Ethanol is the most commonly abused drug worldwide, and excessive alcohol consumption is a major contributing factor in accidents and violent crimes. Methanol is a toxic alcohol and is less commonly detected but holds significant forensic relevance due to its potential for causing fatal poisoning. The study aims to detect the concentrations of ethanol and methanol in postmortem blood, vitreous humor, urine, and cerebrospinal fluid, and to create a database of the involvement of alcohol in postmortem cases. A total of 150 postmortem cases with different causes of death were enrolled for the study. Gas Chromatography-Headspace was employed for the quantitative determination of ethanol and methanol concentrations in the biological specimens. Out of 150 cases, 108 cases (72%) exhibited positive ethanol concentrations. The high prevalence of positive ethanol concentration, particularly in cases of road traffic accidents and hanging, indicated a significant amount of alcohol use prior to death and underscores the role of alcohol consumption in fatal incidents. Methanol was detected in only those cases that had a high ethanol concentration, which may be due to adulteration or contamination of methanol in the alcoholic beverages that the deceased consumed before death. The study highlighted that an alternative/ complementary specimen to the blood should be considered to assess the alcohol concentration and to differentiate antemortem ingestion of alcohol from postmortem formation. The toxicological analysis of alcohol is important in understanding consumption patterns and in developing protocols and policies for preventing such cases.
IoanBGJitaruVDamianR, et al.Study on the relationship between the concentration of ethanol in the blood, urine and the vitreous humour. Romanian J Legal Med2015; 23: 211–216.
2.
DaviesM. The role of GABAA receptors in mediating the effects of alcohol in the central nervous system. J Psychiatry Neurosci2003 Jul; 28: 263–274.
3.
OlsenTHearnWL. Stability of ethanol in post-mortem blood and vitreous humor in long-term refrigerated storage. J Anal Toxicol2003; 27: 517–519.
4.
CaplanYHLevineB. Vitreous humor in the evaluation of post-mortem blood ethanol concentrations. J Anal Toxicol1990; 14: 305–307.
5.
World Health Organization, World Health Organization. Substance Abuse Department, World Health Organization. Department of Mental Health, Substance Abuse. Global status report on alcohol 2004. World Health Organization; 2004.
6.
De MartinisBSde PaulaCMBragaA, et al.Alcohol distribution in different post-mortem body fluids. Hum Exp Toxicol2006; 25: 93–97.
7.
SylvesterPAWongNAWarrenBF, et al.Unacceptably high site variability in post-mortem blood alcohol analysis. J Clin Pathol1998; 51: 250–252.
8.
KugelbergFCJonesAW. Interpreting results of ethanol analysis in post-mortem specimens: a review of the literature. Forensic Sci Int2007 Jan 5; 165: 10–29.
9.
CaughlinJD. Correlation of post-mortem blood and vitreous humor alcohol concentration. Canad Soc Forensic Scie J1983 Jan 1; 16: 61–68.
10.
JollymoreBDFraserADMossMA, et al.Comparative study of ethanol in blood and vitreous humor. Canad Soc Forensic Sci J1984 Jan 1; 17: 50–54.
11.
NeilPMillsAJPrabhakaranVM. Evaluation of vitreous humor and urine alcohol levels as indices of blood alcohol levels in 75 autopsy cases. Canad Soc Forensic Sci J1985 Jan 1; 18: 97–104.
12.
SkoppG. Preanalytic aspects in post-mortem toxicology. Forensic Sci Int2004 Jun 10; 142: 75–100.
13.
ButzbachDM. The influence of putrefaction and sample storage on post-mortem toxicology results. Forensic Sci Med Pathol2010 Mar; 6: 35–45.
14.
CullenSAMayesRW. Alcohol discovered in the urine after death: ante-mortem ingestion or post-mortem artefact?Med Sci Law2005 Jul; 45: 196–200.
15.
MurthyKRGoelRSubbannayyaY, et al.Proteomic analysis of human vitreous humor. Clin Proteomics2014 Dec; 11: 1–1.
16.
BévalotFCartiserNBottinelliC, et al.Vitreous humor analysis for the detection of xenobiotics in forensic toxicology: a review. Forensic Toxicol2016 Jan 1; 34: 12–40.
17.
MetushiIGFitzgeraldRLMcIntyreIM. Assessment and comparison of vitreous humor as an alternative matrix for forensic toxicology screening by GC–MS. J Anal Toxicol2016 May 1; 40: 243–247.
18.
KrautAPurchaseCA. Vitreous humor/blood and urine/blood alcohol ratios as an aid to the forensic investigator part 2: application. CanadSoci Forensic Sci J1984 Jan 1; 17: 159–166.
19.
KrautAPurchaseCA. Vitreous humor/blood and urine/blood alcohol ratios as an aid to the forensic investigator. Part I: methodology. Canadian Soc Forensic Sci J1984 Jan 1; 17: 91–97.
20.
WachholzPSkowronekRPawlasN. Cerebrospinal fluid in forensic toxicology: current status and future perspectives. J Forensic Leg Med2021 Aug 1; 82: 102231.
21.
WachholzPSkowronekRPawlasN. Assessing the applicability of cerebrospinal fluid collected from the spinal cord for the determination of ethanol in post-mortem toxicology. Forensic Sci Med Pathol2023 Mar; 19: 44–49.
22.
TiscioneNBAlfordIYeatmanDT, et al.Ethanol analysis by headspace gas chromatography with simultaneous flame-ionization and mass spectrometry detection. J Anal Toxicol2011 Sep 1; 35: 501–511.
23.
OttJGronemannVPontzenF, et al.Ullmann's encyclopedia of industrial chemistry. Weinheim, Germany: Wiley‑VCH Verlag GmbH & Co. KGaA, 2000. DOI: 10.1002/14356007.a16_465.
TianMHeHLiuY, et al.Fatal methanol poisoning with different clinical and autopsy findings: case report and literature review. Leg Med2022 Feb 1; 54: 101995.
26.
PressmanPClemensRSahuS, et al.A review of methanol poisoning: a crisis beyond ocular toxicology. Cutan Ocul Toxicol2020 July 2; 39: 173–179.
27.
D’SilvaJ. India’s problem with toxic alcohol. Br Med J2015 Aug 25; 351: h4536.
28.
BodwalJChauhanMSGhoshM, et al.Hooch tragedies in India: a review. Anil Aggrawal’s Internet J Forensic Med Toxicol2014 Jan 1; 15: 1–9.
29.
SchumannJ. Post-mortem analysis and interpretation of alcohol. In: Encyclopedia of forensic sciences. 3rd ed. Amsterdam, Netherlands: Elsevier, 2023, pp.229–234.
30.
Al-QazzazMAAl-SaffarAJAl-RubaiHK, et al.Evaluation of alcohol concentrations in samples referred to the forensic Laboratory in Baghdad. Egyptian J Forensic Sci2017 Dec; 7: 1–5.
31.
BoucheryEEHarwoodHJSacksJJ, et al.Economic costs of excessive alcohol consumption in the US, 2006. Am J Prev Med2011 Nov 1; 41: 516–524.
ZerbiniTde Carvalho PonceJSinagawaDM, et al.Blood alcohol levels in suicide by hanging cases in the state of Sao Paulo, Brazil. J Forensic Leg Med2012 Jul 1; 19: 294–296.
39.
SinghOP. Startling suicide statistics in India: time for urgent action. Indian J Psychiatry2022 Sep 1; 64: 431–432.
40.
PonnaiahMBhatnagarTAbdulkaderRS, et al.Factors associated with unexplained sudden deaths among adults aged 18–45 years in India–a multicentric matched case–control study. Indian J Med Res2023 Oct 1; 158: 351–362.
MishraPKumarPKumarP. Social and economical problems of alcohol consumption in India. GEHU Law Rev2021 Jul 1; 1: 1–15.
43.
DesaiTSudhalkarAVyasU, et al.Methanol poisoning: predictors of visual outcomes. JAMA Ophthalmol2013 Mar 1; 131: 358–364.
44.
RahimiRZainunKANoorNM, et al.Methanol poisoning in Klang Valley, Malaysia: autopsy case series. Forensic Sci Intern Reports2021 Jul 1; 3: 100170.
45.
BonchevGDZlatevaSZYovchevaMI. Toxicological chemical analysis of methanol in blood of patients with acute ethanol intoxication for determining detectable quantities of methanol and analysis of the correlation between ingested alcohol. J Biomed Clin Res2016; 9: 48–54.
