Notes From the Field: Amphetamine Use Among Workers with Severe Hyperthermia — Eight States, 2010–2019

Details

• Journal Article:
  Morbidity and Mortality Weekly Report
• Personal Author:
  Karasick, Andrew S. ; Thomas, Richard J. ; Cannon, Dawn L. ; Fagan, Kathleen M. ; Bray, Patricia A. ; Hodgson, Michael J. ; Tustin, Aaron W.
• Description:
  Workers can develop hyperthermia when core body temperature rises because of heat stress (environmental heat plus metabolic heat from physical activity). Amphetamines are central nervous system stimulants that can induce hyperthermia independently or in combination with other risk factors. During 2010-2016, the Directorate of Technical Support and Emergency Management's Office of Occupational Medicine and Nursing (OOMN), at the Occupational Safety and Health Administration (OSHA), identified three workers with fatal hyperthermia who tested positive for methamphetamine. To identify additional cases of severe hyperthermia in which workers tested positive for amphetamines, and to support OSHA's enforcement activities, OOMN reviewed all medical records and investigation materials submitted by other OSHA offices to OOMN during January 1, 2010-August 31, 2019. OSHA field offices obtained the records from employers and health care facilities as part of OSHA's inspections to enforce occupational safety and health regulations. Confirmed severe hyperthermia was defined as highly elevated body temperature (e.g., core temperature ≥104 degrees F [40 degrees C] or peripheral temperature ≥102 degrees F [38.9 degrees C]) associated with death or serious central nervous system dysfunction (e.g., coma or seizure). For out-of-hospital deaths with no body temperature measurement, suspected severe hyperthermia was defined as a determination by a medical examiner or other responsible postmortem investigator that hyperthermia caused or contributed to the death. The record review identified 111 heat-related illnesses, 46 of which involved severe hyperthermia (38 fatal and eight nonfatal illnesses). ... This investigation revealed a high prevalence (>25%) of amphetamine use among 34 workers with severe hyperthermia. CDC's National Institute for Occupational Safety and Health (NIOSH) has found that amphetamines are associated with heat intolerance, but reports of workplace hyperthermia where amphetamines were detected are limited. Workers and supervisors should be aware of potential hyperthermia-inducing synergy between amphetamines, physical activity, and environmental heat. Workers should not use illicit amphetamines to maintain alertness or enhance performance, especially when heat stress is present. Prevention of illicit amphetamine use is important, not only to avert hyperthermia but also to prevent other adverse effects. Workers should receive support for overcoming stimulant use disorders. Clinicians who prescribe amphetamines should consider obtaining an occupational history to facilitate discussions with patients about heat stress safety. Stakeholders should implement comprehensive occupational heat stress controls, such as those recommended by NIOSH and OSHA, to prevent illnesses. [Description provided by NIOSH]
• Subjects:
  Amphetamines Heat Stress Disorders Hot Temperature Occupational Health Safety
• Keywords:
  Hyperthermia; Body temperature; Heat stress; Methamphetamine; Hot environments; Drugs; Stimulants
• Source:
  MMWR 2020 Jul; 69(30):1004-1005
• Series:
  Weekly Report: Morbidity and Mortality Weekly Report (MMWR)
• ISSN:
  0149-2195
• Pubmed ID:
  32730241
• Pubmed Central ID:
  PMC7392391
• Document Type:
  Text
• Genre:
  Journal Article
• Place as Subject:
  District of Columbia ; New Jersey ; New York ; OSHA Region 2 ; OSHA Region 3
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  2 pdf pages
• Volume:
  69
• Issue:
  30
• NIOSHTIC Number:
  nn:20065793
• Email:
  tustin.aaron.w@dol.gov
• CAS Registry Number:
  Amphetamine (CAS RN 300-62-9) ; Methamphetamine (CAS RN 537-46-2)
• Federal Fiscal Year:
  2020
• Performing Organization:
  Mount Sinai School of Medicine
• Peer Reviewed:
  False
• Collection(s):
  Morbidity and Mortality Weekly Report (MMWR) National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:5baa553706346f922d0875a9cc109121bc7508710b7d32e17013a074ee8e8a6b74f7f78f2464889bec59b04cc62899ae7658af8c6c4ca3621660125cdf8be5d4
• Download URL:
  https://stacks.cdc.gov/view/cdc/91894/cdc_91894_DS1.pdf
• File Type:
  [PDF - 74.42 KB ]