitivity can occur. • Current Exposure Standards • TLV = 0.1 ppm Ceiling • IDLH = 2 ppm

26. Iodine Exposure Levels • Measured Exposure Range. • 0.23 ppm – 3.7 ppm (almost 2x the IDLH) • Levels measured in the house cook. • Cook area = 0.16 ppm • Down the hall = 0.04 ppm • Levels measured in the hotel cook • 0.001 ppm – 0.05 ppm

27. Iodine Exposure Levels IDLH TLV

28. Solvents • Many different types of solvents can be used. • Symptoms will depend upon solvent type. • Irritation, pulmonary edema, peripheral neuropathy, liver damage. • Explosion hazard may be a major concern. • Current exposure levels depend on the individual solvent. • n-Hexane = 50 ppm • Chloroform = 10 ppm

29. Hydrochloric Acid • Symptoms – Airborne • Upper respiratory tract irritation – cough, burning throat, choking, burning eyes, chest pain. • Acute symptoms may occur as low as 5 ppm. • Skin contact may cause burns and ulceration. • Current Exposure Levels • TLV = 2 ppm Ceiling • IDLH = 50 ppm • Colorless gas with pungent odor.

31. Hydrogen Chloride Exposure Levels • Average exposures during entire cook period. • 0.3 – 2.3 ppm (slightly above the 2 ppm TLV) • Average exposure during salting out. • 3.8 – 7.2 ppm ( > 3 x the TLV) • Peak concentrations during salting out. • 60 ppm – 155 ppm ( > 3 x the IDLH)

32. Hydrochloric Acid Levels IDLH TLV

33. Anhydrous Ammonia • Symptoms • Severe irritant of the eyes, respiratory tract, and skin. • After 70 ppm, most individuals will report irritation. • Levels over 2500 may cause corneal irritation, bronchospasm, chest pain, and pulmonary edema. Bronchitis and pneumonia may also occur. • Tolerance may be acquired. • Current Exposure Standards • TLV = 25 ppm • STEL = 35 ppm • IDLH = 300 ppm

36. Anhydrous Ammonia Levels • All meters overloaded • Highest reading 3000 ppm (10 x the IDLH) • Drager tube readings 500 ppm to 2000 ppm • Cook exposures range from 130 ppm to 370 ppm (10 x the STEL) • Exposures at the cook were 190 ppm and 410 ppm for a 2 hour period

37. Anhydrous Ammonia Levels Dissipate quickly with fan and ventilation 50-100 ppm in flow to fan

38. Anhydrous Ammonia Exposures IDLH TLV

39. Methamphetamine • Symptoms • Very little known regarding low level chronic exposures. • Irritation of the skin, eyes, mucous membranes, and upper respiratory tract. • High levels may cause dizziness, headache, metallic taste, insomnia, high or low blood pressure, etc. • Chronic exposures may cause irritability, personality changes, anxiety, hallucinations, psychotic behavior. • Smaller infants, altered behavior patterns, lower IQ scores, teratogenic affects, cerebral hemorrhage. • Current Standards • None • Therapeutic dose = 5 mg (2 to 3 x per day) • Surface contamination = 5 ug/100 cm2 or ft2

40. Methamphetamine Levels on Surfaces • Ranged from non-detect to 16,000 ug/100cm2. • Levels inside microwaves were high. • Levels on air returns were elevated suggesting airborne quantities. • Levels on flat surfaces in the lab area were very high. • Levels exceeding the standard were found in every verified lab.

41. Surface Methamphetamine Levels

42. Airborne Methamphetamine using Red P Method 4200 ug/m3 To 5500 ug/m3

43. Airborne Methamphetamine: Nazi Method Early Stages of the Process: 2.4 ug/m3 to 10.1 ug/m3

44. Airborne Methamphetamine: Nazi Method Salting Out Stage of the Process: 7.6 ug/m3 to >680 ug/m3

45. Methamphetamine Surface Levels at Home • Horizontal Surfaces • 6 inches from cook – 87 ug/100 cm2 • 72 inches from cook – 28 ug/100 cm2 • Vertical Surfaces • 63 inches from cook – 20 ug/100 cm2 • 113 inches from cook – 10 ug/100 cm2 • Clothing • ND to 18 ug/wipe

46. Methamphetamine Surface Levels at Hotel • Vertical Surfaces • 36 inches from Cook – 130 ug/100 cm2 • 88 inches from Cook – 120 ug/100 cm2 • 146 inches from Cook – 30 ug/100 cm2 • 200 inches from Cook – 11.6 ug/100 cm2 • Hallway 216 inches from Cook – 8 ug/100 cm2 • Clothing Contamination • 1 ug/sample to 580 ug/sample • Highest during salting out • Higher in Red P Methodology

47. Exposure Conclusions • Exposures to iodine, phosphine, anhydrous ammonia, and hydrochloric acid may exceed occupational standards. • Hydrochloric acid, Iodine, and anhydrous ammonia may exceed IDLH Levels. • Significant amounts of airborne methamphetamine are released during the cook and deposited on both horizontal and vertical surfaces.

48. Conclusions (cont) • Entering the cook area will contaminate clothing with methamphetamine and other chemicals. • The methamphetamine contamination may migrate inside of PPE • The entire area of the home is contaminated by the generated compounds.

49. How can I Protect Myself? • Wear the appropriate personal protective equipment. • Initial entry – SCBA, Protective Clothing (fire and chemical), Gloves, Boots. • After stabilization – Air Supplied Respirators may be OK. • Assume that everything in the building is contaminated. • Establish good decon procedures.