----- Original Message -----From: Alan HallSent: 10/26/2009 12:05:14 PMSubject: Re: [DCHAS-L] Harvard Tightening Security After 6 Poisoned Students, Researchers Ingest Lethal ChemicalD-CHAS,
You might check my Chapter in the most recent version of Haddad and Winchester's Clinical Management of Poisoning and Drug Overdose, 4th ed. Hall, AH: Cyanide and Related Compounds -- Sodium Azide. Shannon MH et al (eds), Haddad and Winchester's Clinical Management of Poisoning and Drug Overdose, 4th ed., Saunders Elsevier, 2007, pp. 1309-1316.
Solutions of sodium azide are indeed colorless, odorless, and tastless laboratory solutions, which can and have been mistaken for water or normal saline and inadvertantly ingested when usual laboratory safety precautions have not been followed. Clearly, using anything resembling water in coffee or tea making in laboratories, especially anything in laboratory glassware, must be prohibited. Suicidal or homicidal exposure cannot be ruled out as both have happened. Indeed, there are very few cases of azide poisoning i! n the world medical literture. At the time of the above review, between 1927-1999, there were only 38 publications regarding sodium azide poisoning found with only 69 actual poisoning cases. Hypotension is the most common clinical effect, which usually occurs within minutes to 1 hour after ingestion exposure.
While the mehanisms of toxic action in azide poisoning is quite similar to that of cyanide, all studies to date indicate that cyanide antidotes are not efficacious in azide poisoning. There are some perhaps interesteing rat mitochondria in vitro studies with hydroxocobalamin, but this remains essentially theoretical at this time.
We will be discussing sodium azide/hydroazoic acid poisoning in an upcoming revision of the appropriate chapter in Irwin and Rippe's Intensive Care Medicine, 7th edition (revision in progress).
Alan H. Hall, M.D.
Toxicology Consulting and ! Medical Translating Services, Inc.
Colorado School o f Public Health
> Date: Mon, 26 Oct 2009 11:13:22 -0400
> From: ecgrants**At_Symbol_Here**UVM.EDU
> Subject: [DCHAS-L] Harvard Tightening Security After 6 Poisoned Students, Researchers Ingest Lethal Chemical
> To: DCHAS-L**At_Symbol_Here**LIST.UVM.EDU
> Harvard Tightening Security After 6 Poisoned Students, Researchers
> Ingest Lethal Chemical
> BOSTON -- Harvard University Medical School will increase security and
> install new video cameras at its laboratories this week as police work
> to determine whether six people were intentionally poisoned at a
> research building.
> The scientists and students fell ill on Aug. 26 after consuming a
> potentially lethal chemical that was present in their coffee,
> according to an internal memo sent to medical school students on Friday.
> All six people had used a single-serve coffee machine near their
> pathology lab at Harvard’s New Research Building to prepare the
> coffee, and all later reported dizziness and low blood pressure.
> Testing revealed the presence of sodium azide, a common preservative,
> in the coffee, the memo said. Sodium azide is an odorless white solid,
> according to the Centers for Disease Control Web site.
> One person became unconscious. All six were taken to Beth Israel
> Deaconess Medical Center for treatment. None suffered long-term
> consequences from the poisoning.
> The university said it does not know if the poisoning was deliberate
> or accidental.
> “While we do not yet know how the incident occurred, we have recently
> learned that sodium azide ... was present in the coffee consumed by
> the six employees,” the memo reads.
> Ma! ny workers and students who frequent the building said they had not > yet heard about the incident.
> "I'm actually kind of surprised," one said.
> Swallowing the chemical can cause rapid breathing, dizziness and
> nausea, according to the CDC.
> The federal Occupational Safety and Health Administration and the
> Boston Public Health Commission are investigating.
> “We are in the process of installing additional security cameras
> throughout our buildings, and we are strengthening the security
> systems that manage access to the laboratories during both normal
> business hours and off hours,” the Harvard memo said.
> Copyright 2009 by TheBostonChannel.com. All rights reserved. This
> material may not be published, broadcast, rewritten or redistributed.
> http://news.bostonherald.com/news/regional/view/20091026experts_discount_accident_theory_in_harvard_coffee_poisoning/srvc=hom! e&position=2
> Experts discount ‘accident’ theory in Harvard coffee poisoning
> By Adam Smith and Jessica Van Sack
> Buzz up!
> A leading toxicologist believes the chances are slim that six lab
> workers at Harvard University Medical School were poisoned by accident.
> “An accident? Sodium azide is a poison,” said David M. Benjamin, a
> toxicologist and Chestnut Hill-based clinical pharmacologist.
> “Absolutely not.”
> The Herald reported yesterday that six scientists and students at the
> New Research Building in Boston’s Longwood Medical area were
> mysteriously poisoned after drinking from a communal, single-serve
> coffee machine on the eighth floor near their pathology lab on Aug.
> 26. Seconds later all six reported symptoms including dizziness and
> low blood pressure and were taken to Beth Israel Deaconess Medical
> Cent! er for treatment.
> “Could it have gotten in the coffee machine inadvertantly? Absolutely
> not,” Benjamin said of the compound, an odorless white solid used in
> labs as a preservative. “It could be considered an attempted murder or
> Harvard did not make the poisoning public until after repeated
> inquiries from the Herald. The university continued to skirt questions
> yesterday, with a spokesman referring inquiries to Harvard police, and
> the police referring questions back to the spokesman.
> “This is crazy,” said a Harvard Medical School researcher who did not
> want to be identified. “I don’t know why it would take two months to
> announce this.”
> Although he is not privy to the investigation, medical school
> spokesman David Cameron said, “What I know at this point in time is
> that all options and potential avenues for how this could have
> happened are being very thoroughly and intensel! y investigated.”
> The same substance was used in a string of coffee and tea poisoning
> incidents in Japan a decade ago. In one incident, the chief internist
> of a Kyoto hospital was found guilty of lacing the green tea ingested
> by seven fellow doctors with sodium azide.
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