Fatal intoxication due to dichloromethane exposure: a case report

Introduction. Dicholomethane (DCM) is a solvent, industrially used also as component of paint and varnish removers. Due to its high volatility, its use in confined spaces can cause a serious health hazard as a result of accumulation of the solvent vapour. At high levels, DCM acts on the central nervous system, major toxic effect being narcosis, depression and at last death. A case of accidental death in working place is described. Materials and Methods. A 50-year-old white male was found dead at his working place. He was found on one's back on tank border he was cleaning without using a gas mask.The tank contained paint residuals. The following toxicological analyses were carried out on post-mortem samples: at first sistematic toxicological analysis (STA) by GC-MS, ethanol and volatile substances detection by headspace gas chromatography (HS-GC) were performed in blood. A positive result for dichloromethane emerged and so quantitation in biological fluids, organs and viscera was performed after optimization of the headspace gas chromatography-flame ionization detection technique (GC-HS-FID). Carboxyhemoglobin levels were also measured by spectrophotometric tecnique. Results. No drugs neither ethanol were found in blood sample. The following concentrations of DCM were measured: cardiac blood (220 mg/L), urine (25 mg/L), gastric content (22 mg/L), brain (170 mg/kg), fat (170 mg/kg), liver (250 mg/kg), lung (330 mg/kg), and kidney (160 mg/kg). Carboxyhemoglobin resulted at a level of 8%. Conclusion.The cause of death was an accidental poisoning due to dichloromethane. The normal range of carboxyhemoglobin and the very high levels of DCM in biological samples indicated that the death was the consquence of the direct effect of dichloromethane on the central nervous system.