JIST

Abstract

Lead (Pb) has plethora of industrial applications, and has known to for its deleterious effects on various organs. In the current study, we aimed to assess the occupational Pb exposure and relationship with serum creatinine, cholesterol & preexisting nutritional status, among ‘acid-battery industry’ (Group-A, n=110), and ‘agriculture’ (Group-B, n=50) workers. Blood Lead Levels (BLL), trace elements (Fe, Zn, Cu, Mg & Ca), serum creatinine and cholesterol levels were assessed. The BLL in group-A were significantly (p<0.01) higher than group-B participants with mean BLL being 94.0±40.47 and 11.2±7.85 μg/dL respectively. Serum creatinine and cholesterol levels were significantly higher in group-A subjects than

group-B. Further, elevated BLL of group-A have correlated positively (p<0.01) with serum creatinine (r = 0.333) and inversely with serum albumin (r = -0.240), Fe (r = -0.453), Cu (r = -0.303) & Ca (r = -0.193; p<0.05). The participants from group-A were referred to ‘Chelation therapy (BLL > 80μg/dL)’ and temporarily shifted to ‘no-Pb exposure’ work. The results suggest that group-A had elevated BLL due to persistence exposure to Pb at work place. Further, nutritional and trace element status might have limited effect on elevated BLL in ‘chronic high level exposure’. Regular BLL screening and preventive measures are mandatory to reduce the risks associated with work place Pb exposure.

Background: Postmortem diagnosis of poisoning is one of the biggest challenges faced by the autopsy conducting medical officer in day to-day medico-legal practice. A number of factors have been implicated which influence the vividity of post mortem findings.

Aim of the study: To evaluate the various factors that determine the post mortem findings thus influencing the diagnosis of poisoning during post mortem examination.

Materials and methods: A Total of 388 cases of deaths due to poisoning subjected to medico legal autopsy during the stipulated time period of 3 years were studied based on information in the documents (Hospital records, Inquest report and Dead body chalan) and the facts incorporated in the respective autopsy reports especially the positive findings suggestive of poisoning.

Results: Out of 388 cases, 65.46% cases were insecticidal deaths, 9.02% cases due to Zinc phosphide, 7.47% cases due to alcoholic intoxication, 4.38% and 3.09% due to glycosides and medicinal drugs respectively. In 7.21% cases the type of toxic agent could not be ascertained. Positive post mortem findings of poisoning was found in 77.16% cases of insecticide , 77.14% zinc phosphide poisoning and 62.06%, 41.17%, 40% and 33.33% deaths caused by alcohol, glycosides, corrosives and medicinal drugs respectively. Even after hospital treatment positive post mortem findings corroborative of poisoning was detected in 42.51% cases of death due to insecticide and 42.85% cases of zinc phosphide poisoning. But in corrosive poisoning it was 80%. In 75% cases characteristic odour of the poison was found in the organs of the deceased where the survival time was less than 12 hours. The probability and intensity of the characteristic odour of poison in the viscera of the deceased gradually declined to 46.15%, 32.72% and 26.19% cases with increasing survival time from 12 hours to 1 day, 1 to 2 days and 2 to 3 days respectively. After 3 days characteristic smell of poison was not found in a single case. The probability of detection of the poison during chemical analysis of viscera of the deceased declined from 97.2% with less than one day survival to 33.4% when survival time was more than 14 days. 

Conclusion: Post mortem diagnosis of deaths due to poisoning is influenced by factors like hospital treatment, positive external and internal post mortem findings, survival time and viscera analysis report.