This is an HTML version of an attachment to the Official Information request 'Emails'.
Morbidity and Mortality Weekly Report 
Adverse Health Effects Associated with Living in a Former Methamphetamine 
Drug Laboratory — Victoria, Australia, 2015
Jackie Wright, PhD1; Michaela E. Kenneally2; John W. Edwards, PhD1; G. Stewart Walker, PhD3
The manufacture of methamphetamine in clandestine drug 
amphetamine-based medications. Data concerning health 
laboratories occurs in various locations, including residential 
effects were obtained from documentation of medical assess-
houses and apartments. Unlike the controlled manufacture of 
ments from the family doctor, school medical information, 
chemicals and drugs, clandestine manufacture results in the 
self-reported observations by the family members in response 
uncontrolled storage, use, generation, and disposal of a wide 
to a questionnaire, and evaluation of behavioral issues, based on 
range of chemicals and the deposit of methamphetamine drug 
the completion of the Behavior Assessment System for Children, 
residues on indoor surfaces (1). These residues have been found 
Second Edition (BASC-2)* Parent Rating Scales (PRS).
at high levels on porous and nonporous surfaces and have been 
Assessment of drug exposure levels was based on the collec-
shown to persist for months to years (1). Persons exposed to 
tion and analysis of hair samples from all members of the family 
these environments often have poorly defined exposures and 
1 week after leaving the home, and from the children, approxi-
health effects. It is commonly assumed that these levels of 
mately 3 months later. Because none of the family members used 
exposure are low compared with those related to illicit drug use 
amphetamines, through either prescription or illicit drug use, the 
or therapeutic use of amphetamine-based drugs for managing 
testing of hair to determine environmental exposure was consid-
behavioral issues such as attention deficit hyperactivity disor-
ered suitable. Hair samples measuring 3–4 cm in length (from 
der (2). In 2015, a family that was unknowingly exposed to 
the scalp) were collected, which was considered representative 
methamphetamine residues in a house in Australia was found 
of exposure over the 3–4 months preceding sampling. Testing of 
to have adverse health effects and elevated methamphetamine 
the hair was conducted at Forensic Science, South Australia by 
levels in hair samples, highlighting the potential for public 
methanolic extraction and analysis of the extract by liquid chro-
health risks for persons who might live in methamphetamine-
matography with tandem mass spectrometry using electrospray 
contaminated dwellings. This case study highlights the impor-
ionization. The hair was subjected to a methanol wash before 
tance of the identification and effective decontamination of 
extraction to remove any recent external contamination. The 
former clandestine drug laboratories.
washes also were analyzed for the presence of amphetamines. 
In May 2013, police seized chemicals and manufacturing 
The lower limit of detection for this analysis was 5 pg/mg for 
equipment from a property in rural Victoria, Australia, and 
methamphetamine and amphetamine.
arrested the owner. After completing investigation of the prop-
All family members experienced adverse health effects 
erty, police issued a notice to the local council indicating that the 
while living in the home. The most serious health effects were 
property was a former clandestine drug laboratory and posed a 
reported in the youngest child (a boy aged 7 years) and included 
potential health risk. The council issued a notice to clean up the 
development of asthma-like symptoms, trouble sleeping, and 
property; however, the cleanup was not performed. The property 
behavior changes (Table 1). Of note, a parent-requested cogni-
was sold in August 2013, and normal prepurchase checks did not 
tive behavioral assessment to evaluate potential gifted traits, 
identify the property as a former methamphetamine laboratory 
undertaken for this child 3 months before moving into the 
or reveal that a notice to clean up the house had been issued. 
home identified no at-risk or clinically significant behavioral 
In October 2013, the new owners, a family of five, moved into 
issues. From the BASC-2 PRS evaluation conducted 1 week 
the house. Seven months later, in May 2014, the local council 
after moving out of the home, anxiety, attention issues, and 
contacted the owners to advise them that their home was a 
somatization were scored as at-risk or clinically significant and 
former drug laboratory. Environmental testing of the home 
were consistent with observations provided by the mother and 
was carried out during late May–October 2014 and revealed 
school personnel. Most of the health problems identified in all 
elevated levels of methamphetamine on surfaces inside the home, 
family members, including the youngest child, were observed 
ranging from 11.7–26.0 µg/100 cm2, well above the Australian 
to resolve over time (6–12 months) after they were moved 
limit of 0.5 µg/100 cm2 (3) for safe levels in a residential home. 
from the contaminated premises (Table 1).
The family was required to vacate the property in March 2015.
Methamphetamine was detected in the hair of all family 
The family included two adults and three children aged 
members at concentrations ranging from 5 to 460 pg/mg 
7, 8, and 11 years. None of the family members had ever 
used methamphetamine or had been taking any prescribed 
MMWR / January 6, 2017 / Vol. 65 / No. 52
US Department of Health and Human Services/Centers for Disease Control and Prevention

Morbidity and Mortality Weekly Report
(Table 2). Amphetamine was also detected in the hair of the 
members. Methamphetamine (60 pg/mg) was reported in the 
two youngest children, ranging from 16 to 20 pg/mg (Table 2). 
hair sample of the boy aged 8 years and was thought to be related 
The highest methamphetamine levels in the hair samples col-
to differences in hair growth rate and hair sample collection.
lected were found in the two youngest children (boys aged 7 
and 8 years), with a lower level (50 pg/mg) found in the hair 
of the older child, a girl aged 11 years.
The data from this case study of a single family present 
Lower levels of methamphetamine were reported in the hair 
evidence of adverse health effects and reflect exposure to 
of the children’s mother (17 pg/mg) and father (5 pg/mg). The 
methamphetamine that occurred while living in a home with 
only detection of methamphetamine in the hair wash was from 
environmental methamphetamine surface contamination levels 
the mother (8 pg/mg).
in the range of 11.7–26.0 µg/100 cm2.
Retesting for drugs in hair samples 3 months after moving 
The highest levels of methamphetamine detected in the 
out of the home (June 2015), indicated clearance of the drug, 
hair samples analyzed were from the two younger children. 
with no detection of amphetamines in the hair for most family 
These children had the lowest body weights in the family 
TABLE 1. Adverse health effects reported by family members while living in and after vacating a methamphetamine-contaminated house — 
Victoria, Australia, 2015
Age (yrs)

Other adverse health effects
Persistent cough, asthma-
Trouble sleeping, fearfulness, vivid/scary dreams, irritability, 
Skin rashes; sore, watery eyes
like symptoms
aloof, easily distracted. BASC-2 testing: anxiety, somatization, 
ADHD (at-risk or clinically significant; not present before living 
in home)
BASC-2 testing: no issues identified 1 week after vacating 
Sore, watery eyes
home; anxiety and somatization reported 3 months after 
vacating home, while living in rented accommodation without 
access to personal possessions
Persistent cough
Trouble sleeping, irritability. BASC-2 testing: no significant 
Sore, watery eyes
issues identified
Persistent cough
Excess energy
Sore, watery eyes; weight loss; 
improved distance vision
Trouble sleeping, decreased memory function (self-reported)
Sore, watery eyes; dizziness and 
blurry vision while cleaning 
contaminated areas
Abbreviations: BASC-2 = Behavior Assessment System for Children, Second Edition; ADHD = attention deficit hyperactivity disorder.
TABLE 2. Concentrations of methamphetamine and amphetamine in hair samples collected from members of a family exposed to a 
methamphetamine-contaminated residence 1 week and 3 months after vacating the home — Victoria, Australia, 2015
Concentrations at 1 week after  
Concentrations at 3 months after  
vacating the home (pg/mg)
vacating the home (pg/mg)
Factors that might increase or decrease 
Age (yrs)
exposure in the home
Not detected
Not detected
Regularly played games that involved rolling 
on the floor, touching all surfaces and 
running hands along the walls. Infrequent 
Not detected
washing of hands.
Not detected
Not detected
Not detected
Spent a lot of time on electronic media and 
limited active play with brothers.
Not detected
Not tested
Not tested
Regularly cleaned the home, including just 
before hair samples were collected. Has 
colored hair.
Not detected
Not tested
Not tested
Works out of the home most of the day, 
including weekends.
* Methamphetamine (8 pg/mg) also was detected in the methanol wash of this hair sample.
US Department of Health and Human Services/Centers for Disease Control and Prevention
MMWR / January 6, 2017 / Vol. 65 / No. 52 

Morbidity and Mortality Weekly Report 
and, according to their parents, had multiple opportunities for 
regular close contact with indoor surfaces, including engag-
ing in activities that involved rolling on the floor, running 
What is already known about this topic?
around the house, rubbing their hands on walls, and touching 
The clandestine manufacture of methamphetamine is known to 
items throughout the home. In addition, these children were 
result in various levels of contamination of all surfaces in homes. 
Information is available on drug exposures and health effects 
reported by their parents to wash their hands less frequently 
for drug users as well as persons exposed during manufacture.
than other members of the family. The oldest child reportedly 
What is added by this report?
spent more time using electronic media and was involved in 
limited physical play; her hair methamphetamine level was 
A family of five, including three children aged 7–11 years, lived 
in a home in rural Victoria, Australia, that was previously a 
substantially lower than those of her two brothers.
clandestine methamphetamine drug laboratory with docu-
The lower levels of methamphetamine reported in the hair of 
mented environmental contamination. The family members 
the mother potentially reflect lower levels of methamphetamine 
developed adverse health effects, and there was evidence of 
exposure in the home. In addition, the mother reported that 
systemic absorption of methamphetamine from the environ-
she colored her hair, which has been reported to result in some 
ment, based on hair samples collected after they had vacated 
the premises. Health effects were most pronounced in the 
loss of amphetamine in tested hair samples (4,5). The children’s 
youngest child, who also had the highest methamphetamine 
mother reported regularly cleaning the house, including just 
levels in hair, possibly related to a combination of repeated 
before hair sampling after moving out of the home. This might 
contact with surfaces during play activities and less frequent 
account for a measured level of methamphetamine identified 
hand washing.
in the extract from the external hair wash. The children’s father 
What are the implications for public health practice?
worked away from the home most of the day; his hair had the 
If properties formerly used for the clandestine manufacture of 
lowest level of methamphetamine contamination.
methamphetamine are not properly cleaned the public might be 
Methamphetamine levels in the hair samples of the two younger 
unknowingly exposed to drug residues. Appropriate identifica-
children (460 pg/mg and 330 pg/mg) are consistent with the lower 
tion and management of these properties, including measures by 
authorities to prevent the sale of unremediated homes, are 
end of the range reported in children removed from clandestine 
important to prevent exposures and adverse health effects.
drug laboratories (range = 100 pg/mg–131,000 pg/mg) (6,7) and 
chronic adult drug users (range = 100 pg/mg–128,000 pg/mg) 
(6,8). The levels reported were similar to those reported in stud-
is significant variation among persons who might have had the 
ies conducted on low-level methamphetamine use by adults 
same level of exposure and the measured levels in hair, although 
smoking doses of approximately 500–1,000 mg/day (8). The 
for an individual, correlation between dose and the concentration 
detection of amphetamine in the hair of the younger children 
of amphetamines in hair has been reported (8,10). However, the 
might reflect environmental exposures in the home, where low 
data reported for the family members support the association 
levels of amphetamine also were detected in the surface samples 
of higher levels of methamphetamine and amphetamine in hair 
analyzed (but not quantified by the laboratory), or the presence 
with higher levels of exposure (based on reported activities, body 
of metabolites, supporting the systemic absorption of metham-
weight, and time in the contaminated home). The fact that hair 
phetamine. The ratio of methamphetamine to amphetamine 
concentrations declined precipitously after the exposure was 
in the hair was found to be consistent with the mean reported 
removed is consistent with an association between exposure and 
in hair samples from children removed from clandestine drug 
elevated hair levels. Second, the presence of methamphetamine 
laboratories and from drug-exposed children (6,7).
and amphetamine in the hair samples collected reflect exposures 
The most substantial health effects were in the youngest 
that might have occurred during the preceding 3–4 months (10
child, who also had the highest measured levels of metham-
with the environmental data (surface residue sampling) reflecting 
phetamine in hair. The health effects reported in this study also 
contamination levels at the time of sampling only (approximately 
have been reported in children removed from active metham-
3–6 months before the collection of hair samples). Levels of envi-
phetamine drug laboratories (9). Follow-up with the family 
ronmental contamination and exposures that might have occurred 
has identified that the respiratory effects, trouble sleeping, and 
before this time are not known and might have been higher.
behavioral changes mostly resolved during the 12 months after 
Residual environmental methamphetamine contamination can 
the family vacated the contaminated home.
result in adverse health effects in exposed persons, particularly in 
The findings in this report are subject to at least two limitations. 
young children. Appropriate identification and management of 
First, there is no established quantitative relationship between 
former clandestine drug laboratories, including appropriate reme-
the dose of methamphetamine to which a person is exposed and 
diation and measures to prevent the sale of contaminated homes, is 
the measured methamphetamine level in hair. In addition, there 
important to prevent exposures and adverse health effects.
MMWR / January 6, 2017 / Vol. 65 / No. 52
US Department of Health and Human Services/Centers for Disease Control and Prevention

Morbidity and Mortality Weekly Report
 1Health and Environment, School of the Environment, Flinders University, 
  5. Tsanaclis L, Wicks JF. Patterns in drug use in the United Kingdom as 
Adelaide, South Australia, Australia; 2Toxicology, Forensic Science SA, 
revealed through analysis of hair in a large population sample. Forensic 
Government of South Australia, Adelaide; 3School of Chemical & Physical 
Sci Int 2007;170:121–8.
Sciences, Flinders University, Adelaide, South Australia, Australia.
 6. Bassindale T. Quantitative analysis of methamphetamine in hair of 
children removed from clandestine laboratories—evidence of passive 
Corresponding author: Jackie Wright, [email address].
exposure? Forensic Sci Int 2012;219:179–82. http://dx.doi.
 7. Castaneto MS, Barnes AJ, Scheidweiler KB, et al. Identifying 
1. Martyny JW, Arbuckle SL, McCammon CS Jr, Esswein EJ, Erb N, Van 
methamphetamine exposure in children. Ther Drug Monit 
Dyke M. Chemical concentrations and contamination associated with 
clandestine methamphetamine laboratories. J Chem Health Saf 
  8. Han E, Paulus MP, Wittmann M, Chung H, Song JM. Hair analysis 
and self-report of methamphetamine use by methamphetamine 
2. Weisheit R. Making methamphetamine. South Rural Sociol 
dependent individuals. J Chromatogr B Analyt Technol Biomed Life 
Sci 2011;879:541–7.
3. Australian Government. Clandestine drug laboratory remediation 
  9. Wright J, Edwards J, Walker S. Exposures associated with clandestine 
guidelines. Canberra, Australia: Commonwealth of Australia; 2011. 
methamphetamine drug laboratories in Australia. Rev Environ Health
 10. Polettini A, Cone EJ, Gorelick DA, Huestis MA. Incorporation of 
4. Baeck S, Han E, Chung H, Pyo M. Effects of repeated hair washing and 
methamphetamine and amphetamine in human hair following controlled 
a single hair dyeing on concentrations of methamphetamine and 
oral methamphetamine administration. Anal Chim Acta 2012;726:35–43. 
amphetamine in human hairs. Forensic Sci Int 2011;206:77–80. http://
US Department of Health and Human Services/Centers for Disease Control and Prevention
MMWR / January 6, 2017 / Vol. 65 / No. 52