Fire Deaths in the Glasgow Area: III the Role of Hydrogen Cyanide

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Abstract
An assessment is presented of the importance of cyanide in fire deaths in the United Kingdom during the period 1976–79. Concentrations of cyanide and its principal metabolite in man, thiocyanate, were measured in 139 fire fatalities and for comparison purposes, in groups of non-fatal fire casualties, firemen and controls. Cyanide levels were found to be significantly elevated in fatalities and non-fatal casualties but not in firemen when compared to controls and in addition, smokers showed higher blood levels of cyanide than non-smokers. 78 per cent of the fatalities had elevated cyanide levels. 31 per cent had levels which would have caused toxic effects and of these, 12 per cent were likely to have shown symptoms of severe cyanide poisoning. No additive or synergistic effects were observed in fatalities between cyanide and other factors including carbon monoxide, alcohol, the age of the victim and the presence of heart disease. Thiocyanate levels in fatalities showed some correlation with the cyanide level but this was not sufficiently significant to permit thiocyanate to be used as an index of metabolised cyanide.