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N MAY 28, four children, ages 4 or “Nazi Method,” which uses ephe- phetamine and staying “high” brings
to 15, were placed in protective drine or pseudoephedrine, sodium or specific dangers to children in these
custody after police seized a lithium and anhydrous ammonia.1 environments. Decreased appetite and
methamphetamine manufacturing oper- Three basic categories of chemicals attentiveness of caretakers contributes
ation in the home of the children and are found at meth labs: solvents, caus- to neglect of children’s hygiene and
their two adult caretakers. HazMat team tics/irritants, and metals/salts. Solvents nutrition. Increased sexual arousal
members, dressed in protective gear, like acetone, freon, methanol, toluene, from meth use is associated with un-
entered the home to take samples of the trichloroethane, white gas, and xylene protected sex, pregnancy risk, spread
numerous unlabeled hazardous chemi- are ubiquitous in meth labs. They can be of STDs and sexual abuse of children
cals, many in open containers and in absorbed after ingestion, inhalation or present in the vicinity. Paranoia, agita-
easy reach of the children. The three dermal contact. Aspiration of small tion and rage put children at risk of
youngest children tested positive for quantities (<1 ml) can produce signifi- physical abuse, exposure to domestic
methamphetamine. This issue of the CD cant pneumonitis. CNS depression, violence, and deadly accidents due to
Summary reviews the problems faced by hepatotoxicity and renal toxicity mishaps with firearms and “booby
children in the environment of metham- (pyuria, hematuria, acute renal failure) traps” often present in meth labs.
phetamine production. have been described. Toluene, which is Children who inhabit homes with
METHAMPHETAMINE “LABS” volatile and heavier than air, can cause meth labs may inhale dangerous chemi-
The use and home manufacture of ventricular arrhythmias, respiratory cal fumes or second-hand methamphet-
methamphetamine is on the increase. depression and sudden death. amine smoke, or ingest toxic chemicals
The number of meth lab seizures in Caustics, including acids and alkalis, or illicit drugs (commonly excess meth-
Oregon increased from 67 in 1995 to cause chemical burns by direct contact amphetamine powder left on surfaces,
591 in 2001. The number of seized labs with the skin; by ingestion (oral burns; clothing or cooking utensils). They are
doubled in the US between 2000 and GI tract burns with pain, drooling, vom- at risk of chemical and thermal burns
2002. Methamphetamine, a sympatho- iting); and by inhalation (burns of eyes; from processing or easy access to chem-
mimetic drug, is currently an illicit respiratory tract irritation; pulmonary ical ingredients or wastes (often stored
“drug of choice” due to its ease of man- edema). Commonly used caustics are in pop bottles and open food containers
ufacture, comparatively low cost, 12- anhydrous ammonia, hydrochloric acid, or disposed of in bathtubs, sinks or
hour half-life, and the euphoria, energy, sodium hydroxide, sodium thiosulfate, toilets, or in the yard), or injury by
feelings of power, and sexual arousal and sulfuric acid (drain cleaner). discarded, contaminated needles.
that it produces. Metals and salts routinely found at Where testing has been done in Ore-
Those involved in the clandestine labs include iodine, red phosphorus, gon, one-third to one-half of the children
production (“cooking”) of methamphet- lithium and sodium metal. These can found in meth labs have tested positive
amine select from over 30 different cause multiorgan toxicity affecting for methamphetamine in their urine
chemicals, 10 of which are classified as gastrointestinal, renal, hematologic and because of accidental ingestion or pas-
“extremely hazardous.”1 Ephedrine or nervous systems. Skin burns, eye and sive inhalation of the drug. Appropriate
pseudoephedrine serves as the starting respiratory tract irritation, headache, testing of these children helps identify
point in a simple, highly volatile chemi- seizures and GI irritation are concerns. occult exposures in this environment.
cal reaction, in which strong acids, THE THREAT TO CHILDREN CLINICAL FINDINGS
iodine and red phosphorus are combined Between 2000 and 2002, the number Some poisoned children become
and heated. Sodium hydroxide (lye), of children present at seized labs has acutely ill after exposure to chemicals
solvents, and hydrogen chloride gas doubled,2,3 and Oregon was third in the or methamphetamine, but others show
complete the process. A potential by- nation for number of children (241) few overt signs of toxicity. Children
product, phosphine gas, is extremely found at methamphetamine labs during may present for medical care—but
flammable and explosive, and is a respi- 2001–2. without accurate histories. In one case
ratory tract irritant that causes peripher- Every aspect of methamphetamine series, pediatric patients with metham-
al vascular collapse, cardiac failure and manufacture, distribution and use poses phetamine poisoning experienced tachy-
pulmonary edema. Another common hazards to children. The preoccupation cardia, agitation, inconsolable crying,
method of production is the “dry cook” of users with manufacturing metham- irritability, and vomiting. The most
The CD Summary (ISSN 0744-7035) is published biweekly, free of CD SUMMARY PERIODICALS
charge, by the Oregon Dept. of Human Services, Office of Communicable
Disease and Epidemiology, 800 NE Oregon St., Portland, OR 97232 August 12, 2003 POSTAGE
Periodicals postage paid at Portland, Oregon.
Postmaster—send address changes to: Vol. 52, No. 16 PAID
CD Summary, 800 NE Oregon St., Suite 730, Portland, OR 97232 Portland, Oregon