Hydrogen Sulfide Risk to EMS Providers

Hydrogen Sulfide Suicides a New Concern for Canadian Police

By Sgt. Larry Burden

Royal Canadian Mounted Police

©2012

Let’s consider this scenario, you are dispatched to a scene where an unconscious person is slumped over the steering wheel of a car, you open the door to check on the victim and then you notice a bucket on the floor filled with what appears to be powdered chemicals and you smell rotten eggs… What you didn’t know was that this was a suicide and the method chosen was Hydrogen Sulfide gas and you may have taken the last breath you will ever breathe!

Most suicide methods pose little threat to first responders, but we are now faced with an alarming new trend that can quickly kill a police officer or EMT who unknowingly opens a door to a vehicle, or an apartment filled with Hydrogen Sulfide gas (H2S)!

This deadly gas is well known in other industries such as sewer maintenance, natural gas wells and even farming and aquaculture, but few Canadian police officers outside of Alberta are aware of the occupational hazards of working around Hydrogen Sulfide.  This gas is so dangerous that industries that deal with it, have mandatory occupational training in this field, but until relatively recently it has not been the kind of thing that first responders to sudden deaths have had to contend with. The RCMP in the New Brunswick recently responded to the Provinces first H2S Suicide (the second known in Canada) and fortunately the victim posted warning signs on the vehicle advising anyone who approached the car that there was poisonous gas present and to contact Hazmat. Had the victim not posted these signs the citizen who discovered the vehicle and the first police officer on the scene could have been seriously injured or even killed by inhaling the gas had they opened the vehicle.  If you Google Hydrogen Sulfide suicide or go on YouTube you will find plenty of information about this new method of committing suicide. You will find videos on how to make H2S along with postings of suicidal people asking how they can kill themselves this way. Sadly there are posts from people telling them how to do it! Several online articles describe how this trend began in Japan in 2007 with the recipe for “detergent suicides” being circulated on the internet resulting in over 220 men, women and children trying to kill them killing themselves within 6 months! Included in this statistic are family members who tried to save the victim and were overcome by the gas as well.  The methodology quickly spread to the United States and incidents of H2S suicides began popping up in August and December of 2008 in California, Georgia and Florida have incidents have continued to spread throughout the US and England since.

In 2010 Jennifer Adkins authored the ROCIC (Regional Organized Crime Information Center) publication “Hydrogen Sulfide Suicide” Latest Technique Hazardous to First Responders and the Public. In the paper she noted that H2S can pose other problems for the law enforcement community when it is used in populated places such as an apartment building. In one incident in Japan a young girl killed herself in her apartment using H2S resulting in 90 other occupants of the building becoming sick from the gas as it dissipated throughout the building. H2S has even become a terrorist concern. Though no incidents of a pending terrorist attack using H2S, the “Mujahideen Poisons Handbook” by Abdel-Aziz describes how to make H2S gas.

Hydrogen sulfide classified as a “broad spectrum” poison that affects several systems within the human body. It is five times more toxic than carbon monoxide and is similar in nature to Hydrogen Cyanide in that it bonds with iron and prevents cellular respiration. Not only is it a toxic gas it is heavier than air and highly flammable. H2S can be ignited at only 260C/500F, to put that in perspective a cigarette burns at 649C/1200F! When H2S is mixed with air (i.e. opening the car door) the gas has the ability to spread a long distance and could be ignited causing a flashback. Although H2S has a distinct “rotten egg” smell, high concentrations can cause olfactory fatigue and you can lose your ability to smell. Unfortunately there is no proven antidote for H2S poisoning current treatments consist of support to respiratory and cardiovascular functions. Low exposure to H2S is not likely to cause any long term health issues, but moderate and serious exposure may cause residual problems such as respiratory issues but serious exposure that results in coma or convulsion may damage the heart and brain.

Hydrogen sulfide can easily be made by mixing commonly found chemicals located under many kitchen sink’s. The two primary ingredients’ are an acid based product (Toilet bowl cleansers, acidic based drain cleaners or acids such as muriatic or sulfuric) and sulfur based compound (detergents, pesticides) and when combined they produce H2S. Low concentrations (0 -10 ppm) will cause irritation of the eyes, nose and throat, moderate concentrations (10-50 ppm) will cause headaches, dizziness, coughing and breathing difficulties nausea and vomiting and if the concentration is high (50-100 ppm) the gas can cause severe eye damage, at 100–150 ppm the olfactory nerve is paralyzed, and the sense of smell disappears. At 320 -530 ppm will cause a pulmonary edema (fluid on the lungs) and the loss of breathing function. At 800 ppm 50% of humans will die within 5 minutes of exposure and at concentrations of over 1000 ppm it will cause an immediate collapse and loss of breathing, after only one breath.

The threat to the safety of first responders cannot be overstated and we have to ensure that we change the way we do business or someone is going to die. The days of walking up to a vehicle and simply opening the door to check on an unconscious occupant are over, personal safety is a must. Furthermore if you happen to have your standard issue gas mask with you and think that it will protect you from the effects of H2S you are mistaken. According to S/Sgt. Ron Matthews NCO i/c of the RCMP national CBRNE (chemical, biological, radiological, nuclear and explosive), Training Unit advises that the PC4 gas mask with the FR64 canister is not recommended for a Haz-Mat response to H2S. According to Matthews the canister does offer limited protection as outlined by 3M Technical Data Bulletin #153 and should only be used in emergencies and for escape. Matthews further stated that without knowing exactly what you’re dealing with and without proper training, I suggest Haz-Mat take the lead in determining proper PPE for Chem/Bio/Rad incidents.

H2S can leech out of a car or room in which it was released and pose a threat to first responders. For example in October 2010 a Florida State Trooper was hospitalized simply because he touched the car door with his bare hands when he was investigating a H2S suicide. The vehicle had such a high concentration of the gas inside that it was emitting the smell of sulfur and rotten eggs. Another police officer was hospitalized in St. Petersburg Florida after inhaling some gas from a suicide vehicle.

H2S suicides don’t only occur in vehicles, people have used H2S to commit suicide in their homes and in university residences. Indiana University was the scene of one such event in 2010 when residents noted a chemical smell in the air of a dormitory. A search located a dead student inside a closet with a bucket of H2S. Authorities then had to evacuate 90 residents of the building. In May 2009 a similar event occurred in Toronto when a woman committed a H2S suicide in the bathroom of her residence.

First responders must not rush in functioning in “hero mode” with the intent on making a rescue otherwise they may need to be rescued themselves. In his article in Police Magazine on H2S suicides author Dean Scoville noted: “of the 72 chemical suicides in the U.S. since 2008, 80% have resulted in injuries to first responders.”  Look the scene over and look for the unusual. So far most H2S suicide victims have posted warning signs on their vehicles (some web sites even provide downloadable signs) but not all suicide victims are that considerate. In North Carolina a 35 year old woman exposed several first responders to her chemical mixture that she had prepared in a bucket in her car. She didn’t post any warning signs. Warning signs can fall off, blow away or not be visible in the dark thereby endangering first responders.

Dealing with cases such as these requires diligence on the part of everyone from the dispatchers to the investigators.

The call taker receiving a call about an unconscious person in a vehicle should ask about warning signs or the presence of odors such as rotten eggs or almonds. They should warn the caller to not approach or enter any vehicle or room and let the police handle the mater. These details need to be passed on immediately to the first responders so they are aware they may not be dealing with a carbon monoxide poisoning.

First responder; it takes approximately half a gallon each of the acid and the sulfide to produce a lethal amount of gas, so look for visible containers for liquid inside and outside the car.  Can you smell rotten eggs? Look at the victim; are they conscious/unconscious, responsive or unresponsive? What colour is their skin tone? Is their chest rising or not?

If the victim is unconscious do not open the door to the vehicle in an attempt to wake them, shout from a safe distance or use a loud hailer. Look for warning signs that may in or near the vehicle that may be obscured due to condensation or vapours. First responders should note the wind speed and direction and if necessary evacuate nearby buildings.

If a chemical substance is suspected or confirmed the responders must ensure they follow their agencies policy regarding hazardous materials protocols and advise the area Haz-Mat team.

Look for tape around the doors and windows. In the New Brunswick case the victim taped all of the door seals including the driver’s door so that the tape attached when it was closed from the inside. Look for containers of household cleaning supplies and buckets containing chemical mixtures.

According to the ATSDR (Agency for Toxic Substance and Disease Registry) bulletin; “Persons exposed to hydrogen sulfide pose no serious risks of secondary contamination to personnel outside of the Hot Zone. However personnel could be secondarily contaminated by contacting or breathing vapors from clothing heavily soaked with hydrogen sulfide- containing solution.” In the New Brunswick case the victim’s clothing was not soaked with any solution but the odor of H2S was very pronounced and the Hazmat team had to strip the body in the Hot Zone. In addition odors from the body permeated the double body bags (body bags are not recommended cover the body with a sheet instead) and could not be transported in the body removal vehicle. Instead a hermetically sealed coffin was brought to the Hot Zone and the body was secured in it.

Another concern is the possibility off gassing from the victims lungs when moving the victim.

As the H2S suicides become more known we can expect to see more of them and as such we should not be publicizing them because that will only lead to more copycats such as occurred in England in March 2011 when a couple who met on the internet chose to kill themselves the same way a couple in Essex England had done five months before. Publicity about H2S can also increase the awareness about the hazards associated to this gas and become a new threat to first responders or investigators in the form of flash bomb booby traps. Additionally the potential for staged H2S suicides that are actually homicides present further challenges for the law enforcement community. We need to recognize that this is a growing global problem for first responders and we need to act now to amend our investigative policies and training procedures sooner than later.

References:

Journal of Occupational Medicine and Toxicology (London, England), Japanese experience of hydrogen sulfide: the suicide craze in 2008

Kansas City Regional TWE www.kctew.org

Chemical & Detergent Suicides, Hampden County (MA) Sheriff’s Department

Central Florida Intelligence Exchange, Intelligence Bulletin Oct. 2010

Regional Organized Crime Information Center – Special Research Report – Hydrogen Sulfide Suicide

Agency for Toxic Substance and Disease Registry (ATSDR)

Toronto Police Officer Safety Bulletin No. 42/2009

Police Magazine, “Chemical Suicides” Dean Scoville, April 2011

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