As the prevalence of chemical suicides appears to be on the increase, mirroring its take-up in the United States and Japan, FIRE's Security Correspondent Dr Dave Sloggett examines the implications for the Fire and Rescue Service as the techniques are taken up more widely by those seeking to die and may also be adopted by terrorists. 

 

Since the terrorist attacks on New York and Washington almost a decade ago the threat of a Chemical, Biological, Radiological or Nuclear (CBRN) attack has hung over western society. With trans-national terrorist groups such as Al Qaeda committed to conducting mass casualty attacks, where over 1,000 people die, the preparations and investment made in providing equipment and training for the emergency services in the United Kingdom has been a vital part of being able to respond should an attack take place. Whilst preparing for a mass casualty event however it is also valid to ask if the same equipment is more likely to be used in dealing with the aftermath of a suicide attempt using chemicals or a small-scale terrorist event.  

 

Sarin Gas Attack   

The sarin gas attack upon the Tokyo underground system on March 20, 1995 killed 12 people and caused over 5,000 to seek medical assistance. The low death toll of the event can, in part, be attributed to the decision the night before the attack to dilute the concentration of the sarin that was being used; undoubtedly it could have been so much worse. Conducted by the Aum Shinrikyo cult the attack remains the iconic example of a CBRN event. The response was chaotic and disorganised leaving many lessons to be learnt. The responders simply had never experienced anything of its kind before.  

The five people that carried out the attack were not intent on suicide. They carried antidotes with them. One, fearing he had been exposed to the gas as he punctured the plastic container in which the substance was held in a liquid form, injected himself with the serum as he sped away in a taxi that had been waiting at the top of the steps by the underground station that was the target for the attack.  

 

Hara-kiri   

Ending one's life through suicide has a specific cultural resonance in Japan. In many situations it is seen as the honourable thing to do, accepting blame for an outcome. It is enshrined in the act of hara-kiri; also known as sepuku, an ancient form of ritualistic suicide used by defeated samurai to restore their honour in death. The words hara-kiri are Japanese for stomach and cut. The act is supposed to be performed without any noise. This act was depicted by Hollywood in Tom Cruise's film The Last Samurai and dramatised by the novelist James Clavell in his well known book Shogun.  

This form of honourable ending motivated the kamikaze pilots towards the end of the Second World War. Arguably they were amongst the forerunners of today's suicide bombers, giving their lives for the cause in a final desperate act. 

In 2006 32,155 people committed suicide in Japan. This was the ninth highest rate in the world at the time. More recently people have been using a new way of bringing their lives to an end. This technique is called 'detergent suicide' or 'chemical suicide'. It involves mixing a number of readily available household chemicals, such as toilet bowl cleaner with other reactive elements to create a poisonous gas such as hydrogen sulphide. Inhaled in small doses, at less than 40 parts per million (ppm), exposure to this gas can cause eye and mucous membrane irritation. But as the dosage level increases people exposed can quickly experience confusion and cyanosis with coughing fits. At dose levels above 500 ppm patients often die. At 700 ppm two or three breaths can cause immediate death.  

 

Advent of Chemical Suicides 

To achieve high dosage levels the people intent on suicide often either tap up the windows in their houses and attempt to seal a single room or use a car to decrease the volume of air in which the toxic material is released. With hydrogen sulphide being a colourless gas it can be a major hazard for first responders whose first inclination on seeing a body slumped in a car might be to characterise the incident as a methane poisoning and break the car window, accidentally exposing themselves to a much more threatening situation.  

In the first half of 2008 over 500 people committed suicide in this way; taking their instructions on the mixing of the deadly substances from a number of Internet sites that were available. The instructions that are available on such sites are very detailed, often containing precise portions of the respective elements. They also offer advice on providing warning signs to neighbours alerting them and any emergency services responders to the nature of the threat. Many who chose to die in this way do not want to accidentally kill others who may come to their aid. Some sites actually provide a degree of counselling to those contemplating suicide; encouraging them to end their lives in this way.  

 

Collateral Damage   

One of the more notorious incidences in Japan occurred on April 24, 2008 in Konan, southern Japan, when a 14 year-old girl gassed herself to death by mixing a laundry detergent with a cleanser. The resulting toxic fumes caused over 90 people in the same apartment block to become sick as the fumes escaped through her bathroom window entering nearby apartments. In an attempt to minimise the impact upon her neighbours she had posted a note on her door that read 'gas being emitted'. Of the 90 people affected only 10 required hospital treatment.  

The threat from the inhalation or ingestion of these detergents does not solely occur at the site where the suicide has been attempted. In May 2008 one man was found barely alive in Kumamoto in Japan and rushed to hospital. On arrival the man vomited during an attempt to pump out his stomach. This caused chloropicrin, a highly dangerous pesticide, to become airborne affecting 54 doctors, nurses and patients. They all experienced breathing difficulties and sore eyes. All of them needed immediate treatment for their symptoms with 10 being hospitalised.  

The condition of a 72 year-old pneumonia patient exposed to the chemical dramatically deteriorated and she nearly died. To deal with the incident 90 additional hospital people were called in and the local fire and rescue service was mobilised to decontaminate the emergency room in which the initial event had started.   


Global Suicide Spread   

It was inevitable in the globally connected world in which we all now live that this approach to suicide would not remain a solely Japanese phenomena. In August 2008 a 23 year-old Californian man was found dead in his car in a car park at a shopping centre in Pasadena. The car's doors were locked and the windows rolled up. A warning sign was placed on one of the windows. Firefighters attending the scene donned chemical suits to recover the body.  

This is believed to have been the first detergent suicide in the United States. It has since been followed by a number of other events. In America reporting of these types of suicide is on the increase with six events recorded alone in February 2010 from Florida to Colorado and California. In one of these events the Fire and Rescue Service personnel encountered sodium cyanide held in a container in powder form.  

 

UKContamination   

As with many trends in society what happens in the United States has a tendency to migrate to the United Kingdom. In May 2009 Surrey Police were mobilised to a farm near Guildford where a man who ran a rare breed's farm had been found unconscious. He died before he could be taken to hospital. He was facing eviction from his farm and had decided to commit suicide. In the immediate aftermath of the event seven police officers complained of feeling unwell and were hospitalised for observation having come into contact with a suspected poisonous substance.  

In September 2010 police found the bodies of a man and a woman on an industrial estate near Braintree in Essex. They had printed warning notices that had been placed on the windows of the car saying there were toxic chemicals in the car and that any passers-by should not open the windows. It was subsequently reported that they had only recently met on the Internet. Presumably they made a pact to die drawing strength from each other in the final moments as they mixed the chemicals.  

In October 2010 police officers were called to a house in Putney in the middle of the morning where they discovered the bodies of two young women. Reports surfacing in the media at the time contained suggestions that one of the women had become obsessed with death. 

In November 2010 a major alert was issued in Luton when two police officers investigating a reported burglary noted string fumes emerging from a house. A 200 metre cordon was established and specialised staff from Bedfordshire Fire and Rescue Service were mobilised to the scene. On this occasion no body was found but the approach taken to this incident, based upon developing a dynamic risk assessment, was clearly entirely sensible given the increasing number of people choosing to die using chemicals.    

In January 2011 an incident was reported in St Albans. Recently a man and a woman were found in a car on a rural road in Buckinghamshire with a sign on the window saying it contained hazardous substances. 

 

Terrorist Contagion   

The problem with these methods and ideas is that they act like a contagion. Once the idea is out on the Internet it is difficult to stop it spreading. Whilst none of the incidents recorded in the United Kingdom could yet be described as terrorism the potential for individuals drawn into seeking to become jihadists should not readily be dismissed.  

Trans-national terrorist groups like Al Qaeda have recently started to encourage a new form of martyr; the individual jihadist. Publications, such as the recently developed Inspire Magazine published by Al Qaeda's media arm, have contained articles that encourage potential recruits to 'build a bomb in the kitchen of your mum'. It is not a large leap in the imagination to move from building bombs out of readily available chemicals to trying to assemble a crude device.  

The issue with people tempted to respond to the call to become individual jihadists is that their fervour might overtake their ability to sit back, do research and plan how an attack might be conducted. In the wake of a major event on the television characterised as requiring a response from those committed to defending their faith, it is entirely possible that ad-hoc devices and situations might be created. Whilst very few of these are ever likely to achieve the kind of mass casualty event so sought after by groups such as Al Qaeda or their franchises in the Yemen and the Maghreb in Africa, they may still create a degree of panic in a shopping centre; with unknown consequences.  

 

Unseen Killer 

It is not difficult to imagine a small device being carried into a shopping centre in a disguised form by a potential martyr who then mixes the two chemicals in a way that spreads gas over a relatively small area. Whilst the death toll is unlikely to be high the impact upon the public might be considerable. When death comes in the form of a colourless gas it can easily dent public confidence. Even what on the surface appears to be a hugely amateurish attack could still have significant economic repercussions. 

For the Fire and Rescue Service some enduring lessons are clear. Dispatchers involved in taking calls need to be alert to the indications that they are sending crews into this kind of situation. Careful questioning of the caller is important with any references to bad odours, such as a smell of almonds (indicative of a cyanide compound) or rotten eggs (indicative of the presence of hydrogen sulphide) needing to be taken seriously.  

As responders attend the scene they need to be on the look out for situations where a person may have attempted to create the kind of environment in which dosage levels can quickly reach fatal levels. Residential bathrooms, cars and other small spaces - especially when sealed off from the outside - are all places to be wary. In apartment buildings, as occurred in the incident in Japan referred to earlier, a decision may need to be taken about evacuation. The presence in a vehicle of large tubs or containers is also a major indicator. Relying on the presence of warning signs to provide a strong indicator would also place first responders at risk from a terrorist-related event where the perpetrator is seeking to use the situation to draw first responders into a hazardous situation. 

Despite the development of the idea that detergent suicide was a painless and straightforward method for those seeking death, the potential for such techniques to be adapted and used by those involved in terrorism cannot be ignored. Terrorism has a history of developing in unexpected ways and it is important for the members of the Fire and Rescue Service to always be prepared for the unexpected. Whilst it is a well known cliché, it may also ensure that some of them do not accidentally become exposed to fatal levels of a concoction readily assembled from advice over the Internet and a few visits to the supermarket.  

 

Posted: 16.42pm, 09.05.11