Journal of forensic and legal medicine · 2026
Examining the role of cyanide poisoning in the autopsies of closed-space fire deaths in Istanbul (Türkiye).
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Okudan Mustafa, Tufekci Doruktan, Ofluoglu Fatma, Asirdizer Mahmut
Аннотация
BACKGROUND: Most deaths in closed-space fires occur due to inhalation of carbon monoxide, hydrogen cyanide, and other gases in the environment.
MATERIAL AND METHODS: This study retrospectively examined 42 forensic autopsy reports and the associated crime scene reports of individuals who died in indoor fires. The autopsies were performed at the Morgue Department of the Forensic Medicine Institute in 2022 and 2023.
RESULTS: Cyanide analysis was not conducted in 33.3 % of the 42 cases, and cyanide was detected in only 10.7 % of the 28 cases in which blood cyanide analysis was requested. All cases had positive carboxyhemoglobin levels, although 76.2 % of cases had HbCO values more than 10 %. More than half of the deaths occurred at the scene, primarily in the victims' homes. All cases had burns on their bodies, ranging from second degree to carbonization degree, and soot contamination in the upper and lower respiratory tracts was determined in 77.7 %. The toxicological analysis of blood from victims who received medical treatment, either in ambulances or hospitals, showed no evidence of antidote administration.
CONCLUSION: The findings of this study highlight the importance of collecting blood samples from the bodies of those who have died at the fire scene, administering cyanide antidotes to survivors via immediate intravenous injection after smoke exposure, and testing survivors for metabolites due to the short half-life of cyanide. For the prevention of cyanide poisoning exposure, and implementation of the administrative actions and training that medical professionals in Türkiye should undertake to assist victims who survive smoke exposure, a brief review is also provided of the legal requirements that must be followed in the construction and interior design of buildings where people congregate.
MATERIAL AND METHODS: This study retrospectively examined 42 forensic autopsy reports and the associated crime scene reports of individuals who died in indoor fires. The autopsies were performed at the Morgue Department of the Forensic Medicine Institute in 2022 and 2023.
RESULTS: Cyanide analysis was not conducted in 33.3 % of the 42 cases, and cyanide was detected in only 10.7 % of the 28 cases in which blood cyanide analysis was requested. All cases had positive carboxyhemoglobin levels, although 76.2 % of cases had HbCO values more than 10 %. More than half of the deaths occurred at the scene, primarily in the victims' homes. All cases had burns on their bodies, ranging from second degree to carbonization degree, and soot contamination in the upper and lower respiratory tracts was determined in 77.7 %. The toxicological analysis of blood from victims who received medical treatment, either in ambulances or hospitals, showed no evidence of antidote administration.
CONCLUSION: The findings of this study highlight the importance of collecting blood samples from the bodies of those who have died at the fire scene, administering cyanide antidotes to survivors via immediate intravenous injection after smoke exposure, and testing survivors for metabolites due to the short half-life of cyanide. For the prevention of cyanide poisoning exposure, and implementation of the administrative actions and training that medical professionals in Türkiye should undertake to assist victims who survive smoke exposure, a brief review is also provided of the legal requirements that must be followed in the construction and interior design of buildings where people congregate.