Four deaths due to carbon monoxide poisoning in car washes.

In a period of 13 months, three separate incidents of lethal carbon monoxide (CO) poisoning in closed car wash bays resulted in the deaths of 4 white men aged 20 to 36 years. Each man appears to have been intoxicated with mind-altering substances, which may impair judgment, perception of outside conditions, and self-awareness. All four died in winter months. For three men, the deaths were ruled accidental, and for the remaining man, the previous deaths appear to have provided a model for suicide. Warning signs may not be effective to prevent future CO deaths in car washes because of the possible role of intoxication. Mechanical or electronic methods to prevent a bay door from closing completely may be preferable.     

Suicide by inhalation of carbon monoxide in a residential fire

Fire deaths are usually accidental, but atypical cases of homicide or suicide have been described. In suicide by fire, the only method reported by several authors consists of self-immolation. We present here the unusual case of an adult female who committed suicide by waiting in the living room after setting fire to her bedroom. The autopsy revealed smoke inhalation and the toxicological analysis revealed carboxyhemoglobin levels of 67%. Very few cases of suicide by fire not of the self-immolation type have been reported, and all have been anecdotal. A review of the literature is presented and a new term, "suicide by inhalation of carbon monoxide in a fire," is proposed for such cases.     

The role of hydrogen cyanide and carbon monoxide in fire casualties: a prospective study

Determinations of blood cyanide and carboxyhemoglobin concentrations were performed in 18 victims found dead in buildings after fires during a 2-year period. The results indicated that 50% of the victims had been exposed to toxic levels of hydrogen cyanide and 90% to toxic levels of carbon monoxide. Lethal concentrations of carbon monoxide were found in 83% of the victims. In one case a lethal blood cyanide but a non-toxic blood carboxyhemoglobin value was found. It is concluded that carbon monoxide appears to be more important than hydrogen cyanide as a toxic agent in the fire atmosphere, but cyanide poisoning without carbon monoxide poisoning may, under certain circumstances, be the cause of death in fire victims.     

Asphyxial deaths caused by automobile exhaust inhalation not attributable to carbon monoxide toxicity: study of 2 cases

The authors report two suicides that resulted from the intentional inhalation of automobile exhaust gases in which death occurred without the formation of physiologically significant amounts of carboxyhemoglobin. These circumstances are correlated with measurements of the involved vehicles' exhaust gases, which showed reduced concentrations of carbon monoxide present, reflecting improvements in automobile engine technology. In the absence of carbon monoxide toxicity, the authors attribute death in these cases to asphyxia caused by carbon dioxide intoxication and diminished atmospheric oxygen concentrations.     

血液保存中碳氧血红蛋白稳定性研究进展

通过分析近年来有关血液样品中碳氧血红蛋白稳定性方面的研究资料,发现血液中碳氧血红蛋白的稳定性受到盛放容器、保存温度、容器顶部空气体积、初始HbCO饱和度及防腐剂的添加与否的影响,其中保存温度、容器顶部空气体积及初始HbCO饱和度则是其主要影响因素。     

Concentration of carbon monoxide (CO) in postmortem human tissues: effect of environmental CO exposure

We studied how carbon monoxide (CO) is distributed within the human body through quantitation of CO concentrations in postmortem tissue samples from fatalities including possible CO exposure. Stored, frozen tissues were diced, sonicated in water, and 0.01-8.0 mg wet weight (ww) tissues were incubated with sulfosalicylic acid in CO-purged, septum-sealed vials. CO released into the headspace was quantitated by reduction gas chromatography. Mean tissue CO concentrations (pmol/mg ww) from subjects diagnosed to have no known CO exposure (control, N=14), died from fire (N=13), and CO asphyxiation (N=7), respectively, were: adipose (2;13;9), brain (3;13;65), muscle (15;97;297), heart (30;99;371), kidney (22;432;709, lung (54;690;2638), spleen (73;1366;3548), and blood (162;2238;5070). Carboxyhemoglobin concentrations were 1.4%, 25.2%, and 69.1% of total hemoglobin, respectively. We conclude that measurements of CO concentration in a variety of tissues can be used as markers for the degree of exogenous CO exposure and the identification of possible causes of death.     

Blood carbon monoxide and hydrogen cyanide concentrations in the fatalities of fire and non-fire associated civil aviation accidents, 1991-1998

To evaluate pathophysiological significance of post-mortem urinary myoglobin levels in determining the cause of death, we investigated 210 forensic autopsy cases, partially in comparison with serum levels. Post-mortem serum myoglobin levels were extraordinary high in most cases possibly due to post-mortem change. Urinary myoglobin levels did not correlate with the serum levels, showing possible post-mortem elevation in cases of a prolonged post-mortem period over 48h. A high (>1000 ng/ml), moderate (100-1000 ng/ml), slight (50-100 ng/ml) and not significant (<50 ng/ml) elevation of urinary myoglobin were observed in 26, 43, 31 and 110 cases, respectively. Half the highly elevated cases were those with a survival time over 24h. In cases of minor muscle injury such as head trauma, elevation of urinary myoglobin level was closely related to longer survival. In acute/subacute deaths with a post-mortem interval within 48h, a significant difference was observed in relation to the blood carboxyhemoglobin (COHb) levels of fire victims: myoglobinuria over 100 ng/ml was more frequently and markedly observed in cases with COHb below 60% than over 60%, suggesting muscle damage in fatal burns. Similar elevation was observed in heat stroke victims, and also in some cases of acute and subacute death from polytrauma, asphyxiation, drowning, electricity and spontaneous cerebral bleeding, but not in myocardial infarction. Thus, it was suggested that high post-mortem urinary myoglobin levels in acute and subacute death cases may be a possible indicator of antemortem massive skeletal muscle damage as well as exertional muscle hyperactivity or convulsive disorders associated with hypoxia.     

A comparative study of analytical methods to determine postmortem changes in carbon monoxide concentration

Twenty-one autopsy blood samples were analyzed using spectrophotometric and gas chromatographic procedures after storage for 30 and 150 days.When carboxyhemoglobin was measured spectrophotometrically at the absorbance ratio of $\text{540}\text{nm}\text{555}\text{nm}$, the observed average percent losses were 8 ± 9% and 35 ± 27% after 30 and 150 days of storage, respectively. When measured at the absorbance ratio of $\text{540}\text{nm}\text{579}\text{nm}$, the average percent losses of carboxyhemoglobin were 7 ± 8% and 34 ± 25% after 30 and 150 days, respectively. Wavelength shifts and distorted spectral scans were observed at 150 days.When carbon monoxide was determined by gas chromatographic methods based on combining capacity, the average percent loss was 15 ± 24% and 37 ± 36% after 30 days and 150 days, respectively. The average percent loss of calculated CO based on hemoglobin concentration after 30 days was 31 ± 14% and at 150 days, 40 ± 24%. The average percent loss of calculated CO based on iron content was 23 ± 13% and 37 ± 23% after 30 and 150 days, respectively.     

The prevalence of drugs in carbon monoxide-related deaths: a retrospective study, 2000-2003

The objective of this study was to review demographic characteristics and drugs detected in carbon monoxide (CO)-related deaths from cases received by the Office of the Cuyahoga County Coroner in Cleveland, Ohio, from 2000-2003. Postmortem reports were reviewed, and decedents for which CO was listed as the cause of death were included. The data were compiled into 3 groups according to the official coroner's verdict as to the manner of death: accident, suicide, and homicide. Included in this study were 122 cases: 84 (69%) accidental, 31 (25%) suicide, and 7 (6%) homicide. Accident decedents were typically white males, aged 40-59 years, residing in Cleveland. Suicide decedents were also middle-aged, white males but residing in the suburbs. Homicide decedents under the age of 6 were characteristically black (N=2), while decedents over the age of 39 were predominately white (N=3). Carboxyhemoglobin (COHb) levels in suicide cases were higher than concentrations measured in accidental deaths. The highest percentage of suicide decedents (36%) had a COHb level>70% saturation, accident decedents (36%) between 50% and 69% saturation, and homicide decedents (71%) below 50% saturation. Ethanol (N=34) was detected in 28% of deaths, and therapeutic and/or abused drugs (N=50) were detected in 41% of deaths. Illicit drugs were detected in 11% of cases (cocaine/metabolites; THC/metabolites), other drug positives were therapeutic medications. The most common drugs detected were antidepressants and antihistamines in suicides and pain medications and antihistamines in accidents.     

不同来源一氧化碳中毒死亡者血液中COHb含量分析

目的探索一氧化碳中毒存在的个体差异性,分析女性可能存在的抵御一氧化碳中毒的机制。方法收集207例不同来源的一氧化碳中毒死亡者血液,测量COHb含量,将案例按照不同的因素分类进行统计学分析。结果不同一氧化碳的来源对于死者的COHb浓度影响显著,而性别对于COHb浓度影响不显著,少年儿童和老年人有可能对COHb的抵御能力差于成年人。     

The identification investigation of the material evidence of biological origin after multifactorial exposure

The possibility of investigating pieces of material evidence of biological origin after exposure to various factors is evaluated. The possibility of detecting proteins of liquid media of human organism by electrophoresis in polyacrylamide denatured gel is investigated. The method is intended for identification of biological material in a state of grave destruction. Methodology of such studies is proposed. The data indicate that the structural integrity and qualitative composition of the spectrum of main serum proteins are retained after combined exposure to damaging factors and complete destruction of blood cells.     

甲醛对一氧化碳中毒血检验干扰的研究

目的探讨甲醛对一氧化碳中毒血的检测是否产生干扰,提高一氧化碳中毒鉴定的可靠性。方法采用常用的血中一氧化碳或碳氧血红蛋白饱和度的检测方法对未加甲醛和加甲醛的血样分别进行实验研究。结果甲醛对加热法、氢氧化钠法、氯化钯法、分光光度法等检测方法均可产生不同程度的干扰。结论经福尔马林灌注或固定的检材不宜用于一氧化碳中毒血检测,否则可能导致错误的鉴定结论。     

The use of the term "obesity" in deaths reported to coroners in Australia

There is growing government awareness of the increasing incidence of obesity in the Australian community and its potential impact on health policy issues. This column considers the appropriateness of the WHO definition of the term "obesity" and analyses its use by Australian forensic pathologists and coroners as a cause of death in "medical cause of death" statements. While families may have concerns about the use of this term in reference to a deceased family member, the use of "obesity" in medical cause of death statements could have considerable influence on coroners' recommendations with regard to health policy in this area.     

固相微萃取与气相色谱仪联用技术在火场助燃剂检验中的应用

目的建立检验纵火案件现场燃烧残留物中助燃剂的一种方法。方法利用固相微萃取器吸附浓缩燃烧残留物中的挥发性气体,使用气相色谱仪对挥发性气体进行定性分析。结果固相微萃取与气相色谱仪联用能较好地对火场不同介质燃烧残留物中汽油、煤油、柴油等助燃剂进行种类认定。结论该方法简便易行。     

Unique case of fatal carbon monoxide poisoning in the absence of a combustible fossil fuel

A 37-year-old man died as a result of exposure to carbon monoxide within an apartment. An investigation of the apartment showed no gas appliances or gas supply to the apartment and no evidence of any combustion event to any part of the apartment or roof space. Inhalation of dichloromethane was excluded. Heating to the apartment was found to be via an electrical storage heater, the examination of which revealed that the cast-iron core and insulating material showed evidence of heat damage with significant areas devoid of carbon. This electric storage heater is hypothesized to be the source of carbon for the fatal production of carbon monoxide within the apartment.     

试论走私犯罪侦查工作必须把握的三个关系

海关缉私警察队伍组建五年多来,依法严厉打击走私犯罪,取得了一定的成绩。随着我国“入世”和国家经济政策及政府职能调整的日益深化,如何在新形势下进一步充分发挥缉私警察的职能作用,保持旺盛的生命力和强大的战斗力,为国家进出口贸易的健康稳定发展提供切实有力的保障和服务,是缉私警察工作全面提高完善,进而达到可持续发展目标的重要问题。因此我们必须从强烈的政治使命感和历史责任感的高度不断加深认识,以推动和提升走私犯罪侦查工作,更好地完成党和国家交给我们的光荣任务。就目前打私斗争的实际状况而言,我们有必要在以下三个方面进…