An investigation of 140 deaths associated with volatile substance abuse in the United Kingdom (1971-1981).

1 In the UK, from 1971 to 81, 140 deaths associated with volatile substance abuse (VSA) were identified from press reports and a variety of other sources. Data about each death were obtained from inquest proceedings, post-mortem and toxicological reports, and death certificates. 2 Based on the year 1981, in which 39 deaths occurred, VSA deaths accounted for over 1% of deaths from all causes, and nearly 2% of deaths from injury and poisoning in males aged 10-19 years. 3 The median age was 16.8 years (range 11-63), and 79% were under age 20. The male to female ratio was 13:1. 4 Death rates were highest in conurbations, and in Scotland, Northern Ireland and Northern England. Deaths tended to be more frequent among manual social classes but this association was not marked. 5 The chief substances were butane (28%), solvents in adhesives (23%), other solvents (26%), aerosols (15%) and fire extinguishing agent (5%). Solvents in adhesives were more important with increasing age. 6 Most deaths occurred alone, at home. In about 41% of cases, death appeared to be only indirectly associated with VSA (trauma 8%, plastic bag over head 19%, and inhalation of stomach contents 14%). In 49% death was attributed to the direct toxic effects of the substance; this proportion was highest with aerosols and lowest with solvents in adhesives. 7 The implications of these findings for prevention, monitoring and research are discussed.