Gas Analysis Using the Air in the Pulmonary Bullae: A Case of Toluene Intoxication

Toluene is a colorless, transparent liquid aromatic hydrocarbon with a sweet and pungent odor similar to that of benzene. It has a low flash point, making it easily flammable, and its vapor can form explosive mixtures with air, thus classifying it as highly flammable. Toluene inhalation can cause lung irritation, respiratory distress syndrome, acute pulmonary edema, central nervous system disorders, and symptoms such as dizziness, drowsiness, and skin and eye irritation. High concentrations can cause loss of consciousness and even death. In cases where poisoning is suspected, blood from the heart, stomach contents, and urine from the bladder are typically collected for toxicology testing during an autopsy. In cases where it is difficult to collect the aforementioned specimens, the vitreous humor, cerebrospinal fluid, hair, and bones containing bone marrow can be collected for testing. In this case, unruptured pulmonary bullae were identified using postmortem computed tomography before the autopsy, and gas from the pulmonary bullae was collected with a syringe during the autopsy. Gas chromatography analysis was conducted, and toluene was detected in the samples, including the gas within the pulmonary bullae. As in this case, when volatile gas intoxication is suspected, toxicological analysis using blood is difficult due to decomposition and other factors; however, gas sampling from the pulmonary bullae allows for the detection of toxic substances. Herein, we report a case of toluene exposure with forensic considerations and warnings regarding the work environment.