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Gravagnuolo R, Tambuzzi S, Gentile G, Boracchi M, Crippa F, Madeddu F, Zoja R, Calati R. Is It Correct to Consider Caustic Ingestion as a Nonviolent Method of Suicide? A Retrospective Analysis and Psychological Considerations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6270. [PMID: 37444118 PMCID: PMC10341094 DOI: 10.3390/ijerph20136270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 06/20/2023] [Accepted: 06/25/2023] [Indexed: 07/15/2023]
Abstract
BACKGROUND Suicide methods chosen by victims are particularly critical in suicide risk research. To differentiate suicide deaths, it is usual to categorize them as violent and nonviolent depending on the detrimental method chosen by the victims. Caustic ingestion, for example, is traditionally considered as a nonviolent suicide method. It results in severe consequences for the human body and it is associated with high levels of lethality. METHODS In this study, we retrospectively analyzed suicides that occurred between 1993 and 2021 in Milan (Italy) and that underwent autopsy. We compared a sample of 40 victims that ingested caustic substances with a sample of 460 victims of other chemical ingestion, and a sample of 3962 victims from violent suicide. Univariate analyses and univariate logistic regression models were performed. Suicides from caustic poisoning were significantly older, had a higher mean number of diseases and were more affected by psychiatric diseases compared to other chemical ingestion victims. By contrast, caustic suicides, compared to violent suicides, had a more balanced gender ratio, a higher mean number of diseases, were more affected by psychiatric diseases, had a higher rate of complex suicides (more than one modality), and had victims who died more frequently inside instead of outside. In logistic regression models, age was the only feature differentiating caustic from other chemical ingestion suicides while the features differentiating caustic from violent suicides were gender, mean number of diseases and suicide place. CONCLUSIONS Suicides by caustic ingestion showed substantial differences compared to violent suicides, with a higher severe profile. However, some differences were reported comparing caustic ingestion to other chemical ingestion as well. Thus, we argue whether it is more appropriate to differentiate the suicidal ingestion of caustics from both violent and nonviolent suicide methods.
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Affiliation(s)
- Rosa Gravagnuolo
- Department of Psychology, University of Milan-Bicocca, 20126 Milan, Italy (F.C.)
| | - Stefano Tambuzzi
- Department of Biomedical Sciences for Health, Section of Legal Medicine and Insurance, University of Milan, 20122 Milan, Italy
| | - Guendalina Gentile
- Department of Biomedical Sciences for Health, Section of Legal Medicine and Insurance, University of Milan, 20122 Milan, Italy
| | - Michele Boracchi
- Department of Biomedical Sciences for Health, Section of Legal Medicine and Insurance, University of Milan, 20122 Milan, Italy
| | - Franca Crippa
- Department of Psychology, University of Milan-Bicocca, 20126 Milan, Italy (F.C.)
| | - Fabio Madeddu
- Department of Psychology, University of Milan-Bicocca, 20126 Milan, Italy (F.C.)
| | - Riccardo Zoja
- Department of Biomedical Sciences for Health, Section of Legal Medicine and Insurance, University of Milan, 20122 Milan, Italy
| | - Raffaella Calati
- Department of Psychology, University of Milan-Bicocca, 20126 Milan, Italy (F.C.)
- Department of Adult Psychiatry, Nimes University Hospital, 30900 Nimes, France
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Tambuzzi S, Gentile G, Andreola S, Migliorini AS, Zoja R. Visceral Microscopic Pattern From Suicidal Ingestion of Professional Lysoform® With Delayed Death. Acad Forensic Pathol 2022; 12:118-125. [PMID: 36093372 PMCID: PMC9459401 DOI: 10.1177/19253621221119081] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 07/24/2022] [Indexed: 08/14/2023]
Abstract
Lysoform® in the formulation of professional detergent is widely used in several fields, whereas its suicidal ingestion is an unusual occurrence. Therefore, the biological signs of this fatal poisoning remain unclear and elusive, similarly to the histological lesions induced by its main constituent, which is benzalkonium chloride (BZK). Furthermore, since all the deaths that has been reported in the literature occurred immediately, microscopic pictures of BZK lethal toxicity in subjects with prolonged survival have never been reported to date. Specifically, this brief communication reports the unique case of a woman who ingested professional Lysoform® to commit suicide, for which she died two weeks later. The autopsy examination showed either local or systemic signs of caustic ingestion; moreover, the histological analysis showed clear cellular damage of lungs, heart, and kidneys. In our case, toxicological investigations were not authorized as they were no longer considered significant. In this framework, the histological examination has therefore assumed a fundamental role in investigating and demonstrating the lethal effects caused by the systemic dissemination of BZK, which would otherwise no longer be investigable. Therefore, in cases of substance intoxication with prolonged survival where forensic toxicological investigations may be no longer possible or feasible, the histological examination may be the only resource to successfully observe and demonstrate its lethal effects.
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Affiliation(s)
| | - Guendalina Gentile
- Guendalina Gentile BSc, Sezione di Medicina
Legale—Dipartimento di Scienze Biomediche per la Salute—Università degli Studi, via Luigi
Mangiagalli, 37, 20133 Milano, Italy,
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Sudden and unexpected deaths due to non-traumatic abdominal disorders: A forensic perspective. J Forensic Leg Med 2022; 89:102355. [DOI: 10.1016/j.jflm.2022.102355] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 04/08/2022] [Accepted: 04/23/2022] [Indexed: 12/22/2022]
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Guendalina G, Stefano T, Salvatore A, Paolo B, Giorgia B, Ilaria G, Riccardo Z. Analysis of the corrosive effects of hydrochloric acid (HCl) on human bone: Preliminary microscopic study and observations for forensic purposes. Forensic Sci Int 2021; 329:111095. [PMID: 34775329 DOI: 10.1016/j.forsciint.2021.111095] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 10/29/2021] [Accepted: 11/01/2021] [Indexed: 11/25/2022]
Abstract
The destruction of a corpse in caustic acid can cause complex forensic scenarios to deal with. Furthermore, the literature on the subject is poor, having been the few studies carried out only on animal bones. We carried out an experimental analysis on human cranial, ribs, vertebrae, and femur bone fragments. These samples were sent for dissolution by hydrochloric acid (HCl) at two different concentrations in the lab: 10% and 37%. We have performed macroscopic and microscopic histological and cytological observations at set time intervals: 3, 4, 19, 24, 48, and 72 h of immersion in acids. The purpose of the study was threefold: to investigate the temporal evolution of bone dissolution, evaluate the destructive effect of the two hydrochloric acids, and establish whether or not the human pattern of histological structure could be recognized. A more significant destructive action of HCl at 37% has been observed. In the 10% acid, the bone nature of the samples was demonstrable up to 24 h of immersion, but the human pattern of histological structure was already compromised at 19 h, being lost at 24 h. Instead, in the 37% acid, the bone nature of the sample was demonstrable only within 4 h of immersion, and the human pattern of histological structure was markedly compromised within 3 h. At 19 h of immersion, neither the recognition of the bone nor its human nature was feasible. These preliminary findings and observations may be of practical use in forensic investigations of bodies found in acidic substances, for which there is no scientific evidence to refer.
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Affiliation(s)
- Gentile Guendalina
- Laboratorio di Istopatologia Forense e Microbiologia Medico Legale - Sezione di Medicina Legale e delle Assicurazioni - Dipartimento di Scienze Biomediche per la Salute - Università degli Studi di Milano, Via Luigi Mangiagalli, 37-20133 Milano, Italy.
| | - Tambuzzi Stefano
- Laboratorio di Istopatologia Forense e Microbiologia Medico Legale - Sezione di Medicina Legale e delle Assicurazioni - Dipartimento di Scienze Biomediche per la Salute - Università degli Studi di Milano, Via Luigi Mangiagalli, 37-20133 Milano, Italy
| | - Andreola Salvatore
- Laboratorio di Istopatologia Forense e Microbiologia Medico Legale - Sezione di Medicina Legale e delle Assicurazioni - Dipartimento di Scienze Biomediche per la Salute - Università degli Studi di Milano, Via Luigi Mangiagalli, 37-20133 Milano, Italy
| | - Bailo Paolo
- Laboratorio di Istopatologia Forense e Microbiologia Medico Legale - Sezione di Medicina Legale e delle Assicurazioni - Dipartimento di Scienze Biomediche per la Salute - Università degli Studi di Milano, Via Luigi Mangiagalli, 37-20133 Milano, Italy
| | - Bilato Giorgia
- Laboratorio di Istopatologia Forense e Microbiologia Medico Legale - Sezione di Medicina Legale e delle Assicurazioni - Dipartimento di Scienze Biomediche per la Salute - Università degli Studi di Milano, Via Luigi Mangiagalli, 37-20133 Milano, Italy; Dipartimento di Biotecnologie e Scienze della Vita (DBSV) Università degli Studi Insubria di Varese, Italy
| | - Gorini Ilaria
- Dipartimento di Biotecnologie e Scienze della Vita (DBSV) Università degli Studi Insubria di Varese, Italy
| | - Zoja Riccardo
- Laboratorio di Istopatologia Forense e Microbiologia Medico Legale - Sezione di Medicina Legale e delle Assicurazioni - Dipartimento di Scienze Biomediche per la Salute - Università degli Studi di Milano, Via Luigi Mangiagalli, 37-20133 Milano, Italy
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Rahman NA, Das S, Chaudhari VA, Nandagopal S, Badhe B. Blending of rodenticide and battery acid - a rare and fatal suicide mix. EGYPTIAN JOURNAL OF FORENSIC SCIENCES 2017; 7:8. [PMID: 28781900 PMCID: PMC5514184 DOI: 10.1186/s41935-017-0002-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Accepted: 05/24/2017] [Indexed: 11/16/2022] Open
Abstract
Background Self-poisoning usually occurs by the ingestion of a single lethal compound and majority of the poisoning cases in our country are due to the pesticides. Suicide by ingestion of more than one poisonous substance is rare except alcohol and multiple drugs. To the best of our knowledge, suicidal ingestion of a mixture of rodenticide and battery acid has not been reported before in medical literature. Case presentation Here we are discussing a case of simultaneous ingestion of two poisonous substances, i.e., aluminium phosphide and battery acid. In general, an acid is mainly locally acting while metal phosphide is a systemic poison. Features suggestive of both these poisonous substances were noticed on clinical, autopsy and histopathological examination and supported by a positive chemical analysis report of viscera. Moreover, we analysed the possible reactions which may occur between these two compounds and their by-products outside and inside our body. Conclusion In cases where, combination of poisons is suspected a proper history, meticulous autopsy and ancillary investigation including histopathogy and analytical toxicology are required to conclude the cause of death and mechanism of poisoning.
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Affiliation(s)
| | - Siddhartha Das
- Department of Forensic Medicine & Toxicology, JIPMER, Puducherry, India
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Amadasi A, Camici A, Porta D, Cucca L, Merli D, Milanese C, Profumo A, Rassifi N, Cattaneo C. Assessment of the Effects Exerted by Acid and Alkaline Solutions on Bone: Is Chemistry the Answer? J Forensic Sci 2017; 62:1297-1303. [PMID: 28144942 DOI: 10.1111/1556-4029.13429] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 12/07/2016] [Accepted: 12/07/2016] [Indexed: 11/29/2022]
Abstract
The treatment of corpses with extremely acid or basic liquids is sometimes performed in criminal contexts. A thorough characterization by chemical analysis may provide further help to macroscopic and microscopic analysis; 63 porcine bone samples were treated with solutions at different pH (1-14) for immersion periods up to 70 days, as well as in extremely acidic sulfuric acid solutions (9 M/18 M) and extremely basic sodium hydroxide. Inductively coupled optical emission spectrometry (ICP-OES)/plasma mass spectrometry (ICP-MS), Fourier transform infrared spectroscopy (FT-IR), energy dispersive X-ray analysis (EDX), X-ray powder diffraction (XRPD), and scanning electron microscopy (SEM) showed that only the sulfuric acid solution 18 M was able to completely dissolve the sample. In addition, chemical analysis allowed to recognize the contact between bone and substances. Hydrated calcium sulfate arose from extreme pH. The possibility of detecting the presence of human material within the residual solution was demonstrated, especially with FT-IR, ICP-OES, and EDX.
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Affiliation(s)
- Alberto Amadasi
- LABANOF, Laboratorio di Antropologia ed Odontologia Forense, Sezione di Medicina Legale, Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, V. Mangiagalli 37, 20133 Milano, Italy
| | - Arianna Camici
- LABANOF, Laboratorio di Antropologia ed Odontologia Forense, Sezione di Medicina Legale, Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, V. Mangiagalli 37, 20133 Milano, Italy
| | - Davide Porta
- LABANOF, Laboratorio di Antropologia ed Odontologia Forense, Sezione di Medicina Legale, Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, V. Mangiagalli 37, 20133 Milano, Italy
| | - Lucia Cucca
- Dipartimento di Chimica, Università di Pavia, Viale Taramelli 12, 27100 Pavia, Italy
| | - Daniele Merli
- Dipartimento di Chimica, Università di Pavia, Viale Taramelli 12, 27100 Pavia, Italy
| | - Chiara Milanese
- Dipartimento di Chimica, Università di Pavia, Viale Taramelli 12, 27100 Pavia, Italy
| | - Antonella Profumo
- Dipartimento di Chimica, Università di Pavia, Viale Taramelli 12, 27100 Pavia, Italy
| | - Nabila Rassifi
- Dipartimento di Chimica, Università di Pavia, Viale Taramelli 12, 27100 Pavia, Italy
| | - Cristina Cattaneo
- LABANOF, Laboratorio di Antropologia ed Odontologia Forense, Sezione di Medicina Legale, Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, V. Mangiagalli 37, 20133 Milano, Italy
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