# Presentation: 164077

## INHALANT ABUSE BY STREET CHILDREN IN BRAZIL: CAUSES AND CONSEQUENCES 

**Helena M. T. Barros**
- FFFCMPA, Porto Alegre, RS

## INTRODUCTION

**Drug use by students according to countries  **
- (CEBRID, 2002; CONACE 2005;CICAD 2005;ESPAD 2005;EMCDDA 2005;NIDA 2005)

## INTRODUCTION

**Drug use according to the Brazilian Household (Carlini et al., 2002) and the School Survey (Galduróz et al., 2005)**

## INTRODUCTION

**Drug use by youngsters: School Survey (Galduróz et al., 2005) and data from neglected children wards of FEBEM institution (Ferigolo et al., 2004)**

## INTRODUCTION

**Drug use by youngsters from neglected children or detention wards of FEBEM institution (Ferigolo et al., 2004)**

## INTRODUCTION

## INTRODUCTION

## General characteristics of the 2807 interviewed street children and adolescents in 27 Brazilian capitals

**General characteristics of the 2807 interviewed street children and adolescents in 27 Brazilian capitals**
**Noto et al., 2004**

## Daily activities of the 2807 interviewed street children and adolescents (Noto et al., 2004)

**Daily activities of the 2807 interviewed street children and adolescents (Noto et al., 2004)**

## First drug use episode of 1226 children and adolescents that had consumed solvents (Noto et al., 2004)

**First drug use episode of 1226 children and adolescents that had consumed solvents (Noto et al., 2004)**

## Daily use of psychotropic drugs, also alcohol and tobacco, between 154 children and adolescents living in streets in Porto Alegre (Noto et al., 2004)

**Daily use of psychotropic drugs, also alcohol and tobacco, between 154 children and adolescents living in streets in Porto Alegre (Noto et al., 2004)**

## OBJECTIVES

- Determine urinary hippuric acid (UHA) levels correspondent to intentional exposure to toluene by street youngsters
- Correlate UHA and blood toluene levels
- Determine factors that lead to intense toluene inhalation
- Study the consequences of daily intense toluene inhalation

## METHODS

- NIGHT SHELTER FOR STREET YOUNGSTERS
- ESTIMATED NUMBER: 300
- 6 MONTH PERIOD: 68 (3 denied participation)
- Informed consent-samples collection-interview-physical and neurological developmental examination
- Samples
-       HPLC-FID

- CH

- 3

- CONHCH

- 2

- COOH

- CH

- 3

- CONHCH

- 2

- COOH

## RESULTS

- .

## RESULTS- Consequences

- Toluene blood levels of street youngsters interviewed in a night shelter in Porto Alegre, Brazil. Green bar:not intoxicated with toluene, yellow bars:mild to severe toluene intoxication, red bars: levels within the range for risk of death.

**male 20.6 + 18.3 X female 19.7 +10.4 ug/ml; p=0.87**

## RESULTS- Consequences

- Urinary hippuric acid levels of street youngsters interviewed in a night shelter in Porto Alegre, Brazil. Green bar:not intoxicated with toluene, yellow bars:mild to severe toluene intoxication, red bars: levels within the range for risk of death

**male 14.9 + 12.4 X female 24.9 +13.8 g/g creat (p=0.02)**

## RESULTS- Consequences

**ln (toluene blood concentration) = 0,155 + 0,961 ln (urinary hippuric acid concentration + 0,5). **
-  r = 0,78; P < 0,01

## RESULTS- Consequences

**Estimated levels of blood toluene according to urinary hippuric acid found in               ****	****        street youngsters in Brazil.**
** **

** **

## RESULTS- Consequences

**Positive illicit drug and other solvents toxicological screening of street youngsters interviewed in a night shelter in Porto Alegre, Brazil.**

## RESULTSConsequences

**Number of youngsters**

**Development 6-7 years old**

## RESULTS- Consequences

- Perceived effects induced by toluene inhalantion by street children

## RESULTS- Consequences

**Clinical Pathology**

| Test | Blood Toluene |  |  |
| --- | --- | --- | --- |
|  | Negative (n=5) | Positive (n=57) | P |
| Urea (mg/dL) | 20,8 ± 2,2 | 18,8 ± 6,0 | 0,14 |
| Creatinine (mg/dL) | 0,8 ± 0,1 | 0,7 ± 0,1 | 0,15 |
| D. Bilirrubine d (mg/dL) | 0,1 (0,05-0,1) | 0,1 (0,1-0,1) | 0,53 |
| T. Bilirrubine (mg/dL) | 0,24 ± 0,05 | 0,18 ± 0,07 | 0,08 |
| ALT* (U/L) | 10,0 (8,5-11,0) | 12,0 (9,0-16,0) | 0,10 |
| AST** (U/L) | 4,0 (2,0-6,0) | 5,0 (4,0-7,5) | 0,19 |
| Gamma-GT***  (U/L) | 6,0 (5,5-7,0) | 13,0 (9,0-20,0) | < 0,01 |
| Alc Phosphatase (U/L) | 201,6 ± 29,8 | 285,5 ± 137,4 | 0,34 |

## RESULTS- Consequences

| test | Blood Toluene |  |  |
| --- | --- | --- | --- |
|  | Negative(n=5) | Positive (n=57) | P |
| Red cells (milhões/μL) | 4,6 ± 0,3 | 4,5 ± 0,5 | 0,37 |
| Ht (%) | 39,9 ± 1,5 | 37,8 ± 2,8 | 0,06 |
| Hb (g/dL) | 12,2 ± 1,6 | 12,5 ± 0,3 | 0,15 |
| VCM* (fl) | 86,6 ± 3,9 | 84,3 ± 9,6 | 0,64 |
| White cells (μL) | 9480 ± 3706 | 8676 ± 2865 | 0,80 |
| Bastões (%) | 2,0 (0,5-3,5) | 1,0 (1,0-4,0) | 0,98 |
| Neutr. (%) | 44,2 ± 10,5 | 38,8 ± 15,6 | 0,57 |
| Basó.(%) | 0,0 (0,0-0,5) | 0,0 (0,0-0,0) | 0,92 |
| Eosi. (%) | 3,0 (1,0-8,5) | 5,0 (2,0-7,0) | 0,72 |
| Mon (%) | 6,0 (2,5-9,0) | 4,0 (2,0-9,0) | 0,82 |
| Lin (%) | 38,2 ± 6,0 | 46,7 ± 16,8 | 0,18 |

## RESULTS- Cause

## RESULTS- Cause

## RESULTS- Cause

## Conclusions

| Cause | Consequence |  |  |
| --- | --- | --- | --- |
|  |  |  |  |
| Family | Family |  |  |
| Single mom | Streets |  |  |
| Poor | Lack of opportunities |  |  |
| Bad school system | Dropping out of school |  |  |
| Lack of opportunities
Violence | Drug use | Tolerance
 |  |
|  | Burglary |  |  |
|  | Drug Traffic | Violence |  |
|  | Health risk |  |  |
|  | Juvenile detention |  |  |
|  |  |  |  |
|  |  |  |  |

## Conclusions

**Examination of intoxicated youngsters - High levels of blood toluene and UHA with low levels of effects**
**Major problems: recall of time and amount of drug use**
**Public health impact: prevention based on health effects information is not accurate**
**FUTURE**
**Compare blood toluene and UHA of school/FEBEM/street**
**Study the kynetics of blood toluene and UHA of school/FEBEM/street- acute x chronic users**
**Long-term follow-up of children who use inhalants: medical examinations and imaging**
**Treatment plan adapted to street children**