Evaluation and review of ways to differentiate sources of ethanol in postmortem blood
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REVIEW
Evaluation and review of ways to differentiate sources of ethanol in postmortem blood Zijie Lin 1 & Hao Wang 1 & Alan Wayne Jones 2 & Fanglin Wang 3 & Yunfeng Zhang 3 & Yulan Rao 1 Received: 22 May 2020 / Accepted: 27 August 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Accurate determination of a person’s blood alcohol concentration (BAC) is an important task in forensic toxicology laboratories because of the existence of statutory limits for driving a motor vehicle and workplace alcohol testing regulations. However, making a correct interpretation of the BAC determined in postmortem (PM) specimens is complicated, owing to the possibility that ethanol was produced in the body after death by the action of various micro-organisms (e.g., Candida species) and fermentation processes. This article reviews various ways to establish the source of ethanol in PM blood, including collection and analysis of alternative specimens (e.g., bile, vitreous humor (VH), and bladder urine), the identification of non-oxidative metabolites of ethanol, ethyl glucuronide (EtG) and ethyl sulfate (EtS), the urinary metabolites of serotonin (5-HTOL/5HIAA), and identification of n-propanol and n-butanol in blood, which are known putrefaction products. Practical utility of the various biomarkers including specificity and stability is discussed. Keywords Ethanol analysis . Alternative specimens . Postmortem synthesis . Interpretation . Biomarkers
Introduction Alcohol consumption is tightly linked with many types of accidents, such as violence at home and in the workplace, trauma, and death on the street and highway when drunken drivers cause traffic crashes [1–3]. During police investigations of sudden and unexpected deaths, the deceased person’s blood alcohol concentration (BAC) furnishes important forensic evidence because of the well-established relationship between drinking and impairment of body functions [4–6]. The methods used to determine BAC are the same regardless of whether the specimens are taken from living or
Zijie Lin and Hao Wang contributed equally to this work. * Yulan Rao [email protected] 1
Department of Forensic Medicine, School of Basic Medical Sciences, Fudan University, Shanghai 200032, People’s Republic of China
2
Division of Drug Research, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
3
Institute of Forensic Science, Ministry of Public Security, Beijing 100038, People’s Republic of China
deceased persons, namely headspace gas chromatography with flame ionization detector (HS-GC-FID) or with mass spectrometric detector (HS-GC-MS) [7]. However, interpreting the analytical results is more difficult for postmortem (PM) blood, owing to the possibility that ethanol, at least in part, was generated in the body after death [8, 9]. After death, cells and tissues begin to decompose without an adequate supply of oxygen and ~ 12–24 h later gut bacteria start to invade adjacent tissues and blood vessels [10]. A normal blood glucose content of 0.80–
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