Chemical Exposures Associated with Methamphetamine Labs Implications for

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

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.

What is a Meth Lab?

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.

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

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

The Project

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

Pre-Sampling at Colorado Springs Police Department

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

Red P Cook at a Home

Red P Cook at a Motel

The “Birch” or “Nazi” Method

New Mexico Methamphetamine Cook

Nazi Lab in Dallas, TX

Results of Exposure Study

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)

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?

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.

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.

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

Iodine Exposure Levels • Measured Exposure Range. • 0. 23 ppm – 3. 7 ppm (almost 2 x 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

Iodine Exposure Levels IDLH TLV

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

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.

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)

Hydrochloric Acid Levels IDLH TLV

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

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

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

Anhydrous Ammonia Exposures IDLH TLV

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 cm 2 or ft 2

Methamphetamine Levels on Surfaces • Ranged from non-detect to 16, 000 ug/100 cm 2. • 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.

Surface Methamphetamine Levels Location ug/100 cm 2 Night Stand 2800 Ceiling Fan 2500 Microwave 2400 Bath Exhaust Grill 1600 Microwave 1700 Hotel Table 920 Kitchen Stove 790 Floor 520 Return Air Vent 450 Livingroom Table 430

Airborne Methamphetamine using Red P Method 4200 ug/m 3 To 5500 ug/m 3

Airborne Methamphetamine: Nazi Method Early Stages of the Process: 2. 4 ug/m 3 to 10. 1 ug/m 3

Airborne Methamphetamine: Nazi Method Salting Out Stage of the Process: 7. 6 ug/m 3 to >680 ug/m 3

Methamphetamine Surface Levels at Home • Horizontal Surfaces • 6 inches from cook – 87 ug/100 cm 2 • 72 inches from cook – 28 ug/100 cm 2 • Vertical Surfaces • 63 inches from cook – 20 ug/100 cm 2 • 113 inches from cook – 10 ug/100 cm 2 • Clothing • ND to 18 ug/wipe

Methamphetamine Surface Levels at Hotel • Vertical Surfaces • 36 inches from Cook – 130 ug/100 cm 2 • 88 inches from Cook – 120 ug/100 cm 2 • 146 inches from Cook – 30 ug/100 cm 2 • 200 inches from Cook – 11. 6 ug/100 cm 2 • Hallway 216 inches from Cook – 8 ug/100 cm 2 • Clothing Contamination • 1 ug/sample to 580 ug/sample • Highest during salting out • Higher in Red P Methodology

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.

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.

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.

Will Children be exposed?

Outer Layer of Bear – 3100 ug/100 cm 2 Inner Clothing – 2100 ug/100 cm 2

Implications to Children Associated with Methamphetamine Labs • All children will be exposed to methamphetamine. • • Touch Food Airborne Ingestion • Children may be exposed to levels of iodine, acid, ammonia, and phosphine that exceed occupational standards. • Children may be exposed to IDLH levels of hydrochloric acid anhydrous ammonia.

Decontamination

Decontamination • Thought out in advance. • • Hospital decon should be planned. What will happen to clothing? What about evidence shipment? Child friendly • Involve the least contact possible. • Hospital, ambulance, vehicles • Confine exposures to one area. • EMERGENCIES

How much contamination? • Red “P” Cook Meth Contamination • Cooking Phase – ND • Filtering Phase – ND – 580 ug/sample • Salting Out – ND – 10. 3 ug/sample • Anhydrous Ammonia Meth Contamination • All phases – ND – 58 ug/sample

Wet or Dry Decon • Wet decontamination may move contamination under suit. • Dry decon may allow better containment Study Results Pending

SUSPECTS 20 to 30 times above the 0. 5 ug/100 cm 2 reference.

SWAT • Gloves -. 93 ug • Hands -. 5 ug • Front – ND

Controlled “Smoke”

Study Process • Standard motel room • Did not inhale • Total amount: 2. 45 grams

0. 32 Stages: Pre 1/10 g 1/4 g 2. 0 g 0. 98 ug/100 cm 2 0. 04 Shower 0. 20 0. 10 0. 22 0. 32 4. 8 Smoke Stages Area 32 1. 50 12 17 Table 0. 04 22 0. 26 0. 50 A/C Heater 1. 90 8. 5

Controlled Smoke Findings • Airborne meth levels ranged from 330 ug/m 3 to 1600 ug/m 3. (Typical lab levels = 4000 – 5000 ug/m 3) • Surface areas throughout the room were contaminated with up to 35 ug/100 cm 2. (Typical lab levels range up to 2800 ug/100 cm 2) • These levels may be less due to inhalation.

Unanswered Questions • Acute and long-term health effects • Children • Law enforcement personnel • Decontamination Methodologies • Effectiveness of decontamination • Law enforcement, child protective services, emergency services personnel • Children, adults, and items in the building. • Education • Law enforcement • Medical Facilities • Child Protective Services