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报告一起因意外吸入汽油导致的猝死案例。

Reporting a sudden death due to accidental gasoline inhalation.

机构信息

Instituto Nacional de Toxicologia y C. Forenses, Ministerio de Justicia, C/José Echegaray, 4, 28232 Las Rozas de Madrid, Madrid, Spain.

出版信息

Forensic Sci Int. 2012 Feb 10;215(1-3):114-20. doi: 10.1016/j.forsciint.2011.01.039. Epub 2011 Feb 26.

DOI:10.1016/j.forsciint.2011.01.039
PMID:21354726
Abstract

The investigation of uncertain fatalities requires accurate determination of the cause of death, with assessment of all factors that may have contributed to it. Gasoline is a complex and highly variable mixture of aliphatic and aromatic hydrocarbons that can lead to cardiac arrhythmias due to sensitization of the myocardium to catecholamines or acts as a simple asphyxiant if the vapors displace sufficient oxygen from the breathing atmosphere. This work describes a sudden occupational fatality involving gasoline. The importance of this petroleum distillate detection and its quantitative toxicological significance is discussed using a validated analytical method. A 51 year-old Caucasian healthy man without significant medical history was supervising the repairs of the telephone lines in a manhole near to a gas station. He died suddenly after inhaling gasoline vapors from an accidental leak. Extensive blistering and peeling of skin were observed on the skin of the face, neck, anterior chest, upper and lower extremities, and back. The internal examination showed a strong odor of gasoline, specially detected in the respiratory tract. The toxicological screening and quantitation of gasoline was performed by means of gas chromatography with flame ionization detector and confirmation was performed using gas chromatography-mass spectrometry. Disposition of gasoline in different tissues was as follows: heart blood, 35.7 mg/L; urine, not detected; vitreous humor, 1.9 mg/L; liver, 194.7 mg/kg; lung, 147.6 mg/kg; and gastric content, 116,6 mg/L (2.7 mg total). Based upon the toxicological data along with the autopsy findings, the cause of death was determined to be gasoline poisoning and the manner of death was accidental. We would like to alert on the importance of testing for gasoline, and in general for volatile hydrocarbons, in work-related sudden deaths involving inhalation of hydrocarbon vapors and/or exhaust fumes.

摘要

本研究调查了一起不明原因的死亡事件,需要准确确定死亡原因,并评估所有可能导致死亡的因素。汽油是一种复杂且高度可变的脂肪族和芳香族碳氢化合物混合物,如果蒸气从呼吸空气中置换出足够的氧气,它可能导致心肌对儿茶酚胺的敏感性增加,从而引起心律失常,或者本身作为一种简单的窒息剂。本工作描述了一起涉及汽油的突发性职业死亡事件。使用经过验证的分析方法,讨论了这种石油馏分的检测及其定量毒理学意义。一名 51 岁的白人健康男性,无明显病史,在加油站附近的人孔中监督电话线的维修。他在吸入汽油蒸气后突然死亡,这是一起意外泄漏事故。面部、颈部、前胸、上下肢和背部皮肤可见广泛的水疱和脱皮。内部检查显示有强烈的汽油味,特别是在呼吸道中检测到。通过火焰离子化检测器的气相色谱法进行了汽油的毒理学筛选和定量分析,并通过气相色谱-质谱法进行了确认。汽油在不同组织中的分布如下:心血,35.7mg/L;尿液,未检出;玻璃体,1.9mg/L;肝脏,194.7mg/kg;肺,147.6mg/kg;胃内容物,116.6mg/L(总 2.7mg)。根据毒理学数据和尸检结果,死因确定为汽油中毒,死亡方式为意外。我们希望提醒大家注意测试工作场所中与吸入碳氢化合物蒸气和/或废气有关的突发性死亡事件中是否存在汽油以及一般挥发性碳氢化合物的重要性。

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