Epidemiology of alcohol-related unintentional drowning : is post-mortem ethanol production a real challenge?

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http://hdl.handle.net/10138/299795

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Pajunen , T , Vuori , E & Lunetta , P 2018 , ' Epidemiology of alcohol-related unintentional drowning : is post-mortem ethanol production a real challenge? ' , Injury epidemiology , vol. 5 , no. 1 . https://doi.org/10.1186/s40621-018-0169-4

Title: Epidemiology of alcohol-related unintentional drowning : is post-mortem ethanol production a real challenge?
Author: Pajunen, T.; Vuori, E.; Lunetta, P.
Contributor: University of Helsinki, Medicum
University of Helsinki, University of Turku
Date: 2018
Language: eng
Belongs to series: Injury epidemiology
ISSN: 2197-1714
URI: http://hdl.handle.net/10138/299795
Abstract: Background: Post-mortem (PM) ethanol production may hamper the interpretation of blood alcohol concentration (BAC) in victims of drowning. Different exclusion criteria (e.g. cases with low BAC or with protracted interval between death and toxicological analysis) have been proposed with no factual figures to reduce the potential bias due to PM ethanol production when examining the prevalence rates for alcohol-related drowning. The aim of this study is to verify the extent to which PM alcohol production may affect the accuracy of studies on drowning and alcohol. Findings: Unintentional fatal drowning cases (n = 967) for which a full medico-legal autopsy and toxicological analysis was performed, in Finland, from 2000 to 2013, and relevant variables (demographic data of the victims, month of incident, PM submersion time, blood alcohol concentration, urine alcohol concentration (UAC), vitreous humour alcohol concentration (VAC) were available. Overall, out of 967 unintentional drownings, 623 (64.4%) were positive for alcohol (BAC > 0 mg/dL), 595 (61.5%) had a BAC ≥ 50 mg/dL, and 567 (58.6%) a BAC ≥ 100 mg/dL. Simultaneous measurements, in each victim, of BAC, UAC, and VAC revealed PM ethanol production in only 4 victims (BAC: 25 mg/dL – 48 mg/dL). These false positive cases represented 0.4% of drownings with BAC > 0 mg/dL and 14.3% of drownings with BAC > 0 mg/dL and <50 mg/dL. Conclusions: The present study suggests that PM ethanol production has a limited impact on research addressing the prevalence rate for alcohol-related drowning and that the use of too rigorous exclusion criteria, such as those previously recommended, may led to a significant underestimation of actual alcohol-positive drowning cases. © 2018, The Author(s).
Subject: Alcohol
Epidemiology
Post-mortem ethanol production
Unintentional drowning
alcohol
adult
alcohol blood level
alcohol production
Article
autopsy
child
comparative study
death
demography
drowning
gas chromatography
human
ICD-10
immersion
male
measurement accuracy
medicolegal aspect
middle aged
near drowning
preschool child
prevalence
priority journal
retrospective study
toxicology
urinalysis
victim
vitreous body
319 Forensic science and other medical sciences
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