title: Acute anhydrous ammonia injury from accidents during illicit methamphetamine production.
abstract: BACKGROUND
  Anhydrous ammonia (AA), a chemical commonly used in agriculture, is a key component in illicit methamphetamine production. Although injuries associated with AA exposure are well studied, AA injuries associated with incidents during illicit methamphetamine production have not been adequately described in the literature.
  
  
  OBJECTIVE
  This study better characterizes AA injuries occurring in an agricultural region where illicit methamphetamine production is common.
  
  
  METHODS
  We performed a cross-sectional study based on a chart review of 49 patients who were admitted to a tertiary hospital in Illinois with known or suspected exposures to chemical agents. Indices of morbidity were compared between injuries resulting from exposure to AA and injuries from other chemicals, and between AA injuries from incidents during illicit methamphetamine production and AA injuries from other causes.
  
  
  RESULTS
  AA was the most common cause of chemical injury (41%; n=20/49). Incidents during illicit methamphetamine production were the most common cause of AA injury (75%; n=15/20). AA injury was associated with significantly greater morbidity compared to non-AA chemical injury. In addition, methamphetamine-related AA injury was associated with significantly greater morbidity compared to non-methamphetamine-related AA injury.
  
  
  CONCLUSIONS
  Chemical burns during illicit methamphetamine production were the most common cause of both chemical and AA-related injury in our agricultural population and these injuries were associated with greater morbidity during hospitalization.
authors.affiliation: Department of Emergency Medicine, York Hospital, York, PA, USA.
authors.forename: Glenn R
authors.initials: GR
authors.lastname: Bloom
authors.forename: Faten
authors.initials: F
authors.lastname: Suhail
authors.forename: Patricia
authors.initials: P
authors.lastname: Hopkins-Price
authors.forename: Akshay
authors.initials: A
authors.lastname: Sood
mesh_terms: D000062:Accidents, Occupational; D000328:Adult; D000383:Agriculture; D000641:Ammonia / Q000009:adverse effects*; D002057:Burns, Chemical / Q000209:etiology*; D002059:Burns, Inhalation / Q000209:etiology; D000697:Central Nervous System Stimulants / Q000138:chemical synthesis*; D003430:Cross-Sectional Studies; D005126:Eye Burns / Q000139:chemically induced; D005260:Female; D006801:Humans; D013287:Illicit Drugs / Q000138:chemical synthesis*; D008297:Male; D008694:Methamphetamine / Q000138:chemical synthesis*; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D000697:Central Nervous System Stimulants; D013287:Illicit Drugs; D008694:Methamphetamine; D000641:Ammonia