Chemical Exposures Chemical Exposures Associated with Associated with

Methamphetamine Labs: Methamphetamine Labs: Implications for ChildrenImplications for Children

byby

John Martyny, Ph.D., CIHJohn Martyny, Ph.D., CIHNational Jewish Medical and Research National Jewish Medical and Research

CenterCenter

Methamphetamine Methamphetamine “Truisms”“Truisms”

• The chemicals used are just household chemicals The chemicals used are just household chemicals and will not hurt anyone.and will not hurt anyone.

• If it doesn’t hurt the cooks, it can’t hurt anyone If it doesn’t hurt the cooks, it can’t hurt anyone else.else.

• As long as you don’t smell a chemical odor, As long as you don’t smell a chemical odor, everything will be OK.everything will be OK.

• Exposures only last for a short time and therefore Exposures only last for a short time and therefore will not hurt anyone.will not hurt anyone.

• Exposures are usually below current standards Exposures are usually below current standards and do not present a hazard for anyone.and do not present a hazard for anyone.

What is a Meth Lab?What is a Meth Lab?

Is there a concern for Is there a concern for adults?adults?

• University of Washington StudiesUniversity of Washington Studies• 17% of law enforcement chemists report illness.17% of law enforcement chemists report illness.• Irritation symptoms occur in investigators that do Irritation symptoms occur in investigators that do

not wear proper PPE.not wear proper PPE.• Most symptoms occur in the processing phase.Most symptoms occur in the processing phase.

• Reported CasesReported Cases• Phosphine exposure in a law enforcement officerPhosphine exposure in a law enforcement officer• Skin and pulmonary irritation in law enforcement Skin and pulmonary irritation in law enforcement

officers.officers.

• Questionnaire ResultsQuestionnaire Results• 52% of officers attending training sessions reported 52% of officers attending training sessions reported

symptoms at previous laboratory investigations.symptoms at previous laboratory investigations.

What about kids?What about kids?

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

Meth Labs and ChildrenMeth Labs and Children• About About 30-35%30-35% of labs seized are residences of labs seized are residences

with childrenwith children• Elevated sensitivity in children: Elevated sensitivity in children:

– Physiologic statusPhysiologic status (higher rates of growth, (higher rates of growth, metabolism, respiration, and development) metabolism, respiration, and development)

– BehaviorsBehaviors (hand-to-mouth and increased contact (hand-to-mouth and increased contact with physical environment)with physical environment)

• 35% - 55%35% - 55% of children removed from meth of children removed from meth labs test positive for methlabs test positive for meth

• 10%10% of children removed from homes of of children removed from homes of heavy users test positive for methheavy users test positive for meth

The ProjectThe Project

Project SponsorsProject Sponsors

• Colorado Department of Public SafetyColorado Department of Public Safety• U.S. Dept. of JusticeU.S. Dept. of Justice• Colorado Methamphetamine ProgramColorado Methamphetamine Program

• Colorado Alliance for Drug Endangered Colorado Alliance for Drug Endangered ChildrenChildren

• National Institutes of Occupational Safety National Institutes of Occupational Safety and Health (NIOSH)and Health (NIOSH)

• North Metro Drug Task ForceNorth Metro Drug Task Force• Tri-County Health DepartmentTri-County Health Department• National Jewish Medical and Research National Jewish Medical and Research

CenterCenter

Pre-Sampling at Colorado Pre-Sampling at Colorado Springs Police DepartmentSprings Police Department

Meth Lab Responses - Meth Lab Responses - InactiveInactive

• Responded to suspected Responded to suspected clandestine laboratories.clandestine laboratories.

• Hotel RoomsHotel Rooms• HomesHomes• ApartmentsApartments• VehiclesVehicles• Mobile HomesMobile Homes

Red P Cook at a HomeRed P Cook at a Home

Red P Cook at a MotelRed P Cook at a Motel

The “Birch” or “Nazi” The “Birch” or “Nazi” MethodMethod

New Mexico Methamphetamine Cook

Nazi Lab in Dallas, TXNazi Lab in Dallas, TX

Results of Exposure StudyResults of Exposure Study

DefinitionsDefinitions• Threshold Limit Value (TLV)Threshold Limit Value (TLV)

• 8 hour time-weighted average (TWA)8 hour time-weighted average (TWA)• Occupational exposures onlyOccupational exposures only

• Ceiling ValueCeiling Value• A concentration that should not be A concentration that should not be

exceeded during any part of the working exceeded during any part of the working exposure.exposure.

• Short Term Exposure Limit (STEL)Short Term Exposure Limit (STEL)• Not to be exceeded for a 15 minute TWANot to be exceeded for a 15 minute TWA

• Immediately Dangerous to Life and Immediately Dangerous to Life and Health (IDLH)Health (IDLH)

Questions????Questions????

• Would you enter an area without Would you enter an area without PPE where a chemical was PPE where a chemical was reported to be at the TLV?reported to be at the TLV?

• Would you allow your children to Would you allow your children to enter an area where a chemical enter an area where a chemical was reported to be at the TLV?was reported to be at the TLV?

PhosphinePhosphine• SymptomsSymptoms

• Severe pulmonary irritantSevere pulmonary irritant• Nausea, vomiting, diarrhea, chest Nausea, vomiting, diarrhea, chest

tightness, cough, headache, may be tightness, cough, headache, may be caused by exposures as low as 10 ppmcaused by exposures as low as 10 ppm

• Pulmonary edema has caused death.Pulmonary edema has caused death.• Implicated in deaths at Meth Labs.Implicated in deaths at Meth Labs.

• Current Exposure StandardsCurrent Exposure Standards• TLV = 0.3 ppmTLV = 0.3 ppm• STEL = 1 ppmSTEL = 1 ppm• IDLH = 50 ppmIDLH = 50 ppm

• Invisible with slight fish or garlic Invisible with slight fish or garlic odor.odor.

Phosphine Exposure Phosphine Exposure LevelsLevels

• In Red “P” and Hypophosphorous cooks.In Red “P” and Hypophosphorous cooks.• Ranges from ND to 3.5 ppm (Ranges from ND to 3.5 ppm (10 x the TLV of 0.3 ppm10 x the TLV of 0.3 ppm))• In the area of the cook in a home it averaged 0.94 In the area of the cook in a home it averaged 0.94

ppm.ppm.

• Phosphine may be present in the “death Phosphine may be present in the “death bag” at high concentrations.bag” at high concentrations.

• The cook temperature and water content The cook temperature and water content may have a significant effect on the may have a significant effect on the amounts of phosphine generated.amounts of phosphine generated.

IodineIodine• Iodine – AirborneIodine – Airborne

• Irritant of the eyes, mucous membranes, Irritant of the eyes, mucous membranes, and skin.and skin.

• May cause chest tightness and difficulty May cause chest tightness and difficulty breathing.breathing.

• Levels of 1.63 ppm will cause eye Levels of 1.63 ppm will cause eye irritation in all exposed within 5 minutes.irritation in all exposed within 5 minutes.

• Skin rash due to hypersensitivity can Skin rash due to hypersensitivity can occur.occur.

• Current Exposure StandardsCurrent Exposure Standards• TLV = 0.1 ppm CeilingTLV = 0.1 ppm Ceiling• IDLH = 2 ppmIDLH = 2 ppm

Iodine Exposure LevelsIodine Exposure Levels

• Measured Exposure Range.Measured Exposure Range.• 0.23 ppm – 3.7 ppm (0.23 ppm – 3.7 ppm (almost 2x the IDLHalmost 2x the IDLH))

• Levels measured in the house cook.Levels measured in the house cook.• Cook area = 0.16 ppmCook area = 0.16 ppm• Down the hall = 0.04 ppmDown the hall = 0.04 ppm

• Levels measured in the hotel cookLevels measured in the hotel cook• 0.001 ppm – 0.05 ppm0.001 ppm – 0.05 ppm

0

0.5

1

1.5

2

2.5

3

3.5

4

Hallway Cook Area Cook Max.

IDLH

TLV

Iodine Exposure Levels

SolventsSolvents• Many different types of solvents can be Many different types of solvents can be

used.used.

• Symptoms will depend upon solvent type.Symptoms will depend upon solvent type.• Irritation, pulmonary edema, peripheral Irritation, pulmonary edema, peripheral

neuropathy, liver damage.neuropathy, liver damage.

• Explosion hazard may be a major concern.Explosion hazard may be a major concern.

• Current exposure levels depend on the Current exposure levels depend on the individual solvent.individual solvent.

• n-Hexane = 50 ppmn-Hexane = 50 ppm• Chloroform = 10 ppmChloroform = 10 ppm

Hydrochloric AcidHydrochloric Acid• Symptoms – AirborneSymptoms – Airborne

• Upper respiratory tract irritation – cough, Upper respiratory tract irritation – cough, burning throat, choking, burning eyes, chest burning throat, choking, burning eyes, chest pain.pain.

• Acute symptoms may occur as low as 5 ppm.Acute symptoms may occur as low as 5 ppm.• Skin contact may cause burns and ulceration.Skin contact may cause burns and ulceration.

• Current Exposure LevelsCurrent Exposure Levels• TLV = 2 ppm CeilingTLV = 2 ppm Ceiling• IDLH = 50 ppmIDLH = 50 ppm

• Colorless gas with pungent odor.Colorless gas with pungent odor.

Hydrogen Chloride Hydrogen Chloride Exposure LevelsExposure Levels

• Average exposures during entire cook Average exposures during entire cook period.period.

• 0.3 – 2.3 ppm (0.3 – 2.3 ppm (slightly above the 2 ppm TLVslightly above the 2 ppm TLV))

• Average exposure during salting out.Average exposure during salting out.• 3.8 – 7.2 ppm ( 3.8 – 7.2 ppm ( > 3 x the TLV> 3 x the TLV))

• Peak concentrations during salting out.Peak concentrations during salting out.• 60 ppm – 155 ppm ( 60 ppm – 155 ppm ( > 3 x the IDLH> 3 x the IDLH))

0

20

40

60

80

100

120

140

160

Cook SaltingOut

Avg. Peak Max.

IDLH

TLV

Hydrochloric Acid Levels

Anhydrous AmmoniaAnhydrous Ammonia• SymptomsSymptoms

• Severe irritant of the eyes, respiratory tract, and Severe irritant of the eyes, respiratory tract, and skin. skin.

• After 70 ppm, most individuals will report After 70 ppm, most individuals will report irritation.irritation.

• Levels over 2500 may cause corneal irritation, Levels over 2500 may cause corneal irritation, bronchospasm, chest pain, and pulmonary bronchospasm, chest pain, and pulmonary edema. Bronchitis and pneumonia may also edema. Bronchitis and pneumonia may also occur.occur.

• Tolerance may be acquired.Tolerance may be acquired.

• Current Exposure StandardsCurrent Exposure Standards• TLV = 25 ppmTLV = 25 ppm• STEL = 35 ppmSTEL = 35 ppm• IDLH = 300 ppmIDLH = 300 ppm

Anhydrous Ammonia Anhydrous Ammonia LevelsLevels

• All meters overloadedAll meters overloaded• Highest reading 3000 ppm (Highest reading 3000 ppm (10 x the 10 x the

IDLHIDLH))• Drager tube readings 500 ppm to 2000 Drager tube readings 500 ppm to 2000

ppmppm• Cook exposures range from 130 ppm to Cook exposures range from 130 ppm to

370 ppm (370 ppm (10 x the STEL10 x the STEL))• Exposures at the cook were 190 ppm Exposures at the cook were 190 ppm

and 410 ppm for a 2 hour periodand 410 ppm for a 2 hour period

Anhydrous Ammonia Levels

Dissipate quickly with

fan and ventilation

50-100 ppm in flow to fan

0200400600800

100012001400160018002000

Cook Area Cook Peak

IDLH

TLV

Anhydrous Ammonia Exposures

MethamphetamineMethamphetamine• SymptomsSymptoms

• Very little known regarding low level chronic Very little known regarding low level chronic exposures.exposures.

• Irritation of the skin, eyes, mucous membranes, and Irritation of the skin, eyes, mucous membranes, and upper respiratory tract.upper respiratory tract.

• High levels may cause dizziness, headache, metallic High levels may cause dizziness, headache, metallic taste, insomnia, high or low blood pressure, etc.taste, insomnia, high or low blood pressure, etc.

• Chronic exposures may cause irritability, personality Chronic exposures may cause irritability, personality changes, anxiety, hallucinations, psychotic behavior.changes, anxiety, hallucinations, psychotic behavior.

• Smaller infants, altered behavior patterns, lower IQ Smaller infants, altered behavior patterns, lower IQ scores, teratogenic affects, cerebral hemorrhage.scores, teratogenic affects, cerebral hemorrhage.

• Current StandardsCurrent Standards• NoneNone• Therapeutic dose = 5 mg (2 to 3 x per day)Therapeutic dose = 5 mg (2 to 3 x per day)• Surface contamination = 5 ug/100 cmSurface contamination = 5 ug/100 cm22 or ft or ft22

Methamphetamine Levels Methamphetamine Levels on Surfaceson Surfaces

• Ranged from non-detect to 16,000 ug/100cmRanged from non-detect to 16,000 ug/100cm22..

• Levels inside microwaves were high.Levels inside microwaves were high.

• Levels on air returns were elevated suggesting Levels on air returns were elevated suggesting airborne quantities.airborne quantities.

• Levels on flat surfaces in the lab area were Levels on flat surfaces in the lab area were very high.very high.

• Levels exceeding the standard were found in Levels exceeding the standard were found in every verified lab.every verified lab.

Surface Methamphetamine LevelsSurface Methamphetamine Levels

LocationLocation ug/100cmug/100cm22

Night StandNight Stand 28002800

Ceiling FanCeiling Fan 25002500

Microwave Microwave 24002400

Bath Exhaust GrillBath Exhaust Grill 16001600

MicrowaveMicrowave 17001700

Hotel TableHotel Table 920920

Kitchen StoveKitchen Stove 790790

FloorFloor 520520

Return Air VentReturn Air Vent 450450

Livingroom TableLivingroom Table 430430

Airborne Methamphetamine using Red P Method

4200 ug/m3

To

5500 ug/m3

Airborne Methamphetamine: Nazi Method

Early Stages of the

Process:

2.4 ug/m3 to

10.1 ug/m3

Airborne Methamphetamine: Nazi Method

Salting Out Stage of the

Process:

7.6 ug/m3 to >680 ug/m3

Methamphetamine Methamphetamine Surface Levels at HomeSurface Levels at Home

• Horizontal SurfacesHorizontal Surfaces• 6 inches from cook – 87 ug/100 cm6 inches from cook – 87 ug/100 cm22

• 72 inches from cook – 28 ug/100 cm72 inches from cook – 28 ug/100 cm22

• Vertical SurfacesVertical Surfaces• 63 inches from cook – 20 ug/100 cm63 inches from cook – 20 ug/100 cm22

• 113 inches from cook – 10 ug/100 cm113 inches from cook – 10 ug/100 cm22

• ClothingClothing• ND to 18 ug/wipeND to 18 ug/wipe

MethamphetamineMethamphetamine Surface Surface Levels at HotelLevels at Hotel

• Vertical SurfacesVertical Surfaces• 36 inches from Cook – 130 ug/100 cm36 inches from Cook – 130 ug/100 cm22

• 88 inches from Cook – 120 ug/100 cm88 inches from Cook – 120 ug/100 cm22

• 146 inches from Cook – 30 ug/100 cm146 inches from Cook – 30 ug/100 cm22

• 200 inches from Cook – 11.6 ug/100 cm200 inches from Cook – 11.6 ug/100 cm22

• Hallway 216 inches from Cook – 8 ug/100 Hallway 216 inches from Cook – 8 ug/100 cmcm22

• Clothing ContaminationClothing Contamination• 1 ug/sample to 580 ug/sample1 ug/sample to 580 ug/sample• Highest during salting outHighest during salting out• Higher in Red P MethodologyHigher in Red P Methodology

Exposure ConclusionsExposure Conclusions

• Exposures to iodine, phosphine, anhydrous Exposures to iodine, phosphine, anhydrous ammonia, and hydrochloric acid may exceed ammonia, and hydrochloric acid may exceed occupational standards.occupational standards.

• Hydrochloric acid, Iodine, and anhydrous Hydrochloric acid, Iodine, and anhydrous ammonia may exceed IDLH Levels.ammonia may exceed IDLH Levels.

• Significant amounts of airborne Significant amounts of airborne methamphetamine are released during the cook methamphetamine are released during the cook and deposited on both horizontal and vertical and deposited on both horizontal and vertical surfaces.surfaces.

Conclusions (cont)Conclusions (cont)

• Entering the cook area will contaminate Entering the cook area will contaminate clothing with methamphetamine and clothing with methamphetamine and other chemicals.other chemicals.

• The methamphetamine contamination The methamphetamine contamination may migrate inside of PPEmay migrate inside of PPE

• The entire area of the home is The entire area of the home is contaminated by the generated contaminated by the generated compounds.compounds.

How can I Protect Myself?How can I Protect Myself?• Wear the appropriate personal Wear the appropriate personal

protective equipment.protective equipment.• Initial entry – SCBA, Protective Clothing (fire and Initial entry – SCBA, Protective Clothing (fire and

chemical), Gloves, Boots.chemical), Gloves, Boots.• After stabilization – Air Supplied Respirators may After stabilization – Air Supplied Respirators may

be OK.be OK.

• Assume that everything in the building Assume that everything in the building is contaminated.is contaminated.

• Establish good decon procedures.Establish good decon procedures.

Will Children be exposed?Will Children be exposed?

Outer Layer of Bear – 3100 ug/100 cm2

Inner Clothing – 2100 ug/100 cm2

Implications to Children Associated Implications to Children Associated with Methamphetamine Labswith Methamphetamine Labs

• All children will be exposed to All children will be exposed to methamphetamine.methamphetamine.

• TouchTouch• FoodFood• AirborneAirborne• IngestionIngestion

• Children may be exposed to levels of Children may be exposed to levels of iodine, acid, ammonia, and phosphine that iodine, acid, ammonia, and phosphine that exceed occupational standards.exceed occupational standards.

• Children may be exposed to IDLH levels of Children may be exposed to IDLH levels of hydrochloric acid and anhydrous ammonia.hydrochloric acid and anhydrous ammonia.

DecontaminationDecontamination

DecontaminationDecontamination• Thought out in advance.Thought out in advance.

• Hospital decon should be planned.Hospital decon should be planned.• What will happen to clothing?What will happen to clothing?• What about evidence shipment?What about evidence shipment?• Child friendlyChild friendly

• Involve the least contact possible.Involve the least contact possible.• Hospital, ambulance, vehiclesHospital, ambulance, vehicles

• Confine exposures to one area.Confine exposures to one area.

• EMERGENCIESEMERGENCIES

How much contamination?How much contamination?

• Red “P” Cook Meth ContaminationRed “P” Cook Meth Contamination• Cooking Phase – NDCooking Phase – ND• Filtering Phase – ND – 580 ug/sampleFiltering Phase – ND – 580 ug/sample• Salting Out – ND – 10.3 ug/sampleSalting Out – ND – 10.3 ug/sample

• Anhydrous Ammonia Meth Anhydrous Ammonia Meth ContaminationContamination

• All phases – ND – 58 ug/sampleAll phases – ND – 58 ug/sample

Wet or Dry DeconWet or Dry Decon• Wet decontamination may move Wet decontamination may move

contamination under suit. contamination under suit. • Dry decon may allow better containmentDry decon may allow better containment

Study Results Pending

SUSPECTSSUSPECTS

20 to 30 times 20 to 30 times above the above the 0.5 0.5

ug/100cm2 ug/100cm2 reference.reference.

SWATSWAT

• Gloves - .93 ugGloves - .93 ug

• Hands - .5 ugHands - .5 ug

• Front – NDFront – ND

Controlled “Smoke”

Study ProcessStudy Process•Standard motel roomStandard motel room•Did not inhaleDid not inhale•Total amount: 2.45 gramsTotal amount: 2.45 grams

Stages

Shower

Smoke

Area

Table

A/C Heater

0.04

0.20

0.32

0.98

4.8

0.04

0.26

0.50

1.90

8.5

32

22

17

0.10

0.22

0.32

1.50

12

Stages:Pre

1/10g1/10g1/4g2.0g

ug/100cm2

Controlled Smoke FindingsControlled Smoke Findings

• Airborne meth levels ranged from 330 Airborne meth levels ranged from 330 ug/mug/m33 to 1600 ug/m to 1600 ug/m33. (. (Typical lab levels Typical lab levels = 4000 – 5000 ug/m= 4000 – 5000 ug/m33))

• Surface areas throughout the room were Surface areas throughout the room were contaminated with up to 35 ug/100 cmcontaminated with up to 35 ug/100 cm22. . ((Typical lab levels range up to 2800 Typical lab levels range up to 2800 ug/100 cmug/100 cm22))

• These levels may be less due to These levels may be less due to inhalation.inhalation.

Unanswered QuestionsUnanswered Questions

• Acute and long-term health effectsAcute and long-term health effects• ChildrenChildren• Law enforcement personnelLaw enforcement personnel

• Decontamination MethodologiesDecontamination Methodologies• Effectiveness of decontaminationEffectiveness of decontamination• Law enforcement, child protective services, Law enforcement, child protective services,

emergency services personnelemergency services personnel• Children, adults, and items in the building.Children, adults, and items in the building.

• EducationEducation• Law enforcement Law enforcement • Medical FacilitiesMedical Facilities• Child Protective ServicesChild Protective Services