Characteristics and circumstances of volatile solvent misuse-related death in Australia, 2000-2021

IntroductionVolatile solvent misuse-related death is associated with neuropsychiatric, cardiovascular, respiratory and renal pathology, as well as sudden death. The study aimed to determine: (1) the circumstances of death and case characteristics of volatile solvent misuse-related death in Australia, 2000-2021; (2) the toxicological profile of cases; and (3) the major autopsy findings.MethodsRetrospective study of volatile solvent misuse-related death in Australia, 2000-2021 retrieved from the National Coronial Information System.FindingsOne hundred and sixty-four cases were identified, 79.9% male, mean age 26.5 years (8.5% aged 40 years or older). Circumstances of death were unintentional toxicity (61.0%), unintentional asphyxia (20.1%), intentional self-harm (12.2%) and traumatic accident (6.7%). The most commonly reported acute presentation prior to death was sudden collapse (22 of 47 witnessed events). The most frequently used solvents at the fatal incident were gas fuels (35.4%), gasoline (petrol) (19.5%) adhesives/paints (19.5%), aerosol propellants (12.8%), and volatile anaesthetics (12.8%). The most commonly detected volatile substances were butane (40.7%), toluene (29.6%), and propane (25.9%). Cannabis was present in 27.6% and alcohol in 24.6%. The prevalence of acute pneumonia amongst autopsied cases was low (5.8%) which, together with reports of sudden collapse, suggests that in many cases, death was extremely rapid. There were low levels of major organ pathology.ConclusionsWhile the average age of volatile solvent misuse-related death was in the mid-twenties, a substantial proportion occurred amongst people aged 40 years or older. Reflecting availability, gas fuels predominated. In many cases, death appeared to have been rapid.

Automated summary

This study investigated volatile solvent misuse-related death in Australia from 2000 to 2021. The major cause of death was unintentional toxicity, and the most commonly used solvents were gas fuels, gasoline, adhesives/paints, and aerosol propellants. Autopsy findings showed that the deceased often experienced sudden collapse, indicating rapid death, and there were low levels of major organ pathology.