Characteristics and circumstances of volatile solvent misuse-related death in Australia, 2000–2021

Abstract

Introduction

Volatile solvent misuse-related death is associated with neuropsychiatric, cardiovascular, respiratory and renal pathology, as well as sudden death. The study aimed to determine: (1) the circumstances of death and case characteristics of volatile solvent misuse-related death in Australia, 2000–2021; (2) the toxicological profile of cases; and (3) the major autopsy findings.

Methods

Retrospective study of volatile solvent misuse-related death in Australia, 2000–2021 retrieved from the National Coronial Information System.

Findings

One hundred and sixty-four cases were identified, 79.9% male, mean age 26.5 years (8.5% aged 40 years or older). Circumstances of death were unintentional toxicity (61.0%), unintentional asphyxia (20.1%), intentional self-harm (12.2%) and traumatic accident (6.7%). The most commonly reported acute presentation prior to death was sudden collapse (22 of 47 witnessed events). The most frequently used solvents at the fatal incident were gas fuels (35.4%), gasoline (petrol) (19.5%) adhesives/paints (19.5%), aerosol propellants (12.8%), and volatile anaesthetics (12.8%). The most commonly detected volatile substances were butane (40.7%), toluene (29.6%), and propane (25.9%). Cannabis was present in 27.6% and alcohol in 24.6%. The prevalence of acute pneumonia amongst autopsied cases was low (5.8%) which, together with reports of sudden collapse, suggests that in many cases, death was extremely rapid. There were low levels of major organ pathology.

Conclusions

While the average age of volatile solvent misuse-related death was in the mid-twenties, a substantial proportion occurred amongst people aged 40 years or older. Reflecting availability, gas fuels predominated. In many cases, death appeared to have been rapid.

Keywords:

• Volatile solvents
• mortality
• hydrocarbons
• nitrous oxide
• toxicology

Acknowledgements

The authors acknowledge the Victorian Department of Justice and Community Safety as the source organisation for the data presented here, and the National Coronial Information System as the data source. We would like to thank the staff at the National Coronial Information System.

Disclosure statement

AP has received untied educational grants from Seqirus and Mundipharma for post-marketing surveillance of pharmaceutical opioids. This organisation had no role in study design, analysis and reporting, and funding support was for work unrelated to this project. MF has received untied educational grants from Seqirus, Mundipharma and Indivior for post-marketing surveillance of pharmaceutical opioids. This organisation had no role in study design, analysis and reporting, and funding support was for work unrelated to this project. AP is funded by an NHMRC Investigator Fellowship.

Additional information

Funding

This work was funded by the National Drug & Alcohol Research Centre at the University of New South Wales. The National Drug & Alcohol Research Centre is supported by funding from the Australian Government.