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Personal Protective Equipment Recommendations 

for Response to Chemical Suicide Incidents 

RECOMMENDATIONS 

To minimize the likelihood of responder exposures, injuries, and fatalities 

during chemical suicide incidents, the National Institute for Occupational 

Safety and Health (NIOSH) recommends that first responder agencies ensure

that responders: 

 Recognize the potential incident health and safety hazards associated 

with response to chemical suicides 

 Understand what the potentially immediately dangerous to life or 

health (IDLH) environment is and who should be permitted to enter it

 Assume an IDLH environment until a hazard assessment is performed 

to determine the specific personal protective equipment (PPE) and 

PPE support tools, such as air monitoring equipment, needed to 

protect responders during each phase of response including 

decontamination

 Understand where to find additional resources to plan for, 

respond to, recover from, and mitigate the effects of incidents 

involving chemical suicides

 Coordinate response exercises and training with other relevant agencies 

 

 

EXPOSURE, INJURY, & FATALITY PREVENTION FOR CHEMICAL SUICIDE INCIDENTS 

Chemical suicides involve the use of lethal toxic gases generated by intentionally mixing common household 

chemicals in a confined space such as a car, bathroom, or closet. Indicators of a chemical suicide in these 

confined spaces may include signs posted warning of toxic gas, empty cleaning supply containers, and a 

victim showing no signs of trauma. Information about this method of suicide is publicly available online. The 

most common toxic gases produced in chemical suicide incidents are hydrogen sulfide, hydrogen cyanide, 

and carbon monoxide. Published research and media reporting have documented both inhalation and 

transdermal absorption injuries to first responders resulting from responses to chemical suicide incidents. 

These injuries involved inconsistent use of PPE. First responders need to understand the potential incident 

health and safety hazards associated with response to chemical suicide as well as the relevant PPE and PPEsupport tools such as air monitoring equipment recommended for response. 

Example of a posted sign warning

of a chemical suicide. Photo by NIOSH.
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Personal Protective Equipment Recommendations for Response to 

Chemical Suicide Incidents

QUESTIONS & ANSWERS

What are the potential incident health and safety hazards associated with response to chemical suicides? Chemical suicides should be treated as hazardous materials (HAZMAT) incidents. The vapors from the toxic gases trapped 

in an enclosed space potentially exist in hazardous concentrations. Direct exposure risks to responders include both 

inhalation and transdermal absorption (through the skin). Off-gassing from the victims, bodily fluids, solids and/or liquids

from the enclosed space (whether mixed or unmixed household chemicals), or decontamination/clean-up operations may 

also present potential exposure and inhalation risks. 

What is the IDLH environment at a chemical suicide incident and who should be permitted to enter it? The IDLH environment presents the greatest threat to emergency responders. This environment may include the enclosed 

space (e.g., car, bathroom, closet) and the area surrounding it. PPE must be sufficient for the expected hazards. All 

chemical suicide incidents should be treated as an emergency or planned entry into unknown concentrations or IDLH 

conditions. Only those with appropriate PPE, PPE-support tools such as air monitoring equipment, and HAZMAT training 

are permitted to enter the IDLH environment. 

What PPE is recommended for response to chemical suicide incidents? 

The Emergency Response Guidebook and the NIOSH Pocket Guide to Chemical Hazards recommend a NIOSH Approved®

self-contained breathing apparatus (SCBA) or a combination SCBA and type C supplied-air respirator with a full facepiece 

for emergency or planned entry into unknown concentrations or IDLH conditions. Structural turnout gear and PPE-support 

tools such as air monitoring equipment are recommended for working outside of and prior to opening (ventilating) the 

enclosed space during initial incident response and reconnaissance operations while hazards are being identified. 

Chemical protective clothing (selected according to NFPA 1891) is recommended when there is no risk of fire as well as 

continued use of air monitoring equipment for tasks involving entry into or opening (ventilating) the enclosed space. This 

includes tasks such as stabilizing the problem, rescue, spill control, recovery, and decontaminating responders, victims, 

equipment, clean-up operations, etc.

What are some other considerations for response to chemical suicide incidents? 

To ensure the safety of both responders and the public, decontamination and clean-up operations are required to reduce 

the level of contamination at the scene and minimize the potential for secondary contamination beyond the incident. 

When conducting these operations, responders should: 

• Treat victims as chemically contaminated (e.g., assume that off-gassing is possible). 

• Decontaminate victims at the scene prior to transportation to prevent further contamination and notify emergency

medical services (EMS), hospitals, medical examiners/coroners, and their facilities of potential contamination.

NIOSH also recommends that first responder agencies train their personnel for these types of incidents. Coordinated 

response exercises with relevant agencies such as law enforcement, EMS, and fire services can enhance decision-making

and ensure that recommended PPE, PPE-support tools such as air monitoring equipment, and appropriate responder 

tactics are employed. 

Are there additional resources? 

• Emergency Response Safety and Health 

Database 

• CHEMM website

• NIOSH Certified Equipment List 

• Chemical, Biological, Radiological, and Nuclear 

Respiratory Protection Handbook

NIOSH Approved is a certification mark of the U.S. Department of Health and Human Services (HHS) registered in the United States and 

several international jurisdictions.

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safety and health questions: 

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cdc.gov/cdc-info | cdc.gov/niosh/programs/pubsaf

DHHS (NIOSH) Publication No. 2023-139 (revised 09/2023) | 

September 2023

DOI: https://doi.org/10.26616/NIOSHPUB2023139revised092023

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