1. FORENSIC SCIENCE TOXICOLOGY AND ALCOHOL The study of Poisons and how they affect the human body.

2. 2 Toxicology Toxicology—the study of the adverse effects of chemicals or physical agents on living organisms… Poisons Types: Environmental—air, water, soil Consumer—foods, cosmetics, drugs Medical, clinical, forensic

3. MATHIEU ORFILA (1787-1853) “Father of Toxicology” He gave the subject its first formal treatment in 1813 in his book Traité des poisons, also called Toxicologie générale. (General Toxicology) Wrote about the detection of poisons & their effects on animals.

4. 4 Forensic Toxicology Postmortem—medical examiner or coroner Criminal—motor vehicle accidents (MVA) Workplace—drug testing Sports—human and animal Environment—industrial, catastrophic, terrorism

5. 5 Toxicology Toxic substances may: Be a cause of death Contribute to death Cause impairment Explain behavior Video

6. 6 Aspects of Toxicity Dosage – Has 5 factors: The chemical or physical form of the substance The mode of entry into the body Body weight and physiological conditions of the victim, including age and sex The time period of exposure The presence of other chemicals in the body or in the dose

7. Exposure Times for Toxins Exposure to poisons can be short term or long term Acute exposure is short term and sudden Snake bites, overdoses, lethal injection Chronic exposure is long term and usually lower doses Heavy metals, cigarette smoke, petroleum products, chemicals A poison may get into the body through ingestion, inhalation (gas, vapors, dust, fumes, smoke, spray), skin contact (pesticides), or injection (bites and stings, drug injection

8. 8 Lethal Dose LD 50 refers to the dose of a substance that kills 50% of the test population, usually within four hours Expressed in milligrams of substance per kilogram of body weight

9. 9 Toxicity Classification LD 50 (rat,oral)Correlation to Ingestion by 150-lb Adult Human Toxicity <1 mg/kga taste to a dropextreme 1–50 mg/kgto a teaspoonhigh 50–500 mg/kgto an ouncemoderate 500–5,000 mg/kgto a pintslight 5–15 g/kgto a quartpractically nontoxic Over 15 g/kgmore than 1 quartrelatively harmless Link to LD 50 table

10. TOXICOLOGY OF ALCOHOL

11. 11 Alcohol—Ethyl Alcohol (C 2 H 5 OH) Most abused drug in America About 40 percent of all traffic deaths are alcohol- related Toxic—affecting the central nervous system, Acts as a depressant, especially the brain. Colorless liquid, generally diluted in water Alcohol appears in blood within minutes of consumption; 30–90 minutes for full absorption Detoxification—about 90 percent in the liver About 5 percent is excreted unchanged in breath, perspiration, and urine

12. Alcohol & Circulatory System Alcohol is absorbed from the stomach and small intestines into the blood stream. Alcohol is carried to the liver where the process of its oxidation starts. It also goes through the circulatory system into the lungs where it is exhaled as a gas.

13. Alcohol Effects upon the body As can be seen, the effects of alcohol upon the body are not good. With repeated exposure, general health declines.

14. Alcohol Breaks down to Acetaldehyde In humans, acetaldehyde is a carcinogen and is the reason for hang overs. It causes drowsiness, delirium, hallucinations and loss of intelligence. Exposure may also cause severe damage to the mouth, throat and stomach; accumulation of fluid in the lungs, chronic respiratory disease, kidney and liver damage, throat irritation, dizziness, reddening and swelling of the skin

15. 15 Rate of Absorption and BAC Depends on: Amount of alcohol consumed The alcohol content of the beverage Time taken to consume it Quantity and type of food present in the stomach Physiology of the consumer

16. What's a "standard" drink? 12 fl oz of regular beer =8-9 fl oz of malt liquor (shown in a 12-oz glass) =5 fl oz of table wine =3-4 oz of fortified wine (such as sherry or port; 3.5 oz shown) =2-3 oz of cordial, liqueur, or aperitif (2.5 oz shown) =1.5 oz of brandy (a single jigger or shot) =1.5 fl oz shot of 80- proof spirits ("hard liquor" ) Many people are surprised to learn what counts as a drink. In the United States, a "standard" drink is any drink that contains about 0.6 fluid ounces or 14 grams of "pure" alcohol. Although the drinks below are different sizes, each contains approximately the same amount of alcohol and counts as a single standard drink.

17. BLOOD ALCOHOL CONCENTRATIONS. 020 - light to moderate drinkers begin to feel some effects *.040 - most people begin to feel relaxed *.060 - judgment is somewhat impaired, people are less able to make rational decisions about their capabilities (for example, driving) *.080 - there is a definite impairment of muscle coordination and driving skills; this is legal level for intoxication in all states *.10 - there is a clear deterioration of reaction time and control; this is legally drunk in most states *.120 - vomiting usually occurs. Unless this level is reached slowly or a person has developed a tolerance to alcohol *.150 - balance and movement are impaired. This blood-alcohol level means the equivalent of 1/2 pint of whiskey is circulating in the blood stream *.300 - many people lose consciousness *.400 - most people lose consciousness; some die *.450 - breathing stops; this is a fatal dose for most people

18. BLOOD ALCOHOL CHART

19. WHAT IS BLOOD ALCOHOL CONCENTRATION: What is blood alcohol concentration? Ratio of amount of alcohol in the blood to the amount of blood. 1 gram of alcohol per kilogram of blood is a ratio of 1/1000 or 0.001 alcohol/blood. 0.001 alcohol/blood concentration is 0.10%

20. Alcohol Levels Experimental evidence has verified that the amount of alcohol exhaled in the breath is in direct proportion to the blood concentration.

21. 21 BAC: Blood Alcohol Content Expressed as percent weight per volume of blood Legal limit in all states is 0.08 percent Parameters influencing BAC: Body weight Alcohol content Number of beverages consumed Time since consumption

22. BAC Calculation Male BAC = Female BAC = Your liver oxidizes alcohol to filter it out of the body. This Burn-off rate is 0.015 percent per hour, (but can vary) 0.071  (oz)  (% alcohol) body weight 0.085  (oz)  (% alcohol) body weight

23. Calculate for yourself ! http://bloodalcoholcalculator.org/ http://bloodalcoholcalculator.org/ BLOOD ALCOHOL CALCULATOR

24. NOW YOUR TURN Find the BAC for a 255-lb man who, in 2 hours, has drunk 13 beers. (Assume that each beer is 12 oz with a 4.5% alcohol content.) Round your answer to the nearest thousandth.

25. SOLUTION BAC = 0.071  (oz)  (% alcohol) body weight BAC = 0.071 x 12 oz x 13 beers x 4.5% 255 lbs = 0.19%

26. Field Testing Law enforcement officers typically use field sobriety tests to estimate a motorist’s degree of physical impairment by alcohol and whether or not an evidential test for alcohol is justified. The horizontal gaze nystagmus test, walk and turn, and the one-leg stand are all considered reliable and effective psychophysical tests.

27. 27 Field Tests Preliminary tests—used to determine the degree of suspect’s physical impairment and whether or not another test is justified Psychophysical tests—three basic tests: Horizontal gaze nystagmus (HGN): follow a pen or small flashlight, tracking left to right with one’s eyes. In general, wavering at 45 degrees indicates 0.10 BAC. Nine-step walk and turn (WAT): comprehend and execute two or more simple instructions at one time One-leg stand (OLS): maintain balance; comprehend and execute two or more simple instructions at one time

28. Breath Testers It’s the degree of the interaction of the light with alcohol in the captured breath sample that allows the instrument to measure a blood alcohol concentration in breath. Some breath testing devices also use fuel cells.

29. 29 The Breathalyzer More practical in the field Collects and measures alcohol content of alveolar breath Breath sample mixes with 3 ml of 0.025 percent K 2 Cr 2 O 7 in sulfuric acid and water: 2K 2 Cr 2 O 7 +3C 2 H 5 OH + 8H 2 SO 4  2Cr 2 (SO 4 ) 3 + 2K 2 SO 4 + 3CH 3 COOH + 11H 2 O Potassium dichromate is yellow; as concentration decreases, its light absorption diminishes, so the breathalyzer indirectly measures alcohol concentration by measuring light absorption of potassium dichromate before and after the reaction with alcohol.

30. 30 Generalizations During absorption, the concentration of alcohol in arterial blood is higher than in venous blood. Breath tests reflect alcohol concentration in the pulmonary artery. The breathalyzer also can react with acetone (as found in diabetics), acetaldehyde, methanol, isopropyl alcohol, and paraldehyde, but these are toxic and their presence means the person is in serious medical condition. Breathalyzers now use an infrared light-absorption device with a digital readout. Prints out a card for a permanent record.

31. Breath Testers Breath testers that operate on the principle of infrared light absorption are becoming increasingly popular within the law enforcement community. LinkLink

32. Atomic Emission Spectra

33. Breath Testers Many types of breath testers are designed to analyze a set volume of breath. The captured breath is exposed to infrared light. Can be built into cars. Car can’t start if drunk.

34. Field Testing A portable, handheld, roadside breath tester may be used to determine a preliminary breath- alcohol content.

35. Gas Chromatography Testing Gas chromatography offers the toxicologist the most widely used approach for determining alcohol levels in blood.

36. DRUNK DRIVER KILLS CYCLIST

37. Alcohol and Law The American Medical Association and the National Safety Council have been able to exert considerable influence in convincing the states to establish uniform and reasonable blood- alcohol standards. Between 1939 and 1964 a person having a blood-alcohol level in excess of 0.15 percent w/v was to be considered under the influence, which was lowered to 0.10 percent by 1965.

38. Alcohol and Law In 1972 the impairment level was recommended to be lowered again to 0.08 percent w/v. Starting in 2003, states adopted the 0.08 percent Commercial drivers are allowed only 0.04% because of the possible dangers of driving large and hazardous payloads.

39. Alcohol and Law To prevent a person’s refusal to take a test for alcohol consumption, the National Highway Traffic Safety Administration recommended an “implied consent” law. Adopted by all states by 1973, this law states that the operation of a motor vehicle on a public highway automatically carries with it the stipulation that a driver will submit for a test for alcohol intoxication if requested or be subject to loss of the license. What are the legal penalties for DUI in Texas? linklink

41. HOW DOES EUROPE COMPARE TO USA IN ALCOHOL DRIVING LEVELS?

43. In 1984 at the Union Carbide India pesticide plant in Bhopal,. Over 500,000 people were exposed to methyl isocyanate gas and other chemicals. The toxic substance made its way in and around the shanty towns located near the plant. The government of India confirmed a total of 3,787 deaths related to the gas release. [3] Others estimate 8,000 died within two weeks and another 8,000 or more have since died from gas-related diseasespesticide Bhopalmethyl isocyanateshanty townsgovernment of [3] Video

44. The deadliest snake is a Belcher's Sea-snake. It takes only 0.02 milligrams of venom to kill a person. They usually injects around 35 milligrams and that can kill around 15,000 people with one bite. Death can happen within 2 minutes.

45. An estimated 12,000 people die annually from Cobra bites in India. It is possible that under the right conditions a person could die from a cobra bite in 30 minutes

46. 46 Symptoms of Various Types of Poisoning Symptom/Evidence Characteristic burns around the lips and mouth of victim Red or pink patches on the chest and thigh, unusually bright red lividity Black vomit Greenish-brown vomit Yellow vomit Coffee-brown vomit, onion or garlic odor Burnt almond odor Extreme diarrhea Nausea and vomiting, unconsciousness possibly blindness Type of Poison Caustic poison (lye) Carbon monoxide Sulfuric acid Hydrochloric acid Nitric acid Phosphorus Cyanide Arsenic, mercury Methyl (wood) or isopropyl (rubbing) alcohol

47. Hemlock or Conium is a highly toxic flowering plant indigenous to Europe and South Africa. It was a popular one with the ancient Greeks, who used it to kill off their prisoners. For an adult, the ingestion of 100mg of conium or about 8 leaves of the plant is fatal – death comes in the form of paralysis, your mind is wide awake, but your body doesn’t respond and eventually the respiratory system shuts down. Probably the most famous hemlock poisoning is that of Greek philosopher, Socrates. Condemned to death for impiety in 399 BC, he was given a very concentrated infusion of hemlock.

48. Arsenic has been called “The King of Poisons”, for its discreetness and potency – it was virtually undetectable, so it was very often used either as a murder weapon or as a mystery story element. It causes cardiac arrest. The Marsh test detects presence of this poison in water, food and the like. It has taken many famous lives: Napoleon Bonaparte and Simon Bolivar to name a few. On another note, arsenic, like belladonna, was used by the Victorians for cosmetic reasons. A couple of drops of the stuff made a woman’s complexion white and pale.

49. If you’re watching Sherlock Holmes, then you’ll know about this one. The Botulinum toxin causes Botulism, a fatal condition if not treated immediately. It involves muscle paralysis, eventually leading to the paralysis of the respiratory system and, consequently, death. The bacteria enter the body through open wounds or by ingesting contaminated food. By the way, botulinum toxin is the same stuff used for Botox injections for cosmetics!

50. Cyanide seems to be extremely popular (spies use cyanide pills to kill themselves when caught) and there are plenty of reasons for this. Firstly, it is found in a great variety of substances like almonds, apple seeds, apricot kernel, tobacco smoke, insecticides, and pesticides. It is used in pesticides – a fatal dose of cyanide for humans is 1.5 mg per kilogram of body weight. It’s a rapid killer: depending on the dose, death occurs within 1 to 15 minutes by stopping cellular respiration. Hydrogen cyanide gas was used by Nazi Germany for mass murders in gas chambers during the Holocaust. link link

51. There are three forms of mercury which are extremely dangerous. Elemental mercury is the one you can find in glass thermometers, ingestion of 1 gram is fatal. Inorganic mercury is used to make batteries, and is deadly only when ingested. And finally, organic mercury is found in fish, such as tuna and swordfish (consumption should be limited to 170g fish per week), but can be potentially deadly over long periods of time. A famous death caused by mercury is that of Amadeus Mozart, who was given mercury pills to treat his syphilis. It kills by liver and brain damage by blocking blood flow. LinkLink

52. The name of this plant is derived from Italian and means beautiful woman. That’s because it was used in the middle-ages for cosmetic purposes – diluted eye-drops dilated the pupils, making the women more seductive. It kills by paralysis. If gently rubbed on their checks, it would create a reddish color, what today would be known as blush! If ingested, a single leaf is lethal and that’s why it was used to make poison-tipped arrows. The berries and roots of this plant are the most dangerous – consumption of ten of the attractive-looking berries is fatal. linklink

53. Carbon Monoxide Carbon monoxide poisoning can happen when fires, stoves, heaters or ovens are used in rooms, huts which do not have proper ventilation to let the gas out. It kills by blocking oxygen out of blood link

54. 54 To Prove a Case of Poisoning Prove a crime was committed: 1. Motive ? 2. Intent? 4. Access to poison? 5 Access to victim? 6. Death was homicidal? 7. Death was caused by poison?

55. History of the crime What poison was ingested. Time since ingestion. Total amount of poison ingested. Route of exposure. Progression of signs and symptoms since ingestion. Family history of epilepsy, mental sub normality, bleeding disorder. Whether the patient is receiving other medications which may interact with the poison.

56. Pattern of poisoning Chemical products, most often swallowed by children include household cleaners (bleach, detergents) fuel (kerosene, paraffin), cosmetics, medicines, paints and products for household repairs and household pesticides. Bites and stings of animals and insects, and ingestion of poisonous plants and seeds also considerably account for outdoor poisoning in children.

57. Ecology of poisoning Interaction between the host and the environment (including easy access to the poisonous substances) determines the magnitude of the problem. Age. About 40% of all cases of accidental poisoning in children are reported in the second year of life; about 12% of the cases occur in the first and 20% in the third year. As the children start crawling and walking around 1 year, they become very active and try to explore unfamiliar objects by putting these into their mouth and testing these. Thus they expose themselves to accidental poisoning. Hyperactive male children are more prone to accidental poisoning.

58. Environment : Lead poisoning is common in children living in areas were there are workshops for automobile, lead storage batteries or for manufacture of lead typesets for printing presses. Caustic soda poisoning used to be observed frequently in children of families, which prepared washing soap for domestic or commercial purposes in their own houses. Insecticides, medicines, naphthalene balls and kerosene are common household things which are potential hazards. Rural or Urban areas: The pattern of poisoning varies in rural and urban areas due to exposures to different types of potential poisons. Snakebites are more common in those wandering in fields. Also pesticides are more common in rural setting. The poor are driven by starvation to experiment on roots and fruits thus leading to poisoning.

59. Classification of poisons Based on the chief symptoms they produce 1. Corrosives- strong acids, strong alkalis, metallic salts. 2. Irritants- organic, inorganic. 3. Systemic- cerebral, spinal, peripheral, CVS, asphyxiants. 4. Miscellaneous- food poisoning & botulism.

60. General signs and symptoms Symptoms- pain, odor, sweating, fever, delirium, convulsions, burns of mouth, blindness, GI symptoms, abnormal movements, coma. Signs- blindness, facial twitching, dull & mask like expression, pallor, cyanosis, hypothermia, sweating, respiratory symptoms, cardiovascular symptoms, Central nervous symptoms.

61. Basic Management of a poisoned patient Antidotes are available for very few commonly encountered poisons, and treatment is usually non-specific and symptomatic. In such cases management consists of emergency first aid and stabilization measures, appropriate treatment to reduce absorption, measures to enhance life support followed by psychiatric counseling.

62. Identification of Poison Identify the poison by careful history and helpful clues. Determine what, when and how much of the poison was ingested or inhaled. Find the supporting evidence for your diagnosis from the nature of the symptoms and physical signs. Some common toxidromes based on certain signs and symptoms. Instrumental chemical analysis is the best way to find out exactly what it is.