A Fatal Case of Intoxication in a Confined Space: Forensic Evaluation of Epoxy-Related VOC Exposure

Buğra Kaan Yazgı; Zerrin Erkol; Erdem Hösükler

doi:10.7197/cmj.1904637

EN TR

A Fatal Case of Intoxication in a Confined Space: Forensic Evaluation of Epoxy-Related VOC Exposure

Abstract

Aim: Volatile organic compounds (VOCs) are low-molecular-weight carbon-containing substances widely used in industrial processes and solvent-based products such as paints and epoxy materials. Exposure occurs mainly through inhalation and may lead to neurological, respiratory, and cardiovascular effects. This study aims to present a fatal case associated with VOC exposure during epoxy application in a confined space and to emphasize the importance of occupational safety measures. Case: A 28-year-old male who had entered the enclosed motor room of a villa swimming pool to apply epoxy insulation was found deceased the following morning. On-site investigation revealed that the area was enclosed and poorly ventilated, and that epoxy and solvent-based materials were present. A strong chemical odor was reported, and environmental measurements detected VOC concentrations of 130 ppm. Autopsy revealed conjunctival hyperemia, frothy fluid in the airways, pulmonary edema, and widespread chemical contamination on the body surface. Toxicological analysis identified p-xylene and toluene in blood and lung samples. Death was attributed to acute intoxication due to VOC exposure in a confined space. Conclusion: This case highlights the potential lethality of VOC exposure in confined environments and underscores the importance of adequate ventilation, personal protective equipment, and occupational safety precautions when working with solvent-based materials.

Keywords

Supporting Institution

The authors received no financial support for the research, authorship, and/or publication of this article.

Ethical Statement

This study is a retrospective case report and therefore does not require ethics committee approval. Permission for the use of institutional records was obtained from the relevant institution, and written informed consent was obtained from the relative of the case. No identifying personal information is included in the manuscript.

Thanks

No acknowledgements.

Kapalı Alanda Ölümcül Zehirlenme: Epoksiye Bağlı Uçucu Organik Bileşik Maruziyetinin Adli Tıbbi Değerlendirmesi

Abstract

Amaç: Uçucu organik bileşikler (VOC), sanayide, boya ve epoksi gibi solvent bazlı ürünlerde yaygın olarak kullanılan, düşük molekül ağırlıklı karbon içeren maddelerdir. Maruziyet çoğunlukla inhalasyon yoluyla gerçekleşir ve nörolojik, solunumsal ve kardiyovasküler etkilere yol açabilir. Bu çalışmada, kapalı alanda gerçekleştirilen epoksi uygulamasıyla ilişkili ölümcül bir olgu sunulmakta ve VOC maruziyeti sırasında alınması gereken iş güvenliği önlemlerinin önemi vurgulanması amaçlanmaktadır. Olgu: Kapalı alanda epoksi uygulaması yaptığı bilinen 28 yaşındaki erkek olgu ertesi gün bu alanda hareketsiz halde bulunmuştur. Olay yerinde yapılan incelemede ortamın kapalı ve yetersiz havalandırıldığı, ortamda epoksi ve solvent içerikli materyallerin bulunduğu tespit edilmiştir. Ortam ölçümlerinde uçucu organik bileşik konsantrasyonunun yüksek olduğu belirlenmiştir. Otopsisi sırasında akciğerlerde konjesyon ve ödem gibi nonspesifik bulgular gözlenmiş, toksikolojik incelemede Ksilen ve Toluene saptanmıştır. Olay yeri incelemesi, tanık ifadeleri, otopsi bulguları ve toksikolojik incelemeler sonucunda ölümün kapalı ortamda gelişen VOC maruziyetine bağlı akut intoksikasyon sonucunda geliştiği değerlendirilmiştir. Sonuç: Bu olgu, kapalı ortamlarda VOC maruziyetinin ölümcül sonuçlar doğurabileceğini göstermekte ve epoksi gibi solvent bazlı materyallerle çalışırken yeterli havalandırma sağlanmasının, kişisel koruyucu ekipman kullanımının ve iş güvenliği önlemlerinin önemini vurgulamaktadır.

Keywords

Supporting Institution

Bu çalışma için herhangi bir finansal destek alınmamıştır.

Ethical Statement

Bu çalışmada sunulan olgu retrospektif bir olgu sunumu niteliğinde olduğundan etik kurul onayı gerekmemektedir. Olguya ait klinik ve adli verilerin bilimsel amaçla kullanılabilmesi için ilgili kurumdan çalışma izni alınmış ve olgu yakını tarafından bilgilendirilmiş onam verilmiştir. Çalışmada kişisel kimlik bilgilerine yer verilmemiştir.

References

1. Rumchev K, Brown H, Spickett J. Volatile organic compounds: do they present a risk to our health? Rev Environ Health. 2007;22(1):39-55. doi:10.1515/REVEH.2007.22.1.39.
2. Feng X, Qiu F, Zheng L, et al. Exposure to volatile organic compounds and mortality in US adults: a population-based prospective cohort study. Sci Total Environ. 2024;928:172512. doi:10.1016/j.scitotenv.2024.172512.
3. Tsai WT. An overview of health hazards of volatile organic compounds regulated as indoor air pollutants. Rev Environ Health. 2019;34(1):81-9. doi:10.1515/reveh-2018-0046.
4. Li AJ, Pal VK, Kannan K. A review of environmental occurrence, toxicity, biotransformation and biomonitoring of volatile organic compounds. Environ Chem Ecotoxicol. 2021;3:91-116. doi:10.1016/j.enceco.2021.01.001.
5. Janfaza S, Khorsand B, Nikkhah M, Zahiri J. Digging deeper into volatile organic compounds associated with cancer. Biol Methods Protoc. 2019;4(1). doi:10.1093/biomethods/bpz014.
6. Rajan ST. Health hazards of xylene: a literature review. J Clin Diagn Res. 2014;8(2):271-4. doi:10.7860/JCDR/2014/7544.4079.
7. Camara-Lemarroy CR, Rodríguez-Gutiérrez R, Monreal-Robles R, González-González JG. Acute toluene intoxication: clinical presentation, management and prognosis. BMC Emerg Med. 2015;15(1):19. doi:10.1186/s12873-015-0039-0.
8. Niaz K, Bahadar H, Maqbool F, Abdollahi M. A review of environmental and occupational exposure to xylene and its health concerns. EXCLI J. 2015;14:1167-86. doi:10.17179/excli2015-623.

9. Rajput SK, Singh S, Bhardwaj R. Hazardous Chemicals: Toluene toxicity: outline, management, and prognosis. Elsevier; 2025:391-404. doi:10.1016/B978-0-323-95235-4.00052-9.
10. Prayulsatien W. Sudden death from toluene intoxication: a case report and review of literature. J Med Assoc Thai. 2013;96(9):1242-4.
11. Djurendic-Brenesel M, Stojiljkovic G, Pilija V. Fatal intoxication with toluene due to inhalation of glue. J Forensic Sci. 2016;61(3):875-8. doi:10.1111/1556-4029.13019.
12. Hiroshi K, Naoko T, Ayaka T, et al. Detection of toluene, methanol and formic acid in an autopsy case of solvent abuse. Soud Lek. 2019;64(2):20-2.
13. Vucinic S, Jovanovic D, Vucinic Z, et al. A near-fatal case of acute poisoning by amitraz/xylene showing atrial fibrillation. Forensic Toxicol. 2007;25(1):41-4. doi:10.1007/s11419-006-0019-x.
14. Takamiya M, Niitsu H, Saigusa K, Kanetake J, Aoki Y. A case of acute gasoline intoxication at the scene of washing a petrol tank. Leg Med (Tokyo). 2003;5(3):165-9. doi:10.1016/S1344-6223(03)00051-8.
15. Papi L, Chericoni S, Bresci F, Giusiani M. Fatal acute poisoning from massive inhalation of gasoline vapors: case report and comparison with similar cases. J Forensic Sci. 2013;58(2):552-5. doi:10.1111/1556-4029.12041.
16. Jang JW, Na JY, Kim MJ, et al. Gas analysis using the air in the pulmonary bullae: a case of toluene intoxication. Korean J Leg Med. 2025;49(3):94-8. doi:10.7580/kjlm.2025.49.3.94.
17. Dharmarajan L, Ammar H. Expanding the differential: toluene-induced toxicity. BMJ Case Rep. 2017;2017:bcr-2017-220986. doi:10.1136/bcr-2017-220986.
18. Guo TJ. A rare but serious case of toluene-induced sudden sniffing death. J Acute Med. 2015;5(4):109-11. doi:10.1016/j.jacme.2015.09.006. 19. Park JT, Jung HH, Choi KH. Cerebellar infarction following accidental inhalation of toluene-mixed paint. Am J Emerg Med. 2018;36(10):1924.e5-1924.e7. doi:10.1016/j.ajem.2018.06.048.
20. National Institutes of Health. NIH xylene program. Published 2019.
21. New Jersey Department of Health. Right to Know hazardous substance fact sheet: xylene. Published 2016. Accessed March 17, 2026. http://nj.gov/health/workplacehealthandsafety/right-to-know/

Details

Primary Language

English

Subjects

General Practice

Journal Section

Case Report

Authors

Buğra Kaan Yazgı ^*
0000-0002-2719-4840
Türkiye

Zerrin Erkol
0000-0003-0281-9389
Türkiye

Erdem Hösükler
0000-0002-7736-748X
Türkiye

Publication Date

June 30, 2026

Submission Date

March 10, 2026

Acceptance Date

March 25, 2026

Published in Issue

Year 2026 Volume: 48 Number: 2

DOI

https://doi.org/10.7197/cmj.1904637

IZ

https://izlik.org/JA35ME29BN

Cite

RIS / Bibtex

APA

Yazgı, B. K., Erkol, Z., & Hösükler, E. (2026). A Fatal Case of Intoxication in a Confined Space: Forensic Evaluation of Epoxy-Related VOC Exposure. Cumhuriyet Medical Journal, 48(2), 75-79. https://doi.org/10.7197/cmj.1904637

AMA

1.Yazgı BK, Erkol Z, Hösükler E. A Fatal Case of Intoxication in a Confined Space: Forensic Evaluation of Epoxy-Related VOC Exposure. CMJ. 2026;48(2):75-79. doi:10.7197/cmj.1904637

Chicago

Yazgı, Buğra Kaan, Zerrin Erkol, and Erdem Hösükler. 2026. “A Fatal Case of Intoxication in a Confined Space: Forensic Evaluation of Epoxy-Related VOC Exposure”. Cumhuriyet Medical Journal 48 (2): 75-79. https://doi.org/10.7197/cmj.1904637.

EndNote

Yazgı BK, Erkol Z, Hösükler E (June 1, 2026) A Fatal Case of Intoxication in a Confined Space: Forensic Evaluation of Epoxy-Related VOC Exposure. Cumhuriyet Medical Journal 48 2 75–79.

IEEE

[1]B. K. Yazgı, Z. Erkol, and E. Hösükler, “A Fatal Case of Intoxication in a Confined Space: Forensic Evaluation of Epoxy-Related VOC Exposure”, CMJ, vol. 48, no. 2, pp. 75–79, June 2026, doi: 10.7197/cmj.1904637.

ISNAD

Yazgı, Buğra Kaan - Erkol, Zerrin - Hösükler, Erdem. “A Fatal Case of Intoxication in a Confined Space: Forensic Evaluation of Epoxy-Related VOC Exposure”. Cumhuriyet Medical Journal 48/2 (June 1, 2026): 75-79. https://doi.org/10.7197/cmj.1904637.

JAMA

1.Yazgı BK, Erkol Z, Hösükler E. A Fatal Case of Intoxication in a Confined Space: Forensic Evaluation of Epoxy-Related VOC Exposure. CMJ. 2026;48:75–79.

MLA

Yazgı, Buğra Kaan, et al. “A Fatal Case of Intoxication in a Confined Space: Forensic Evaluation of Epoxy-Related VOC Exposure”. Cumhuriyet Medical Journal, vol. 48, no. 2, June 2026, pp. 75-79, doi:10.7197/cmj.1904637.

Vancouver

1.Buğra Kaan Yazgı, Zerrin Erkol, Erdem Hösükler. A Fatal Case of Intoxication in a Confined Space: Forensic Evaluation of Epoxy-Related VOC Exposure. CMJ. 2026 Jun. 1;48(2):75-9. doi:10.7197/cmj.1904637