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The
Methamphetamine Problem:
A
Health & Safety Overview for Fire Fighters
Background1-5
Methamphetamine and amphetamine-like
compounds date back
nearly 100 years. In 1919, a Japanese pharmacologist first synthesized
methamphetamines. However, the abuse of methamphetamine became apparent
during the 1930’s due to the stimulant, euphoric, and
anorexic properties of the drug. During World War II, the drug was
commonly used to increase wakefulness and attention. In fact, the
Nazi’s developed a method of methamphetamine production
called the Nazi Method that is still commonly used today in clandestine
labs.
Until recently, most of the methamphetamine
production
occurred in Hawaii and other western states, such as California. Within
the last decade there has been a rapid expansion of clandestine
laboratories toward the east, but more prominent in the mid-west and
especially in rural areas. For example, in Colorado, there were 31
clandestine lab seizures in 1998 and 455 seizures in 2001. Rural areas
provide an ideal site for methamphetamine labs given the wide, open
spaces, easy accessibility to ingredients such as anhydrous ammonia,
and the small and usually understaffed law enforcement in these areas.
This movement towards the east and in rural
areas has created
some problems for all first responders. Many of these small clandestine
labs are run by inexperienced individuals who do not have any knowledge
of the safety hazards associated with the chemicals being used in the
production of methamphetamines. The end result is a number of injuries,
fires, and uncontrolled dumping of waste materials. To make matters
worse, many times fire fighters responding to fires or accidents are
unaware that the site is a clandestine laboratory and structural fire
fighting gear is not designed to provide adequate protection. Thus,
these individuals are exposed to a number of chemical, physical,
biological, and environmental hazards.
The purpose of this document is to give an
overview of some of
the health and safety issues associated with clandestine drug labs.
This is accomplished by discussing a number of different topics: the
various methamphetamine production methods; the chemicals used, their
sources, and some of their individual hazards; physical and biological
hazards; acute and chronic health effects; and finally a review of
controlled clandestine laboratory experiment by the Colorado Springs
Police Department.
Methamphetamine
Production Laboratories2-3, 5-10
There are two types of methamphetamine
production
laboratories: "super labs" and "mom and pop" labs. Super labs are
typically found in California and Mexico and have the capability to
produce 10 to 20 pounds of methamphetamine at a time. The product is
usually sold in large metropolitan areas such as Los Angeles, San
Diego, Phoenix, and San Francisco. "Beavis and Butthead" is an
alternative name given to "mom and pop" labs since the term best
describes the individuals operating in these methamphetamine
laboratories. All jokes aside, these labs are the most problematic.
Operators of these small clandestine labs often obtain methamphetamine
recipes from the Internet or even fellow-inmates while incarcerated.
The labs are constructed with everyday household items such as mason
jars, stove burners, plastic tubing, tape, etc. Furthermore, chemicals
used in the production process are often stored in inappropriate
containers that can lead to accidents. It is not uncommon to have acid
stored in two-liter soda bottles or anhydrous ammonia stored in propane
or butane tanks which are not appropriate storage containers for these
chemicals and therefore pose hazards to anyone in the area.
Methamphetamines can be produced by three
different methods,
each with their own inherent hazards: P2P, Ammonia lab, and Red
Phosphorus lab
P2P Lab:
Also known as Phenyl-2-Propanone (P2P) or
"Biker" lab
P2P is reduced in a chemical process using
methylamine and
mercuric chloride to form a mixture of d- and l-methamphetamine
Hazards: Severe eye and
skin irritation can
occur from the methylamine, which can lead to blindness. Mercuric
chloride is highly toxic
This production method is less common today
due to the
restriction of phenyl acetic acid and because the end product is not as
pure as the other methods and there are significant side-effects that
can result from consumption of the methamphetamine that is produced
using this method
Ammonia Lab:
Also known as "Nazi" or "Sodium Metal" lab
Ephedrine or Pseudoephedrine is reduced in a
chemical process
using anhydrous ammonia and lithium or sodium metal to form
d-methamphetamine
Hazards: Anhydrous ammonia
is stored as a
compressed liquid, but it will rapidly expand upon
release creating a toxic environment, which can be fatal at high
concentration. Often, anhydrous ammonia is stolen from farms and stored
in containers, such as propane tanks, that are not approved for storage
of this agent. As a result, there have been a number of accidents where
anhydrous ammonia is released into the atmosphere causing severe
respiratory problems to both methamphetamine lab workers and first
responders. Ammonia can also cause eye/nose/throat irritation,
shortness of breath, wheezing, chest pain, pulmonary edema, pink frothy
sputum, skin burns, and frost bite. Lithium reacts violently with water
creating a fire and explosion hazard. Lithium is caustic to body tissue.
Red Phosphorus:
Also known as "Red P", "Tweeker" or "Mexican
National" lab
Ephedrine or Pseudoephedrine is reduced in a
chemical process
using red phosphorus and hydriodic acid to form d-methamphetamine
Hazards: Red phosphorus is
highly unstable:
slight friction will cause ignition and deadly phosphine gas can be
produced if overheated. Symptoms can include: shortness of breath,
headache, double vision, tremor, jaundice, and pulmonary edema. Lung
toxicity can occur immediately or can even be delayed for 18 hours or
more.
There are a number of other chemicals used in
the production
of methamphetamines, but these items cannot be purchased in their
natural form. Thus, many automotive and/or household chemicals are used
as sources of substitution:
Acetone: fingernail polish
remover
Methanol: brake cleaner
fluid
Benzene: varnishes,
lacquers
Ether: starter fluid
Hydriodic acid: driveway
cleaner
Iodine crystals:
antiseptics
Lithium metal: lithium
batteries
Muriatic acid: swimming
pool cleaner
Sodium hydroxide: drain
cleaners, lye
Sulfuric acid: battery acid
Toluene: paint thinners
Note: It is not
important to know each of the individual chemicals or the different
types of methamphetamine production process used, but understand that
the process has a number of dangerous hazards. The chemicals used,
whether alone or in combination, can cause serious health problems and
are considered fire and explosion hazards. In addition, clandestine
labs are considered hazardous waste sites and should be managed by
hazmat trained individuals to clear the site according to appropriate
safety standards such as OSHA’s 29 CFR 1910.120.
Physical
& Biological Hazards5, 11-12
In the early stages of methamphetamine abuse,
users quickly
become addicted to the euphoric feeling and from the vast amount of
energy they have from using the drug. However, chronic use leads to
multiple medical problems including paranoia. It is not uncommon for a
user in a paranoid state to create a number of physical hazards, such
as booby traps, that are potentially lethal to unsuspecting individuals
including fire fighters. The purpose of these traps is to destroy
evidence and discourage entry by injury or killing. Common traps
include: animal traps, trip wires, grenades in lamp sockets, C-4
plastic explosives in VCR’s, light-bulbs filled with
gasoline, or buried planks with protruding nails or spikes. Another
hazard is "Mini-bombs", which consist of explosives wrapped in foil.
They are very sensitive to heat, shock, and friction and people have
been known to lose fingers or have been seriously injured while trying
to dismantle these bombs.
Clandestine labs can also pose a biological
hazard to fire
fighters and other first responders. A commonly used route of ingestion
of methamphetamine is through injection, especially in major
metropolitan areas. In fact, injection of methamphetamine has led to
lowered inhibition and the resurgence of HIV/AIDS in San Francisco.
Clandestine lab cooks frequently operate in squalid living conditions,
which can include leaving needles lying around the lab. This can
increase the risk of needle sticks to fire fighters, thus exposing them
to infectious diseases such as HIV or Hepatitis C. EMT’s also
risk exposure to these infectious agents via accidental needle stick or
though blood exposure while trying to tend to an injured lab cook.
Acute
& Chronic Health Effects10, 13-14
Whether a clandestine methamphetamine lab is
encountered
incidentally or a planned lab invasion occurs, the health effects from
these events are usually acute in nature. Some of the health effects
from chemical exposure are described earlier in the "Methamphetamine
Laboratory Production" methods section of this document. These
chemicals most commonly affect the upper and lower airways. Symptoms
can include coughing, throat irritation, or difficulty breathing.
However, exposure can be much more serious, causing pulmonary edema or
chemical pneumonitis. As mentioned earlier, lung injury may present
early after exposure or maybe delayed for 18 hours or more. Other
symptoms of acute exposure can include eye irritation, nausea or
vomiting, or dizziness or lack of coordination.
Since the rapid spread of methamphetamines
across the U.S. is
a relatively recent event, not much is known about the long-term health
effects fire fighters may develop from dealing with these
methamphetamine laboratories. However, an article titled "Medical
Surveillance of Clandestine Drug Laboratory Investigators" was
published in the Journal of Occupational &
Environmental Medicine that describes some long-term health
effects from exposures from these labs. The authors of the study found,
during spirometry evaluations, there was a significant reduction in the
forced expiratory volume (FEV1) in those study
participants who had longer duration of exposure without respiratory
protection. Furthermore, there was a less rapid rate of decline in FEV1
with the use of respiratory protection.
Colorado
Springs Police Department Clandestine Drug Experiment3
To
better
understand the potential level of exposure that fire fighters may
encounter in clandestine methamphetamine laboratories, we will discuss
the findings of a study conducted by the Colorado Springs Police
Department. In their study, they established methamphetamine labs and
produced methamphetamine under controlled conditions in the following
settings: the police department laboratory and in abandoned house and
motel. Furthermore, they analyzed 16 actual clandestine laboratories.
Departmental Lab Results:
Methamphetamine
production occurred under lab hoods and air and wipe samples were taken
to represent a worst case scenario under these controlled conditions
Air
sample
findings revealed hydrogen chloride and iodine levels were much higher
than the American Conference of Government Industrial Hygienists
(ACGIH) threshold limit values (TLV)
Wipe
sample
findings revealed methamphetamine levels on surfaces were much higher
than the state standard.
The
main point
of this study is that despite controlled conditions under a laboratory
hood with adequate ventilation, the levels of hydrogen chloride,
iodine, and methamphetamine were much higher than threshold limit
values and state standards.
Abandoned House Results:
This
experiment was established to determine the likely exposures during the
cook itself. The same equipment that would normally be used by a
clandestine lab cook was utilized, but less than normal amounts of
methamphetamine were produced
Air
and wipe
samples were taken in close proximity of the cook, away from the cook
(10-15 feet), and in the cook’s breathing zone
When
using the
"Red P" method, phosphine, iodine, and hydrogen chloride levels were
particularly high
Wipe
samples
revealed levels of methamphetamine on surfaces were much higher than
TLV’s
The
main point
of this study was that despite the small amount of methamphetamine
produced in this experiment, high levels were detected in the areas
surrounding the cook. It is believed that these agents are spread
through aerosolization
Abandoned Motel Results:
In
this
experiment, a chemist from the U.S. DEA conducted the cook. The
production process was closely monitored and more water was used in the
experiment. With this controlled environment, exposures were expected
to be much lower than previous controlled cooks.
Air
samples
revealed phosphine and hydrochloric acid levels exceeded ACGIH
TLV’s. On a more serious note, samples taken close to the
cook revealed that hydrochloric acid levels were well above the NIOSH
IDLH (Immediately Dangerous to Life & Health) levels
Wipe
samples
revealed methamphetamine levels were above TLV’s as far away
as 20 feet from the cook. Items, such as a child’s toy,
contained high pH levels, which is due to the presence of acid and/or
methamphetamine. Interestingly, methamphetamine levels were still
detectible on wipe samples taken from the hands of personnel and their
PPE after decontamination
The
main point
of this experiment is that even with a full scale methamphetamine
production (unlike the previous two experiments) under controlled
conditions and with additional water incorporated into the cook,
exposure levels were significantly elevated.
Actual Clandestine Drug Lab Results:
Part
of the
experiment conducted by the Colorado Springs Police Department included
air and wipe samples of 16 clandestine drug labs.
Although
none
of the labs were actively producing methamphetamine at the time of
analysis, methamphetamine residue was present throughout the structures
in high levels including areas such as tables, air return grates,
ceiling fans, refrigerators, and kitchen appliances. In fact,
methamphetamine levels were at extremely high levels throughout a hotel
room in which a clandestine lab exploded
The
main point
of this analysis was to illustrate that in uncontrolled conditions,
unlike the controlled environment in the previous three experiments,
exposures to various chemicals and methamphetamine is widespread and
can be at much higher levels
Colorado
Springs Police Department Experiments—Take Home Points:
Anyone
encountering a clandestine methamphetamine laboratory can have multiple
exposures at varying levels. In this series of experiments, levels of
phosphine, hydrogen chloride, iodine, and methamphetamine levels were
often well above threshold limit values.
Exposure
is
dependent upon whether the laboratory is active at the time of
encounter and the type of production process being used. Unfortunately,
fire fighters will not likely know if the lab is active at the time,
nor the production process being used.
The
recommended protection against the potential exposures in clandestine
drug labs includes total skin protection and the highest respiratory
protection available. This includes chemical resistant clothing, boots,
and gloves and SCBA.
References:
Derlet, R. et
al. "Toxicity,
Methamphetamines". April 29, 2005. Retrieved from
www.emedicine.com/emerg/topic859.htm on 10/13/05
Kraman,
Pilar. "Drug Abuse in
America—Rural Meth". Trends Alert. The Council of State
Governments. Retrieved from
www.csg.org on 9/21/2005.
Martyny, JW,
et al. "Chemical
Exposures Associated with Clandestine Methamphetamine Laboratories".
Retrieved from
www.nationaljewish.org/pdf/chemical_exposures.pdf on
9/21/2005.
"Anhydrous
Ammonia Theft".
U.S. Environmental Protection Agency. Office of Solid Waste and
Emergency Response. Retrieved from www.epa.gov/ceppo
on 9/21/2005.
"Clandestine
Drug Operations:
Awareness and Safety". Alberta Municipal Affairs. Retrieved from
www.municipalaffairs.gov.ab.ca/mahome/fco/pdf/AB-clan6-1.pdf
on 9/28/2005
"Houston Fire
Department
Continuing Education: Clandestine Drug Labs". Retrieved from
www.houstontx.gov/fire/firefighterinfo/ce/2001/February/Feb01CE.htm
on 9/14/2005
Scott, M.
"COPS: Clandestine
Drug Labs". Community Oriented Policing Service: Problem-Oriented
Guides for Police Series. No. 16. U.S. Department of Justice. Retrieved
from
www.cops.usdoj.gov/mime/open.pdf?Item=274 on 9/21/2005
"Hazards of
Methamphetamine
Production". Washington State Department of Health. Division of
Environmental Health. Retrieved from
www.doh.wa.gov/ehp/ts/CDL/methhazards.htm on 9/14/2005
"Anhydrous
Ammonia Thefts and
Releases Associated with Illicit Methamphetamine
Productions—16 States, January 2000-June2004". MMWR Weekly.
April 15, 2005. Retrieved from
www.cdc.gov/mmwr/preview/mmwrhtml/mm5414a4.htm on 9/14/2005
"Methamphetamine
Laboratory
Identification and Hazards". National Drug Intelligence Center.
Retrieved from
www.usdoj.gov/ndic/pubs7/7341/index.htm on 9/14/2005
"Methamphetamine:
A Growing
Domestic Threat". DEA Publications. U.S. Department of Justice.
Retrieved from
www.fas.org/irp/agency/doj/dea/product/meth/threat.htm on
9/14/2005
"Environmental
Impacts of
Methamphetamine". Retrieved from
www.dea.gov/concern/meth_environment.html on 9/14/2005
"Public
Health Consequences
Among First Responders to Emergency Events Associated with Illicit
Methamphetamine Laboratories—Selected States, 1996--1999".
MMWR Weekly. November 17, 2000. Retrieved from
www.cdc.gov/mmwr/preview/mmwrhtml/mm4945a1.htm on 9/14/2005
Burgess. JL,
et al. "Medical
Surveillance of Clandestine Drug Laboratory Investigators". Journal
of Occupational & Environmental Medicine. Vol. 44,
No. 2. February 2002.
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