Analysis of forensic toxicology of carbon monoxide cases in Jeddah, Saudi Arabia

Abstract

Carbon monoxide (CO) poisoning remains a leading source of morbidity and mortality across the world. It stems from the partial combustion of carbon-containing materials, and it can come from heating equipment, motor vehicle emissions, and the use of charcoal. CO poisoning in Saudi Arabia is most common during winter because of faulty heating equipment and lack of fresh air. Despite acknowledged public health significance, there is scarce case–specific forensic toxicological evidence of CO poisoning in Jeddah. The current study adopted a retrospective cross-sectional study involving data collected from the Jeddah Poison Control and Forensic Medical Chemistry Center from 2019 to 2021. Recorded data were derived from toxicology postmortem reports and the Forensic Toxicology Jeddah Reports & Requests Database. Descriptive analysis was used to determine the COHb level. Of the cases reviewed, fire had the highest COHb level at 60%, being above 50%, burning was 63%, and other sources other than fire, such as car exhaust and charcoal burning, were 59%. Seasonal trend COHb saturation levels were slightly higher during the autumn, summer, and winter months, with 41%, 39%, and 36%, respectively. Male cases were significantly higher in winter and summer, and females were in spring and autumn, with overall higher COHb levels in females. Most cases of CO poisoning incidents occurring in Jeddah were the outcome of fire accidents. Co-poisoning cases are well addressed by forensic toxicology, although better techniques are required. Therefore, public health measures, increased visibility, easier identification of cases, and better diagnostics are necessary components of combating CO poisoning in Jeddah.