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Chronic chloropropene poisoning is a disease mainly caused by peripheral nerve damage due to close contact with chloropropene in industrial production, its clinical manifestations include varying degrees of sensory, motor, or tendon reflex disorders in the distal limbs, and neuromyography can show neurogenic damage. This article analyzed and summarized the clinical characteristics, diagnosis and treatment methods of three patients with occupational chronic chloropropene poisoning, in order to enhance the clinical understanding of occupational chronic chloropropene poisoning and provide reference for clinical diagnosis and treatment.

Volatile Solvents Abuse (VSA) poses major health risks, especially for young people and those living in precarious socio-economic conditions. Such substances can in fact bring about psychoactive effects such as euphoria, and even lead to sudden death from cardiac arrhythmias, respiratory depression, myocardial infarction, laryngospasm, encephalopathy, and rhabdomyolysis. The present case report is centered around a 23-year-old man who died in prison due to inhalation of a cooker gas mixture (n-butane, propane, and isobutane) inside a plastic bag. External examination and autopsy showed non-specific signs of asphyxia associated with edema and brain swelling. Histological signs of early myocardial damage and hypoxic-ischemic injury (HII) were highlighted in the brain and cerebellum, as well as activated macrophages and anthracotic-like material in the lungs. Toxicological investigations revealed the presence of propane, isobutane and n-butane in liquids and biological samples. Besides the cardiotoxic effect, there was an asphyctic component due to the plastic bag that may have facilitated death. The assessment of cerebral HII and cardiopulmonary damage in acute cases is very important to prove death by butane inhalation. In the forensic field, it may be useful to shed more light on intoxications, deaths, and butane encephalopathies, as the latter can be mistaken for a hypoxic-ischemic encephalopathy., Competing Interests: Declaration of competing interest The authors certify that there is no conflict of interest with any financial organization regarding the material discussed in the manuscript., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Complex suicides are highly uncommon suicides in which multiple detrimental methods are used simultaneously or in chronological succession. We retrospectively analyzed through our database the 25512 autopsy reports registered at the Bureau of Legal Medicine of Milan in the last 27 years from 1993 until 2019, where 4498 suicides were documented. We assessed 53 cases of complex suicides and only one case of complicated suicide: for all of them we analyzed both data collected during the on-site investigation and the autopsy. In our case series, we identified a total number of 113 methods chosen and variably combined by the victims, which were classified into 17 categories. On the whole the most frequent association of suicide methods resulted in the combination of the plastic bag suffocation with inert gas inhalation (13 out of 53 complex suicides; 24.5%). We also analyzed our cases of simple suicides (1993-2019), to compare them with the complex suicides. In this study, we present a complete analysis regarding our cases of complex suicides, discussing the challenges and the interpretative issues which a forensic pathologist might deal with. A thorough on-site judicial inspection and a careful autopsy examination are crucial in such cases. Moreover, the clinical history of the victims and laboratory findings are supplemental elements to be necessarily considered to establish the actual manner of death and avoid any misinterpretations., Competing Interests: Declaration of Competing Interest The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this paper., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Volatile substance abuse in order to "get high" is a widespread problem especially among adolescents and young-adults, with significant rates of morbidity and mortality. Despite the studies conducted on this topic, collection and preservation of volatile substances in forensic context is still a matter of debate: there are several scientific papers describing materials and procedures for volatile substance sampling while performing post mortem examinations and how they influence the development of the forensic case. Most of the proposed techniques involve the use of specific, and sometimes expensive, gas tight materials that are not always available. The aim of this paper is to share a simple method for rapid and effective volatile substance sampling that can be used in both evident and suspected VSA-related deaths. The strength of this procedure is to be applicable even in cases when specific gas tight instruments for sampling, collection and preservation of volatile substances are not available.

Death due to inhalation of aliphatic hydrocarbons such as butane and propane is a particularly serious problem worldwide, resulting in several fatal cases of sniffing these volatile substances in order to "get high". Despite the number of cases published, there is not a unique approach to case management of fatal sniffing. In this paper we illustrate the volatile lipophilic substances management in a case of a prisoner died after sniffing a butane-propane gas mixture from prefilled camping stove gas canisters, discussing the comprehensive approach of the crime scene, the autopsy, histology and toxicology. A large set of accurate values of both butane and propane was obtained by gas chromatography-mass spectrometry analyzing the following post-mortem biological samples: peripheral blood, heart blood, vitreous humor, liver, lung, heart, brain/cerebral cortex, fat tissue, kidney, and allowed an in depth discussion about the cause of death. A key role is played by following the proper sampling approach during autopsy., (Copyright © 2017 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.)

The recreational use of inhalants is a fairly widespread habit among adolescents because of the ease of availability and methods of assumption. Their use is however not free of risks, both for direct toxicity on several target organs and for a mechanism of gas replacement with lack of oxygen. The first case concerns a 12-year-old boy who died suddenly after sniffing a mix of butane and propane contained in a can of air freshener. The second case concerns a 14-year-old boy who died by acute poisoning by the same mixture contained in a refill for lighters. High concentrations of the compounds were found in the tissues by analysis with gas chromatography-mass spectrometry. The compounds found in tissues and biological fluids were perfectly compatible with those contained in the containers used for the inhalation. The mechanisms of death were therefore assessed in a combination of the direct toxicity of the compound and oxygen replacement, thus highlighting the crucial help that toxicological analyses can provide in such cases., (Copyright © 2016. Published by Elsevier Ireland Ltd.)

Liquefied hydrocarbon gas, such as propane is considered safe. However there are reports that voluntary exposure to liquefied gas at least could originate hallucinatory states. We report a 20 years old woman who was found in a coma with extensor muscle hypertonia, brisk tendon reflexes and extensor plantar (Babinski) responses after being exposed to propane gas. The brain magnetic resonance imaging (MRI) showed lesions in both hippocampi and white matter in the oval center. The patient had a normal oxygen saturation of 98%, a carboxyhemoglobin of 1.6% and a metabolic acidosis with a pH of 7.01 with an anion gap of 16 mEq/l. This pattern suggested that it was a consequence of the intermediary metabolism of isopropanol. The recovery of the patient was slow and four months later she still had lesions on MRI and limitations in her cognitive sphere, memory and executive functions. Thus, liquefied gas exposure can cause a toxic encephalopathy with a persistent damage of the central nervous system.

Sudden death due to inhalation of aliphatic hydrocarbons such as butane and propane is well described in the literature. The main mechanism involved is the induction of a fatal cardiac arrhythmia. This phenomenon is frequently associated with prisoners who accidentally die while sniffing these volatile substances with an abuse purpose. Furthermore, such prisoners are often under psychiatric treatment; specific drugs belonging to this pharmacological class lead to a drug-related QT interval prolongation, setting the stage for torsade de pointes. In this article, we present the case of a prisoner died after sniffing a butane-propane gas mixture from a prefilled camping stove gas canister. The man was under psychiatric drugs due to mental disorders. He was constantly subjected to electrocardiogram to monitor the QTc (corrected QT interval), which was 460 milliseconds long. Toxicological analysis on cadaveric samples was performed by means of gas chromatography (head space) and revealed the presence of butane and propane at low levels. The aim of this article was to discuss a possible arrhythmogenic interaction of QT interval prolongation induced by psychiatric drugs and butane-propane inhalations, increasing the cardiovascular risk profile. In other words, evidence may suggest that prisoners, under these circumstances, are more likely to experience cardiovascular adverse effects. We believe that this study underlines the need to take this hypothesis into account to reduce death risk in prison and any medical-related responsibilities. Further studies are needed to validate the hypothesis.

A 42-year-old man working at a printing company was referred to our hospital for examination and treatment of icterus. We diagnosed resectable hilar cholangiocarcinoma and provided neoadjuvant chemoradiotherapy, extended right hepatectomy, and extrahepatic bile duct resection. A detailed history revealed that he had used 1,2-dichloropropane as part of his work as an offset colour proof-printer, and he has subsequently been recognized as having occupational cholangiocarcinoma. He has survived without recurrence for more than 2 and half years since the liver resection. In the present report, we describe our valuable experience of neoadjuvant chemoradiotherapy for occupational cholangiocarcinoma.

A 21-year-old woman with no past medical history of note was found unconscious together with five of her family members after prolonged exposure to liquefied petroleum gas. She was admitted to the intensive care unit at Victoria Hospital, Wynberg, Cape Town, South Africa, following resuscitation for pulseless electrical activity. On examination the following was found: coma without focal neurology; shock requiring fluid resuscitation and adrenaline; probable pneumonitis or aspiration pneumonia; acute rhabdomyolysis with severe metabolic acidosis; and raised serum K+. A carboxyhaemoglobin test was unable to confirm or exclude carbon monoxide poisoning.

Propane can be responsible for several types of lethal intoxication and explosions. Quantifying it would be very helpful to determine in some cases the cause of death. Some gas chromatography-mass spectrometry (GC-MS) methods of propane measurements do already exist. The main drawback of these GC-MS methods described in the literature is the absence of a specific propane internal standard necessary for accurate quantitative analysis. The main outcome of the following study was to provide an innovative Headspace-GC-MS method (HS-GC-MS) applicable to the routine determination of propane concentration in forensic toxicology laboratories. To date, no stable isotope of propane is commercially available. The development of an in situ generation of standards is thus presented. An internal-labeled standard gas (C₃DH₇) is generated in situ by the stoichiometric formation of propane by the reaction of deuterated water (D₂O) with Grignard reagent propylmagnesium chloride (C₃H₇MgCl). The method aims to use this internal standard to quantify propane concentrations and, therefore, to obtain precise measurements. Consequently, a complete validation with an accuracy profile according to two different guidelines, the French Society of Pharmaceutical Sciences and Techniques (SFSTP) and the Gesellschaft für toxikologische und Forensische Chemie (GTFCh), is presented.

1,2,3-trichloropropane (1,2,3-TCP) is commonly used as an intermediate in pesticide and an industrial specialty solvent. Acute 1,2,3-TCP poisoning is rare but a medical emergency. Sporadic cases of toxic hepatic injury from 1,2,3-TCP in humans have been reported. Liver is a target organ for 1,2,3-TCP toxicity, which may ensue in a short period after ingestion. A specific antidote against 1,2,3-TCP is not available. So it is important to distinguish that a patient with 1,2,3-TCP poisoning constitutes a medical emergency. In this case study, the poisoned patient's clinical condition and laboratory values improved gradually after she received hemoperfusion (HP) and plasma exchange, which indicated that the therapy with HP and plasma exchange were helpful in the treatment of 1,2,3-TCP poisoning.

Hydrocarbon inhalation is seldom chosen as a means to commit suicide. This practice is exclusively a prerogative of the prison population; it is, however, only exceptionally found in this environment. The two cases of lethal inhalation of propane/butane gas observed by us over a very short time occurred in this context. Toxicologic analyses were performed by means of gas chromatography (head space) and revealed a propane/butane mixture in all specimens (heart blood, bile, and urine) except vitreous humor. Although fatal arrhythmia posthydrocarbon gas abuse is well known, the concentrations of the two hydrocarbons were sufficient to induce death by asphyxiation and were distributed (fairly) homogeneously in all biological fluids and organs examined, a parameter permitting one to assume that death occurred within a relatively short period of time. The absence of finding in vitreous humor and the trace amount in urine suggests that both men died very quickly., (© 2011 American Academy of Forensic Sciences.)

The Office of the Chief Medical Examiner of Maryland recorded a total of 149 drug abuse deaths of teenagers aged 13-19 years between 1991 and 2006. Of these deaths, 96 (64.4%) were caused by the use of narcotic drugs only, 29 (19.5%) by both narcotics and cocaine, four (2.7%) by both narcotics and methylenedioxymethamphetamine, six (4.0%) by cocaine only, and 14 (9.4%) by volatile substances (e.g., butane, Freon, nitrous oxide, and propane). The annual death rate from drug abuse for teenagers increased from 1.4 deaths per 100,000 population in 1991 to 2.7 deaths per 100,000 population in 2006 (chi-square test for time trend, p<0.01). The increase in teenager drug abuse deaths occurred in 1999 and since has remained at a higher rate. Further analysis revealed that the increase in drug abuse deaths was attributable to a large degree to narcotic drugs, particularly heroin/morphine and methadone, and was confined to teenagers residing in the suburban and rural areas., (© 2011 American Academy of Forensic Sciences.)

1,2,3-Trichloropropane is widely used in industrial and agricultural production. However 1,2,3-trichloropropane poisoning has been rarely encountered in clinical practices. Here, a 45-year-old farmer who suffered fulminant hepatic failure due to ingestion of 1,2,3-trichloropropane has been reported and literature about 1,2,3-trichloropane poisoning has been reviewed. For this case, reduced glutathione, vitamin K, pantoprazole were infused intravenously, and transfusion of blood plasma, platelets and red blood cells were carried out. Unfortunately, the patient's family gave up treatment and they left the hospital with the patient because of the low chance of recovery 20 hr after admission. Based on blood toxicology screening, patient history and rapid deterioration of the patient, the cause of fulminant hepatic failure was determined to be acute intoxication of 1,2,3-trichloropropane by unintentional toxicity. 1,2,3-trichloropropane has histopathological toxic effects on many organs and this toxic effect occurs within a short period after ingestion, with liver as the major affected organ., (© 2010 The Author. Basic & Clinical Pharmacology & Toxicology © 2010 Nordic Pharmacological Society.)

Autoerotic fatalities refer to a death resulting from the participation in a sex-related activity designed to heighten sexual arousal. The overwhelming majority of these deaths are due to asphyxia, most often by hanging or ligature compression of the neck. Here we report a case of "atypical" autoerotic fatality in which death was not induced by ligature compression. Unusual death of a 24-year-old man, involving propane inhalation and plastic bag suffocation, is described. The special characteristics of propane gas as an asphyxiant agent are discussed, as well as its effect on the human body.

In contrast to typical autoerotic fatalities, when death is due to asphyxia mostly by mechanical compression of the neck, atypical autoerotic accidental deaths (AADs) involve sexual self-stimulation by other means such as electrocution or inhalation of chemical agents. Especially in lethal cases of volatile substance abuse (VSA), a differentiation between suicide or sexually or nonsexually motivated accident is often complicated in practical casework. Considering the small number of AADs involving chemical substance abuse reported in the literature, the number of unreported cases seems to be very high. We report about 5 lethal cases of VSA; analysis was performed using headspace solid-phase microextraction (HS-SPME) and gas chromatography-mass spectrometry (GC/MS). When headspace sampling is not performed at autopsy, the analysis of volatile substances can be very complicated. In 2 cases, an AAD was diagnosed considering findings at the scene, reconstruction of the event, and discussion of the circumstances of the death. These findings demonstrate the importance of VSA in atypical autoerotic asphyxia. Therefore, in cases of suspected lethal inhalational intoxications, as a matter of principle, headspace asservation should be performed at autopsy and an autoerotic motivational background should be taken into consideration for differential diagnosis.

Aim: To describe patterns of inhalant abuse in New Zealand and discuss management., Methods: Calls to the National Poisons Centre (NPC) from January 1 2003 to December 31 2004 were analysed. In addition, deaths following inhalational abuse were identified from the Institute of Environmental Science and Research Limited (ESR) database for 2001 and 2002 and available data for 2003., Results: Seventy calls were classified as relating to inhalational abuse incidents. In abusers whose age was known, 83% were between 11 and 20 years, and 61% were male. Over half (44/70) of the calls involved abuse of propane or butane, either alone or in combination with a synthetic pyrethroid. ESR coronial data identified 11 inhalant abuse related deaths, most commonly attributed to cardiac effects. 73% of deaths were in teenagers and all but one fatality involved propane and/or butane., Conclusions: Inhalant abuse is a persisting problem in New Zealand. NPC and ESR data demonstrate that teenagers are more likely to abuse inhalants than other age groups and butane and propane are the inhalants of choice. Acute management can be difficult, with significant mortality and morbidity. Continued education and other preventive measures are essential to help curb an extremely dangerous practice.

We present a case of an accidental autoerotic death involving the inhalation of a propane-butane gas mixture, also known as LPG (liquefied petroleum gas). A 19-year-old male was found dead in supine position in his bed in a residential accommodation one day after he was last seen alive. On a personal computer at the end of the bed, a pornographic movie was still running. On his left shoulder, an empty rubber balloon and on the bedside 2 empty "Kisag-Gas" cartridges were found. Toxicologic investigations revealed an intoxication with propane and butane, together with a recent consumption of cannabis. This case report compares the toxicologic findings with other recently published cases, and the theories of the toxic effects are discussed.

We report three cases of sudden death due to inhalation of portable cooking stove fuel (case 1), cigarette lighter fuel (case 2), and liquefied petroleum gas (LPG) (case 3). Specimens of blood, urine, stomach contents, brain, heart, lung, liver, kidney, and fat were collected and analyzed for propylene, propane, isobutane, and n-butane by headspace gas chromatography. n-Butane was the major substance among the volatiles found in the tissues of cases 1 and 2, and propane was the major substance in case 3. A combination of the autopsy findings and the gas analysis results revealed that the cause of death was ventricular fibrillation induced by hard muscle exercise after gas inhalation in cases 1 and 2, and that the cause of death in case 3 might be hypoxia. It is possible that the victim in case 3 was under anesthetic toxicity of accumulated isobutane which is a minor component of liquefied petroleum gas.

A very rare case of non-fatal acute massive rhabdomyolysis caused by unintentional prolonged inhalation of liquid gas (consisting of butane and propane) in a previously healthy adult is presented. The immediate diagnosis and intensive symptomatic therapy prevented any other severe complications of rhabdomyolysis, and the patient made a complete recovery without any sequelae.

Two unusual suicides of a 19-year-old white man and a 47-year-old white man, involving propane inhalation and plastic bag suffocation, are described. The special characteristics of propane gas as an asphyxiant agent are discussed, as well as its effect on the human body. The discussion emphasizes the postmortem examination and the collection of samples for toxicologic analysis.

Fatal intoxications with butane and/or propane are rare although the inhalation of such liquid gases in order to induce hallucinations is not uncommon amongst youngsters, the number of which is difficult to evaluate. Thus the possibility of gas intoxication should be taken into consideration in all cases of unclear death of youngsters, in which case the macroscopic and histological findings will be unspecific whereas the chemical-toxicological analyses, especially of the native brain, lung and liver tissue, lead to definite conclusions.

A case of suicide of a 26-year old woman by propane-butane inhalation is presented with a description of the circumstances, postmortem pathomorphological and toxicological findings. The literature relating to deaths due to inhalation of these gaseous substances was briefly reviewed.

This report describes a fully elaborated and validated method for quantitation of the hydrocarbons n-propane, iso-butane, and n-butane in blood samples. The newly developed analytical procedure is suitable for both emergency cases and forensic medicine investigations. Its practical applicability is illustrated with a forensic blood sample after acute inhalative intoxication with lighter fluid; case history and toxicological findings are included. Identification and quantitation of the analytes were performed using static headspace extraction combined with gas chromatography-mass spectrometry. In order to reconcile the large gas volumes injected (0.5 mL) with the narrowbore capillary column and thus achieve preconcentration, cold trapping on a Tenax sorbent followed by flash desorption was applied. Adequate retention and separation were achieved isothermally at 35 degrees C on a thick-film capillary column. Sample preparation was kept to a strict minimum and involved simply adding 2.5 microL of a liquid solution of 1,1,2-trichlorotrifluoroethane in t-butyl-methylether as an internal standard to aliquots of blood in a capped vial. Standards were created by volumetric dilution departing from a gravimetrically prepared calibration gas mixture composed of 0.3% of n-propane, 0.7% of iso-butane, and 0.8% of n-butane in nitrogen. In the forensic blood sample, the following concentrations were measured: 90.0 microg/L for n-propane, 246 microg/L for iso-butane, and 846 microg/L for n-butane.

The poisoning of Costa Rican banana workers by multinational corporations' excessive use of pesticides is not a local issue; it is embedded in a dominant ideology expressed by the phenomenon of globalization. This ideology seeps into every aspect of our social institutions--economic, political, and legal. The practice of this ideological perspective is evident in the industrialization of global agriculture and the shift from "developmentalism"--liberal welfarism, industrialization, and urbanization--to a dominant, undemocratic, global financial elite with "economism" and a neoliberal political agenda overriding the nation-state polis. A specific effect is to transform the agricultural workers of developing countries, such as Costa Rican banana workers, into politically superfluous flesh-and-blood human beings.

In spite of its serious sequelae, volatile substance abuse (VSA) attracts very little public attention in Germany. Our case report describes an adult male who inhaled propane for recreational purposes. Initially, he achieved short-lived euphoria and hallucinations. He compensated for the developing tolerance by increasing the dosage, finally consuming 5 litres of fluid propane daily. Getting such quantities was facilitated by his occupational access to propane. Since he abused the propane in an apartment house, he also exposed third parties to the danger of explosion. Clinical examination revealed disturbances in orientation, restricted perceptivity and concentration, reduced mnemonic performance, and psychomotor agitation. All these symptoms diminished during a 6-month follow-up. The relationship of his organic mental disorder to the abuse of propane was not clear, since he had also abused alcohol.

Two lethal poisonings by butane and propane are described, and the corresponding concentrations in the body fluids and organ tissues are evaluated. One case appeared to be an accident after deliberate inhalation for butane, one was a suicide. The mechanism of the inhalation could be reconstructed in both cases. The concentrations in the biological material agreed well with observations in similar cases.

We describe 3 unusual autoerotic fatalities in which propane gas was used to induce hypoxia. To our knowledge, these are the first cases of their kind to be reported and described in depth, although brief references to similar cases have appeared. The case histories of 3 white males, aged 22, 42, and 62 years, are described with emphasis on the scene and circumstances and the identification of propane from autopsy materials. In one case, unusual paraphilia and multiple foreign bodies in the rectum were noted. These 3 cases illustrate an unusual form of autoerotic practice in which hypoxia is induced by propane inhalation, unlike the usual neck compression that has been previously described in depth. The importance of scene reconstruction and an awareness of this phenomenon is stressed.

Propane gas is used as a fuel and very rarely it is abused by young people in Greece. In this paper, we report a case of abuse of propane inhalation that resulted in accidental death. The determination of propane in autopsy samples was done by headspace gas chromatography and semiquantitation in liver, blood and the contents of the plastic bag through which the gas was diffused, which proved to be lethal.

Dibromochloropropane, DBCP, has had a seminal role in our current understanding of how to prevent chemical risks to health. Early toxicological studies showed its special impact on the testes, and detection of its mutagenic potency was soon followed by demonstration of its carcinogenicity to animals. Its commercial use as a useful nematocide ignored, at first, these warnings from the laboratory. When production workers, first in California and then in Israel, found they were sterile as a result of their exposure, this was convincing evidence that prevention had failed. The evidence, azospermia, oligospermia, and gonadotrophin response to testicular damage, were found first in production workers. In agricultural applicators in California who used the material, decreased sperm count and increased gonadotrophin levels were found. While production in California, Texas, and Israel was halted, studies continued and so, it seems, did use. Our first Israeli study was of workers on banana crops, and we found convincing evidence of increased spontaneous abortion in their family histories. Follow-up studies among production workers in Israel showed that some recovered testicular function, but among their offspring, otherwise in good health, there was a predominance of females. Those who did not recover from azospermia were those with high levels of follicle stimulating hormone. However data for production workers did not show increased spontaneous abortion. Nor have any studies so far shown increased birth defects or increased infant mortality. Unfavorable reproductive outcomes can be due to other agents, as shown by sprayers in Dutch orchards having hypofecundity (increased interpregnancy period) and sex ratio changes; but the agents responsible have not yet been identified. These experiences have lead to the general acceptance of some implications: (1) Paternal exposures can lead to a variety of unfavorable effects on reproductive outcome, including infertility, spontaneous abortion, and altered sex ratio. (2) Patterns of effects of potent agents in production workers and in applicators or users of chemicals may differ. (3) Although human carcinogenesis has not yet been confirmed, unfavorable reproductive outcomes are a reasonable early indicator of such risk. (4) Shifts in sex ratios of populations may be a subtle sign of more serious risks. (5) Continued use of an agent such as this under circumstances in which these UROs cannot be prevented is unconscionable.

Sudden death due to the inhalation of halogenated hydrocarbons is a well-documented phenomenon in the scientific and medical literature. Recently, there has been sporadic information suggesting that nonhalogenated hydrocarbons may cause potentially fatal cardiac arrhythmias. This report documents five sudden deaths due to inhalation of nonhalogenated hydrocarbons: n-butane, isobutane and propane. The hydrocarbons were identified by headspace gas chromatography in blood, brain, and lung tissue. Case histories, toxicological findings and analytical procedures are discussed.

A case of nonimmune hydrops fetalis resulting from fetal methemoglobinemia is presented. A woman with a pregnancy at 17 weeks' gestation was admitted after combustion gas intoxication. Although the mother totally recovered, the fetus showed signs of nonimmune hydrops fetalis at follow-up. Fetal methemoglobin levels were very high.

A 26-year-old male committed suicide by inducing asphyxia using a combination of plastic bag suffocation and propane-gas inhalation. This method has been reported in the literature, but it remains unusual. Autopsy findings were consistent with a hypoxic event, and blood, brain, and lung tissue tested positive for propane by gas chromatography. Propane, while possessing some narcotic properties, causes death primarily by displacing oxygen in the atmosphere with resultant asphyxia.

The authors report on an acute compartment syndrome occurring symmetrically in the extensors of both forearms. The etiology of this unique compartment syndrome, not previously described, could be attributed to the inhalation of a propane-butane gas mixture, low in oxygen, while sleeping, in combination with external compression of both forearms, due to the patient's head lying on both forearms while sleeping. Ischemic damage to muscles was precisely located using non-invasive MRI (Magnetic Resonance Imaging). The extent of cellular damage due to ischemia after fasciotomy and healing by secondary intention was quantitatively assessed using non-invasive 31P-MRS (Phosphorus Magnetic Resonance Spectroscopy). The results correlate with the clinical and histological findings and indicate a bioenergetic regeneration of the ischemic skeletal muscle's cells.

Two construction workers became ill after applying an epoxy resin coating containing 2-nitropropane in the confined space of an underground concrete vault. One man died 10 days later from fulminant hepatic failure. The second man recovered but has had persistently elevated serum aminotransferase activity. The serum concentration of 2-nitropropane on admission of the man who died was 13 mg/L, and was 8.5 mg/L in his coworker. The acute toxicity of 2-nitropropane has not been widely appreciated despite previous reports of death due to hepatic failure after exposure to the compound in confined spaces. These cases show the importance of effective education and protective work practices.

A death involving asphyxiation by propane inhalation is reported. The presence of propane was determined in blood, brain, kidney, liver, and lung by gas chromatography. Autopsy samples were heated in hot water, and headspace samples from various specimens were injected into the gas chromatograph. The identity of propane was established on the basis of the retention times. The brain of the deceased showed the highest level of propane, whereas the kidney exhibited the lowest level.

The authors present herewith a survey of occupational influences on male fertility and sexuality. From literature data of the last 15 years, the potential risks of physical factors (traumatisms, temperature, radiation, micro-waves), of chemical factors (metals, mineral oils, hormones, pesticides and herbicides, neurotoxins, vinylchloride and analogs, carbondisulfide), of physio(patho)logical factors (infectious diseases occupationally acquired, low back syndrome) and of psychological factors (stress, alcoholism) are discussed. The authors also discuss the methodological aspects in monitoring the fertility and sexuality of male workers. As conclusion, they warn physicians, practising occupational medicine, to be aware of these potential risks regarding gonadal function and to neglect no longer the reproductive and sexual functions of the male. In the future, these problems will be faced more than at present, because of the increasing production of very active and toxic substances. Occupational hygienic measures are the first step in preventing environmental pollution hazards.