Editorials

Fire retardants, biocides, plasticisers, and sudden infant deaths

BMJ 1994; 309 doi: https://doi.org/10.1136/bmj.309.6969.1594 (Published 17 December 1994) Cite this as: BMJ 1994;309:1594
  1. P J Fleming,
  2. M Cooke,
  3. S M Chantler,
  4. J Golding

    The message of the “back to sleep” campaign holds until the chemistry has been worked out

    Recent television programmes linking the sudden infant death syndrome to the antimony added to the plastic of cot mattresses has concerned the public and health care professionals alike. Unfortunately, the programmes and their fallout have been stronger on opinion and invective than on accurate information. There is a danger that the message of the government's “back to sleep” campaign, which has been followed by a dramatic fall in sudden infant deaths in Britain in the past three years,1 may be obscured by incomplete, inaccurate, and sensationalist reporting.

    Barry Richardson, a consulting scientist, proposed in 1989 that fire retardants in cot mattresses might contribute to the sudden infant death syndrome.2 The essential component of his hypothesis was that, under the right conditions of warmth and humidity and in the presence of traces of organic material (for example, from sweat or urine), certain fungi (such as Scopulariopsis brevicaulis) can metabolise constituents of infants' mattresses (phosphorus, arsenic, or antimony) and produce the highly toxic trihydrides—phosphine, arsine, and stibine. These trihydrides, by acting as anticholinesterases, might then kill infants by inducing cardiac or respiratory failure of rapid onset.

    S brevicaulis is common and can degrade nitrogen-containing compounds in organic material (for example, in meat, cheese, and leather), so that ammonia (nitrogen trihydride) is released. Phosphorus, arsenic, and antimony are—like nitrogen—in group V/Vb of the periodic table of the elements, and Richardson's hypothesis is that their trihydrides may be similarly produced. Such a degradation process was recognised in the 19th century as leading to deaths from arsine poisoning. (In damp conditions S brevicaulis degraded arsenic …

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