Inert gas asphyxiation

Inert gas asphyxiation is a form of asphyxiation which results from breathing a physiologically inert

gas in the absence of oxygen, or a low amount of oxygen,[1] rather than atmospheric air (which is
largely composed of nitrogen and oxygen). Examples of physiologically inert gases, which have
caused accidental or deliberate death by this mechanism, are argon, helium, nitrogen and methane.
The term "physiologically inert" is used to indicate a gas which has no toxic or anesthetic properties
and does not act upon the heart or hemoglobin. Instead, the gas acts as a simple diluent to reduce
oxygen concentration in inspired gas and blood to dangerously low levels, thereby eventually
depriving all cells in the body of oxygen.[2]
According to the U.S. Chemical Safety and Hazard Investigation Board, in humans, "breathing an
oxygen deficient atmosphere can have serious and immediate effects, including unconsciousness
after only one or two breaths. The exposed person has no warning and cannot sense that the
oxygen level is too low." In the US, at least 80 people died due to accidental nitrogen asphyxiation
between 1992 and 2002.[3] Hazards with inert gases and the risks of asphyxiation are well
established.[4]
An occasional cause of accidental death in humans, inert gas asphyxia with gases including helium,
nitrogen, methane and argon has been used as a suicide method. Inert gas asphyxia has been
advocated by proponents of euthanasia, using a gas-retaining plastic hood device colloquially
referred to as a suicide bag.
Nitrogen asphyxiation has been suggested as a new way to carry out capital punishment. In April
2015, the Oklahoma Governor Mary Fallin signed a bill authorizing nitrogen asphyxiation as an
alternative execution method in cases where the state's primary method of lethal injection was not
available.[5][6] In March 2018, Oklahoma attorney general Mike Hunter and corrections director Joe M.
Allbaugh announced plans to implement nitrogen executions,[7] but after struggling for years to
design a nitrogen execution protocol, the state announced in February 2020 it abandoned the project
and will resume executions by lethal injection.[8]

Contents

 1Process
 2Physiology
 3Animal slaughter
o 3.1Relation to controlled atmosphere killing
 4Euthanasia of animals
 5Accidental deaths and injury
 6Suicide
 7Capital punishment
 8See also
 9Notes
 10External links

Process[edit]
When humans breathe in an asphyxiant gas, such as pure nitrogen, helium, neon, argon, methane,
or any other physiologically inert gas(es), they exhale carbon dioxide without re-supplying oxygen.
Physiologically inert gases (those that have no toxic effect, but merely dilute oxygen) are generally
free of odor and taste. Accordingly, the human subject detects little abnormal sensation as the
oxygen level falls. This leads to asphyxiation (death from lack of oxygen) without the painful and
traumatic feeling of suffocation (the hypercapnic alarm response, which in humans arises mostly
from carbon dioxide levels rising), or the side effects of poisoning. In scuba
diving rebreather accidents, there is often little sensation, however, a slow decrease in oxygen
breathing gas content has effects which are quite variable.[9] By contrast, suddenly breathing pure
inert gas causes oxygen levels in the blood to fall precipitously, and may lead to unconsciousness in
only a few breaths, with no symptoms at all.[3]
Some animal species are better equipped than humans to detect hypoxia, and these species are
more uncomfortable in low-oxygen environments that result from inert gas exposure; however, the
experience is still less aversive than CO2 exposure.[10]

Physiology[edit]
A typical human breathes between 12 and 20 times per minute at a rate influenced primarily
by carbon dioxide concentration, and thus pH, in the blood. With each breath, a volume of about 0.6
litres is exchanged from an active lung volume (tidal volume + functional residual capacity) of about
3 litres. Normal Earth's atmosphere is about 78% nitrogen, 21% oxygen, and 1% argon, carbon
dioxide, and other gases. After just two or three breaths of nitrogen, the oxygen concentration in the
lungs would be low enough for some oxygen already in the bloodstream to exchange back to the
lungs and be eliminated by exhalation.
Unconsciousness in cases of accidental asphyxia can occur within 1 minute. Loss of consciousness
results from critical hypoxia, when arterial oxygen saturation is less than 60%.[11] "At oxygen
concentrations [in air] of 4 to 6%, there is loss of consciousness in 40 seconds and death within a
few minutes".[12] At an altitude over 43,000 ft (13,000 m), where the ambient oxygen concentration is
equivalent to a concentration of 3.6% at sea level, an average individual can perform flying duties
efficiently for only 9 to 12 seconds without oxygen supplementation.[11] The US Air Force trains air
crews to recognize their individual subjective signs of approaching hypoxia. Some individuals
experience headache, dizziness, fatigue, nausea and euphoria, and some become unconscious
without warning.[11]
Loss of consciousness may be accompanied by convulsions[11] and is followed
by cyanosis and cardiac arrest. About 7 minutes of oxygen deprivation causes death of
the brainstem.[citation needed]
The RAF Institute of Aviation Medicine did a study[13] in which subjects were asked to hyperventilate
in a nitrogen atmosphere. Among the results: "When the duration of over-ventilation with nitrogen
was greater than 8–10 sec the subject reported a transient dimming of vision. In the experiments in
which nitrogen breathing was carried out for 15–16 sec the subject experienced some general
clouding of consciousness and impairment of vision. Vision was frequently lost in these experiments
for a short period. In the few experiments in which nitrogen was breathed for 17–20 sec
unconsciousness supervened and was accompanied on most occasions by a generalized
convulsion. The duration of the interval between the start of over-ventilation with nitrogen and the
onset of symptoms was 12–14 sec." The study did not report how much discomfort the subjects felt.

Animal slaughter[edit]
Relation to controlled atmosphere killing[edit]
Controlled atmosphere killing (CAK) or controlled atmosphere stunning (CAS) is a method for
slaughtering animals such as chickens or cane toads by placing the animals in a container in which
the atmosphere lacks oxygen and consists of an asphyxiant gas (one or more
of argon, nitrogen or carbon dioxide), causing the animals to lose consciousness. Argon and
nitrogen are important components of a gassing process which seem to cause no pain, and for this
reason many consider some types of controlled atmosphere killing more humane than other
methods of killing.[14][15] However, "stunning" is often done using carbon dioxide.[16] If carbon dioxide is
used, controlled atmosphere killing is not the same as inert gas asphyxia, because carbon dioxide at
high concentrations (above 5%) is not biologically inert, but rather is toxic and also produces initial
distress in some animal species.[17] The addition of toxic carbon dioxide to hypoxic atmospheres used
in slaughter without animal distress is a complex and highly species-specific matter, which also
depends on concentration of carbon dioxide.[18][19][20]

Euthanasia of animals[edit]
Diving animals such as rats, minks and burrowing animals are sensitive to low-oxygen atmospheres
and (unlike humans) will avoid them, making purely hypoxic techniques possibly inhumane[citation
needed]
 for them. For this reason, the use of inert gas (hypoxic) atmospheres (without CO2)
for euthanasia is also species-specific.[10][21]

Accidental deaths and injury[edit]

Accidental nitrogen asphyxiation is a possible hazard where large quantities of nitrogen are used. It
causes several deaths per year in the United States,[22] which is asserted to be more than from any
other industrial gas. In one accident in 1981, shortly before the launch of the first Space Shuttle
mission, five technicians lost consciousness and two of them died after they entered the Orbiter aft
compartment. Nitrogen had been used to flush oxygen from the compartment as a precaution
against fire. They were not wearing air packs because of a last-minute change in safety procedures.
[23]

During a pool party in Mexico in 2013, eight party-goers were rendered unconscious and one 21-
year-old male was put into a coma after liquid nitrogen was poured into the pool.[24][25]
Occasional deaths are reported from recreational inhalation of helium, but these are very rare from
direct inhalation from small balloons. The inhalation from larger helium balloons has been reportedly
fatal.[26] A fatal fall from a tree occurred after the inhalation of helium from a toy balloon, which
caused the person to become either unconscious or light headed.[27]
In 2015, a technician at a health spa was asphyxiated while conducting
unsupervised cryotherapy using nitrogen.[28][29]

Suicide[edit]
Main article: Suicide bag
Use of inert gas for suicide was first proposed by a Canadian, Dr Bruce Dunn.[30] Dunn commented
that, "...the acquisition of a compressed gas cylinder, an appropriate pressure reducing regulator,
and suitable administration equipment... [was] not inaccessible to a determined individual, but
relatively difficult for a member of the public to acquire casually or quickly."[31] Dunn collaborated with
other researchers, notably the Canadian campaigner, John Hofsess, who in 1997 formed the group
"NuTech" with Derek Humphry and Philip Nitschke.[32] Two years later, NuTech had streamlined
Dunn's work by using readily-available party balloon cylinders of helium.[33]
The method of suicide based on self-administration of helium in a bag, a colloquial name being the
"exit bag" or suicide bag, has been referenced by some medical euthanasia advocacy groups.
[34]
 Originally such bags were used with helium, and 30 deaths were reported with use of them from
2001 to 2005, and another 79 from 2005 to 2009. This suggested to one set of reviewers that the
popularity of the technique was increasing, as also did the increase in helium suicides in Sweden
during the latter half of the same decade.[35]
After attempts were made by authorities to control helium sales in Australia, a new method was
introduced that instead uses nitrogen.[36] Nitrogen became the main gas promoted by euthanasia
advocates, such as Philip Nitschke, who founded a company called Max Dog Brewing in order to
import canisters of nitrogen into Australia.[37] Nitschke stated that the gas cylinders can be used for
both brewing and, if required, to end life at a later stage in a "peaceful, reliable [and] totally legal"
manner.[38] Nitschke said that nitrogen is "undetectable even by autopsy, which was important to
some people".[39]

Capital punishment[edit]
Execution by nitrogen asphyxiation was discussed briefly in print as a theoretical method of capital
punishment in a 1995 National Review article.[40] The idea was then proposed by Lawrence J. Gist II,
an attorney at law, under the title, International Humanitarian Hypoxia Project.[41]
In a televised documentary in 2007, the British political commentator and former MP Michael
Portillo examined execution techniques in use around the world and found them unsatisfactory; his
conclusion was that nitrogen asphyxiation would be the best method.[42]
In April 2015, Governor Mary Fallin of Oklahoma signed a bill allowing nitrogen asphyxiation as an
alternative execution method.[5] Three years later, in March 2018, Oklahoma announced that, due to
the difficulty in procuring lethal injection drugs, nitrogen gas will be used to carry out executions.[43] In
March 2018, Alabama became the third state (along with Oklahoma and Mississippi), to authorize
the use of nitrogen asphyxiation as a method of execution.[44]
In the case Bucklew v. Precythe, decided 1 April 2019, the U.S. Supreme Court ruled that
a Missouri death row inmate could not avoid death by lethal injection and choose inert gas
asphyxiation using nitrogen, since it has never been used in any execution in the world.
After struggling for years to design a nitrogen execution protocol, Oklahoma announced in February
2020 it abandoned the project after finding a new reliable source of lethal injection drugs.[45]