The Analysis of Blood in Cases of Suspected Solvent Abuse, with a Review of Results during the Period October 1977 to July 1979

Lush, M; Oliver, John S.; Watson, Joyce M.

doi:10.1007/978-1-4684-1478-3_35

Cited by 13 publications

(7 citation statements)

References 5 publications

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“…The whole-blood toluene concentrations attained in the specimens analysed (up to 33.4 mg 1-1) (Ramsey & Flanagan, 1982b) were generally similar to those reported by other groups (Lush, Oliver & Watson, 1980), although preliminary study of the data does not suggest a close correlation between blood concentration and clinical effect in this series. However, this may be due to variation in sampling time or other factors such as loss of toluene from blood specimens.…”

Section: Discussionsupporting

confidence: 88%

Suspected Solvent Abuse in Cases Referred to the Poisons Unit, Guy's Hospital, July 1980-June 1981

et al. 1982

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1 From July 1980 to June 1981, requests for information as to management or prognosis were received concerning 324 patients (219 male, 91 female) aged 3-31 y (median 15 y) in whom 'solvent abuse' was suspected. 2 The principal symptoms reported were unconsciousness (37), drowsiness (62), 'collapse' (7), convulsions (6), ataxia (35), chest pain (9), nausea/vomiting (20), renal impairment (3) and behavioural disturbances (84). At least 105 patients were admitted to hospital, and 1 was dead on arrival. 3 The products abused in 290 clinically diagnosed cases were: adhesives (214), correcting fluids (23), chlorinated solvents (17), fuel gases (18), petrol (5), BCF fire extinguishing agent (5) and others (17). The co-ingestion of alcohol or other drugs was suspected in only 27 cases. 4 Specimens of blood and/or urine were received for analysis from 117 patients. The clinical diagnosis of solvent abuse was confirmed in 71 cases and solvents were detected in 2 further instances. Ethanol/other drugs were detected in 18 instances, either together with solvent(s) (9) or alone (9), although no compounds were detected in the remaining 35 cases. 5 Toluene (and/or raised urinary hippurate/creatinine ratio) was detected in 52 of the analyses, 1,1,1-trichloroethane in 14 and trichloroethylene (and/or trichloroethanol) in 12. Ethanol was detected in 7 instances, and other drugs (principally benzodiazepines) in 13. 6 Although the presenting symptoms and outcome were usually unremarkable, these results emphasise that some patients can develop serious illness such as collapse or convulsions, which may prove fatal, while chronic solvent abuse can be associated with renal impairment.

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Section: Discussionsupporting

confidence: 88%

Suspected Solvent Abuse in Cases Referred to the Poisons Unit, Guy's Hospital, July 1980-June 1981

et al. 1982

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“…(1982) found that 71% of deaths directly attributable to VS abuse had been caused by aerosols, and less than one-quarter by toluene-containing adhesives. Similar findings have been reported by Watson (1979) and by Garriott & Petty (1980), while â€oe¿ sudden sniffing deathsâ€•caused by aerosol inhala tion combined with brief, vigorous exercise such as running have been reported by Bass (1970). The cause of death is thought to be cardiac arrhythmia, resulting from the action of catecholamines released during exercise on a myocardium sensitised by the freons used as aerosol propellants.…”

Section: Table I the Substances Abusedsupporting

confidence: 81%

Volatile Substance Abuse: A Review of Possible Long-Term Neurological, Intellectual and Psychiatric Sequelae

Ron

1986

Br J Psychiatry

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The possibility that chronic abuse of volatile substances can cause permanent neurological, psychiatric, and intellectual sequelae is critically reviewed. Toluene, present in the commonly used adhesives, is most often implicated in 'glue sniffing'; this review focuses on its potential long-term effects. Many criticisms--particularly poor matching of control samples and inability to distinguish between acute and chronic effects--can be levelled at the available studies, while no adequate follow-up studies have been performed. In the light of present knowledge, the possibility that permanent structural brain damage, with accompanying psychiatric manifestations, results from solvent abuse remains inconclusive.

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“…Baselt (9) reviewed toluene concentrations encountered in various populations, citing Lush (10) who reported that in a population of solvent abusers in Scotland, those with blood toluene concentrations of 0.4–1.0 mg/L had noticeable odors of solvents on their breath. Those with concentrations between 1.0 and 2.5 mg/L showed increasing signs of intoxication, and 50% of abusers with blood toluene concentrations between 2.5 and 10.0 mg/L were hospitalized, showing signs of marked intoxication, including hallucinations.…”

Section: Discussionmentioning

confidence: 99%

Toluene‐Impaired Drivers: Behavioral Observations, Impairment Assessment, and Toxicological Findings

Capron¹,

Logan²

2009

Journal of Forensic Sciences

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Toluene is an aromatic hydrocarbon solvent frequently abused for its euphoric and intoxicating properties. This report describes a series of six cases involving drivers arrested for driving under the influence who subsequently tested positive for toluene. Case data including driving behavior, physiological signs and symptoms, evidence of impairment, and toxicology findings were reviewed. Blood toluene concentrations in the drivers ranged from 12 to 45 mg/L (median 23 mg/L, mean 25 mg/L, SD 12.1 mg/L). All drivers were determined to be intoxicated, and displayed symptoms including balance problems, confusion and disorientation, loss of coordination, and inability to follow instructions. They also displayed horizontal but not vertical nystagmus, elevated pulse and blood pressure, and lower body temperature. These findings are consistent with prior reports that subjects with blood toluene concentrations above 10 mg/L are invariably under the influence and their driving skills are affected.

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The Analysis of Blood in Cases of Suspected Solvent Abuse, with a Review of Results during the Period October 1977 to July 1979

Cited by 13 publications

References 5 publications

Suspected Solvent Abuse in Cases Referred to the Poisons Unit, Guy's Hospital, July 1980-June 1981

Suspected Solvent Abuse in Cases Referred to the Poisons Unit, Guy's Hospital, July 1980-June 1981

Volatile Substance Abuse: A Review of Possible Long-Term Neurological, Intellectual and Psychiatric Sequelae

Toluene‐Impaired Drivers: Behavioral Observations, Impairment Assessment, and Toxicological Findings

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