Methamphetamine exposure and chronic illness in police officers: significant improvement with sauna-based detoxification therapy.

2012·0.45 MB·English

by  Ross, Gerald H

ToxicologyandIndustrialHealth
28(8)758–768
Methamphetamine exposure and ©TheAuthor(s)2012
Reprintsandpermissions:
chronic illness in police officers: sagepub.co.uk/journalsPermissions.nav
DOI:10.1177/0748233711425070
significant improvement with tih.sagepub.com
sauna-based detoxification therapy
Gerald H Ross1 and Marie C Sternquist2
Abstract
Background: The medical literature reports health hazards for law enforcement personnel from repeated
exposuretomethamphetamineandrelatedchemicalcompounds.Mosteffectsappeartransitory,butsomeUtah
police officers with employment-related methamphetamine exposures developed chronic symptoms, some
leadingtodisability.Thisreportisofanuncontrolledretrospectivemedicalchartevaluationofsymptomaticoffi-
cers treated with asauna detoxification protocol designed to reduce the chronic symptoms and improve the
quality of life. Methods: Sixty-nine officers consecutively entering the Utah Meth Cops Project were assessed
beforeandafteratreatmentprograminvolvinggradualexercise,comprehensivenutritionalsupportandphysical
saunatherapy.Evaluationsincludedpre-andpost-treatmentscoresoftheResearchandDevelopmentCorpo-
ration(RAND)36-itemShortFormHealthSurvey(SF-36)incomparisonwithRANDpopulationnorms,pre-
andpost-treatmentsymptomscoreintensities,neurotoxicityscores,Mini-MentalStatusExamination,present-
ingsymptomfrequenciesandastructuredevaluationoftreatmentprogramsafety.Results:Statisticallysignificant
healthimprovementswereseenintheSF-36evaluations,symptomscoresandneurotoxicityscores.Thedetox-
ificationprotocolwaswelltolerated,witha92.8%completionrate.Conclusions:Thisinvestigationstronglysug-
gests that utilizing sauna and nutritional therapy may alleviate chronic symptoms appearing after chemical
exposuresassociatedwithmethamphetamine-relatedlawenforcementactivities.Thisreportalsohasrelevance
toaddressingtheapparentilleffectsofothercomplexchemicalexposures.Inviewofthepositiveclinicalout-
comesinthisgroup,broaderinvestigationofthissauna-basedtreatmentregimenappearswarranted.
Keywords
Methamphetamine, police, chemical exposure, contamination, sauna, detoxification
Introduction An estimated half of the approximately 300 Utah
officers involved in methamphetamine lab-related
Persons addicted to methamphetamine develop
activities later developed varying degrees of chronic
serious health problems (Hall et al., 2003), but there
illness and symptoms that were sometimes incapa-
is less understanding surrounding the high numbers
citating (Personal communication from senior Utah
oflawenforcement personnelwhoexperience signif-
icant symptoms associated with clandestine metham-
phetamine drug lab investigations (CDC, 2005).
1Utah Meth Cops Project, c/o American Detoxification
Responding to an active laboratory has been associ-
Foundation,SaltLakeCity,UT,USA
ated with a 7- to 15-time higher risk of becoming ill 2Foundation for Advancements in Science and Education,
when compared to other activities with apparently Pasadena,CA,USA
lower chemical exposures (Burgess et al., 1996).
Correspondingauthor:
AccordingtoMarshall(2000),since1993‘thenum-
Gerald H Ross, Utah Meth Cops Project, c/o American
ber of clandestine drug laboratory investigations has
DetoxificationFoundation,P.O.Box522169,SaltLakeCity,UT
continued to increase, making Utah the number one
84152,USA
state for per capita methamphetamine laboratories.’ Email:[email protected]
Ross and Sternquist 759
officers). In 2005, local telecasts reported apparently Hogstedt, 1994; Herpin et al., 2009). Use of
higher rates of deaths, cancers, or unusual symptoms recreational methamphetamine is clearly detrimental
among these officers, implying a link between meth- to human health (Hall et al., 2003; Schep et al.,
lab-relatedexposuresandsubsequenthealthproblems. 2010). It appears plausible that exposure to metham-
While symptoms may be transitory, many individuals phetamine(especiallyinillegalproductionlaboratory
have persistent symptoms causing them to seek medi- settings)couldpossiblytriggersubsequentchronicill
calattention(Burgess,2001;Burgessetal.,1996;Wit- health but a causal link is not firmly established at
ter et al., 2007). present. Drug enforcement efforts obviously suffer
Methamphetaminesynthesisutilizeshazardousche- when highly trained officers cannot function because
micals including irritants and neurotoxins (Betsinger, of chronic disabling symptoms. However, whether a
2006; Martyny et al., 2004). Aerosolized metham- causallinkbetweenexposureandsubsequentchronic
phetamine and associated toxic substances permeate illnessbecomesapparentornot,medicaltreatmentsto
carpets, walls and surfaces, and even wood construc- restore health and quality of life are clearly needed.
tion(Martynyetal.,2005a,b).Disposedwasteincludes Appropriate treatment responses recognize and
corrosive and other dangerous materials (EHP Forum, address chemical-related illnesses based on clinical
1998). The capture, arrest, and transport of suspects signs or patterns (CDC, 2003). In 2007, the Utah
and toxic materials can pollute officers’ clothing and AttorneyGeneralinvestigatedasauna-baseddetoxifi-
vehicles (Martyny et al., 2005a,b). cation regimen operating in Manhattan for treating
Thesehazardswerenotwellunderstoodduringthe chronically ill rescue and recovery workers exposed
1990’s upsurge of methamphetamine manufacture during the September 11, 2001 World Trade Center
and lab raids. Officers often lacked personal protec- attack and collapse (Cecchini et al., 2006; Dahlgren
tive equipment (PPE), including respiratory protec- etal.,2007).Aseniorpoliceofficerandaprofessional
tion (CDC, 2000). firefighter who were ill after methamphetamine lab-
On-site detection of illicit substances included relatedexposuresinUtahattributedsubstantialhealth
olfactory perception of drug-related odors. After improvement after receiving this treatment.
securing the premises, officers commonly spent sev- Thetreatmentisacombinationofmodalitiesaimed
eral hours on site, taking chemical inventories and at enhancing the broad elimination of body-stored
samples for identification. Officers would often toxic pollutants and improving symptoms common
unknowingly pollute their cars while transporting to chemical exposures, including those from illicit
chemicals and equipment to evidence storage sites or drug use (Hubbard, 2002). After the release of treat-
to the Drug Enforcement Administration (DEA) for mentprotocolin1979,Schnareetal.(1982)described
analysis. Such contaminated vehicles could expose the program’s safety and ability to reduce symptoms
officers’ eyes, skin, and lungs for months afterward. and improve mental functioning among individuals
Canine(K-9)handlerstraineddrug-sniffingdogsusing with a variety of chemical or illicit drug exposures.
residue-laden decoys, thus increasing the handler’s A number of subsequent studies describe the
methamphetamine exposures. Although preparation safety of sauna-based regimens as well as their
for chemical hazards has improved over time, toxic ability to reduce body stores of toxic pollutants and
exposures can still occur. improve symptoms (Crinnion, 2007; Rea et al.,
Theinteractionsofcomplexchemicalmixturesmay 1996; Tsyb et al., 1998). Several studies using the
produce broad symptom patterns that developed in Hubbard method showed significant reductions in
these officers: reduced respiratory function (Burgess human chemical pollutants and improvements in
et al., 2002); headache, cough, throat, and eye irrita- health (Schnare et al., 1984; Tretjak et al., 1989,
tion; variable numbness; heartburn and esophageal 1990). Kilburn et al. (1989) found improvements
reflux, skin rashes; and central nervous system symp- in long-term memory, cognitive dysfunction, and
toms (chronic headaches, irritability, severe insomnia, peripheral neuropathy among the firefighters 6
fatigue, and even psychosis) (Burgess, 2001; Burgess months after PCB (polychlorinated biphenyl) expo-
et al., 1996; CDC, 2000; Witter et al., 2007). sures from burning transformers. The Hubbard
Precise concentrationsofmethamphetamine orthe detoxification procedure is used widely, including
chemicals used for its production were not measured in substance abuse treatment, with evidence of its
in this study, but these chemicals have serious health ability to eliminate chemical and drug residues
effects, even at low concentrations (Alexson and (Cecchini and LoPresti, 2007).
760 Toxicology and Industrial Health 28(8)
The nonprofit American Detoxification Foundation DEA, and officers exposed while performing
(ADF) established and administered The Utah Meth chemical laboratory analyses.
Cops Project (UMCP), which uses the Hubbard
detoxification protocol and monitors health and Summary of the intervention
qualityoflifeamongUtahpoliceofficers,toaddress
Treatment components include (1) 20–30 min of
the symptoms consistent with (and appearing after)
aerobic exercise, (2) comprehensive nutritional sup-
line-of-duty exposures to methamphetamine and
plementation including increasing doses of niacin
related chemicals.
(vitamin B3), and (3) moderate-temperature sauna
therapy, with breaks every 30 min for fluid and elec-
Methods
trolyterestoration,totalingabout4hdaily.Treatment
Description of the study group, inclusion, and is given each day until maximum gains are achieved
exclusion criteria (typically 4–6 weeks). Daily progress is monitored
bytrainedstaffandrecordedusingastructuredreport
Thisisaretrospectivemedicalchartevaluationonthe
form. The detailed protocol is described elsewhere
first 69 police officers sequentially entering the
(Hubbard, 2002; Schnare et al., 1982).
UMCPbetweenOctober2007andJuly2010.Officers
The 8-to-10 person sauna has ceramic tiles on all
were recruited through outreach efforts by project
interior surfaces, with benches made of aged poplar
staff,wordofmouthwithinthepolicecommunityand
wood. All surfaces were cleaned with a dilute
referrals bytheirChiefsof Policeor CountySheriffs.
fragrance-free soap solution, and eliminated through
a floor S-drain. A tempered glass doorprovides direct
Exclusion criteria
assessment of sauna participants, and flow-through
Pregnancy, known active cancer, being wheelchair- ventilation and dedicated ducting slowly evacuates
bound, a history of psychosis, extensive psychiatric sauna air outside the building.
treatment, or suicide attempts were the exclusion The heat source (15,000 W capacity, 240 V, and
criteria. 62.5A)isaceramiccoilsurroundedbygranitestones,
maintainingastable 160(cid:2)F temperature at 5 ft above
Inclusion criteria the sauna floor. The heater emits a full spectrum of
infrared wavelengths matching thousands of years
(1) Law enforcement work within Utah, (2) docu-
of sauna use and protocol specifications (Hubbard,
mented contact with methamphetamine and related
2002).
chemicals through law enforcement activities, and
(3)thesubsequentdevelopmentofpersistentmedical
Outcome evaluations
symptomsorchronicillhealthweretheinclusioncri-
teria.Officersgavewritteninformedconsentfortreat- Symptom changes and quality of life were assessed
ment and outcomes monitoring, including reporting using a baseline history and physical examination,
of aggregate findings. follow-up interviews, and a series of pre- and post-
TheMedicalDirectorincludedparticipantsaccord- treatment assessments:
ingtotheircomprehensivehistoryandphysicalexam-
ination,EKG,andbloodanalysis(metabolicandliver 1. The RAND 36-item Short Form Health Survey
panels,hepatitisB,CandHIVscreen,completeblood (SF-36) assessed the 4-week health-related qual-
count, and thyroid panel). Further tests were done, ity of life before treatment. The RAND SF-36
includingtestosteronelevels,whendirectquestioning scoring mechanism differs from that licensed by
revealedproblemsthatwarrantedevaluation.Officers Medical Outcomes Trust and produces a 9-scale
withdebilitatingsymptomshadsomepriority;nopre- profile of functional ability and physical and
ferentialtreatmentwasgivenforthenumberofmeth- mental well-being. SF-36 scores were also com-
related exposures, age, gender, or police rank. pared pre- and post-treatment and to RAND US
Patients included undercover, narcotics, and adult population norms (Hays et al., 1993).
SpecialWeaponsandTactics(SWAT)officersfrom 2. A 50-item pre- and post-treatment survey of the
many Utah urban and county jurisdictions, Utah preceding 4 weeks’ symptoms, sick days, and
Highway Patrol (UHP), Immigration and Customs sleep patterns was developed by the Foundation
Enforcement (ICE), officers affiliated with the for Advancements in Science and Education
Ross and Sternquist 761
Table1.MethCopsmeanRANDSF-36categoryscoresandstandarddeviationbeforeandaftertreatment(p<0.001for
all categories) andcompared withRAND publishednormsa
Beforetreatment, Aftertreatment, RANDnorm Significance toRAND
n¼61 n¼61 n¼ 2471 norm (pvalue)
Mean SD Mean SD Mean SD Beforeb Afterc
Physical functioning 79.01 17.05 92.78 10.97 70.61 27.42 0.017 <0.001
Role limitationsdue to
Physicalhealth 53.28 38.86 85.25 29.71 52.97 40.78 0.953 <0.001
Emotionalproblems 56.28 38.75 90.16 23.84 65.78 40.71 0.072 <0.001
Energy/fatigue 35.90 19.74 68.61 18.31 52.15 22.39 <0.001 <0.001
Emotionalwell-being 62.16 18.00 85.05 10.30 70.38 21.97 0.004 <0.001
Social functioning 65.37 22.29 85.86 20.35 78.77 25.43 <0.001 0.031
Pain 59.39 19.55 82.17 18.46 70.77 25.48 <0.001 <0.001
General health 49.41 18.56 78.44 13.68 56.99 21.11 0.006 <0.001
Year agohealthchange 45.49 19.64 85.25 19.57 59.14 23.12 <0.001 <0.001
aStatisticalsignificancewasacceptedatp<0.05.AllSF-36meanpre-detoxificationhealthscoreswerestatisticallylower(p<0.001)
comparedwithmeanpost-treatmentscores,basedonpairedtwo-tailedttest.
bMeanSF-36pre-detoxificationhealthscoreswerestatisticallylessthanthepublishedpopulationnormsusingRANDmethodology,
except role limitations due tophysical health (p¼ 0.953) and role limitations due toemotional problems (p ¼ 0.072), based on the two-
tailedttest.
cMeanSF-36post-treatmenthealthscoreswereallsignificantlyhigherthanthepublishedRANDmethodologypopulationnorms.
(FASE) for clinical settings using the Hubbard forpaireddatasets:Wilcoxonmatchedpairstestand
regimen. the sign test.
3. A 13-item pre- and post-treatment neurotoxicity
questionnaire based on the parameters of Singer
(2006) rated the preceding 3 weeks’ problems Results
involvingirritability,socialwithdrawal,decreased
Treatment length and completion rates
motivation,recentmemory,concentration,mental
slowness/fog, sleep disturbances, fatigue, fre- A total of 66 men and 3 women (n ¼ 69), averaging
quencyandseverityofheadaches,sexualdysfunc- 44.6 years of age (range: 31–60 years) enrolled
tion, extremity numbness, and decreased mental sequentiallywitha92.8%completionrate;5mendid
sharpness, expressed on a 0–10 Likert-type scale. notcompletethetreatment.Meantreatmentlengthfor
4. The Mini-Mental State Examination (Folstein et the 64 patients who completed the treatment was 33
al., 1975). days(range:15–56days);forthe5whodidnotcom-
5. Daily report form: a structured summary of pletethetreatment,themeantreatmentlengthwas29
vital signs/events recorded by trained staff on days(range:23–25days).Reasonsfordiscontinuation
each treatment day, including any undesirable are summarized in Table 2.
effects (whether or not related to treatment).
For safety evaluation, any adverse events or
Symptoms present in more than 50% of the
interruptionsoftheprotocolappearonthedaily
officers (n ¼ 66)
report form and are assessed by the medical
director. The enrollment evaluation is shown in Figure 1,
which includes fatigue: 96%, insomnia: 91%, head-
Analyses compared the means and standard devia- aches: 90%, heartburn: 81%, personality changes:
tions of test scores before and after program partici- 78%, numbness in hands and/or feet: 77%, memory
pation. Statistical significance was calculated using loss: 77%, allergic history: 75%, poor concentration:
2-tailedStudentttestwithpairedscoresforpre/post 75%, back pain: 71%, joint pains: 71%, shortness of
comparisonsorunpairedforcomparisonwithRAND breath on exertion: 70%, skin irritation: 68%, anxi-
SF-36 published norms. Two nonparametric mea- ety/depression, 65%; abdominal gas/pain: 65%, sinu-
sures of statistical significance were also calculated sitis/congestion: 55%, and sore throat: 52%.
762 Toxicology and Industrial Health 28(8)
Figure1.PercentageofUtahMethCopsStudygroupreportingspecificsymptoms(symptomsdisplayedwerereported
by>50%of theofficers.) n¼66. See narrative textforfrequency dataof additional symptoms.
Symptoms present in less than 50% of the RAND SF-36 scores: change in health-related
officers (n ¼ 66) quality of life (n ¼ 61)
The symptoms include hearing loss: 46%, lower Table 1 displays the mean pre- and post-treatment
libido: 43%, chronic cough: 41%, slower healing: SF-36 scores calculated using RAND methodology
41%, cardiac palpitations: 39%, history of prior loss and compared with US population norms for those
of consciousness: 39%, eye irritation: 39%, dizziness: officers who completed the regimen. Figure 2 shows
39%, diarrhea: 36%, history of medication allergy or the data in graphic form.
intolerance: 33%, sudden hair loss: 22%, smell loss: Mean values of the officer pre-treatment health-
19%, and ear ringing: 4%. related quality of life scores were significantly lower
than RAND population norms (p < 0.001) in all nine
subscalesexceptrolelimitationsduetophysicalhealth
Percentage of officers with abnormal findings
(p¼0.953)androlelimitationsduetoemotionalprob-
The abnormal findings include elevated blood lipids: lems (p ¼ 0.072). Post-treatment, the officers’ scores
58%,elevatedliverfunctiontests:41%,positiverom- showed statistically significant improvements when
bergism (inability to maintain balance in a ‘tandem compared with pre-treatment scores (p < 0.001 across
stance’ without visual input): 35%, hypertension: all subscales, by either parametric t test or nonpara-
28%, high blood glucose: 19%, low blood testoster- metric comparisons). Officers’ post-treatment scores
one: 17%, and low blood thyroid: 17%. were also significantly improved for all subscales
Ross and Sternquist 763
Table 2.Regimensafety:adverse eventsexperiencedduring thesaunaprotocol
n ¼69patients (patients mayexperience multiple events)
Number who Numberrequesting Number who
Number who missed days medical consult discontinued program
experiencedevent duetoevent due toevent due toevent
Niacin flush, itchyskin 69 0 0 0
Emotional, irritable, despondent 18 0 0 0
Cough,congestion, sorethroat 13 0 0 0
Flu-like symptoms, no fever 11 0 0 0
Flu-like symptoms with mild fever 2 0 0 0
Headache 6 0 0 0
Sleeplessness, vivid dreams 15 12a 0 1b
Fatigue 14 0 0 0
Stomachcramps, nausea, diarrhea 8 3 0 0
Bodyaches 5 2 0 0
Gout 2c 2 1 1
Work orother scheduleconflicts 5 4 0 3d
aPerprotocol,patientswhoachievelessthan6.5hofsleephavetheirnextday’streatmentshortenedto10minofexerciseand4sauna
sessionsof10mineachseparatedby10-minbreaks.
bThis patient reported substantial health improvement but had insufficient sleep throughout the program. Treatment is considered
incompleteforpurposesofalldataanalyses.
cBothpatientsreportedepisodesofgoutpriortostartingtheregimen.
dTwoofficersallottedinsufficienttreatmenttimeandhadtoreturntowork;thethirddiscontinued,citingwork-relatedfactorsandalso
missed6daysinthemiddleoftheregimen.
comparedwithRANDpopulationnorms(p<0.001for Neurotoxicity scores (n ¼ 38)
allsubscales,exceptsocialfunctioningatp¼0.031).
This questionnaire was administered from officer
#20 onward. Excluding incomplete data, there were
Symptom severity and poor health days (n ¼ 62) 38matchedpairsofpre-andpost-treatmentresponses
(84.4%responserate).Themeanpre-treatmentneuro-
Mean pre- and post-treatment symptom severity
toxicity score was 65.5 (SD ¼ 24.8), while the post-
scores are shown in Figure 3 and are significantly
treatment mean score was 14.6 (SD ¼ 11.5,
reduced post-treatment versus pre-treatment
p < 0.001).
(p < 0.001 for all subscales).
Patients reported the number of days of ‘poor
Mini-Mental Status evaluation (n ¼ 38)
health,’ ‘limited activities,’ and ‘sick days’ in the
30-daypre-treatment period versusthe30-dayperiod Ona30-pointscale,scores below25indicatesignifi-
before finishing (i.e. the treatment period). Patients cant cognitive dysfunction. No measurable change
reported means of (A) 9.3 days of poor physical wasdetectedcomparingmeanpre-andpost-treatment
health pre-treatment, improving to 1.8 days by com- scores (29.3 vs. 29.1, respectively; p ¼ 0.122).
pletion; (B) 6.3 days of poor mental health pre-treat-
ment versus 1.4 days by completion; (C) 4.3 days of
Discussion
limitedactivitiesduetopoorhealthpre-treatmentver-
Police officers generally require robust physical qua-
sus0.2daysbycompletion;and(D)2.0sickdayspre-
lifications and emotional stability. In contrast to job
treatment versus 0.3 days by completion (data table
selection criteria, the officers treated in this project
notdisplayed,n¼62,p<0.001foreachcomparison).
had chronic debilitating symptoms consistent with
chemical exposures (Carpenter et al., 2002).
Sleep patterns
Of concern in clandestine meth labs are chemicals
Participants averaged 5.8 h of sleep per night pre- including phosphine, iodine, hydrogen chloride and
treatment, which improved to 7.6 h on completion solvents (acetone, toluene, charcoal lighter fluid, and
(data table not displayed, n ¼ 62, p < 0.001). Coleman fuel), as well as methamphetamine and its
764 Toxicology and Industrial Health 28(8)
Figure2.MethCopsRAND36-itemShortFormHealthSurvey(SF-36)healthstatuspre-andpostdetoxificationtherapy,
in comparison with RAND population norms. n ¼ 61. Means at treatment enrollment compared with completion pro-
ducedsignificance atp <0.001for allsubscales, using pairedtwo-tailed Studentttest.
precursors(Martynyetal.,2004).Eachhasthepoten- levels and might be implicated in these officers’
tialforadversesymptoms,evenatlowexposurelevels. symptoms and laboratory findings (Sharpe, 2003;
Persons exposed to illegal methamphetamine pro- Wu et al., 2010).
duction commonly experience headaches, respiratory Inthissmallgroupof69individuals,itissurprising
and eye irritation, nausea, and vomiting (Thrasher et that 2 subsets of 17% of patients showed low thyroid
al., 2009). Prolonged methamphetamine exposure is and/or low testosterone status. Prevalence of
also associated with neurotoxic effects, including hypothyroidismintheUnitedStatesisabout5%(Hol-
neuropathy, amyotrophic lateral sclerosis (ALS) and lowell et al., 2002). A preexisting thyroid imbalance
Parkinson’s disease (Garwood et al., 2006), suggest- may predispose officers to chronic illness, but low
ing possible neurotoxic effects. thyroid status may have directly resulted from
In addition to immediate symptoms, knowledge of methamphetamine-related exposures, in light of the
toxicitypathwaysandthedownstreameffectsofcom- causal relationship between environmental chemicals
plex chemical exposures are increasing. Many of the and low thyroid function (Miller et al., 2009).
precursor solvents as well as ephedrine, pseudoephe- Alsounusualwasthesymptomsincommonamong
drine, and methamphetamine, havelipophilic proper- those reporting chronic ill health. More than 75% of
ties consistent with bioaccumulation, contributing to officers reported all the following nine symptoms:
their potential for long-term adverse health effects. fatigue, insomnia, headaches, heartburn, personality
Leviskyetal.(2001)showedthedepositionofmetham- changes, numbness in hands and/or feet, memory
phetamineandrelatedchemicalsinhumantissues. loss, a prior history of allergy symptoms, and poor
Manyenvironmentalchemicalscandisruptthyroid concentration. This symptom cluster raises the possi-
hormonelevelsorhaveantiandrogeniceffects (Woo- bilitythat‘exposuresincommon’mayhavetriggered
druff, 2010). Estrogenic pollutants alter androgen ‘symptoms in common.’ This symptom pattern may
Ross and Sternquist 765
Figure 3. Symptom severity pre- and postdetoxification therapy. Reduction in symptom severity with detoxification,
n ¼ 67. p values based on two tailed t test of paired samples. Comparison of Meth Cops symptom severity before and
afterleaving treatment. Meanscores was significant atp <0.001 forallscales using pairedtwo-tailed Studentttest.
Note:these datainclude 3participants who hadnotfully completed theregimen.
help future researchers or treatment professionals It is within this context that the Hubbard sauna-
better recognize or classify methamphetamine- based treatment protocol was utilized. If chemical
related exposures. The ‘pre-treatment’ SF-36 scores exposures and/or contamination caused these
of methamphetamine-exposed officers indicated chronic symptoms, then a multifaceted ‘detoxifica-
more pain, more fatigue, and significantly poorer tion’ program was a reasonable approach.
health than the general population. Toourknowledge,thisisthefirsttimeasauna-based
The ‘Hawthorne effect’ (improvements arising ‘detoxification program’ has been evaluated in
solely from the ‘care and attention’ given and not methamphetamine-exposed police officers. The vast
the treatment itself) (Leonard 2008) should be con- majoritycompletedtheregimenwithminimaldiscom-
sidered given that many of these officers were told fortorinconvenience,achievingsignificantreductions
their health was ‘normal’ and/or the symptoms intheirsymptomsandmeasurablyimprovedthehealth
‘were all in their head.’ However, this effect is andqualityoflife.Thissuggeststhatthisprogramcould
unlikely to be playing any significant role given helpsimilarlyexposedpoliceofficerselsewhere.
the prolonged nature and magnitude of objective Because law enforcement personnel will likely
improvements and also that the SF-36 health scores continue to have exposures to methamphetamine and
and symptom severity profiles were not only statis- associated chemicals, these study data suggest that
tically improved, there was consistent improvement thyroid and androgen dysfunction and neurotoxic
across all sub-scales. effects might appropriately be assessed. Those with
When evaluated individually, some officers might chronic symptoms may benefit from the treatment
appear to have a psychiatric diagnosis. When viewed programs (such as this one) that have been shown to
collectively,however,thepatterncouldjustasreason- improve health and reduce residual pollutant chemi-
ablybeinterpretedasneurotoxicinorigin.TheCenters cal burden. Despite the obvious limitations of this
for Disease Control (2003) states. ‘Treating exposed preliminarystudy,includingthelackofmatchedcon-
persons by chemical syndrome rather than by specific trols,theclinicaloutcomesmakeacaseforcontinued
agent probably is the most pragmatic approach to the investigation of the sauna-based Hubbard detoxifica-
treatment of illnesses caused by chemical exposure.’ tion protocol.
766 Toxicology and Industrial Health 28(8)
Acknowledgments drug laboratory investigators. Journal of Occupational
We sincerely thank Mark Shurtleff (Attorney General of andEnvironmentalMedicine44(2):184–189.
Utah) for arranging financial support to defray the cost of Carpenter DO, Arcaro K, and Spink DC (2002) Under-
treatment; Sandra Lucas, Ted Jubeck, Gairia Taufer, and standingthehumanhealtheffectsofchemicalmixtures.
Morgan Church (American Detoxification Foundation EnvironmentalHealthPerspective110(suppl1):25–42.
[ADF]) for managing the project, help in providing treat- CDC (2000) Public health consequences among first
ment and maintaining case records; Keith Miller, Robert responders to emergency events associated with illicit
Graves, and Carl Smith (Foundation for Advancements in
methamphetamine laboratories—selected states, 1996-
Science and Education [FASE]) for proof-reading and
1999. MMWR Morbidity and Mortality Weekly Report
minor editorial advice.
49(45): 1021–1024.
CDC(2003)Recognitionofillnessassociatedwithexposure
Conflict of interest
to chemical agents—United States, 2003. MMWR Mor-
GHR is a part-time employee of ADF, as the Medical bidityandMortalityWeeklyReport52(39):938–940.
Director for the Utah Meth Cops Project. Within the last CDC(2005)Acutepublichealthconsequencesofmetham-
threeyears,GHRprovidedexpertmedicalwitnessservices
phetamine laboratories—16 states, January 2000-June
fortheLawOfficesofLaurieL.York(Austin,TX,USA),
2004. MMWR Morbidity and Mortality Weekly Report
forDunnandDunn(legalfirm,SaltLakeCity,UT,USA)
54(14): 356–359.
and for Jacobson Law Firm (Tucson, AZ, USA). Marie
Cecchini M, LoPresti V (2007) Drug residues store in the
CecchiniSternquisthasnofinancialrelationshipwithADF
bodyfollowingcessationofuse:impactsonneuroendo-
ortheUtahMethCopsProject.Theauthorsdeclarenoother
crine balance and behavior—use of the Hubbard sauna
actual orpotentialcompeting financialinterest.
regimen to remove toxins and restore health. Medical
Hypotheses68(4): 868–879.
Funding
Cecchini MA, Root DE, Rachunow JR, and Gelb PM
ThisUtahMethCopsProjectinvolvedtwocomponents:(1)
(2006)ChemicalexposuresattheWorldTradeCenter:
provision of treatment for chronically ill police officers,
use of the Hubbard sauna detoxification regimen to
and(2)thegatheringandcompilationofdataforpotential
remove toxins and restore health. Townsend Letter
publication.Thetreatmentprojectwassupportedbyagrant
273: 58–65.
tothenonprofitADFfromtheUtahCommissiononCrim-
inalandJuvenileJustice;twograntstoADFfromtheUtah Crinnion W (2007) Components of practical clinical
Legislative Assembly through the Office of the Utah detox programs—sauna as a therapeutic tool. Alterna-
Attorney General;a granttoADFfromtheUnitedStates tive Therapies in Health and Medicine 13(2):
Department of Justice, Office of Community Oriented S154–S156.
Policing Services ([COPS] 2010CKWX0459). The data Dahlgren J, Cecchini M, Takhar H, and Paepke O (2007)
gathering,analysis,andreportcompilationwasperformed Persistent organic pollutants in 9/11 world trade center
on a volunteer basis.
rescue workers: reduction following detoxification.
Chemosphere 69(8): 1320–1325.
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