1. Industry Tackling VSA the aerosol industry’s experience Scottish Drugs Forum 6 October 2004 Sue Rogers, Director British Aerosol Manufacturers’ Association

2. Raw material suppliers Machinery suppliers Valve makers Can makers Fillers Marketers Member of European Aerosol Federation (FEA)

3. What does BAMA do? BAMA unites the industry Lobbies opinion formers in the UK and Europe Provides a forum for development of technical/environmental best practice Promotes the industry and its products Provides information on all aspects of the industry

4. Aerosol Products There are an estimated 200 different types of aerosol on the market, around 2,000 different brands. They dispense wet sprays, dry sprays, creams, gels and foams. In the UK, around 600 million aerosols are used each year. The UK produces 30% of all the aerosols in Europe. Aerosols are among the everyday products which can be abused

5. VSA Prevalence Many youngsters try solvent abuse usually unaware that it is a “loaded gun” and many deaths occur first try VSA is widespread with an estimated 25,000+ youngsters trying it each year in UK survey of secondary schoolchildren published by DoH found 7% of boys and 8% of girls tried solvents in 2001

6. VSA Fatalities St George’s Hospital Medical School 2004 report shows 63 deaths in 2002, level with 2001 Butane lighter refills still account for c.60% of deaths -fall in deaths in 2000 not sustained? aerosols account for 10 deaths (16%) over 18s now account for more deaths than under 18s

7. VSA Deaths by Year All ages: 1971 to 2002 (n =2050) 152 63 Year Number of deaths 85

8. VSA deaths- unanswered questions Why do more boys die from VSA than girls? Is there a ‘safer’ way to abuse than others? Why is the age of death rising? Why are there so many regional variations in the number of deaths? What can we do to deter determined abusers? What messages are we giving? Are they right?

9. Aerosol Industry Activity BAMA has worked closely with VSA professionals and charities for nearly 30 years How do we get involved? Sponsoring education activities SACKI warning provide focal point for VSA experts/Government Research

11. Aerosol Industry Activity Networking VSA Committee meets regularly with DoH, EducaRI, Re-Solv and St George’s Hospital Medical School On Advisory Group of Solvent Misuse Network and Dissemination Project Participated in VSA National Seminar November 02 and ran a focus group on manufacturing BAMA has a trustee on Re-Solv

12. Aerosol Industry Activity Educational activities: TACADE schools’ packs for primary and secondary schools ‘Poor Ted’ Theatre in Education for primary schools through ONO Theatre Company Quick Fix Solutions -Hungerford Drugs Project Conferences at St George’s,NCB, Solve-it 2004 VS Focus for Scottish Drugs Forum

13. Aerosol Industry Activity Educational activities -more examples: BBC 999 programme VSA special on video for schools Videos for Re-Solv and Richard Ives Xoteric interactive CD-ROM for secondary schools Articles in ‘Chemist and Druggist’, GP and police journals Seminar for pharmacists

14. Aerosol Industry Activity Advisory Council on Misuse of Drugs published its report on VSA in 1995 BAMA led the Industry Forum which resulted from its recommendations Main brief was to: raise awareness review warnings

15. VSA warnings Previous warning on aerosols was: ‘deliberately concentrating and inhaling the contents of this product may be harmful or fatal’ Other abusable products were not labelled VSA Industry Forum researched a wide variety of warnings with DTI Consumer Safety Unit developed the SACKI warning

16. SACKI Label Understood by all audiences including parents and young people Put on most aerosols in the UK by 2000 Voluntary warning

17. SACKI Label Not yet accepted in Continental Europe where VSA is not readily recognised as a problem So we now have UK only packs- took courage and conviction from UK marketers Research shows that consumers see the label as a responsible approach by the marketer Effect on VSA/understanding of risk is not known

18. Aerosol Industry Activity Recent initiatives: University project to look for technical solutions to prevent abuse of aerosols research with VSA field workers and chronic abusers into how products are abused, doses, deterrents

19. How does an Aerosol Work? Liquefied propellant becoming gas mixed with product Product concentrate and liquefied propellant Gaseous propellant exerting pressure

20. Types of aerosol propellants CFCs ( phased out by1989) HCFCs (little used- phased out by 1996) Liquefied gases: hydrocarbons -butane; propane; iso-butane Dimethyl Ether (DME) HFCs - only used in Europe for flammability reasons-widely used in USA. (Kyoto protocol on climate change)

21. Compressed Gas propellants Compressed air, nitrogen, N 2 0 or CO 2 No propellant “reservoir” pressure drops as pack empties variable spray performance No energy from “expanding” propellant rely only on mechanical break-up of spray coarse, wet sprays, poor sensory properties for personal care

22. Compressed Gas Aerosols Propellant can escape completely if pack not upright –cannot use all product Only limited acceptance in furniture polishes, saline solutions

23. Search for a technical solution to deter aerosol abuse There were no ‘off the shelf’ solutions available BAMA employed Design Research Centre, Brunel University to manage industry brain storming project 230 ideas generated and screened down to 20 which were evaluated at an industry workshop in Feb ‘99

24. Search for a technical solution to deter aerosol abuse No solutions but 4 potential routes for further research: Inversion - a device that prevents sniffers getting a pure stream of propellant when the can is inverted Tracer - a mechanism for detecting anyone who had been sniffing

25. Timer - a mechanism which would enable the aerosol to “cut out” if sprayed over a certain length of time (and reset itself later) Reformulation - an additive that results in a bad taste or smell Search for a technical solution to deter aerosol abuse

26. Bitrex Project, Shell Bitrex is the bitterest tasting substance known to man Shell have worked on the Bitrex project for about 10 years and have shown it to be viable solution for lighter gas refills

27. Bitrex- possible deterrent for abuse of gas lighter refills A gas industry-wide approach is now needed Following a meeting with DoH the LP Gas Association has taken the Bitrex project on board Not a solution for aerosols: Bitrex is only expelled in the liquid phase and is not present in gas phase

28. Research with VSA Professionals and Chronic Sniffers BAMA commissioned groundbreaking research by Richard Ives, which was reported in May 2001 and sent to BAMA’s network on VSA, DoH, Health Promotion England Interviews with 11 VSA professionals and 21 chronic sniffers across the country Results gave useful hard information about how aerosols are abused

29. Research with VSA Professionals and Chronic Sniffers Showed determined/chronic sniffer would find way round any of proposed solutions in ways that could result in further risks e.g. piercing the aerosol can sniffing in secluded location Only option given possibility of success was inclusion of additive that would make spray taste bad

30. Research with VSA Professionals and Chronic Sniffers Sniffers had been unaware of the risks they were taking, although they felt that once sniffing regularly this would not have stopped them One conclusion is that research is needed with experimentalists what would deter them ? How best to communicate risks to them ? Research with experimentalists raises ethical issues -not for BAMA to do

31. Next steps Awaiting Secretary of State’s go ahead for National Stakeholder Forum to work on common messages co-ordinated delivery exchange of expertise reduced duplication of effort identification of positive experiences overseas

32. Next steps Frustration that VSA has slipped off the Dept of Health agenda BAMA wants: Government departments to include VSA in their policies Research into most effective messages for key audiences e.g. children, parents, professionals

33. BAMA wants: Strategies on VSA education which ensure consistent key messages (probably within context of broader initiatives on drugs) Further research with young people, especially experimentalists into: the practice of VSA what would deter them effect of any technical solutions Next steps

34. BAMA wants: New retailer campaign and materials Regulators’ support to get “SACKI” warning accepted across Europe Closer government links on VSA with other countries worldwide Meeting Dept of Health in early November Next steps

35. BAMA contact details Web site: www.bama.co.uk Telephone:020 7828 5111 Contact:Sue Rogers, Director email:suerogers@bama.co.uk