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

Daniel Tabian,Simona Irina Damian,Diana Bulgaru Iliescu,Gabi Drochioiu,Oana Toma Gradinaru,Nona Girlescu,Sebastian Ionut Toma

doi:10.3390/toxics9020036

Abstract

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.

Highlights

The exposure to toxic smoke, alone or in combination with cutaneous burns, is responsible for up to 75–80% of deaths after confined space fires [1,2,3,4]
The authors reported that, in 12 of the accidental fire deaths, in spite of evidence that the deceased was alive when the fire started, there was no Carbon monoxide (CO) in the blood, which is in accordance to our data
For 9.3% of victims, the measured concentrations of COHb in blood samples were between 10.1–15.0%, while hydrogen cyanide (HCN) concentrations were between 2.1–6.0 μg × mL−1 [15]

Summary

Introduction

The exposure to toxic smoke, alone or in combination with cutaneous burns, is responsible for up to 75–80% of deaths after confined space fires [1,2,3,4]. HCN is more likely to be encountered in fires in domestic structures with high temperatures and low oxygen content. This can be explained by the increased use of synthetic materials, containing higher levels of nitrogen, in interior finishing and furniture [1,2,3,4,5]. HCN liberation occurs when nitrogen-containing materials such as polyurethane, polyamide and polyacrylonitrile, wool, or silk are burned. These materials can be found in mattresses, pillows and upholstery, wooden furniture [6], victim’s clothes, plastic bottles, and other plastic household waste [5,7]. Lethal concentration of HCN in air can be reached when 2 kg of polyacrylonitrile is combusted in a medium-sized living room [8]

Methods

Results

Conclusion