Nitrate Poisoning Caused by Food Contaminated with Cooling Fluid

Brink, W. A. G. Ten; Wiezer, J. H. A.; Luijpen, A. F. M. G.; Heijst, A. N. P. van; Pikaar, S. A.; Seldenrijk, R.

doi:10.3109/15563658208990376

Cited by 7 publications

(1 citation statement)

References 10 publications

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“…In Australia, among other countries, it was also introduced as a method to humanely control the growth of feral pig populations [6]. Cases of accidental consumption in humans have been reported in the literature [7][8][9][10][11][12][13][14][15][16][17][18].…”

Section: Introductionmentioning

confidence: 99%

Increasing use of sodium nitrite in suicides—an emerging trend

Stephenson

Wills

Heuvel

et al. 2022

Forensic Sci Med Pathol

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Sodium nitrite (NaNO2) is a compound with broad practical applications in food preservation, automotive maintenance, and animal control. Sodium nitrite is also potentially fatal when ingested, as it interferes with the ability of red blood cells to transport oxygen. While incidents of accidental consumption have been reported in the literature, case reports of sodium nitrite being used as a pharmacological suicide agent are becoming more frequent. Therefore, a study was undertaken to evaluate trends in sodium nitrite deaths in South Australia between 2000 and 2019. All cases of fatal sodium nitrite ingestion were identified in the Toxicology database and autopsy reports at Forensic Science SA (FSSA). Ten cases of fatal sodium nitrite ingestion were identified, with the rate of cases increasing significantly over the study period (p > .001). Of the ten deaths attributed to sodium nitrite toxicity, eight were male, and two were female. The age range of decedents was 22–74 years (mean 51.9, SD 21.1), 22–74 years for males (mean 58.4, SD 18.2) and 23–29 years for females (mean 26.0, SD 4.2). Males (80%) and those with a history of depression and/or suicidal ideation (70%) were over-represented within the study population. While autopsy findings were generally consistent with the literature, scene findings emphasized the accessibility of sodium nitrite to the general public. This study highlights both a significant increasing trend in the use of sodium nitrite in suicides and important analytical limitations in the evaluation of suspected cases.

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Section: Introductionmentioning

confidence: 99%

Increasing use of sodium nitrite in suicides—an emerging trend

Stephenson

Wills

Heuvel

et al. 2022

Forensic Sci Med Pathol

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Methemoglobinemia as an uncommon cause of cyanosis

Demirel

Koster

Koot

et al. 1999

The Netherlands Journal of Medicine

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Nitrite Adulteration of Workplace Urine Drug-Testing Specimens I. Sources and Associated Concentrations of Nitrite in Urine and Distinction Between Natural Sources and Adulteration

Urry

Komaromy-Hiller

Staley

et al. 1998

Journal of Analytical Toxicology

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The active ingredient in the commercial workplace urine drug-testing adulterant, Klear, was previously determined to be nitrite ion. Nitrite adulteration compromises the confirmation of some drugs, notably the marijuana metabolite. A previously reported bisulfite step overcomes some nitrite adulteration, but it cannot do so in every case, which leaves the laboratory to report the specimen as not suitable for testing. Unlike many other adulterants, nitrite is found in normal urine at low concentrations. In order to defend a report of nitrite adulteration, it is necessary to provide evidence that the amount of nitrite in a workplace urine specimen could not arise by normal means. The objectives of this study were to identify all sources of nitrite in urine and the range of concentrations associated with these sources and to determine if nitrite adulteration can be supported based upon a quantitative result. The scientific literature was reviewed for internal and external sources of nitrite and their concentration ranges and are reported. The following specimens were obtained and nitrite concentrations measured by a spectrophotometric method: clinical specimens nitrite positive by test strip (< 15 micrograms/mL); specimens culture positive for nitrate-reducing microorganisms (< 36 micrograms/mL); specimens from patients on medications that may metabolize to nitrite (< 6 micrograms/mL); and drug-test specimens, both negative (< 130 micrograms/mL) and others that appeared to be adulterated with nitrite (range 1910-12,200 micrograms/mL, mean 5910). The literature and the nitrite measurements of this study indicate a substantial difference between concentrations from natural sources compared with adulteration. A quantitative measurement of nitrite by a well-structured assay can provide scientifically valid and forensically defensible proof of adulteration with a nitrite-containing substance.

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Nitrate Poisoning Caused by Food Contaminated with Cooling Fluid

Cited by 7 publications

References 10 publications

Increasing use of sodium nitrite in suicides—an emerging trend

Increasing use of sodium nitrite in suicides—an emerging trend

Methemoglobinemia as an uncommon cause of cyanosis

Nitrite Adulteration of Workplace Urine Drug-Testing Specimens I. Sources and Associated Concentrations of Nitrite in Urine and Distinction Between Natural Sources and Adulteration

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