Clinical toxicology of exposures to chemicals from clandestine drug laboratories: a literature review

Figures & data

Table 1. Chemicals and their routes of exposure as mentioned in case reports and surveillance studies on exposures to chemicals from clandestine drug laboratories.

Chemical	Mode of action	Route of exposure	Reference
Irritating gases with systemic effects
Hydrogen sulfide	Blockage cytochrome c oxidase Neuronal inhibition Local (lung)irritation	Inhalation	[44]
Phosphine	Blockage cytochrome c oxidase (Lung)tissue damage	Inhalation	[20,22,23]
Solvents
Acetone	CNS depressant Local irritation	Inhalation, eye, skin	[35]
Methanol	CNS depressant Neurotoxic Acid/base disturbances Nephrotoxic	Inhalation	[40,41]
Naphta	CNS depressant Neurotoxic Local irritation	Inhalation	[15]
Toluene	CNS depressant Neurotoxic Local irritation	Inhalation, eye, skin	[15]
Solvent (undefined)		Inhalation, eye, skin	[35]
Caustic chemicals
Anhydrous ammonia	Alkaline chemical	Inhalation, eye, skin	[10–12,15–19]
Hydrochloric acid	Acidic chemical	Inhalation, eye, skin	[10,11,35]
Iodine	Oxidizing chemical	Inhalation	[15]
Lye	Alkaline chemical	Eye, skin	[15,17]
Sodium hydroxide	Alkaline chemical	Inhalation, eye, skin	[10,35]
Sulfuric acid	Acidic chemical	Skin, ingestion	[32,33]
Acid (not specified)	Acidic chemical	Inhalation, eye, skin	[35]
Alkali (not specified)	Alkaline chemical	Eye	[17]
CNS stimulating chemicals
Ephedrine	Sympathomimetic	Inhalation	[15]
Metamfetamine	Sympathomimetic	Inhalation, eye, skin, ingestion	[26,39]

Table 2. Frequencies of symptoms observed in surveillance studies of exposures to chemicals from drug laboratories.

		respiratory														skin		eye			gastrointestinal				systemic				chemicals involved
Reference	number of subjects	irritation	dyspnea	throat irritation	cough	nasal irritation	chest pain	lung damage	injury	wheezing	chest cold	bronchitis	pneumonia	emphysema	respiratory symptoms	irritation	burns	irritation	burns	injury	nausea	vomitting	abdominal pain	gastrointestinal problems	dizzines /cns	headache	tachycardia	dead
Cooper et al. [10]	155	60	10													1	3	12			9				10	3			anhydrous ammonia, hydrochloric acid, sodium hydroxide
Cooper et al. [11]	947	531																109	104							348		9	ammonia (16% of meth events), meth chemicals (not otherwise specified, 13%) hydrochloric acid (8%)
Arant et al. [12]	85	68																19											anhydrous ammonia
Melnikova et al. [13]	902	485	18													32		99	139					75	67	307		18	not specified
Melnikova et al. [14]	162								72							17	44	35						11	9	11		2	not specified
Bloom et al. [19]	15								15											10									anhydrous ammonia
Thrasher et al. [24]	198		36	40	24	21										15		39	7		52				22	70			ammonia, methamfetamine
Burgess et al. [29]	59		4	12	7	8	2	1								3		3			1		2		3	12			not specified
Burgess et al. [30]	40		6		5					6	4	3	3	1															not specified
Witter et al. [30]	240			95			18								102	59				71				22	76	131	19		not specified
sum	2803	1144	74	147	36	29	20	1	87	6	4	3	3	1	102	127	47	316	250	81	62	0	2	108	187	882	19	29
total per respiratory, skin, eye, gastrointestinal, systemic or dead		1657 59%														174 6%		647 23%			172 6%					1088 39%		29 1%

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