Analytical Challenge in Postmortem Toxicology Applied to a Human Body Found into a Lake after Three Years Immersion

Morini, Luca; Vignali, Claudia; Tricomi, Paolo; Groppi, Angelo

doi:10.1111/1556-4029.12815

Cited by 4 publications

(4 citation statements)

References 13 publications

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“…Vitreous fluid, blood (central and peripheral), gastric fluid, urine, skeletal muscle, visceral, adipose tissue, sequestered hematomas, and even body hair are all candidates for submission and analysis. The choice of matrices will be limited or suboptimal in cases with prolonged submersion and decomposition, but even with these limitations, qualitative or quantitative results are possible (83). Toxicological analysis of adipocere has yielded useful results (63).…”

Section: Discussionmentioning

confidence: 99%

Investigation of Drowning Deaths: A Practical Review

Armstrong

Erskine

2018

Academic Forensic Pathology

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Drowning, which typically involves a watery environment, remains a serious public health concern claiming an estimated 362 000 lives per year worldwide across all socioeconomic classifications and has remained under close observation by the World Health Organization and its signatories. A significant number of water-related deaths are attributed to accidental drowning, while a smaller but still significant number represent suicidal or homicidal drowning. Others involve a combination of drowning precipitated by injury, intoxication, or environmental extremes. Still others involve victims that die from injury, intoxication, or a natural disease entity of such significance as to preclude the drowning process, while near or in water. While there may be an initial presumption that all water-related deaths are accidental drownings, other possibilities must be considered in the investigation of these types of deaths, as drowning as a cause of death is a diagnosis based on the exclusion of other potential causes. The coordinated investigative efforts of multiple agencies and disciplines are required not only for the designation as drowning as the cause of death but also for death certification. The ongoing analysis and dissemination of data generated from all levels of investigation augment our understanding of the impact on public health and safety, guiding allocation of monetary and educational resources in an effort to prevent further mortality and disability.

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Section: Discussionmentioning

confidence: 99%

Investigation of Drowning Deaths: A Practical Review

Armstrong

Erskine

2018

Academic Forensic Pathology

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“…The alcohol marker EtG (97 pg/mg) was detected in pubic hair. Even though no exhaustive interpretation could be made, the investigation showed that the victim had mental conditions and that she used alcohol, at least socially (Morini et al, 2015).…”

Section: Pm Changes Of Alcohol and Drugs In Submerged Bodiesmentioning

confidence: 99%

Role of postmortem toxicology in drowning investigations

Ojanperä,

Kriikku

2023

WIREs Forensic Science

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Drowning is the third most common cause of unintentional injury death worldwide. In forensic medicine, drowning refers to an event in which the victim dies due to liquid penetrating into the airways or due to submersion in a liquid. Medico‐legal examination of bodies found in water is a challenging task. Establishing proper cause and manner of death requires the joint efforts of the police, medical examiner, and representatives of postmortem toxicology. Information of the circumstances, the victim's individual characteristics and medical background, together with postmortem findings is required. The presence of alcohol and drugs revealed by postmortem toxicology can give insight into the decedent's medical history, drug abuse history, and possible impairment at the time of death. There is ample epidemiological research indicating that alcohol is the most important single contributing factor for fatal drowning, while hypno‐sedative medicines and illicit drugs, especially amphetamines, also appear to pose a risk. Evidence shows that alcohol can be produced postmortem in a submerged body by microbial contamination and fermentation, and this phenomenon is even more significant the higher the water temperature and the longer the submersion time. The reliability of the blood alcohol concentration obtained can be verified in many ways, for example by comparing the ratios of blood, vitreous and urine alcohol concentrations with reference values, or by testing for non‐oxidative ethanol metabolites, the presence of which suggests antemortem alcohol ingestion. Compared to alcohol postmortem changes, very little is known about the long‐term stability of drugs in bodies found in water.This article is categorized under: Toxicology > Analytical Toxicology > Post‐Mortem

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“… 37 Also, hEtG has been applied in child custody cases, 38 as well as in examinations of prenatal alcohol exposure. 39 , 40 , 41 , 42 , 43 Further, hEtG has been used in somatic treatment settings 44 , 45 , 46 and is widely utilised in forensic 47 , 48 and criminal justice 49 , 50 , 51 , 52 settings.…”

Section: Introductionmentioning

confidence: 99%

Comparison of self‐reported alcohol consumption and ethyl glucuronide in hair in a sample of 60+ year ‐olds treated for DSM‐5 alcohol use disorder

et al. 2022

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There is a lack of evidence for the consistency between self‐reported alcohol consumption (SRAC) and concentrations of ethyl glucuronide in hair (hEtG) among elderly patients treated exclusively for alcohol use disorder (AUD). Hence, this study assessed the consistency between these two measures in these patients. A total of 190 patients with AUD were assessed for SRAC using Form 90 and hEtG, 14 or 22 weeks after treatment conclusion. Patients were grouped according to SRAC (g/day) and corresponding hEtG concentrations (pg/mg): 0 and <5 (abstinence), 0.1–14.3 and 5.0–9.9 (low consumption), 14.4–21.4 and 10.0–15.9 (moderate consumption), 21.5–59.9 and 16.0–30 (high consumption) and ≥60 and >30 (excessive consumption). The extent of underreporting and overreporting was examined by crosstabulations, and inter‐rater reliability was reported by kappa correlations. Associations and effect modification were examined by conditional logistic regression. Due to multitesting, p‐values ≤0.01 were considered significant. Underreporting was found in 96 patients (50.5%) and overreporting in 41 patients (21.6%). The kappa coefficients varied between 0.19 and 0.34. HEtG was more likely to detect low, moderate and high alcohol consumption compared with SRAC (ORs between 5.1 and 12.6, all p‐values <0.01), but SRAC and hEtG did not differ significantly with respect to identification of abstinence (OR = 1.9, p = 0.05). Inconsistency between the outcome measures was found in a considerable number of the patients. More studies examining the consistency between SRAC and specific direct biomarkers of alcohol in this population seem warranted.

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Analytical Challenge in Postmortem Toxicology Applied to a Human Body Found into a Lake after Three Years Immersion

Cited by 4 publications

References 13 publications

Investigation of Drowning Deaths: A Practical Review

Investigation of Drowning Deaths: A Practical Review

Role of postmortem toxicology in drowning investigations

Comparison of self‐reported alcohol consumption and ethyl glucuronide in hair in a sample of 60+ year ‐olds treated for DSM‐5 alcohol use disorder

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