Inert gas asphyxiation

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Inert gas asphyxiation is a form of asphyxiation which results from breathing a physiologically inert gas in the absence of oxygen, or a low amount of oxygen, [1] rather than atmospheric air (which is composed largely of nitrogen and oxygen). Examples of physiologically inert gases, which have caused accidental or deliberate death by this mechanism, are argon, helium, nitrogen and methane.[ citation needed ] The term "physiologically inert" is used to indicate a gas which has no toxic or anesthetic properties and does not act upon the heart or hemoglobin. Instead, the gas acts as a simple diluent to reduce the oxygen concentration in inspired gas and blood to dangerously low levels, thereby eventually depriving cells in the body of oxygen. [2]

Contents

According to the U.S. Chemical Safety and Hazard Investigation Board, in humans, "breathing an oxygen deficient atmosphere can have serious and immediate effects, including unconsciousness after only one or two breaths. The exposed person has no warning and cannot sense that the oxygen level is too low." In the US, at least 80 people died from accidental nitrogen asphyxiation between 1992 and 2002. [3] Hazards with inert gases and the risks of asphyxiation are well-established. [4]

An occasional cause of accidental death in humans, inert gas asphyxia has been used as a suicide method. Inert gas asphyxia has been advocated by proponents of euthanasia, using a gas-retaining plastic hood device colloquially referred to as a suicide bag.

Nitrogen asphyxiation has been approved in some places as a method of capital punishment. In the world's first instance of its use, on January 25, 2024, Alabama executed convicted murderer Kenneth Eugene Smith via this method. It was used once again in the execution of Alan Eugene Miller, on September 26, 2024, and the execution of Carey Dale Grayson on November 21, 2024. [5]

Alternatively, the use of the term hypoxia has been used but this term is flawed given hypoxia does not necessarily imply death. On the other hand, asphyxiation is technically incorrect given respiration continues and the carbon dioxide metabolically produced from the oxygen inhaled prior to inert gas asphyxiation can be exhaled without restriction, which can prevent acidosis and the strong urge to breathe caused by hypercapnia. [6]

Process

When humans breathe in an asphyxiant gas or any other physiologically inert gas, they exhale carbon dioxide without re-supplying oxygen. Physiologically inert gases (those that have no toxic effect, but merely dilute oxygen) are generally free of odor and taste. Accordingly, the human subject detects little abnormal sensation as the oxygen level falls. This leads to asphyxiation (death from lack of oxygen) without the painful and traumatic feeling of suffocation (the hypercapnic alarm response, which in humans arises mostly from carbon dioxide levels rising), or the side effects of poisoning. In scuba diving rebreather accidents, a slow decrease in oxygen breathing gas content can produce variable or no sensation. [7] By contrast, suddenly breathing pure inert gas causes oxygen levels in the blood to fall precipitously, and may lead to unconsciousness in only a few breaths, with no symptoms at all. [3]

Some animals are better equipped than humans to detect hypoxia, and these species are less comfortable in low-oxygen environments that result from inert gas exposure, though more averse to CO2 exposure. [8]

Physiology

A typical human breathes between 12 and 20 times per minute at a rate influenced primarily by carbon dioxide concentration, and thus pH, in the blood. With each breath, a volume of about 0.6 litres is exchanged from an active lung volume of about three litres. The normal composition of the Earth's atmosphere is about 78% nitrogen, 21% oxygen, and 1% argon, carbon dioxide, and other gases. After just two or three breaths of nitrogen, the oxygen concentration in the lungs would be low enough for some oxygen already in the bloodstream to exchange back to the lungs and be eliminated by exhalation.

Unconsciousness in cases of accidental asphyxia can occur within one minute. Loss of consciousness results from critical hypoxia, when arterial oxygen saturation is less than 60%. [9] "At oxygen concentrations [in air] of 4 to 6%, there is loss of consciousness in 40 seconds and death within a few minutes". [10] At an altitude over 43,000 ft (13,000 m), where the ambient oxygen concentration is equivalent to a concentration of 3.6% at sea level, an average individual can perform flying duties efficiently for only 9 to 12 seconds without oxygen supplementation. [9] The US Air Force trains air crews to recognize their subjective signs of approaching hypoxia. Some individuals experience headache, dizziness, fatigue, nausea and euphoria, and some become unconscious without warning. [9]

Loss of consciousness may be accompanied by convulsions [9] and is followed by cyanosis and cardiac arrest. In a 1963 study by the RAF Institute of Aviation Medicine, [11] subjects were asked to hyperventilate in a nitrogen atmosphere. Among the results:

When the duration of over-ventilation with nitrogen was greater than 8–10 sec the subject reported a transient dimming of vision. In the experiments in which nitrogen breathing was carried out for 15–16 sec the subject experienced some general clouding of consciousness and impairment of vision. Vision was frequently lost in these experiments for a short period. In the few experiments in which nitrogen was breathed for 17–20 sec unconsciousness supervened and was accompanied on most occasions by a generalized convulsion. The duration of the interval between the start of over-ventilation with nitrogen and the onset of symptoms was 12–14 sec.

The study did not report how much discomfort the subjects felt. [11]

Animals

Slaughter

Controlled atmosphere killing (CAK) or controlled atmosphere stunning (CAS) is a method for slaughtering or stunning animals such as swine, poultry, [12] or cane toads by placing the animals in a container in which the atmosphere lacks oxygen and consists of an asphyxiant gas (one or more of argon, nitrogen or carbon dioxide), causing the animals to lose consciousness. Argon and nitrogen are important components of a gassing process which seem to cause no pain, and for this reason many consider some types of controlled atmosphere killing more humane than other methods of killing. [13] [14] Most animals are stunned by carbon dioxide. [15] [16]

If carbon dioxide is used, controlled atmosphere killing is not the same as inert gas asphyxia, because carbon dioxide at high concentrations (above 5%) is not biologically inert, but rather is toxic and also produces initial distress in some animal species. [17] The addition of toxic carbon dioxide to hypoxic atmospheres used in slaughter without animal distress is a complex and highly species-specific matter, which also depends on the concentration of carbon dioxide. [18] [19] [20]

Euthanasia

Diving animals such as rats and minks and burrowing animals are sensitive to low-oxygen atmospheres and will avoid them. For this reason, the use of inert gas (hypoxic) atmospheres (without CO2) for euthanasia is also species-specific. [21]

Accidental deaths and injury

Accidental nitrogen asphyxiation is a possible hazard where large quantities of nitrogen are used. It causes several deaths per year in the United States, [22] which is asserted to be more than from any other industrial gas. In one accident in 1981, shortly before the launch of the first Space Shuttle mission, five technicians lost consciousness and two of them died after they entered the aft compartment of the orbiter. Nitrogen had been used to flush oxygen from the compartment as a precaution against fire. They were not wearing air packs because of a last-minute change in safety procedures. [23]

During a pool party in Mexico in 2013, eight party-goers were rendered unconscious and one 21-year-old male went into a coma after liquid nitrogen was poured into the pool. [24] [25]

Occasional deaths are reported from recreational inhalation of helium, but these are very rare from direct inhalation from small balloons. The inhalation from larger helium balloons has been reportedly fatal. [26] A fatal fall from a tree occurred after the inhalation of helium from a toy balloon, which caused the person to become either unconscious or lightheaded. [27]

In 2015, a technician at a health spa was asphyxiated while conducting unsupervised cryotherapy using nitrogen. [28] [29]

In 2021, six people died of asphyxiation and 11 more were hospitalized following a liquid nitrogen leak at a poultry plant in Gainesville, Georgia. [30] [31]

Suicide

Use of inert gas for suicide was first proposed by a Canadian, Dr Bruce Dunn. [32] Dunn commented that "...the acquisition of a compressed gas cylinder, an appropriate pressure reducing regulator, and suitable administration equipment... [was] not inaccessible to a determined individual, but relatively difficult for a member of the public to acquire casually or quickly". [33] Dunn collaborated with other researchers, notably the Canadian campaigner, John Hofsess, who in 1997 formed the group "NuTech" with Derek Humphry and Philip Nitschke. [34] Two years later, NuTech had streamlined Dunn's work by using readily-available party balloon cylinders of helium. [35]

The method of suicide based on self-administration of helium in a bag, a colloquial name being the "exit bag" or suicide bag, has been referenced by some medical euthanasia advocacy groups. [36] Originally, such bags were used with helium, and 30 deaths were reported with use of them from 2001 to 2005, and another 79 from 2005 to 2009. This suggested to one set of reviewers that the popularity of the technique was increasing, as also did the increase in helium suicides in Sweden during the latter half of the same decade. [37]

After attempts were made by authorities to control helium sales in Australia, a new method was introduced that instead uses nitrogen. [38] Nitrogen became the main gas promoted by euthanasia advocates, such as Philip Nitschke, who founded a company called Max Dog Brewing in order to import canisters of nitrogen into Australia. [39] Nitschke stated that the gas cylinders can be used for both brewing and, if required, to end life at a later stage in a "peaceful, reliable [and] totally legal" manner. [40] Nitschke said that nitrogen is "undetectable even by autopsy, which was important to some people". [41]

Nitschke produced a 3D printed pod, "Sarco", that fills with nitrogen at the push of a button, claiming to cause its user to become unconscious within a minute and then die of oxygen deprivation. [42] [43]

Capital punishment

Execution by nitrogen asphyxiation was discussed briefly in print as a theoretical method of capital punishment in a 1995 National Review article. [44] The idea was then proposed by Lawrence J. Gist II, an attorney at law, under the title, International Humanitarian Hypoxia Project. [45]

In a televised documentary in 2007, the British political commentator and former MP Michael Portillo examined execution techniques in use around the world and found them unsatisfactory; his conclusion was that nitrogen asphyxiation would be the best method. [46]

In April 2015, Governor Mary Fallin of Oklahoma signed a bill allowing nitrogen asphyxiation as an alternative execution method. [47] [48] Three years later, in March 2018, Oklahoma announced that, due to the difficulty in procuring lethal injection drugs, nitrogen gas would be used to carry out executions. [49] [50] After making "good progress" in designing a nitrogen execution protocol, but not actually carrying out any executions, Oklahoma announced in February 2020 it had found a new reliable source of lethal injection drugs, but would continue working on nitrogen execution as a contingency method. [51]

In March 2018, Alabama became the third state (after Oklahoma and Mississippi), to authorize the use of nitrogen asphyxiation as a method of execution. [52]

In August 2023, the Alabama Department of Corrections released its protocol for nitrogen hypoxia executions, designating Kenneth Eugene Smith, convicted of murder for hire in 1996, as the first death row inmate to undergo this method. [53] [54] [55] On November 1, the Supreme Court of Alabama authorized the execution to go ahead using the nitrogen hypoxia protocol. [55] On 25 January 2024, he became the first person to be executed by nitrogen hypoxia in the world. [56] Though the State Attorney General said afterward that Smith's execution showed that nitrogen hypoxia was an "effective and humane method of execution", [57] several people watching the execution reported that Smith "thrashed violently on the gurney" [56] for several minutes, with his death reportedly occurring 10 minutes after the nitrogen was administered to the chamber. [58] [59] The United Nations High Commissioner for Human Rights condemned the use. [60]

On September 26, 2024 Alan Eugene Miller became the second convicted man put to death by way of nitrogen gas, in Alabama.

On March 5, 2024, Louisiana Governor Jeff Landry signed a law allowing executions to be carried out via nitrogen gas. [61]

After Smith's execution, several other states became open to the possibility of legally carrying out nitrogen gas executions. Lawmakers from Ohio, where a moratorium is in effect since the state's last execution in 2018, were considering to legalize nitrogen gas as a new method of execution aside from lethal injection. [62] [63] [64]

In the case Bucklew v. Precythe in 2019, the U.S. Supreme Court ruled that a Missouri death row inmate with cavernous hemangioma, a rare disorder that causes swelling of blood-filled cavities, could not avoid death by lethal injection and choose inert gas asphyxiation using nitrogen, since it had never been used in any execution in the world. [65]

See also

Related Research Articles

<span class="mw-page-title-main">Nitrogen</span> Chemical element with atomic number 7 (N)

Nitrogen is a chemical element; it has symbol N and atomic number 7. Nitrogen is a nonmetal and the lightest member of group 15 of the periodic table, often called the pnictogens. It is a common element in the universe, estimated at seventh in total abundance in the Milky Way and the Solar System. At standard temperature and pressure, two atoms of the element bond to form N2, a colourless and odourless diatomic gas. N2 forms about 78% of Earth's atmosphere, making it the most abundant chemical species in air. Because of the volatility of nitrogen compounds, nitrogen is relatively rare in the solid parts of the Earth.

<span class="mw-page-title-main">Nitrogen narcosis</span> Reversible narcotic effects of respiratory nitrogen at elevated partial pressures

Narcosis while diving is a reversible alteration in consciousness that occurs while diving at depth. It is caused by the anesthetic effect of certain gases at high partial pressure. The Greek word νάρκωσις (narkōsis), "the act of making numb", is derived from νάρκη (narkē), "numbness, torpor", a term used by Homer and Hippocrates. Narcosis produces a state similar to drunkenness, or nitrous oxide inhalation. It can occur during shallow dives, but does not usually become noticeable at depths less than 30 metres (98 ft).

<span class="mw-page-title-main">Asphyxia</span> Severely deficient supply of oxygen

Asphyxia or asphyxiation is a condition of deficient supply of oxygen to the body which arises from abnormal breathing. Asphyxia causes generalized hypoxia, which affects all the tissues and organs, some more rapidly than others. There are many circumstances that can induce asphyxia, all of which are characterized by the inability of a person to acquire sufficient oxygen through breathing for an extended period of time. Asphyxia can cause coma or death.

<span class="mw-page-title-main">Gas chamber</span> Sealed room into which gas is pumped in, causing death by poisoning or asphyxiation

A gas chamber is an apparatus for killing humans or other animals with gas, consisting of a sealed chamber into which a poisonous or asphyxiant gas is introduced. Poisonous agents used include hydrogen cyanide and carbon monoxide.

<span class="mw-page-title-main">Inert gas</span> Gas which does not chemically react under the specified conditions

An inert gas is a gas that does not readily undergo chemical reactions with other chemical substances and therefore does not readily form chemical compounds. Though inert gases have a variety of applications, they are generally used to prevent unwanted chemical reactions with the oxygen (oxidation) and moisture (hydrolysis) in the air from degrading a sample. Generally, all noble gases except oganesson, nitrogen, and carbon dioxide are considered inert gases. The term inert gas is context-dependent because several of the inert gases, including nitrogen and carbon dioxide, can be made to react under certain conditions.

<span class="mw-page-title-main">Rebreather</span> Portable apparatus to recycle breathing gas

A rebreather is a breathing apparatus that absorbs the carbon dioxide of a user's exhaled breath to permit the rebreathing (recycling) of the substantially unused oxygen content, and unused inert content when present, of each breath. Oxygen is added to replenish the amount metabolised by the user. This differs from open-circuit breathing apparatus, where the exhaled gas is discharged directly into the environment. The purpose is to extend the breathing endurance of a limited gas supply, while also eliminating the bubbles otherwise produced by an open circuit system. The latter advantage over other systems is useful for covert military operations by frogmen, as well as for undisturbed observation of underwater wildlife. A rebreather is generally understood to be a portable apparatus carried by the user. The same technology on a vehicle or non-mobile installation is more likely to be referred to as a life-support system.

<span class="mw-page-title-main">Breathing gas</span> Gas used for human respiration

A breathing gas is a mixture of gaseous chemical elements and compounds used for respiration. Air is the most common and only natural breathing gas, but other mixtures of gases, or pure oxygen, are also used in breathing equipment and enclosed habitats. Oxygen is the essential component for any breathing gas. Breathing gases for hyperbaric use have been developed to improve on the performance of ordinary air by reducing the risk of decompression sickness, reducing the duration of decompression, reducing nitrogen narcosis or allowing safer deep diving.

<span class="mw-page-title-main">Hypercapnia</span> Abnormally high tissue carbon dioxide levels

Hypercapnia (from the Greek hyper = "above" or "too much" and kapnos = "smoke"), also known as hypercarbia and CO2 retention, is a condition of abnormally elevated carbon dioxide (CO2) levels in the blood. Carbon dioxide is a gaseous product of the body's metabolism and is normally expelled through the lungs. Carbon dioxide may accumulate in any condition that causes hypoventilation, a reduction of alveolar ventilation (the clearance of air from the small sacs of the lung where gas exchange takes place) as well as resulting from inhalation of CO2. Inability of the lungs to clear carbon dioxide, or inhalation of elevated levels of CO2, leads to respiratory acidosis. Eventually the body compensates for the raised acidity by retaining alkali in the kidneys, a process known as "metabolic compensation".

<span class="mw-page-title-main">Gas blending for scuba diving</span> Mixing and filling cylinders with breathing gases for use when scuba diving

Gas blending for scuba diving is the filling of diving cylinders with non-air breathing gases such as nitrox, trimix and heliox. Use of these gases is generally intended to improve overall safety of the planned dive, by reducing the risk of decompression sickness and/or nitrogen narcosis, and may improve ease of breathing.

Shielding gases are inert or semi-inert gases that are commonly used in several welding processes, most notably gas metal arc welding and gas tungsten arc welding. Their purpose is to protect the weld area from oxygen, and water vapour. Depending on the materials being welded, these atmospheric gases can reduce the quality of the weld or make the welding more difficult. Other arc welding processes use alternative methods of protecting the weld from the atmosphere as well – shielded metal arc welding, for example, uses an electrode covered in a flux that produces carbon dioxide when consumed, a semi-inert gas that is an acceptable shielding gas for welding steel.

An asphyxiant gas, also known as a simple asphyxiant, is a nontoxic or minimally toxic gas which reduces or displaces the normal oxygen concentration in breathing air. Breathing of oxygen-depleted air can lead to death by asphyxiation (suffocation). Because asphyxiant gases are relatively inert and odorless, their presence in high concentration may not be noticed, except in the case of carbon dioxide (hypercapnia).

Equivalent narcotic depth (END) (historically also equivalent nitrogen depth) is used in technical diving as a way of estimating the narcotic effect of a breathing gas mixture, such as nitrox, heliox or trimix. The method is used, for a given breathing gas mix and dive depth, to calculate the equivalent depth which would produce about the same narcotic effect when breathing air.

A euthanasia device is a machine engineered to allow an individual to die quickly with minimal pain. The most common devices are those designed to help terminally ill people die by voluntary euthanasia or assisted suicide without prolonged pain. They may be operated by a second party, such as a physician, or by the person wishing to die. There is an ongoing debate on the ethics of euthanasia and the use of euthanasia devices.

<span class="mw-page-title-main">Breathing</span> Process of moving air in and out of the lungs

Breathing is the rhythmical process of moving air into (inhalation) and out of (exhalation) the lungs to facilitate gas exchange with the internal environment, mostly to flush out carbon dioxide and bring in oxygen.

A suicide bag, also known as an exit bag or hood, is part of a euthanasia device consisting of a large plastic bag with a drawcord used to die by suicide through inert gas asphyxiation. It is usually used in conjunction with a flow of an inert gas that is lighter or less dense than air, like helium or nitrogen. Continuing to breathe expels carbon dioxide and this prevents the panic, sense of suffocation and struggling before unconsciousness, known as the hypercapnic alarm response caused by the presence of high carbon dioxide concentrations in the blood.

Gas blending is the process of mixing gases for a specific purpose where the composition of the resulting mixture is defined, and therefore, controlled. A wide range of applications include scientific and industrial processes, food production and storage and breathing gases.

Human physiology of underwater diving is the physiological influences of the underwater environment on the human diver, and adaptations to operating underwater, both during breath-hold dives and while breathing at ambient pressure from a suitable breathing gas supply. It, therefore, includes the range of physiological effects generally limited to human ambient pressure divers either freediving or using underwater breathing apparatus. Several factors influence the diver, including immersion, exposure to the water, the limitations of breath-hold endurance, variations in ambient pressure, the effects of breathing gases at raised ambient pressure, effects caused by the use of breathing apparatus, and sensory impairment. All of these may affect diver performance and safety.

In fire and explosion prevention engineering, purging refers to the introduction of an inert purge gas into a closed system to prevent the formation of an ignitable atmosphere. Purging relies on the principle that a combustible gas is able to undergo combustion (explode) only if mixed with air in the right proportions. The flammability limits of the gas define those proportions, i.e. the ignitable range.

<span class="mw-page-title-main">Sarco pod</span> Euthanasia device

The Sarco pod is a euthanasia device or machine consisting of a 3D-printed detachable capsule mounted on a stand that contains a canister of liquid nitrogen to die by suicide through inert gas asphyxiation. "Sarco" is short for "sarcophagus". It is used in conjunction with an inert gas (nitrogen) which decreases oxygen levels rapidly which prevents panic, sense of suffocation and struggling before unconsciousness, known as the hypercapnic alarm response caused by the presence of high carbon dioxide concentrations in the blood. The Sarco was invented by euthanasia campaigner Philip Nitschke in 2017. Nitschke said in 2021 that he sought and received legal advice about the device's legality in Switzerland.

<span class="mw-page-title-main">Diving rebreather</span> Closed or semi-closed circuit scuba

A Diving rebreather is an underwater breathing apparatus that absorbs the carbon dioxide of a diver's exhaled breath to permit the rebreathing (recycling) of the substantially unused oxygen content, and unused inert content when present, of each breath. Oxygen is added to replenish the amount metabolised by the diver. This differs from open-circuit breathing apparatus, where the exhaled gas is discharged directly into the environment. The purpose is to extend the breathing endurance of a limited gas supply, and, for covert military use by frogmen or observation of underwater life, to eliminate the bubbles produced by an open circuit system. A diving rebreather is generally understood to be a portable unit carried by the user, and is therefore a type of self-contained underwater breathing apparatus (scuba). A semi-closed rebreather carried by the diver may also be known as a gas extender. The same technology on a submersible or surface installation is more likely to be referred to as a life-support system.

References

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  2. ↑ "Argon, hydrogen, helium, and nitrogen are inert gases that cause asphyxiation if present in high enough concentration to dilute O2 in the inspired air to dangerous levels. ... Asphyxia, which is synonymous with respiratory failure, can be defined as insufficient oxygen at the cellular level. ... Simple asphyxiants are gases that are physiologically inert. They do not suppress cardiac output or alter the function of the hemoglobin. Rather, they cause asphyxiation only when present in high enough concentration to lower the concentration of O2 in the inspired air to levels at which the SaO2 and PaO2 fall, resulting in inadequate O2 delivery to tissues." Quoted from Simple Asphyxiants, Mark Wilkenfield, M.D. Chapter 34, pp. 556–7. in: Environmental and Occupational Medicine, Editors William N. Rom, Steven B. Markawitz. 4th Edition, Publisher: Lippincott Williams & Wilkins, 2007. ISBN   0781762995, 9780781762991.
  3. 1 2 Chemical Safety Board Bulletin Archived 2016-03-04 at the Wayback Machine This is a government summary of accidental 80 nitrogen inhalation deaths, mostly in occupational circumstances. For a presentation form with additional material, see Archived 2016-03-04 at the Wayback Machine
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  27. ↑ Lung ruptures and fatal gas embolisms have occurred from inhalation from a pressure tank and although this was reported as a helium inhalation death, it differs greatly from the process of inert gas asphyxiation. See gas embolism helium death
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  55. 1 2 "Alabama court approves nitrogen gas as new method for executions". The Guardian. Associated Press. 2 November 2023. Archived from the original on 29 November 2023. Retrieved 29 November 2023.
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