Top

Forensic Science, Medicine and Pathology

18-12-2023 | Intoxication | Case Report

A serial analysis of hydrogen sulfide poisoning: three group accidents

Authors: Huaxiong Song, Ronghui Wan, Qishuo Tian, Yong Liu, Hongbin Ruan, Pan Liu, Yunyun Wang, Liang Liu

Published in: Forensic Science, Medicine and Pathology

Abstract

Hydrogen sulfide (H2S) is a powerful toxic gas in workplace incidents, and it poses a threat to colleagues or family members involved in rescues, leading to a “domino effect” of multiple deaths. In this report, we describe three incidents in which 10 people died, and we present the results of the analyses performed in different incidents, including paper pulp pit, sewer, and sewage well. We provide the macroscopic and morphological findings of ten victims, which include conjunctival hemorrhage, corneal erosion, pulmonary edema, and pulmonary hemorrhage. Additionally, we observed large amounts of waste paper pulp or black sludge in the upper and lower respiratory tracts or upper and lower gastrointestinal tracts of six victims. Furthermore, we conducted a toxicological examination of the victims' blood sulfide using an alkylation extraction approach combined with gas chromatography/mass spectrometry. The sulfide concentrations in the 10 victims ranged from 0.06 to 6.72 mg/L.

Winek CL, Collom WD, Wecht CH. Death from hydrogen-sulphide fumes. Lancet. 1968;1:1096. https://doi.org/10.1016/s0140-6736(68)91455-4.CrossRefPubMed

Mooyaart EAQ, Gelderman ELG, Nijsten MW, et al. Outcome after hydrogen sulphide intoxication. Resuscitation. 2016;103:1–6.https://doi.org/10.1016/j.resuscitation.2016.03.012.

Milby TH, Baselt RC. Hydrogen sulfide poisoning: clarification of some controversial issues. Am J Ind Med. 1999;35:192–195. https://doi.org/10.1002/(sici)1097-0274(199902)35:2<192::aid-ajim11>3.0.co;2-c.

Burnett WW, King EG, Grace M, Hall WF. Hydrogen sulfide poisoning: review of 5 years’ experience. Can Med Assoc J. 1977;117:1277–80.PubMedPubMedCentral

Aventaggiato L, Colucci AP, Strisciullo G, Favalli F, Gagliano-Candela R. Lethal Hydrogen Sulfide poisoning in open space: an atypical case of asphyxiation of two workers. Forensic Sci Int. 2020;308:110122.https://doi.org/10.1016/j.forsciint.2019.110122.

Smith SS, Cannon DL, Fagan K, Weis CP. Occupational hydrogen sulfide fatalities and thiosulfate levels. Am J Forensic Med Pathol. 2017;38: 47–48.https://doi.org/10.1097/PAF.0000000000000285.

Imamura T, Kage S, Kudo K, Jitsufuchi N, Nagata T. A case of drowning linked to ingested sulfides--a report with animal experiments. Int J Legal Med. 1996;109:42–44.https://doi.org/10.1007/BF01369601.

Kage S, Nagata T, Kudo K. Determination of polysulphides in blood by gas chromatography and gas chromatography-mass spectrometry. J Chromatogr. 1991;564:163–169.https://doi.org/10.1016/0378-4347(91)80078-q.

State Administration of Market Supervision and Administration. Air quality Determination of hydrogen sulfide, methyl mercaptan, methyl sulfide and dimethyl disulfide by gas chromatography(GB/T 14678–1993). 2023.

10.

Fujita Y, Fujino Y, Onodera M, et al. A fatal case of acute hydrogen sulfide poisoning caused by hydrogen sulfide: hydroxocobalamin therapy for acute hydrogen sulfide poisoning. J Anal Toxicol. 2011;35:119–123. https://doi.org/10.1093/anatox/35.2.119.

11.

Reiffenstein RJ, Hulbert WC, Roth SH. Toxicology of hydrogen sulfide. Annu Rev Pharmacol Toxicol. 1992;32:109–134. https://doi.org/10.1146/annurev.pa.32.040192.000545.

12.

Barbera N, Montana A, Indorato F, Arbouche N, Romano G. Domino effect: An unusual case of six fatal hydrogen sulfide poisonings in quick succession. Forensic Sci Int. 2016;260:e7-e10. https://doi.org/10.1016/j.forsciint.2016.01.021.

13.

Hendrickson RG, Chang A, Hamilton RJ. Co-worker fatalities from hydrogen sulfide. Am J Ind Med. 2024;45:346–350. https://doi.org/10.1002/ajim.10355.

14.

Sams RN, Carver HW, 2nd, Catanese C, Gilson T. Suicide with hydrogen sulfide. Am J Forensic Med Pathol. 2013;34:81–82. https://doi.org/10.1097/PAF.0b013e3182886d35.

15.

Anderson AR. Characterization of chemical suicides in the United States and its adverse Impact on responders and bystanders. West J Emerg Med. 2016;17:680–683. https://doi.org/10.5811/westjem.2016.9.32267.

16.

Azrael D, Mukamal A, Cohen AP, Gunnell D, Barber C, Miller M. Identifying and tracking gas suicides in the U.S. using the national violent death reporting system, 2005–2012. Am J Prev Med. 2016;51:S219-S225. https://doi.org/10.1016/j.amepre.2016.08.006.

17.

Gunnell D, Coope C, Fearn V, et al. Suicide by gases in England and Wales 2001–2011: evidence of the emergence of new methods of suicide. J Affect Disord. 2015;170:190–195. https://doi.org/10.1016/j.jad.2014.08.055.

18.

Lin PT, Dunn WA. Suicidal carbon monoxide poisoning by combining formic acid and sulfuric acid within a confined space. J Forensic Sci. 2014;59:271–273. https://doi.org/10.1111/1556-4029.12297.

19.

Reiffenstein R. Toxicology of hydrogen sulfide. Ann Rev Pharmacol Toxicol. 1992;32:109–134. https://doi.org/10.1146/annurev.pa.32.040192.000545.

20.

Knight LD, Presnell SE. Death by sewer gas: case report of a double fatality and review of the literature. Am J Forensic Med Pathol. 2005;26:181–185.https://doi.org/10.1097/01.paf.0000163834.87968.08.

21.

Tanaka S, Fujimoto S, Tamagaki Y, Wakayama K, Shimada K, Yoshikawa J. Bronchial injury and pulmonary edema caused by hydrogen sulfide poisoning. Am J Emerg Med. 1999;17:427–429. https://doi.org/10.1016/s0735-6757(99)90102-x.

22.

Ago M, Ago K, Ogata M (2008) Two fatalities by hydrogen sulfide poisoning: variation of pathological and toxicological findings. Leg Med (Tokyo) 10: 148–152.https://doi.org/10.1016/j.legalmed.2007.11.005.

23.

Moretti M, Ballardini M, Siodambro C, et al. Fatal poisoning of four workers in a farm: Distribution of hydrogen sulfide and thiosulfate in 10 different biological matrices. Forensic Sci Int. 2020;316. https://doi.org/10.1016/j.forsciint.2020.110525.

24.

Barbera N, Montana A, Indorato F, Arbouche N, Romano G. Evaluation of the role of toxicological data in discriminating between H₂S femoral blood concentration secondary to lethal poisoning and endogenous H₂S putrefactive production. J Forensic Sci. 2017;62:392–4. https://doi.org/10.1111/1556-4029.13291.CrossRefPubMed

25.

Kage S, Ikeda H, Ikeda N, Tsujita A, Kudo K. Fatal hydrogen sulfide poisoning at a dye works. Leg Med (Tokyo). 2004;6:182–6. https://doi.org/10.1016/j.legalmed.2004.04.004.CrossRefPubMed

26.

Oesterhelweg L, Puschel K. “Death may come on like a stroke of lightening”: phenomenological and morphological aspects of fatalities caused by manure gas. Int J Legal Med. 2008;122:101–7. https://doi.org/10.1007/s00414-007-0172-8.CrossRefPubMed

27.

Maebashi K, Iwadate K, Sakai K, et al. Toxicological analysis of 17 autopsy cases of hydrogen sulfide poisoning resulting from the inhalation of intentionally generated hydrogen sulfide gas. Forensic Sci Int. 2011;207:91–5. https://doi.org/10.1016/j.forsciint.2010.09.008.CrossRefPubMed

28.

McAnalley BH, Lowry WT, Oliver RD, Garriott JC. Determination of Inorganic sulfide and cyanide in blood using specific ion electrodes: application to the investigation of hydrogen sulfide and cyanide Poisoning. J Anal Toxicol. 1979;3:111–4. https://doi.org/10.1093/jat/3.3.111.CrossRef

29.

Wang R, Fan Z, Wei Z, et al. Decomposition kinetics and postmortem production of hydrogen sulfide and its metabolites. Forensic Sci Int. 2022;340. https://doi.org/10.1016/j.forsciint.2022.111426.

30.

Hildebrandt TM, Grieshaber MK. Three enzymatic activities catalyze the oxidation of sulfide to thiosulfate in mammalian and invertebrate mitochondria. FEBS J. 2008;275:3352–61. https://doi.org/10.1111/j.1742-4658.2008.06482.x.CrossRefPubMed

31.

Evans CL. The toxicity of hydrogen sulphide and other sulphides. Q J Exp Physiol Cogn Med Sci. 1967;52:231–48. https://doi.org/10.1113/expphysiol.1967.sp001909.CrossRefPubMed

32.

Carfora A, Campobasso CP, Cassandro P, et al. Fatal inhalation of volcanic gases in three tourists of a geothermal area. Forensic Sci Int. 2019;297:e1–7. https://doi.org/10.1016/j.forsciint.2019.01.044.CrossRefPubMed

33.

Ministry of Health of the People’ Republic of China. Occupational exposure limits for harmful factors in the workplace(GBZ 2.1–2019). 2019.

34.

Miyazato T, Ishikawa T, Michiue T, Oritani S, Maeda H. Pathological and toxicological findings in four cases of fatal hydrogen sulfide inhalation. Forensic Toxicol. 2012;31:172–9. https://doi.org/10.1007/s11419-012-0167-0.CrossRef

35.

Kage S, Takekawa K, Kurosaki K, Imamura T, Kudo K. The usefulness of thiosulfate as an indicator of hydrogen sulfide poisoning: three cases. Int J Legal Med. 1997;110:220–2. https://doi.org/10.1007/s004140050071.CrossRefPubMed

Title: A serial analysis of hydrogen sulfide poisoning: three group accidents
Authors: Huaxiong Song
Ronghui Wan
Qishuo Tian
Yong Liu
Hongbin Ruan
Pan Liu
Yunyun Wang
Liang Liu
Publication date: 18-12-2023
Publisher: Springer US
Keywords: Intoxication
Autopsy
Cerebral Edema
Published in: Forensic Science, Medicine and Pathology
Print ISSN: 1547-769X
Electronic ISSN: 1556-2891
DOI: https://doi.org/10.1007/s12024-023-00743-x

ERS Congress 2024

Springer Medicine

A serial analysis of hydrogen sulfide poisoning: three group accidents

Abstract

ERS Congress 2024

Springer Medicine

Abstract

Please log in to get access to this content