To the Editor.
—We recently studied the circumstances surrounding the sudden death of an apparently healthy woman with asthma.The patient was an active 76-year-old homemaker who was taking 40 mg of prednisone on alternate mornings and regularly using a flunisolide inhaler. She and her family regarded her as being in good health and symptom-free, although her most recent 1-second forced expiratory volume was less than 1L. Several minutes before her death, a derusting agent containing sulfite, Super Iron-out, had been put in her dishwasher in an effort to open a clogged drain. The machine was run for a few minutes. When she opened the dishwasher to check the results, offensive hot steamy vapors emerged. She gasped and immediately began to wheeze. She attempted to use her bronchodilator, but severe wheezing continued and she died within a few minutes. An autopsy done after embalming revealed mild to moderate coronary artery
Huber AL, Loving TJ. Fatal Asthma Attack After Inhaling Sulfur Fumes. JAMA. 1991;266(16):2225. doi:10.1001/jama.1991.03470160057032