THE DANGERS LURKING IN A DEODORANT

FORTY years ago, addiction to "sniffing" used to be an anaesthetist's
proclivity. Anaesthetists, when testing their equipment, were in the
habit of taking a few exploratory sniffs from the mask to make sure
the patient was going to get the mixture of gases as prescribed. Some
rather took to the substances and became hooked on their own
anaesthetics. Ether was a firm favourite. Today, those given to
inhalant abuse are unlikely to be elderly, theatre-worn doctors but,
instead, inner-city youths.More teenagers in America, for instance,
use inhalants than they do cocaine or acid - but rather fewer than
those who smoke marijuana to excess. In this country, the Health
Education Authority recently issued an accessible report produced by
St George's Hospital medical school that deals with solvent abuse and
subsequent deaths among teenagers.

There is no big money involved in solvent abuse, no international
crooks deal in the rather dreary world of sniffing clubbers - and
hence the habit doesn't receive the publicity afforded to Ecstasy
deaths. In the past 25 years, more than 1,500 teenagers have died from
solvent abuse - a rate of about one a week. The favourite substances
include lighter fuel (containing butane), glues, dry-cleaning fluids,
nail-polish removers, paint thinners and liquid correction fluid.

As those who followed the recent inquest into the death of Jonathan
Capewell will have learnt, deodorants and anti-perspirants also
contain butane, as well as propane and fluorocarbons. Although there
is no doubt the 16-year-old died - in his bedroom - from butane and
propane poisoning, the motivation for the excessive use of deodorants
which led to this must remain a subject of speculation. The coroner
rightly said that there was no evidence that the youth had indulged in
any form of butane and propane inhalation in the way some of his
contemporaries might sniff lighter fuel. Even so, Jonathan had used so
many varieties of deodorant in such quantities for so long that the
level of butane in his blood at death was more than three times
greater than a possibly fatal dose. He must have built up a tolerance
to the substances over time.

Although his motivation is unknown, there can be no doubt that in a
confined space the butane and propane would have made him feel
light-headed, rather like being drunk and perhaps a bit dizzy. It
would have been surprising if he had not noticed this. During his
deodorising regime, he may well have hallucinated and experienced a
loss of coordination. He may have regarded these symptoms as a price
worth paying to enable him to smell more appealing.

Conversely, he may have enjoyed the sensations the deodorants
produced. Either way, he was, like those who deliberately inhale
solvents, at grave risk of sudden death as a result of an irregular
heart action, or excessive slowing of the heart. In particular, some
patients, if suddenly alarmed when they have been sniffing, may suffer
an adrenaline rush and die instantly. Inhalant overexposure may also
cause chronic damage to the heart, kidneys, liver and lungs and, in
the long term, the bone marrow may be destroyed.

There is little or no previous evidence of accidental death from
sniffing deodorants, but there are numerous reported cases where it
has resulted from deliberate inhalation.

The general view seems to have been that Jonathan's troubles were not
primarily related to solvent abuse but to an obsession with deodorants
and, hence, presumably to his smell as he perceived it. It is possible

this may have been part of some ritualistic procedure perhaps stemming
from an obsessive compulsive disorder involving anxieties over
cleanliness. A "compulsion" is a repetitive, purposeful and
intentional behaviour performed in response to an obsession. On the
other hand, excessive anxiety over one's own real or perceived smell
is a common symptom in a variety of psychiatric conditions. In some
cases, hypersensitivity to a smell could be thought of as a variant of
a form of anxiety known as dysmorphophobia. This condition is
particularly common from adolescence until the mid-30s and is a
feature of many different psychiatric disorders, and sometimes as a
solitary symptom unconnected to any other problem.

Checked-by: Rich O'Grady