Summary of key papers describing harms relating to butane
Although volatile solvent use comprises a wide range of products and substances, Real et al (2021, p291) make the point that:
“Misusing inhalants implies introducing gases other than air into the body causing poor brain oxygenation (hypoxia) and the deleterious consequences associated with it. This happens with all inhalants regardless of their pharmacological profile and is a significant health hazard in itself.”
Later in the same chapter (p299), they write:
"The most direct pulmonary effects are related to direct damage to the lung tissue or are related to asphyxia, since volatile solvents can displace oxygen and produce hypoxia and loss of consciousness."
Real T., Cruz S.L., Medina-Mora M.E., Robles R., González H. (2021). Inhalant Addiction. In: el-Guebaly N., Carrà G., Galanter M., Baldacchino A.M. (eds) Textbook of Addiction Treatment. Springer, Cham. pp. 281-306. DOI: 10.1007/978-3-030-36391-8_20.
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Anecdotal evidence from Re-Solv’s clients is that the long-term use of butane has caused them physiological harm. This was not evidenced in Stewart et al's 1978 physiological study carried out with healthy male and female volunteers:
"Acute exposures to isobutane, propane, F-12, and F-11 in concentrations of 250, 500, or 1000 ppm for periods of 1 min to 8 hr did not produce any untoward physiological effects as determined by the methods employed ... Repetitive exposures to these four propellants were also without measurable untoward physiological effect with the exception of the eight male subjects repetitively exposed to 1000 ppm, F-11, who did show minor decrements in several of the cognitive tests. Of particular importance is the observation that none of the subjects showed any decrement in pulmonary function or alteration in cardiac rhythm as the result of exposure to concentrations of the gases or vapors far greater than encountered in the normal use of aerosol products in the home."
In regard to the eight male subjects who did show minor decrements in several cognitive tests, the authors reported:
"Should these observations prove representative of the general population, a significant percentage of persons identically exposed to the upper industrial limits of F-11 would be expected to show similar decrements in cognitive function. Fortunately, the magnitude of the decrements observed was minute and transient. In the opinion of the investigators, these small decrements occurring during repetitive exposures were spurious in that similar decrements were not observed in the subjects acutely exposed to the same concentration for equal periods of time. Further research on the effect of F-11 on cognitive function is merited."
Stewart R.D., Newton P.E., Baretta E.D., Herrmann A.A., Forster H.V., Soto R.J. (1978) Physiological Response to Aerosol Propellants. Environmental Health Perspectives, 26, pp. 275-285. DOI: 10.1289/ehp.7826275.
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In their paper, Global emissions of VOCs from compressed aerosol products, Yeoman and Lewis (2021) cite Stewart et al but suggest the possibility of long-term toxic health effects:
“Although acute, single exposure (250, 500, and 1,000 ppm) to propellants, iso-butane and propane were shown to have “no untoward physiological effects” on pulmonary and cognitive function or cardiac rhythm, repetitive exposure to 1,000 ppm did cause minor cognitive decline. Additionally, participants had detectable traces of propellants in their blood and on their breath. Possible long-term toxic health effects could be caused by propellants making their way into the respiratory and cardiovascular systems; however, there have been no long-term studies on the inhalation of propellants from the continuous use of aerosol consumer products to evaluate this.”
Yeoman A.M, Lewis A.C. (2021). Global emissions of VOCs from compressed aerosol products. Elementa: Science of the Anthropocene. 9(1): DOI: 10.1525/elementa.2020.20.00177.
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Alunni et al (2018, p334) also accept the potential for long-term harm when they write:
“The fatal outcome of butane inhalation depends not only on the quantity of butane inhaled ... but also on the chronicity of the abuse insofar as chronic abuse results in organ damage that can lead to life-threatening complications in the event of further intoxication or acute stress.”
The authors identify “several bronchial lesions suggestive of asthma” in one case of death from butane inhalation:
“… with epithelial hypercrinia, thickening of the basement membranes, and a focal inflammatory infiltrate with eosinophils and mastocytes. Preexisting asthma had to be considered but was ruled out after investigation, suggesting that these lesions could have been related to cronchial irritation caused by the repeated inhalation of butane.”
In the same case, they also note: “Evidence of the chronic nature of abuse could also be suggested by the presence of signs of neuron damage (satellitosis), reflecting the brain tropism related to the lipophilic nature of the inhaled toxics.” (p334)
Alunni V., Gaillard, Y., Castier, F., Piercecchi-Marti, M-D., Quatrehomme, G. (2018). Death from Butane Inhalation Abuse in Teenagers: Two New Case Studies and Review of the Literature. Journal of Forensic Sciences, 63(1), pp. 330-335. DOI: 10.1111/1556-4029.13520.
Both Real et al (2021, p299) and Bowen (2011, p69) cite Adgey et al’s 1995 paper which found that “butane gas inhalation may be associated with severe laryngeal oedema and laryngospasm”.
Adgey A.A., Johnston P.W., McMechan S. (1995). Sudden cardiac death and substance abuse. Resuscitation, 29(3), pp. 219-21. DOI:https://doi.org/10.1016/0300-9572(95)00854-M.
Bowen SE. (2011). Two serious and challenging medical complications associated with volatile substance misuse: sudden sniffing death and fetal solvent syndrome. Substance Use & Misuse, 46 Suppl 1, pp. 68-72. DOI: 10.3109/10826084.2011.580220
Real et al, as above.
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Cruz and Bowen (2021) report that: "Women who have misused solvents like toluene have been reported to have higher pregnancy and teratogenic risks as compared to women with occupational solvent exposure" and note later that "there is a suggestion that for a given daily dose of toluene a binge pattern of exposure may pose a greater risk for fetal development." However, they recognise that the current state of our understanding about inhalant use during pregnancy remains under-investigated.
Cruz S.L, Bowen S.E. (2021) The last two decades on preclinical and clinical research on inhalant effects. Neurotoxicology and Teratology, 87. DOI: 10.1016/j.ntt.2021.106999.
There is even less research specifically on the effects of butane inhalation during pregnancy although Higueras and Hernandez (1986) found:
"A newborn infant who suffered intra-uterine anoxia is described, whose mother inhaled butane gas accidentally during the sixth month of pregnancy. The infant was born at 39 weeks. Ultrasonography and neuroradiological studies (CT scan and angiography) showed an almost complete absence of both cerebral hemispheres. The thalamus, brainstem and cerebellum were preserved. These findings were compatible with hydranencephaly. The authors believe that the malformation was due to intra-uterine anoxia occurring during fetal brain-development."
Fernandez F., Perez-Higueras A., Hernandez R., et al. (1986). Hydranencephaly after maternal butane gas intoxication during pregnancy. Develop Med Child Neurol, 28:361-367. DOI: 10.1111/j.1469-8749.1986.tb03885.x
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posted by Re-Solv @ 9:26 am
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