Elevated Serum Creatine Kinase (CK-MM) in Petrol Sniffers Using Leaded or Unleaded Fuel

Abstract

This study examined blood lead and creatine kinase levels in a group of 24 Australian Aboriginal males admitted to the hospital for treatment of severe petrol sniffing related illness after using only leaded petrol and 27 sniffers, 16 ex-sniffers and 13 non-sniffers from an isolated Aboriginal community using only unleaded petrol. Creatine kinase levels (which were nearly all creatine kinase-skeletal muscle isoenzyme indicating skeletal muscle damage) were correlated with blood lead levels and were elevated in active sniffers of leaded petrol on admission to hospital but were also increased in those sniffing unleaded petrol in the remote community. After fourteen days in hospital, median creatine kinase levels of leaded petrol sniffers dropped rapidly to levels similar to those of ex-sniffers and non-sniffers while median blood lead levels decreased but still remained higher than the other three groups. The data suggest that elevated creatine kinase associated with petrol sniffing may be due to compounds in petrol other than the lead additives, possibly volatile hydrocarbon components. Elevated creatine kinase may be useful in detecting current petrol sniffing activity, particularly in locations using unleaded petrol.

Adolescent inhalant abuse leads to other drug use and impaired growth; implications for diagnosis

“…Data collection methods have been previously described in detail, 9,12,17 but are summarised here and discussed in the following paragraphs. Data collection methods have been previously described in detail, 9,12,17 but are summarised here and discussed in the following paragraphs.…”

“…This study retrospectively analysed an historical dataset, collected with the aim of investigating the social and neurological outcomes of adolescent inhalant abuse in Indigenous populations. Data collection methods have been previously described in detail, 9,12,17 but are summarised here and discussed in the following paragraphs. Data was collected from two remote Indigenous communities, where petrol sniffing had been prevalent for many years.…”

“…9 However, the relevance of creatine kinase to inhalants other than petrol is unknown. In this study, 73.5% of the petrol sniffing individuals had a zero reading of serum toluene within 12 hours of petrol sniffing.…”

“…Therefore, the first level of recognition of inhalant abuse often relies on a high index of suspicion from parents/guardians, teachers or health care workers before referral to an appropriate health professional can occur, which makes diagnosis problematic. 9 For most users, the pattern of inhalant abuse is chronic but intermittent, 10 which highlights the need for diagnostic markers that are more responsive to sustained use. 7 Toluene is the primary volatile solvent in abused products, and therefore serum toluene can be used as an acute diagnostic test.…”

“…8 As creatine kinase is elevated in response to petrol sniffing it has also been suggested as a potential diagnostic tool, though its relevance to inhalants other than petrol remains unknown. 9 For most users, the pattern of inhalant abuse is chronic but intermittent, 10 which highlights the need for diagnostic markers that are more responsive to sustained use. Chronic inhalant abuse is associated with long-term health and psychological harm including increased use of other drugs, 11 cognitive decline and brain injury 12 and adverse psychological consequences including suicide.…”