The Methamphetamine Problem:

A Health & Safety Overview for Fire Fighters

Methamphetamine and amphetamine-like compounds date back nearly 100 years. In 1919, a Japanese pharmacologist first synthesized methamphetamines. However, the abuse of methamphetamine became apparent during the 1930’s due to the stimulant, euphoric, and anorexic properties of the drug. During World War II, the drug was commonly used to increase wakefulness and attention. In fact, the Nazi’s developed a method of methamphetamine production called the Nazi Method that is still commonly used today in clandestine labs.

Until recently, most of the methamphetamine production occurred in Hawaii and other western states, such as California. Within the last decade there has been a rapid expansion of clandestine laboratories toward the east, but more prominent in the mid-west and especially in rural areas. For example, in Colorado, there were 31 clandestine lab seizures in 1998 and 455 seizures in 2001. Rural areas provide an ideal site for methamphetamine labs given the wide, open spaces, easy accessibility to ingredients such as anhydrous ammonia, and the small and usually understaffed law enforcement in these areas.

This movement towards the east and in rural areas has created some problems for all first responders. Many of these small clandestine labs are run by inexperienced individuals who do not have any knowledge of the safety hazards associated with the chemicals being used in the production of methamphetamines. The end result is a number of injuries, fires, and uncontrolled dumping of waste materials. To make matters worse, many times fire fighters responding to fires or accidents are unaware that the site is a clandestine laboratory and structural fire fighting gear is not designed to provide adequate protection. Thus, these individuals are exposed to a number of chemical, physical, biological, and environmental hazards.

The purpose of this document is to give an overview of some of the health and safety issues associated with clandestine drug labs. This is accomplished by discussing a number of different topics: the various methamphetamine production methods; the chemicals used, their sources, and some of their individual hazards; physical and biological hazards; acute and chronic health effects; and finally a review of controlled clandestine laboratory experiment by the Colorado Springs Police Department.

There are two types of methamphetamine production laboratories: "super labs" and "mom and pop" labs. Super labs are typically found in California and Mexico and have the capability to produce 10 to 20 pounds of methamphetamine at a time. The product is usually sold in large metropolitan areas such as Los Angeles, San Diego, Phoenix, and San Francisco. "Beavis and Butthead" is an alternative name given to "mom and pop" labs since the term best describes the individuals operating in these methamphetamine laboratories. All jokes aside, these labs are the most problematic. Operators of these small clandestine labs often obtain methamphetamine recipes from the Internet or even fellow-inmates while incarcerated. The labs are constructed with everyday household items such as mason jars, stove burners, plastic tubing, tape, etc. Furthermore, chemicals used in the production process are often stored in inappropriate containers that can lead to accidents. It is not uncommon to have acid stored in two-liter soda bottles or anhydrous ammonia stored in propane or butane tanks which are not appropriate storage containers for these chemicals and therefore pose hazards to anyone in the area.

Methamphetamines can be produced by three different methods, each with their own inherent hazards: P2P, Ammonia lab, and Red Phosphorus lab

P2P Lab:

There are a number of other chemicals used in the production of methamphetamines, but these items cannot be purchased in their natural form. Thus, many automotive and/or household chemicals are used as sources of substitution:

In the early stages of methamphetamine abuse, users quickly become addicted to the euphoric feeling and from the vast amount of energy they have from using the drug. However, chronic use leads to multiple medical problems including paranoia. It is not uncommon for a user in a paranoid state to create a number of physical hazards, such as booby traps, that are potentially lethal to unsuspecting individuals including fire fighters. The purpose of these traps is to destroy evidence and discourage entry by injury or killing. Common traps include: animal traps, trip wires, grenades in lamp sockets, C-4 plastic explosives in VCR’s, light-bulbs filled with gasoline, or buried planks with protruding nails or spikes. Another hazard is "Mini-bombs", which consist of explosives wrapped in foil. They are very sensitive to heat, shock, and friction and people have been known to lose fingers or have been seriously injured while trying to dismantle these bombs.

Clandestine labs can also pose a biological hazard to fire fighters and other first responders. A commonly used route of ingestion of methamphetamine is through injection, especially in major metropolitan areas. In fact, injection of methamphetamine has led to lowered inhibition and the resurgence of HIV/AIDS in San Francisco. Clandestine lab cooks frequently operate in squalid living conditions, which can include leaving needles lying around the lab. This can increase the risk of needle sticks to fire fighters, thus exposing them to infectious diseases such as HIV or Hepatitis C. EMT’s also risk exposure to these infectious agents via accidental needle stick or though blood exposure while trying to tend to an injured lab cook.

Whether a clandestine methamphetamine lab is encountered incidentally or a planned lab invasion occurs, the health effects from these events are usually acute in nature. Some of the health effects from chemical exposure are described earlier in the "Methamphetamine Laboratory Production" methods section of this document. These chemicals most commonly affect the upper and lower airways. Symptoms can include coughing, throat irritation, or difficulty breathing. However, exposure can be much more serious, causing pulmonary edema or chemical pneumonitis. As mentioned earlier, lung injury may present early after exposure or maybe delayed for 18 hours or more. Other symptoms of acute exposure can include eye irritation, nausea or vomiting, or dizziness or lack of coordination.

Since the rapid spread of methamphetamines across the U.S. is a relatively recent event, not much is known about the long-term health effects fire fighters may develop from dealing with these methamphetamine laboratories. However, an article titled "Medical Surveillance of Clandestine Drug Laboratory Investigators" was published in the Journal of Occupational & Environmental Medicine that describes some long-term health effects from exposures from these labs. The authors of the study found, during spirometry evaluations, there was a significant reduction in the forced expiratory volume (FEV₁) in those study participants who had longer duration of exposure without respiratory protection. Furthermore, there was a less rapid rate of decline in FEV₁ with the use of respiratory protection.

To better understand the potential level of exposure that fire fighters may encounter in clandestine methamphetamine laboratories, we will discuss the findings of a study conducted by the Colorado Springs Police Department. In their study, they established methamphetamine labs and produced methamphetamine under controlled conditions in the following settings: the police department laboratory and in abandoned house and motel. Furthermore, they analyzed 16 actual clandestine laboratories.

The International Association of Fire Fighters recognizes Rashad Saeed, DO MPH, Post-Doctoral Fellow in Occupational & Environmental Medicine at the Johns Hopkins Bloomberg School of Public Health who authored this report. Dr. Saeed served as a Medical Resident with the International Association of Fire Fighters in 2005. Through IAFF convention action in 1986, the occupational medicine residency program was established. The IAFF, in conjunction with the Johns Hopkins University, supports full-time medical residents each for a multiple month rotation in the IAFF Division of Occupational Health, Safety and Medicine.