title: Occupational asphyxiation by unknown compound(s): environmental and toxicological approach.
abstract: During a routine truck-tank washing operation, five healthy workers were found motionless inside an empty tanker. Four of them died inside the tanker while the fifth died the following day in hospital. Since the true nature of the fatal compound(s) were not known, a rigorous environmental and toxicological approach supported by autopsy findings was essential to clarify the cause of death. Environmental results indicated that H(2)S fumes arising from the liquid sulfur previously shipped were responsible for the serial deaths, also confirmed by a simulation performed on two similar truck-tanks. These environmental findings were supported by toxicological analyses through the measurement of thiosulfate, one of the main H(2)S metabolites. Abnormal thiosulfate concentrations from 1.1 to 186.2 mg/kg were revealed in all post-mortem biological samples (blood, lung, liver, kidney, brain and fat). Finally, the cluster analysis performed on thiosulfate body distribution contributed to establishing the time of death according to the accident scene reconstruction. This report presents valuable findings in correctly identifying the cause of death in gas asphyxiation cases by unknown compound(s).
authors.affiliation: National Institute of Occupational Safety and Prevention Research Center at the University of Parma, Parma, Italy. diana.poli@unipr.it
authors.forename: D
authors.initials: D
authors.lastname: Poli
authors.forename: B
authors.initials: B
authors.lastname: Solarino
authors.forename: G
authors.initials: G
authors.lastname: Di Vella
authors.forename: L
authors.initials: L
authors.lastname: Tattoli
authors.forename: G
authors.initials: G
authors.lastname: Strisciullo
authors.forename: M
authors.initials: M
authors.lastname: Goldoni
authors.forename: A
authors.initials: A
authors.lastname: Mutti
authors.forename: R
authors.initials: R
authors.lastname: Gagliano-Candela
mesh_terms: D000062:Accidents, Occupational; D000273:Adipose Tissue / Q000737:chemistry; D000328:Adult; D000393:Air Pollutants / Q000506:poisoning*; D001237:Asphyxia / Q000139:chemically induced*; D001923:Brain Chemistry; D001929:Brain Edema / Q000473:pathology; D053593:Forensic Toxicology; D008401:Gas Chromatography-Mass Spectrometry; D005740:Gases; D006801:Humans; D006862:Hydrogen Sulfide / Q000506:poisoning*; D007668:Kidney / Q000737:chemistry; D008099:Liver / Q000737:chemistry; D008168:Lung / Q000737:chemistry; D008297:Male; D008875:Middle Aged; D011654:Pulmonary Edema / Q000473:pathology; D013885:Thiosulfates / Q000032:analysis
chemical_list: D000393:Air Pollutants; D005740:Gases; D013885:Thiosulfates; D006862:Hydrogen Sulfide