Aerospace Medicine Technical Reports
FAA Office of Aerospace Medicine
Civil Aerospace Medical Institute
Report No: DOT/FAA/AM-04/13
Title and Subtitle: Accurate Assignment of Ethanol Origin in Postmortem Urine: A Case Study
Report Date: August 2004
Authors: Johnson RD, Lewis RJ, Canfield DV, Dubowski KM, Blank CL
Abstract: Specimens from fatal aviation accident victims are submitted to the FAA Civil Aerospace Medical Institute for toxicological analysis. During toxicological evaluations, ethanol analysis is performed on all cases. Care must be taken when interpreting a positive ethanol result due to the potential for postmortem ethanol formation.
Several indicators of postmortem ethanol formation exist; however, none are completely reliable. The consumption of ethanol has been shown to alter the concentration of two major serotonin metabolites, 5-hydroxytryptophol (5-HTOL) and 5 hydroxyindole-3-acetic acid (5-HIAA). While the 5-HTOL/5-HIAA ratio is normally very low, previous studies using living subjects have demonstrated that the urinary 5 HTOL/5-HIAA ratio is significantly elevated for 11-19 hours after acute ethanol ingestion.
Recently, our laboratory developed and validated an analytical method for the simultaneous determination of both 5-HTOL and 5-HIAA in forensic urine samples using a simple liquid/liquid extraction and LC/MS/MS and LC/MS/MS/MS. In this previous work, a 15 pmol/nmol serotonin metabolite ratio cutoff was established in postmortem urine, below which it could be conclusively determined that no recent antemortem ethanol consumption had occurred. In the current study, this newly validated analytical method was applied to five ethanol-positive aviation fatalities where the origin of the ethanol present could not previously be conclusively determined.
Key Words: Postmortem Ethanol, LC/MS, Serotonin, 5-hydroxytryptophol, 5-hydroxyindole-3-acetic Acid, Aircraft Accident Investigation
No. of Pages: 11
Civil Aerospace Medical Institute
Report No: DOT/FAA/AM-04/13
Title and Subtitle: Accurate Assignment of Ethanol Origin in Postmortem Urine: A Case Study
Report Date: August 2004
Authors: Johnson RD, Lewis RJ, Canfield DV, Dubowski KM, Blank CL
Abstract: Specimens from fatal aviation accident victims are submitted to the FAA Civil Aerospace Medical Institute for toxicological analysis. During toxicological evaluations, ethanol analysis is performed on all cases. Care must be taken when interpreting a positive ethanol result due to the potential for postmortem ethanol formation.
Several indicators of postmortem ethanol formation exist; however, none are completely reliable. The consumption of ethanol has been shown to alter the concentration of two major serotonin metabolites, 5-hydroxytryptophol (5-HTOL) and 5 hydroxyindole-3-acetic acid (5-HIAA). While the 5-HTOL/5-HIAA ratio is normally very low, previous studies using living subjects have demonstrated that the urinary 5 HTOL/5-HIAA ratio is significantly elevated for 11-19 hours after acute ethanol ingestion.
Recently, our laboratory developed and validated an analytical method for the simultaneous determination of both 5-HTOL and 5-HIAA in forensic urine samples using a simple liquid/liquid extraction and LC/MS/MS and LC/MS/MS/MS. In this previous work, a 15 pmol/nmol serotonin metabolite ratio cutoff was established in postmortem urine, below which it could be conclusively determined that no recent antemortem ethanol consumption had occurred. In the current study, this newly validated analytical method was applied to five ethanol-positive aviation fatalities where the origin of the ethanol present could not previously be conclusively determined.
Key Words: Postmortem Ethanol, LC/MS, Serotonin, 5-hydroxytryptophol, 5-hydroxyindole-3-acetic Acid, Aircraft Accident Investigation
No. of Pages: 11
Last updated: Friday, June 1, 2012