Suspected Solvent Abuse in Cases Referred to the Poisons Unit, Guy's Hospital, July 1980-June 1981

Abstract

1 From July 1980 to June 1981, requests for information as to management or prognosis were received concerning 324 patients (219 male, 91 female) aged 3-31 y (median 15 y) in whom 'solvent abuse' was suspected. 2 The principal symptoms reported were unconsciousness (37), drowsiness (62), 'collapse' (7), convulsions (6), ataxia (35), chest pain (9), nausea/vomiting (20), renal impairment (3) and behavioural disturbances (84). At least 105 patients were admitted to hospital, and 1 was dead on arrival. 3 The products abused in 290 clinically diagnosed cases were: adhesives (214), correcting fluids (23), chlorinated solvents (17), fuel gases (18), petrol (5), BCF fire extinguishing agent (5) and others (17). The co-ingestion of alcohol or other drugs was suspected in only 27 cases. 4 Specimens of blood and/or urine were received for analysis from 117 patients. The clinical diagnosis of solvent abuse was confirmed in 71 cases and solvents were detected in 2 further instances. Ethanol/other drugs were detected in 18 instances, either together with solvent(s) (9) or alone (9), although no compounds were detected in the remaining 35 cases. 5 Toluene (and/or raised urinary hippurate/creatinine ratio) was detected in 52 of the analyses, 1,1,1-trichloroethane in 14 and trichloroethylene (and/or trichloroethanol) in 12. Ethanol was detected in 7 instances, and other drugs (principally benzodiazepines) in 13. 6 Although the presenting symptoms and outcome were usually unremarkable, these results emphasise that some patients can develop serious illness such as collapse or convulsions, which may prove fatal, while chronic solvent abuse can be associated with renal impairment.