Decomposition kinetics and postmortem production of hydrogen sulfide and its metabolites

A serial analysis of hydrogen sulfide poisoning: three group accidents

Hydrogen sulfide (H2S) is a powerful toxic gas in workplace incidents, and it poses a threat to colleagues or family members involved in rescues, leading to a "domino effect" of multiple deaths. In this report, we describe three incidents in which 10 people died, and we present the results of the analyses performed in different incidents, including paper pulp pit, sewer, and sewage well. We provide the macroscopic and morphological findings of ten victims, which include conjunctival hemorrhage, corneal erosion, pulmonary edema, and pulmonary hemorrhage. Additionally, we observed large amounts of waste paper pulp or black sludge in the upper and lower respiratory tracts or upper and lower gastrointestinal tracts of six victims. Furthermore, we conducted a toxicological examination of the victims' blood sulfide using an alkylation extraction approach combined with gas chromatography/mass spectrometry. The sulfide concentrations in the 10 victims ranged from 0.06 to 6.72 mg/L.

Fatal sequelae of hydrogen sulphide poisoning

Hydrogen sulphide (H2S) is a toxic, colourless gas abundantly present at waste plants and sewers due to the presence of anaerobic forming organisms. Hazardous exposure via accidental, intentional or occupational contact results in endothelium disruption, cellular instability, decreased respiratory functional capacity and cardiovascular compromise with a rapidly fatal clinical course. Clinical manifestations are variable depending on the level of exposure with moderate or heavy exposure associated with rapid fatality. Respiratory manifestations remain the primary reason for admission to critical care facilities. We describe a case of a 30-year-old sewer worker with a history of heavy accidental occupational exposure of inhaled H2S admitted with acute respiratory distress syndrome and a rapid respiratory decline ultimately leading to death.