LEAD Action News Vol 2 no 2 Autumn 1994
Local Strategies Needed to Counter Petrol Sniffing
News Release from AMA. Contact Dr John Dunne (09) 224 2593 or Dr Ross Goodheart Phone (018) 905 696.
Petrol sniffing is an important cause of sickness and death in some rural Aboriginal communities, according to a research article in the Medical Journal of Australia (MJA Vol. 160, 21 Feb 1994, pp 178-181).
The authors, neurologists Dr Ross Goodheart and Dr John Dunne of the Royal Perth Hospital, said that petrol sniffing can cause death or irreversible encephalopathy and, despite treatment, those severely affected have a poor prognosis.
The article follows a study of 29 admissions from 25 patients to Perth teaching hospitals between 1984 and 1991 where intentional petrol sniffing was diagnosed.
Of the 25 patients, 22 were male and three female. Ages ranged from five to 27. Twenty were Australian Aborigines, 18 of whom were chronic petrol sniffers and 17 of whom had been transferred from the Eastern Goldfields and Western Desert regions of Western Australia (W A).
Of the chronic sniffers, a high prevalence of seizures and an alarmingly high case fatality ratio - eight of 20 was found. Eighteen of the 20 patients were treated with specific agents to reduce the lead load, but the results were "extremely disappointing".
While the short term effects of petrol inhalation were the likely result of several constituents of petrol, long-term effects were currently considered to be largely due to organic lead poisoning.
Ten to 15 breaths were sufficient to produce intoxication for three to six hours. Absorption of petrol components through the lungs was rapid and symptoms became evident within three to five minutes.
An initial euphoria was experienced which may be accompanied by hallucinations, delusions, nausea and vomiting and after prolonged inhalation there may be delirium, loss of consciousness and coma and sudden death may occur.
The authors said that primary care of petrol sniffers posed many practical problems as most were from remote areas where a solitary health nurse was in attendance.
The replacement of leaded with unleaded petrol may reduce the morbidity associated with petrol sniffing but it may be some time before leaded petrol was unavailable in remote areas of W A, and the contents of other highly toxic ingredients of petrol, leaded and unleaded, should not be underestimated.
While primary prevention strategies had so far had limited success, the poor prognosis of those severely affected, even with treatment, further emphasised the need for locally based strategies for prevention. The researchers reported "a highly significant association between the mean admission blood lead level and survival" (see graph).
"For the survivors, length of acute admission averaged 33 days, but was as long as 147 days. Ataxia and dementia were common at the time of discharge with only one patient being functionally independent."
The goal for all Australians is to have a blood lead level below 0.48 µmol/L (micromoles per litre) which converts to 10 µg/dL (micrograms per decilitre).
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