title: Volatile substance misuse deaths in Washington State, 2003-2012.
abstract: BACKGROUND
  Volatile substance misuse (VSM - also known as huffing or sniffing) causes some deaths, but because there are no specific cause-of-death codes for VSM, these deaths are rarely tabulated.
  
  
  OBJECTIVE
  Count and describe VSM deaths occurring in Washington State during 2003-2012.
  
  
  METHODS
  We used the textual cause-of-death information on death certificates to count VSM-associated deaths that occurred in Washington State during 2003-2012. We extracted records that contained words suggesting either a method of inhalation or a substance commonly used for VSM, and reviewed those records to identify deaths on which the inhalation of a volatile substance was mentioned. We conducted a descriptive analysis of those deaths.
  
  
  RESULTS
  Fifty-six deaths involving VSM occurred in Washington State during 2003-2012. VSM deaths occurred primarily among adults age 20 and over (91%), males (88%), and whites (93%). Twelve different chemicals were associated with deaths, but 1 of them, difluoroethane, was named on 30 death certificates (54%), and its involvement increased during the study period. Gas duster products were named as the source of difluoroethane for 12 deaths; no source was named for the other 18 difluoroethane deaths.
  
  
  CONCLUSIONS
  Most VSM deaths occurred among white male adults, and gas duster products containing difluoroethane were the primary source of inhalants. Approaches to deter VSM, such as the addition of bitterants to gas dusters, should be explored.
authors.affiliation: Washington State Department of Health , Olympia, WA , USA.
authors.forename: Eric M
authors.initials: EM
authors.lastname: Ossiander
mesh_terms: D000328:Adult; D016739:Behavior, Addictive; D003644:Death Certificates; D005260:Female; D006801:Humans; D008297:Male; D012737:Sex Factors; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D055549:Volatile Organic Compounds / Q000506:poisoning*; D014861:Washington / Q000453:epidemiology
chemical_list: D055549:Volatile Organic Compounds
keywords: Difluoroethane; drug poisoning; huffing; volatile substance misuse