Prevalence and medical risks of body packing in the Amsterdam area.
OBJECTIVE
Body packing is a way to deliver packets of drugs across international borders by ingestion. The aim of the study was to provide an estimate of the medical risks of body packing, describe predictors for hospital referral in detained body packers and provide an estimate for the prevalence of body packing in the Amsterdam area.


METHODS
From May 2007 to December 2008, we studied medical records of body packers immediately detained after arrival at Amsterdam Schiphol airport, hospital records of both detained body packers and self-referrers at two emergency departments of hospitals in Amsterdam and records kept by forensic physicians in charge of post-mortem examinations of all unnatural deaths in the area (years 2005-2009).


RESULTS
In airport detainees, the hospital referral rate was 4.2% (30 out of 707 detained body packers), the surgery rate was 1.3%. Significant predictors of hospital referral were delayed production of drug packets after arrest, cigarette smoking and country of departure. The surgery rate in self-referrers was comparable to the rate observed in those referred from the detention centre to hospital (30% vs. 31%). In addition, from 2005 to 2009, 20 proven cases of lethal body packing were identified. Based on our data, it is estimated that minimally 38% of all incoming body packers were missed by airport controls.


CONCLUSIONS
The risk for lethal complications due to body packing is low on a population basis and comparable to other studies. This also applies for the hospital referral and surgery rates found in this study. Cigarette smoking has not yet been described in the literature as a potential predictor for hospital referral in detained body packers and therefore deserves attention in future research. A substantial fraction of body packers manages to remain undiscovered.
Department of Epidemiology, Documentation and Health Promotion, Public Health Service Amsterdam, P.O. Box 2200, 1000 CE Amsterdam, The Netherlands. tdorn@ggd.amsterdam.nl
Tina
T
Dorn
Manon
M
Ceelen
Koos J C
KJ
de Keijzer
Marcel C A
MC
Buster
Jan S K
JS
Luitse
Edwin
E
Vandewalle
Henk J
HJ
Brouwer
Kees
K
Das
D000328:Adult; D059028:Airports; D003415:Crime; D004636:Emergency Service, Hospital; D005260:Female; D005547:Foreign Bodies; D049429:Forensic Pathology; D053593:Forensic Toxicology; D006801:Humans; D013287:Illicit Drugs / Q000506:poisoning; D007415:Intestinal Obstruction / Q000209:etiology; D008297:Male; D009426:Netherlands; D011329:Prisoners; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012907:Smoking / Q000453:epidemiology; D013270:Stomach; D014195:Travel
D013287:Illicit Drugs