Double Fatal Inhalation of Dichloromethane

Abstract

<jats:p> 1 Two cases of lethal poisoning following acute inhalation of extremely high concentrations of dichloromethane (DCM) are reported. The concentrations of the solvent found in the blood of the two subjects collected at autopsy and analysed by gas chromatography/ mass spectrometry (572 and 601 mg 1<jats:sup>-1</jats:sup>) were compatible with those measured in the air a few hours after the discovery of the bodies (up to 168,000 ppm). </jats:p><jats:p> 2 Extensive brain and lung oedema and congestion, microhaemorrhagic changes of the stomach and congestion in other organs were observed on macroscopic and microscopic examination of both subjects. In addition, and in both cases, high but not lethal carboxyhaemoglobin (COHb) levels (30%) were found in the blood collected at autopsy. </jats:p><jats:p> 3 Narcosis and respiratory depression due to the effect of DCM on the central nervous system (CNS) appear to have played a critical role in the death of the two men. However, biotransformation of the solvent to toxic metabolites, including carbon monoxide (via oxidative dehalogenation by the cytochrome P450-dependent mixed function oxidase system) or formaldehyde, formic acid, inorganic chloride and carbon dioxide (via the glutathione-S-transferase pathway) may have also contributed significantly to fatal toxicity. </jats:p>

Solvent‐based paint and varnish removers: a focused toxicologic review of existing and alternative constituents

“…When used indoors in the absence of adequate ventilation/other exposure controls, it has been associated with multiple fatalities due to the combination of solvent narcosis, arrhythmogenesis, and impaired oxygen delivery from its secondary metabolite, CO (Chester, Rosenman, Grimes, Fagan, & Castillo, 2012;Fechner, Ortmann, Du Chesne, & KohIer, 2001;Goulle, Lacroix, Vaz, Rouvier, & Proust, 1999;Hall & Rumack, 1990;Leikin, Kaufman, Lipscomb, Burda, & Hryhorczuk, 1990;Macisaac et al, 2013;Manno, Rugge, & Cocheo, 1992;Takeshita et al, 2000;Winek, Collom, & Esposito, 1981 flooring, from which it has been documented to be emitted in vapor form (Bonisch et al, 2012).…”

Pitfalls in forensic toxicology

“…Dichloromethane, a common solvent in the home and industry as a component in paint stripper and metal cleansing solutions, is, after inhalation or ingestion, metabolized (via oxidative dehalogenation by the P 450 -dependent mixed-function oxidase system or by the glutathione-S-transferase pathway) to formaldehyde, formic acid, inorganic chloride and CO. 103 Users of this solvent in a poorly ventilated work place are thus at risk.…”

Detection of dichloromethane with a bioluminescent (lux) bacterial bioreporter

“…Chronically, formaldehyde is a potent carcinogen. While most long-term health concerns involve the genotoxic effect of DCM metabolites, immediate and lethal DCM poisoning has been confirmed in several individuals after high-level occupational exposures [10, 15,18]. Occupational safety standards are generally designed to minimize personal exposure through adequate ventilation.…”