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Japanese detergent poison- AIIMS offering easy way out???

 More recently people have been using a new way of bringing their lives to an end. This technique is called ‘detergent suicide’ or ‘chemical suicide’. It involves mixing a number of readily available household chemicals, such as toilet bowl cleaner with other reactive elements to create a poisonous gas such as hydrogen sulphide. Inhaled in small doses, at less than 40 parts per million (ppm), exposure to this gas can cause eye and mucous membrane irritation. But as the dosage level increases people exposed can quickly experience confusion and cyanosis with coughing fits. At dose levels above 500 ppm patients often die. At 700 ppm two or three breaths can cause immediate death.




To achieve high dosage levels the people intent on suicide often either tap up the windows in their houses and attempt to seal a single room or use a car to decrease the volume of air in which the toxic material is released. With hydrogen sulphide being a colourless gas it can be a major hazard for first responders whose first inclination on seeing a body slumped in a car might be to characterise the incident as a methane poisoning and break the car window, accidentally exposing themselves to a much more threatening situation.



It is not difficult to imagine a small device being carried into a shopping centre in a disguised form by a potential martyr who then mixes the two chemicals in a way that spreads gas over a relatively small area. Whilst the death toll is unlikely to be high the impact upon the public might be considerable. When death comes in the form of a colourless gas it can easily dent public confidence. Even what on the surface appears to be a hugely amateurish attack could still have significant economic repercussions. 
For the Fire and Rescue Service some enduring lessons are clear. Dispatchers involved in taking calls need to be alert to the indications that they are sending crews into this kind of situation. Careful questioning of the caller is important with any references to bad odours, such as a smell of almonds (indicative of a cyanide compound) or rotten eggs (indicative of the presence of hydrogen sulphide) needing to be taken seriously.  
As responders attend the scene they need to be on the look out for situations where a person may have attempted to create the kind of environment in which dosage levels can quickly reach fatal levels. Residential bathrooms, cars and other small spaces – especially when sealed off from the outside – are all places to be wary. In apartment buildings, as occurred in the incident in Japan referred to earlier, a decision may need to be taken about evacuation. The presence in a vehicle of large tubs or containers is also a major indicator. Relying on the presence of warning signs to provide a strong indicator would also place first responders at risk from a terrorist-related event where the perpetrator is seeking to use the situation to draw first responders into a hazardous situation. 
Despite the development of the idea that detergent suicide was a painless and straightforward method for those seeking death, the potential for such techniques to be adapted and used by those involved in terrorism cannot be ignored. Terrorism has a history of developing in unexpected ways and it is important for the members of the Fire and Rescue Service to always be prepared for the unexpected. Whilst it is a well known cliché, it may also ensure that some of them do not accidentally become exposed to fatal levels of a concoction readily assembled from advice over the Internet and a few visits to the supermarket. 

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