There’s a lot of debate among journalists regarding whether we should publish stories about suicide. On the one hand, not publishing them is viewed as following an outdated taboo and depriving families of public attention to a loved one’s memory. On the other, there’s worry that seeing a story about suicide may give dark inspiration to someone whose emotional state is already on the brink.

So I confess, I have some hesitancy in talking about a bulletin published Thursday evening by the Centers for Disease Control and Prevention. They did it, not only to document a public health trend, but to highlight a real danger to first responders. That seems to me a legitimate concern — and since first responders have been a big part of stories I have covered over years, I’m going to publish it too.

So here’s the story: The CDC has observed a small trend of people in the United States copying a practice widely followed in Japan, in which people seal themselves in an enclosed space such as a car, mix household chemicals in an open container, and die from that  exposure. Between 2006 and 2010, in data from 15 states that participate in a hazardous-events registry, the CDC found 10 such suicide attempts in six states: one each in 2006 and 2007, and four each in 2009 and 2010. Nine of the 10 were successful, and the person died. (A different database recorded two in 2008, 10 in 2009 and 18 in 2010.)

Here are the larger public health implications, though: In the aftermath of those attempts, which resulted in the formation inside the cars of hydrogen sulfide, hydrogen cyanide and thiosulfate, four first responders were also exposed and injured as they tried to rescue the victims and transport their bodies. One was hospitalized. All four survived. In addition, in one case described in the CDC bulletin, nearby houses had to be evacuated, and in another, in a car in a park, hikers had to be tracked down and cleared from the area as well.

As part of the bulletin, the CDC published a list of precautions for first responders (which is difficult to see in the online version, but is captured in the pdf here). Important points:

• Several of the gases released by these chemical mixes have no odor and therefore give no warning of their presence, and have no antidote.
• Gases may be leaking from the vehicle; first responders should stay upwind, alert dispatchers to the situation, and summon a hazmat team.
• The risk is not limited to the vehicle or other site where the chemicals were mixed. If someone has deliberately inhaled such fumes, it is not safe to give them mouth-to-mouth resuscitation.
• The victim’s clothes and body can give off hazardous gases for some period afterward, and can endanger both emergency services personnel transporting the corpse and even morgue personnel.

Suicide is always sad and often unnecessary (let’s not, right now, get into the complexity of suicide in the face of a life-endangering illness). It’s important to know that there are always people to talk to, at the National Suicide Lifeline and at 1-800-273-TALK.

But there are, as the CDC report demonstrates, times when suicide attempts endanger others also. I hope first responders will give the CDC report a thorough look.

Cite: CDC Morbidity and Mortality Weekly Report. Chemical Suicides in Automobiles — Six States, 2006–2010. Sept. 9, 2011.  60(35);1189-1192

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