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January 13, 1975

Aerosol Propellants

Author Affiliations

Riker Laboratories, Inc. Northridge, Calif

JAMA. 1975;231(2):136-137. doi:10.1001/jama.1975.03240140010008

To the Editor.—  Dr. W. L. Chiou, in his letters (227:658, 1974, and 229:1722, 1974), ignores the evidence in the literature, much of it cited in the JAMA guest editorial (222:827, 1972). In his attempts to "prove" that toxic levels of trichloromonofluoromethane (Freon 11 [F 11]) can be produced from 18 inhalations of an albuterol aerosol and 36 inhalations of isoproterenol sulfate (Medihaler-Iso), Chiou misread or ignored the reports he cites. He states that Dollery et al1 reported that a blood concentration of 1.7μg/ml of F 11 was achieved after three puffs of isoproterenol sulfate and that Paterson et al2 recorded a blood level of 2.6μg of F 11 in a patient after only two inhalations of albuterol aerosol (Ventolin). He makes no attempt to distinguish between arterial and venous blood levels, and this is most important since he refers to the work of Clark and Tinston3 (without