Effect of combined exposure to carbon monoxide and cyanides in selected forensic cases

Turrina, Stefania; Neri, Carla; Leo, Domenico De

doi:10.1016/j.jcfm.2004.01.006

Cited by 8 publications

(3 citation statements)

References 15 publications

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“…In the reported case of a fire fatality, the color of the lividity and the presence of soot particles on the body and within the respiratory tract (Figures 1 and 2) suggest death due to smoke poisoning. Despite the fact that Popovic et al (2009) reported a statistical significance between COHb saturation levels above 10% and the aspiration of soot, in our case, at 6.15%, the concentration of COHb was far below a level that would made CO poisoning plausible and cannot be interpreted as a vital sign of a smoker [10,[12][13][14]. Büyük and Koçak (2009) conducted a retrospective study on 320 cases of fire burn-related fatalities.…”

Section: Discussioncontrasting

confidence: 65%

“…Ethanol intoxication may determine impaired conscious level and disorientation, vomiting, tachydysrhythmias, and respiratory depression, followed by coma and even death. The appearance and severity of these symptoms depends on how quickly the alcohol is ingested and the peak of the blood alcohol concentration [4,14,19]. In the reported case, we can discuss alcohol tolerance due to the chronic use of alcohol, which would explain why, at the high levels of blood and urine alcohol concentrations, severe symptoms did not appear before the fire started.…”

Section: Discussionmentioning

confidence: 97%

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Toxic Blood Hydrogen Cyanide Concentration as a Vital Sign of a Deceased Room Fire Victim—Case Report

Tabian

Drochioiu

Damian

et al. 2021

Toxics

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Carbon monoxide (CO) and hydrogen cyanide (HCN) are two common toxic products of combustion. HCN concentrations of fire victims are not routinely determined in most legal medicine services in Romania. We present the case of a room fire victim in which we evaluated the concentrations of HCN and carboxyhemoglobin (COHb), their contribution to the mechanism of death, and the possibility that HCN concentration can be interpreted as vital sign. COHb was determined by spectrophotometry. HCN was spectrophotometrically determined with ninhydrin in postmortem blood samples after its removal with 20% phosphoric acid and uptake into a solution of potassium carbonate. The presence of ethyl alcohol was determined by gas chromatography. The COHb concentration was 6.15%, while the blood HCN concentration was 1.043 µg × mL−1 and the total HCN was 1.904 µg × ml−1. A blood alcohol content of 4.36 g‰ and a urine alcohol content of 5.88 g‰ were also found. Although the fire produced a considerable amount of soot, and there were signs of inhalation of soot particles, the COHb level cannot be interpreted as a vital sign. Toxic concentrations of HCN and total HCN can be interpreted as a vital sign and indicates a contributive effect of HCN in the mechanism of death.

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Section: Discussioncontrasting

confidence: 65%

Section: Discussionmentioning

confidence: 97%

Toxic Blood Hydrogen Cyanide Concentration as a Vital Sign of a Deceased Room Fire Victim—Case Report

Tabian

Drochioiu

Damian

et al. 2021

Toxics

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“…There were no measurements of the variety of potential pyrolytic toxins generated in fires involving vehicle interiors (30). Several studies have evaluated cyanide and other toxic gases in fire fatalities and generally concluded that their contribution is probably of secondary importance and not independent of carbon monoxide, heat, and oxygen depletion (25)(26)(27)(31)(32)(33).…”

Section: Discussionmentioning

confidence: 99%

Analysis of 101 Vehicle Fire Fatalities

Harruff

Lubin

2012

Academic Forensic Pathology

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Vehicle fire fatalities encompass both fire and traffic investigations important for the forensic pathologist. Previous studies have demonstrated the challenges in victim identification, determining cause and manner of death, evaluating the role of collision dynamics, and estimating the excess burden of deaths due to post-collision fire. To address these challenges, the present study analyzed 101 vehicle fire fatalities representing 85 accidents, six suicides, four homicides, two natural deaths and four deaths of undetermined manner. Deliberately set fires in homicides, suicides, and suspicious deaths caused nine deaths. Nonaccidental deaths were twice as common in parked vehicles. Of 78 collision fatalities, 46 were occupants of cars, 47 were drivers, and 48 died in collisions involving fixed objects or non-impact rollovers. Occupants of heavy trucks and collisions with light trucks and SUVs had the highest per-collision fatality rates. Frontal and rollover collisions claimed most lives, and rear collisions had the highest fatality rate. Carboxyhemoglobin (COHb) levels were highest in parked cars wherein toxic inhalation occurred prior to fire. In post-collision fires, COHb ranged no higher than 31% saturation and were much lower than in house fires. Potentially survivable blunt force injuries (BFI) and no BFI were present in more than half of charred bodies of post-collision fires. Evidence of inhalation of combustion products correlated imperfectly with severity of BFI, and airway soot deposition was a more sensitive indicator of post-collision viability than COHb. Between 13% and 59% of collision fatalities were due to post-collision fire and not BFI.

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