title: [The role of carbon monoxide and ethanol in fire casualties: A retrospective study of carboxyhemoglobin and blood ethanol levels in fire victims].
abstract: The study included 36 fire casualties that were submitted to post-mortem pathological and toxicological examination at the Departments of Forensic Medicine and Pharmacology, University of Iceland, during the period 1971-1990. Twenty eight were males and eigth females. The mean age was 45.3 years (range 3-74 years). Carboxyhemoglobin levels ranged from 0-84%, mean 53.5% (fig. 1) and were considered fatal (> approximately 50%) in 24 cases. Fourteen victims with fatal carboxyhemoglobin levels had no significant burn injuries. Death was therefore attributed to carbon monoxide poisoning alone. In these cases carboxyhemoglobin levels (mean 65.5%, range 49-84) were lower than those found in cases of fatal car exhaust poisonings (mean 73.0%, range 47-87%) investigated by us in the same period (8). The difference was statistically significant (t-test, P<0.01). It supports the idea that combustion products, other than carbon monoxide, may contribute to the toxic effect of fires. Ethanol was found in blood in two thirds (24) of the cases. Blood ethanol levels were in the range 0.47-4.37%0 (mean 2.34%o). Blood ethanol levels and prevalence of inebriation were compared to those found in other fatal accidents investigated by us in the same period. Ethanol levels were significantly higher in the fire cases and inebriation more common than in the reference group (t-test, P<0.01; Chi-square, P<0.001, df=l). Although poisoning with carbon monoxide is of major importance in fire casualties it should not be disregarded that inebriation may often be an equally important factor. This was in fact strongly indicated by our results.
authors: J
authors: J
authors: Kristinsson
authors: T
authors: T
authors: Johannesson
authors: O
authors: O
authors: Bjarnason