Characterization of Chemical Suicides in the United States and Its Adverse Impact on Responders and Bystanders.
BACKGROUND
A suicide trend that involves mixing household chemicals to produce hydrogen sulfide or hydrogen cyanide, commonly referred to as a detergent, hydrogen sulfide, or chemical suicide is a continuing problem in the United States (U.S.). Because there is not one database responsible for tracking chemical suicides, the actual number of incidents in the U.S. is unknown. To prevent morbidity and mortality associated with chemical suicides, it is important to characterize the incidents that have occurred in the U.S.


METHODS
The author analyzed data from 2011-2013 from state health departments participating in the Agency for Toxic Substances and Disease Registry's National Toxic Substance Incidents Program (NTSIP). NTSIP is a web-based chemical incident surveillance system that tracks the public health consequences (e.g., morbidity, mortality) from acute chemical releases. Reporting sources for NTSIP incidents typically include first responders, hospitals, state environmental agencies, and media outlets. To find chemical suicide incidents in NTSIP's database, the author queried open text fields in the comment, synopsis, and contributing factors variables for potential incidents.


RESULTS
Five of the nine states participating in NTSIP reported a total of 22 chemical suicide incidents or attempted suicides during 2011-2013. These states reported a total of 43 victims: 15 suicide victims who died, seven people who attempted suicide but survived, eight responders, and four employees working at a coroner's office; the remainder were members of the general public. None of the injured responders reported receiving HazMat technician-level training, and none had documented appropriate personal protective equipment.


CONCLUSIONS
Chemical suicides produce lethal gases that can pose a threat to responders and bystanders. Describing the characteristics of these incidents can help raise awareness among responders and the public about the dangers of chemical suicides. Along with increased awareness, education is also needed on how to protect themselves.
Agency for Toxic Substances and Disease Registry, Atlanta, Georgia.
Ayana R
AR
Anderson
D055884:Chemical Hazard Release / Q000401:mortality*; D060731:Emergency Responders; D015386:Hazardous Substances / Q000506:poisoning*; D006795:Household Products / Q000009:adverse effects*; D006801:Humans; D006862:Hydrogen Sulfide / Q000506:poisoning; D013405:Suicide; D014481:United States
D015386:Hazardous Substances; D006862:Hydrogen Sulfide