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Sodium Azide: Toxic Substance in COVID-19 Home Tests

Sodium Azide, an odorless, colorless, and deadly chemical, is one of the key ingredients in over-the-counter COVID-19 tests. This substance is used as a preservative in the reagent solution used to test the swabs for coronavirus. If ingested, this substance is known to produce acute toxicity and long-term specific organ damage, even if no symptoms are present. Why was Sodium Azide included in the ingredients of at home coronavirus tests?

This substance is given a National Fire Protection Association Rating System1 (NFPA) which was created to advise emergency respondents of dangers they may encounter when entering a residence in response to a fire or other sutation. Substances are given diamond shaped stickers displaying each threat on a scale of 1-4. These include, Health RiskFlammability, and Reactivity.

Sodium Azide is classified as a NFPA Health Risk 4, meaning “Materials that can affect health or cause serious injury, during periods of very short exposure, even though prompt medical treatment is given.”


Center for Disease Control and Prevention (CDC)

The Center for Disease Control and Prevention2 (CDC) warns of Sodium Azide’s toxicology, emphasizing its high reactivity, and easy ability to ingest small quantities leading to permanent damage. Sodium Azide can be ingested through skin contact. These injuries can occur even without immediate symptoms. Sodium Azide prevents the organs from receiving oxygen. This can produce serious damage in the brain and the heart. The CDC states,

“Sodium azide is a rapidly acting, potentially deadly chemical that exists as an odorless white solid.”

“When it is mixed with water or an acid, sodium azide changes rapidly to a toxic gas with a pungent (sharp) odor. It also changes into a toxic gas (hydrazoic acid) when it comes in contact with solid metals (for example, when it is poured into a drain pipe containing lead or copper).”

“The odor of the gas may not be sharp enough, however, to give people sufficient warning of the danger.”

“People exposed to a small amount of sodium azide by breathing it, absorbing it through their skin, or eating foods that contain it may have some or all of the following symptoms within minutes:”

  • Clear drainage from the nose (gas or dust exposure)
  • Cough (gas or dust exposure)
  • Dizziness
  • Headache
  • Nausea and vomiting
  • Rapid breathing
  • Rapid heart rate
  • Red eyes (gas or dust exposure)
  • Restlessness
  • Weakness
  • Skin burns and blisters (explosion or direct skin contact)

“Exposure to a large amount of sodium azide by any route may cause these other health effects as well”

  • Convulsions
  • Low blood pressure
  • Loss of consciousness
  • Lung injury
  • Respiratory failure leading to death
  • Slow heart rate

The CDC takes Sodium Azide seriously, going as far as suggesting users develop an exit strategy before even using Sodium Azide indoors.

“If the sodium azide release was indoors, get out of the building. If leaving the area that was exposed to sodium azide is not an option, stay as low to the ground as possible, because sodium azide fumes rise”

“If you think you may have been exposed to sodium azide, you should remove your clothing, rapidly wash your entire body with soap and water, and get medical care as quickly as possible.”

“If you think you may have been exposed to sodium azide, you should remove your clothing, rapidly wash your entire body with soap and water, and get medical care as quickly as possible.”

“When sodium azide is ingested, it mixes with stomach acid and forms the toxic gas, hydrozoic acid.”

“Do not pour substances containing sodium azide (such as food, water, or vomit) in the drain, because the drain can explode and cause serious harm.”


Sodium Azide “Survivors”

The Center for Disease Control and Prevention states those exposed to Sodium Azide, are considered “survivors”. Long term effects stated by the Center for Disease Control and Prevention (CDC) warn of heart and brain damage,

“Survivors of serious sodium azide poisoning may have heart and brain damage.” states the CDC

“Showing these signs and symptoms does not necessarily mean that a person has been exposed to sodium azide.”


National Institutes of Health (NIH)

The National Institutes of Heath (NIH) states3 that Sodium Azide is, “Toxic by ingestion.” Sodium Azide is also a corrosive chemical, the NIH stating4,

“Very corrosive to aluminum, moderate to copper and lead”

“Sodium azide exists as an odorless white solid. When mixed with water or an acid it changes rapidly to a toxic gas with a sharp odor as well as releasing hydrazoic acid (HN3). The odor of the gas may not provide sufficient warning of exposure.”

“Persons who work on automobiles regularly are at an increased risk of exposure to sodium azide, which is used as a propellant in airbags5.”

“Sodium azide is also used in the preparation of various chemicals; in agriculture, as a preservative and as a microorganism fumigant; in clinical and research laboratories; in sponge rubber; in detonators; and as an intermediate in explosives manufacturing. Exposure to sodium azide can be fatal.”

Source: PubChem [Internet]. Bethesda (MD): National Library of Medicine (US), National Center for Biotechnology Information; 2004-. PubChem Compound Summary for CID 33557, Sodium azide; https://pubchem.ncbi.nlm.nih.gov/compound/Sodium-azide

Sodium Azide Deaths

In one of the various instances of deaths reported6 by the National Institutes of Health,

“A 35-year-old man ingested an unknown amount of sodium azide and died within 2 hr.”

Although in a second instance7, a suicidal ingestion of Sodium Azide left a woman dead 25 hours after contact, dying from “metabolic acidosis, ARDS (acute respiratory distress syndrome) and acute cardiac failure.”

Source: PubChem [Internet]. Bethesda (MD): National Library of Medicine (US), National Center for Biotechnology Information; 2004-. PubChem Compound Summary for CID 33557, Sodium azide; https://pubchem.ncbi.nlm.nih.gov/compound/Sodium-azide

The NIH warns that Sodium Azide causes death if swallowed, as well as ingested by other means. Physical contact can cause burns to the skin and eyes. Death from Sodium Azide begins first by affecting the central nervous system, before reducing oxygen flow to vital organs.


Harvard

Harvard8 also notes of the dangers of Sodium Azide, stating,

[Sodium Azide] “will react with metals such as silver, gold, lead, copper, brass, or solder in plumbing systems, to produce explosive metal azides. A stainless-steel spatula is ok.”

“Sodium azide rapidly hydrolyzes in water, when mixed with water or acid, to form hydrazoic acid, a highly toxic and explosive gas.”


BinaxNOWTM COVID-19 Antigen Self TEST

The BinaxNOWTM COVID-19 Antigen Self TEST9 states a warning that the product contains Sodium Azide, calling it “a hazardous ingredient” and “a harmful chemical.”

“The solution in the tube contains a hazardous ingredient10

“The Reagent Solution contains a harmful chemical (see table below). If the solution contacts the skin or eye, flush with copious amounts of water. If irritation persists, seek medical advice: https://www.poison.org/contact-us or 1-800-222-1222.”

The pamphlet encourages users of the devices, to avoid accidentally coming in contact with the reagent solution, warning,

“Do not dip the swab into the liquid reagent or other liquid before inserting the swab into the nose”

“The BinaxNOW COVID-19 Antigen Self Test is only for use under the Food and Drug Administration’s Emergency Use Authorization.”


CareStart COVID-19 Rapid Antigen

CareStart11 COVID-19 Rapid Antigen Tests warn that their devices also contain the substance, capable of producing a very toxic gas, when exposed to “acids.” In addition, sodium azide can cause an azide buildup through improper disposal, resulting in the formation of “highly explosive metal azides” when exposed to copper plumbing.

“Reagents contain sodium azide, which is harmful if inhaled, swallowed, or exposed to skin. Contact with acids produces a very toxic gas. If there is contact with skin, wash immediately with plenty of water. Sodium azide may react with lead and copper plumbing to form highly explosive metal azides. On disposal, flush with a large volume of water to prevent azide build-up”

“Do not eat, drink, or smoke in the area where the specimens and kit contents are handled.”

“Use appropriate precautions in the collection, handling, storage, and disposal of patient samples and used kit contents.”

“Dispose of used contents as biohazardous wastes in accordance with federal, state, and local requirements.”

“Nitrile or latex gloves should be worn when performing this test.”

“If the extraction buffer contacts the skin or eye, flush with copious amounts of water.”

“The SARS-CoV-2 positive control swabs have been prepared from recombinant viral proteins and do not contain infectious material.”

“Handle all specimens as though they contain infectious agents”


BD Veritor

BD Veritor12 ingredients include Sodium Azide. The device’s pamphlet warns against eye exposure, swallowing, or exposing the solution to skin. It also warns not to dispose of the liquid down the drain. Shouldn’t these warnings be located in a more accessible location? How many users are aware of these hazards, especially when transporting these products?

“The tube liquid contains sodium azide. Do not inhale, swallow, or expose to skin and eyes. If the liquid contacts skin, wash immediately with plenty of soap and water. If the liquid contacts eyes, flush with plenty of water. Do not flush the tube liquid down the drain.”

“This product has not been FDA cleared or approved; but has been authorized by FDA under EUA.”

Formulation:

Tris-HCL (buffer solution),
Sodium Azide (preservative),
Triton X-100 (detergent) NaCl


Panbio™ COVID-19 Ag Rapid Test Device

Panbio™13 warns of the hidden dangers of Sodium Azide, encouraging users to take caution when disposing of the product, stating that even though the solution is less than 0.1% sodium azide, it may be toxic if ingested.

The buffer contains <0.1% sodium azide as a preservative which may be toxic if ingested. When disposed of through a sink, flush with a large volume of water.”

Panbio™ cited14 reference to the “Current Intelligence Bulletin 13: Explosive Azide Hazard DHHS (NIOSH) Publication Number 78-127 August 16, 1976”


Assure COVID-19 IgG/IgM Rapid Test Device

Assure COVID-19 IgG/IgM Rapid Test Device15 states,

“Avoid skin contact with buffer containing sodium azide which is a skin irritant”

“This test has not been FDA cleared or approved. This test has been authorized by FDA under an EUA for use by authorized laboratories.”


SPERATM COVID-19 Ag Test

The SPERATM COVID-19 Ag Test16 states their devices also contain Sodium Azide, similarly stating that the product is “harmful if inhaled” or “exposed to skin,” warning against the possibility of “very toxic gas,” when combined with acids.

“Reagents contain sodium azide, which is harmful if inhaled, swallowed, or exposed to skin. Contact with acids produces a very toxic gas. If there is contact with skin, wash immediately with plenty of water. Sodium azide may react with lead and copper plumbing to form highly explosive metal azides. On disposal, flush with a large volume of water to prevent azide build-up.”

“This product has not been FDA cleared or approved; this product is authorized by FDA under an EUA for use by authorized laboratories certified under the Clinical Laboratory Improvement Amendments of 1988 (CLIA), 42 U.S.C §263a”


ACON Flowflex

The ACON Flowflex17 COVID-19 Antigen home Test package insert contains confirms that the rapid coronavirus test contains two known hazardous ingredients inside the reagent solution: Sodium azide, and TX-100.

What is TX-100?

Triton-X-100 is a poly(ethylene glycol) derivative18, resulting in a nonionic surfactant mixture19. Its uses include:

  • Paint remover
  • Laboratory diagnostics, solvents and reagents used for experiments
  • Anti-fungal pest products
  • Anti-microbial pest products
  • Liquid or gel ink pens
  • Home air fresheners, candles with fragrance

The National Institutes of Health (NIH) defines nonionic surfactant mixtures as detergents, defoaming agents, wetting agents, emulsifiers, and spermicides. The NIH warns that T-X-100 causes “specific organ toxicity,” warning of brain damage. In addition, Triton-X-100 also produces “serious eye damage” and is a known “long-term aquatic hazard.”

“Nonionic surfactant mixtures varying in the number of repeating ethoxy (oxy-1,2-ethanediyl) groups. They are used as detergents, emulsifiers, wetting agents, defoaming agents, etc. Octoxynol-9, the compound with 9 repeating ethoxy groups, is a spermatocide.”

Source: PubChem [Internet]. Bethesda (MD): National Library of Medicine (US), National Center for Biotechnology Information; 2004-. PubChem Compound Summary for CID 5590, Triton X-100; https://pubchem.ncbi.nlm.nih.gov/compound/Triton-X-100


Chemical Ventors

ThermoFisher Scientific

One chemical vendor that creates Sodium Azide, ThermoFisher Scientific20, suggests the usage for their product as “laboratory chemicals”.

The manufacturers note of the risks of “Specific Organ Toxicity”, including Target Organs – Central nervous system (CNS), Cardiovascular system, Liver, Kidney, Heart, and spleen.

When using any form of Sodium Azide, ThermoFisher Scientific suggests physical protection, encouraging users to “Wear appropriate protective eyeglasses or chemical safety goggles as described by OSHA’s eye and face protection regulations in 29 CFR 1910.133 or European Standard EN166” in addition, the company advises its users to “Follow the OSHA respirator regulations found in 29 CFR 1910.134 or European Standard EN 149. Use a NIOSH/MSHA or European Standard EN 149 approved respirator if exposure limits are exceeded or if irritation or other symptoms are experienced.”

“Handle in accordance with good industrial hygiene and safety practice”

Sodium Azide – Additional Information

ThermoFisher Scientific claims that mutagenic and tumorigenic effects have been reported in animals, warning of the environmental dangers, and proper disposal procedures, stating,

Animal Testing

“Mutagenic effects have occurred in experimental animals”

“Tumorigenic effects have been reported”

Ecotoxicity

“The product contains following substances which are hazardous for the environment. Very toxic to aquatic organisms, may cause long-term adverse effects in the aquatic environment”

“Very toxic to aquatic life with long lasting effects”

Disposal

“Chemical waste generators must determine whether a discarded chemical is classified as a hazardous waste. Chemical waste generators must also consult local, regional, and national hazardous waste regulations to ensure complete and accurate classification.”

How many consumers who purchase COVID-19 at-home-tests will read these pamphlets? How many users believe the gloves are meant to be worn to prevent contamination of the test results, as opposed to the substance itself? What protections will be ensured to provide proper disposal of the Sodium Azide?


Conclusion

Why has this hazardous chemical been placed in civilian COVID-19 tests, designed to make the individual feel “safe”? Was a dangerous chemical used in these tests, used to encourage people to receive the vaccine? Or, was it cheaper to use a deadly toxic substance allowing at home coronavirus test manufacturers to reel in profit, before their temporary emergency use authorizations expire in 2022?

While the FDA continues to pass COVID-19 tests under Emergency Use Authorization, many unapproved chemicals and substances are able to make their way into the ingredients. What will the long term effects be for those who “serial test” or repeat test, increasing their exposure to Sodium Azide. How many individuals taking at-home COVID-19 tests will responsibly dispose of the toxic substance after the test is conducted? What ecological devastations will Sodium Azide produce as a result of the world-wide mass disposal of COVID-19 at-home rapid tests? Was the use of Sodium Azide a conscience decision among COVID-19 testing device manufacturers? Can less toxic chemical substances be used as a preservative for at-home COVID-19 tests? If so, when will the FDA, and at-home COVID-19 test manufacturers, begin implementing safer substances without long term effects, into the very testing devices designed to keep us safe?

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