Ethanol as a single toxin in non-traumatic deaths – A toxicology perspective

Tormey, William; Moore, Tara

doi:10.1016/j.legalmed.2012.10.001

Cited by 5 publications

(3 citation statements)

References 32 publications

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“…The mean BAC in 175 fatal cases recorded by Heatley and Crane [21] was 3.55 mg/mL. As a result of differences between individuals, the lethal threshold of the BAC is undefined and seems to be lower than conventional acknowledgement [22]. Jones [23] stated that the BAC of a driver in Sweden was >5.00 mg/mL but he was alive.…”

Section: Discussionmentioning

confidence: 99%

Forensic appraisal of death due to acute alcohol poisoning: three case reports and a literature review

Wang

et al. 2019

Forensic Sciences Research

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Death due to acute alcohol poisoning lacks specific anatomical characteristics, compared with other deaths due to drug poisoning. We report three forensic cases of death from acute alcohol poisoning due to inhibition of the respiratory centre and eventual asphyxia. Blood alcohol concentrations in the three fatalities were 5.28, 3.33 and 3.78 mg/mL, respectively. Lethal doses and blood alcohol concentrations showed differences between individuals. Detailed auxiliary tests besides autopsy were undertaken. These cases show that forensic scientists should exclude other causes of death, combine the autopsy with auxiliary tests, and then make an appraisal.

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Section: Discussionmentioning

confidence: 99%

Forensic appraisal of death due to acute alcohol poisoning: three case reports and a literature review

Wang

et al. 2019

Forensic Sciences Research

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“…Besides the concentration units used, whether m/m or m/v, BAC for legal purposes in Germany requires the analysis of serum samples and dividing the concentration by a factor of 1.236, which underestimates the true BAC (m/v) by about 10% [41, 57]. Autopsy studies from Finland found that the mean BAC in deaths attributed to acute alcohol poisoning was 3.5 g/kg [58], although this corresponds to a mean of 3.69 g/L (3.5 × 1.055) or 0.369 g% w/v, which is more in line with international publications [59–61].…”

Section: Discussionmentioning

confidence: 99%

Concentration units used to report blood‐ and breath‐alcohol concentration for legal purposes differ between countries which is important to consider when blood/breath ratios of alcohol are compared and contrasted

Jones

2024

Journal of Forensic Sciences

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This technical note reviews the plethora of concentration units used to report blood‐alcohol concentration (BAC) and breath‐alcohol concentrations (BrAC) for legal purposes in different countries. The choice of units sometimes causes confusion when scientific papers originating from a certain country might be introduced into evidence via expert testimony, such as when alcohol‐related crimes are prosecuted. The concentration units are also important to consider when blood/breath ratios (BBRs) of alcohol are calculated and compared between countries. Statutory BAC limits for driving in most nations are reported in mass/volume (m/v) units, such as g/100 mL (g%) in the United States, mg/100 mL (mg%) in the United Kingdom and Republic of Ireland, or g/L (mg/mL) in many EU nations. By contrast, Germany and the Nordic countries report BAC as mass/mass (m/m) units, hence g/kg or mg/g, which are ~5.5% lower than m/v units, because whole blood has an average density of 1.055 g/mL. There are historical reasons for reporting BAC in mass/mass units because the aliquots of blood analyzed were measured by weight rather than volume. The difference between m/m and m/v is also important in postmortem toxicology, such as when distribution ratios of ethanol between blood and other biological specimens, such as urine, vitreous humor, and cerebrospinal fluid, are reported.

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“…Alcohol also has a direct cardiotoxic effect, with the production of fatal ventricular arrhythmias that can also lead to sudden death; this is likely a result of prolonged ventricular polarization and conduction delays (11). It is important to note that the blood concentration at which ethanol has a cardiotoxic effect is not well-studied and may occur at lower concentrations than what is typically quoted as minimum fatal concentrations (12).…”

Section: Discussionmentioning

confidence: 99%

How Alcohol Kills: Alcohol-Attributable and Alcohol-Associated Deaths in a Medical Examiner Population

Hamilton

Pinckard

2014

Academic Forensic Pathology

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Forensic pathologists frequently encounter the myriad effects of acute and chronic ethanolism and the many ways that alcohol contributes to sudden natural and unnatural deaths. Alcohol may act as risk factor for sudden death or directly participate as a cause of sudden death through its acute and chronic toxic effects. This retrospective descriptive study examines the causes and manner of deaths potentially attributable to alcohol and the results of postmortem toxicology testing for ethanol in unnatural deaths and alcohol-attributable natural deaths over a five-year period in a large medical examiner's office. Ethanol was detected in all types of unnatural deaths as well as alcohol-attributable natural deaths due to the complications of chronic ethanol abuse with a wide range of overlapping concentrations. Of the unnatural deaths involving individuals with a detectable ethanol concentration, 61% were accidents, 25% suicides, and 14% were homicides; ethanol was detected in 40.2% of accidents, 42.0% of suicides, and 53.1% of homicides. Ethanol was also detected in 41% of deaths due to chronic alcoholism. For the unnatural deaths involving intoxicated individuals and deaths due to chronic alcoholism, the deaths were certified as a wide variety of causes. In general, the results are similar to those in the existing literature. Forensic pathologists need to be well-versed in interpreting postmortem ethanol concentrations and determining the role of acute and/or chronic ethanolism in sudden deaths.

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Ethanol as a single toxin in non-traumatic deaths – A toxicology perspective

Cited by 5 publications

References 32 publications

Forensic appraisal of death due to acute alcohol poisoning: three case reports and a literature review

Forensic appraisal of death due to acute alcohol poisoning: three case reports and a literature review

Concentration units used to report blood‐ and breath‐alcohol concentration for legal purposes differ between countries which is important to consider when blood/breath ratios of alcohol are compared and contrasted

How Alcohol Kills: Alcohol-Attributable and Alcohol-Associated Deaths in a Medical Examiner Population

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