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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Fatal alcohol immersion during the SARS epidemic in Taiwan</title>
<author><name sortKey="Wu, Yen Liang" sort="Wu, Yen Liang" uniqKey="Wu Y" first="Yen-Liang" last="Wu">Yen-Liang Wu</name>
</author>
<author><name sortKey="Guo, How Ran" sort="Guo, How Ran" uniqKey="Guo H" first="How-Ran" last="Guo">How-Ran Guo</name>
</author>
<author><name sortKey="Lin, Hung Jung" sort="Lin, Hung Jung" uniqKey="Lin H" first="Hung-Jung" last="Lin">Hung-Jung Lin</name>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">PMC</idno>
<idno type="pmid">15749375</idno>
<idno type="pmc">7131152</idno>
<idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7131152</idno>
<idno type="RBID">PMC:7131152</idno>
<idno type="doi">10.1016/j.forsciint.2004.06.014</idno>
<date when="2004">2004</date>
<idno type="wicri:Area/Pmc/Corpus">000880</idno>
<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000880</idno>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Fatal alcohol immersion during the SARS epidemic in Taiwan</title>
<author><name sortKey="Wu, Yen Liang" sort="Wu, Yen Liang" uniqKey="Wu Y" first="Yen-Liang" last="Wu">Yen-Liang Wu</name>
</author>
<author><name sortKey="Guo, How Ran" sort="Guo, How Ran" uniqKey="Guo H" first="How-Ran" last="Guo">How-Ran Guo</name>
</author>
<author><name sortKey="Lin, Hung Jung" sort="Lin, Hung Jung" uniqKey="Lin H" first="Hung-Jung" last="Lin">Hung-Jung Lin</name>
</author>
</analytic>
<series><title level="j">Forensic Science International</title>
<idno type="ISSN">0379-0738</idno>
<idno type="eISSN">1872-6283</idno>
<imprint><date when="2004">2004</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass></textClass>
</profileDesc>
</teiHeader>
<back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Todd K, K" uniqKey="Todd K K">K. Todd K</name>
</author>
<author><name sortKey="Berk, W A" uniqKey="Berk W">W.A. Berk</name>
</author>
<author><name sortKey="Welch, R D" uniqKey="Welch R">R.D. Welch</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Yip, L" uniqKey="Yip L">L. Yip.</name>
</author>
</analytic>
</biblStruct>
</listBibl>
</div1>
</back>
</TEI>
<pmc article-type="brief-report"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Forensic Sci Int</journal-id>
<journal-id journal-id-type="iso-abbrev">Forensic Sci. Int</journal-id>
<journal-title-group><journal-title>Forensic Science International</journal-title>
</journal-title-group>
<issn pub-type="ppub">0379-0738</issn>
<issn pub-type="epub">1872-6283</issn>
<publisher><publisher-name>Elsevier Ireland Ltd.</publisher-name>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">15749375</article-id>
<article-id pub-id-type="pmc">7131152</article-id>
<article-id pub-id-type="publisher-id">S0379-0738(04)00389-5</article-id>
<article-id pub-id-type="doi">10.1016/j.forsciint.2004.06.014</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Fatal alcohol immersion during the SARS epidemic in Taiwan</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Wu</surname>
<given-names>Yen-Liang</given-names>
</name>
</contrib>
<contrib contrib-type="author"><name><surname>Guo</surname>
<given-names>How-Ran</given-names>
</name>
</contrib>
<contrib contrib-type="author"><name><surname>Lin</surname>
<given-names>Hung-Jung</given-names>
</name>
<email>erdrwu@yahoo.com.tw</email>
<xref rid="cor1" ref-type="corresp">*</xref>
</contrib>
</contrib-group>
<aff>Department of Emergency Medicine, ChiMei Medical Center, No. 901 Junghua Road, Yungkang City 710, Tainan, Taiwan</aff>
<author-notes><corresp id="cor1"><label>*</label>
Corresponding author. Tel.: +886 6 2812811x7196; fax: +886 6 2099339. <email>erdrwu@yahoo.com.tw</email>
</corresp>
</author-notes>
<pub-date pub-type="pmc-release"><day>11</day>
<month>11</month>
<year>2004</year>
</pub-date>
<pmc-comment> PMC Release delay is 0 months and 0 days and was based on .</pmc-comment>
<pub-date pub-type="ppub"><day>10</day>
<month>5</month>
<year>2005</year>
</pub-date>
<pub-date pub-type="epub"><day>11</day>
<month>11</month>
<year>2004</year>
</pub-date>
<volume>149</volume>
<issue>2</issue>
<fpage>287</fpage>
<lpage>287</lpage>
<history><date date-type="received"><day>29</day>
<month>5</month>
<year>2004</year>
</date>
<date date-type="rev-recd"><day>4</day>
<month>6</month>
<year>2004</year>
</date>
<date date-type="accepted"><day>4</day>
<month>6</month>
<year>2004</year>
</date>
</history>
<permissions><copyright-statement>Copyright © 2004 Elsevier Ireland Ltd. All rights reserved.</copyright-statement>
<copyright-year>2004</copyright-year>
<copyright-holder>Elsevier Ireland Ltd</copyright-holder>
<license><license-p>Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.</license-p>
</license>
</permissions>
</article-meta>
</front>
<body><p>Alcohol (ethanol) can be absorbed through the skin, but intoxication caused by skin absorption is rare, especially in adults. During the epidemic of severe acute respiratory syndrome (SARS) in Taiwan, a 45-year-old woman was found deceased in a bathtub filled with alcohol. She had put herself into the fluid from around 11 p.m. believing it could prevent SARS and was found dead at about 11 a.m. the next day by her family.</p>
<p>Her head was above the fluid level and there was no sign of drowning. Neither trauma nor ingestion of drugs was detected on analysis. No significant fluid was found in her stomach. The fluid in the bathtub was found to contain 40.5% (v/v) of ethanol, and her blood alcohol concentration (BAC) was 1350 mg/100 mL (1.35%). A BAC near 400 mg/100 mL can be lethal <xref rid="bib1" ref-type="bibr">[1]</xref>
. In order to reach this BAC, she should have absorbed about 1500 mL of 40% alcohol according to the formula: BAC = ethanol (mg) ÷ [volume of distribution (L/kg) × body weight (kg) × 10] <xref rid="bib2" ref-type="bibr">[2]</xref>
. Since the bathtub was too small to fit her whole body and her head was above the fluid, she was not likely to have drunk a large amount of alcohol. Nevertheless, she might have inhaled some alcohol, which would have accelerated her intoxication. It is likely that the woman would have exhibited some CNS depression at a BAC of about 100–200 mg/100 mL <xref rid="bib2" ref-type="bibr">[2]</xref>
, inhibiting her ability to climb out of the bathtub.</p>
<p>This tragic case has demonstrated that people facing a crisis such as the SARS epidemic may take extreme measures. Skin absorption is a generally overlooked route of exposure to hazardous substances. The public should be informed of the potential of intoxication by alcohol and other chemicals through skin absorption.</p>
</body>
<back><ref-list><title>References</title>
<ref id="bib1"><label>1</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Todd K</surname>
<given-names>K.</given-names>
</name>
<name><surname>Berk</surname>
<given-names>W.A.</given-names>
</name>
<name><surname>Welch</surname>
<given-names>R.D.</given-names>
</name>
</person-group>
<article-title>Prospective analysis of mental status progression in ethanol-intoxicated patients</article-title>
<source>Am. J. Emerg. Med.</source>
<volume>10</volume>
<year>1992</year>
<fpage>271</fpage>
<lpage>273</lpage>
<pub-id pub-id-type="pmid">1616511</pub-id>
</element-citation>
</ref>
<ref id="bib2"><label>2</label>
<element-citation publication-type="book"><person-group person-group-type="author"><name><surname>Yip.</surname>
<given-names>L.</given-names>
</name>
</person-group>
<chapter-title>Ethanol</chapter-title>
<person-group person-group-type="editor"><name><surname>Goldfrank</surname>
<given-names>L.R.</given-names>
</name>
<name><surname>Flomenbaum</surname>
<given-names>N.E.</given-names>
</name>
<name><surname>Lewin</surname>
<given-names>N.A.</given-names>
</name>
<name><surname>Howland</surname>
<given-names>M.A.</given-names>
</name>
<name><surname>Huffman</surname>
<given-names>R.S.</given-names>
</name>
<name><surname>Nelson</surname>
<given-names>L.S.</given-names>
</name>
</person-group>
<source>Goldfrank's Toxicologic Emergencies</source>
<edition>seventh ed.</edition>
<year>2002</year>
<publisher-name>The McGraw-Hill Companies Inc.</publisher-name>
<publisher-loc>New York, NY</publisher-loc>
<fpage>952</fpage>
<lpage>955</lpage>
</element-citation>
</ref>
</ref-list>
</back>
</pmc>
</record>
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