Anne

 

Thanks for having a chat with me on Wednesday. It was interesting to hear what you have been doing and what information you have been looking for etc.

 

As indicated on the call there are very little research into health effects of environmental exposures to methamphetamine, whether this is from manufacture or use. I have been doing some research for the past 5-6 years and an continuing on with my work which looks at linking environmental (residue) exposures and internal doses/exposure levels (from hair analysis) with verified health effects. While we have some preliminary data that shows health effects and certainly shows that methamphetamine enters the body from environmental exposures (Wright et al 2017), we have not go to the point where we have enough data to conclude at what level adverse health effects may occur, and if these are different for exposures that occur from labs or use. More research is needed to be able to make such decisions.

 

As noted, feel free to look through my PhD thesis for additional data I have on contamination levels in properties known to be used for manufacture (busted by police) and other case studies related to health effects and exposure. I have also attached my published literature review that has summarised a bunch of other available data that may be helpful. Let me know if you need any of the papers I have referenced.

 

An additional note on exposures – we really lack any data or clear understanding of inhalation exposures (from fine particles or vapours) relevant to living in methamphetamine contaminated properties. At present we assume inhalation exposures are small/negligible but this is not based on any data, so it cannot be confirmed if it is or is not a pathway that needs to be considered or addressed. I hope to be able to get some data (working with Worksafe NZ) to better understand this pathway. Until we get this data it is difficult to dismiss the pathway completely.

 

In relation to the health effects we have been seeing in individuals exposed in methamphetamine, these are effects that have been seen in studies conducted on use. As we lack any good studies that relate to chronic exposures from the routes of exposure likely to be important for environmental exposures, we have to go back to studies that relate to assessing clinical/pharmacological use or drug use, many of which are animal studies. Many of these studies do not enable the identification of dose-response. I have attached a few of the available published studies that relate to some of the effects more commonly seen in meth contaminated homes that are assumed not to be related to methamphetamine (note that I have not completed a detailed literature review in relation to this yet – so there are a number of other papers available as well):

 

• Range of effects of methamphetamine abuse: summarised by Vearrier et al 2012
• Respiratory effects: Wells et al 2008; Hassan et al 2016
• Immune effects: Potula et al 2010; Salamanca et al 2015; Prakash et al 2017

 

How these studies etc relate to environmental exposures etc has not been properly evaluated or addressed. As discussed there is a disconnect between these types of studies and what is relevant to understating what is going on with environmental exposures – which is challenging. This is why we are looking more at an epidemiological approach to evaluating environmental exposures/health effects etc. Gathering this data is not yet complete.

 

I hope the above is helpful.

 

Also, could you please pass on the contacts you have in relation to Auckland Council to assist me in collecting the data I am looking for in my study. Any assistance would be very much appreciated.

 

Regards

Jackie

 

 

Dr Jackie Wright

Adjunct Lecturer

Health and Environment

School of the Environment

Flinders University

 

Principal/Director

Environmental Risk Sciences Pty Ltd

 

Phone: +61 2 9614 0297

[mobile number]

 

Email: [email address] 

 

 

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Hi Jackie

 

As Miles may have told you, we are very interested in any data you may have on health effects from third-hand* exposure to low levels of methamphetamine on household surfaces. We are aware of your work on exposures from clan labs, but are assessing the risks of methamphetamine itself and trying to gather the full picture of levels that are typically found in New Zealand houses.

 

Miles has offered to put us in touch with members of the public who feel they have experienced health effects from methamphetamine in their houses. However, we are looking for a dataset, not anecdotal stories. We attempted to obtain this type of information from public health professionals here in Auckland, and I have sought similar information from the US, but have come up with nothing. The NZ Ministry of Health has received no notifications of cases of health issues relating to this type of methamphetamine exposure.

 

Following our meeting with Miles this morning, I had a discussion the head of the New Zealand Poisons Centre, a medical toxicologist who recently (16 months ago) moved to New Zealand from the US. He has experience with acute methamphetamine toxicity from his work there, and is well versed in exposure pathways and plausibility of effects from environmental exposures. We discussed the situation here in New Zealand, and how it differs from the US in terms of the perception of the risk (where as far as I can tell, the focus is on clan labs and not meth itself). His professional opinion is that exposure to the methamphetamine levels we know to be common in NZ houses would not reach a threshold to have clinical concern for the wellbeing of occupants.

 

Miles has indicated that you have some information on this. We would appreciate anything you can offer in terms of data or published works. If you would like to discuss this over the phone, I can be best reached by mobile (+64 27 6302296).

 

Many thanks

Anne

 

*third-hand exposure = not from direct use; not from being present in the vicinity of active use (second-hand smoke)

 

 

Good morning Anne and Felicia

 

It was good to catch up with you today. As identified this morning, there is little by way of real world investigation as to the long term health effects associated with being in a property where meth related behaviour believed to be limited to use alone. While we agree that a lack of evidence does not mean a lack of effect, the sense I get is that you are under pressure to complete the report commissioned by Government.

 

To this end, I note that at this stage of your investigation you do not wish to engage with people who believe they have experienced adverse health effects from living in a meth affected property.

 

You have advised that you are speaking to parties around the world on this issue. And you did indicate that you had read some of the work Jackie Wright has produced. It appeared though that you were not fully conversant with all of Jackie’s work. To this end, I know that Jackie is open to discussing this with you. I have copied Jackie into this email and will leave it with you to exchange correspondence such that a conversation can occur.

 

Reflecting on our conversation, I believe it is worth noting that while ESR holds the view that the level of 30µg/100cm2 is the point at which use alone can be ruled out, this does not mean that levels that sit below this point are not contributed to by manufacture. We know that labs move around. And we know that some of these labs operate for short periods only. This further challenges the ability to separate use alone from use and/or manufacture.

 

It is to be hoped that an recommended output of your investigation will be a recommendation that more research be done.

 

Kind regards

 

 

 

Miles Stratford

Director – MethSolutions

Tel 09 320 0863

[mobile number]

 

 

Westpac Growth Grant National Finalists 2017

 

www.methsolutions.co.nz

 

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