Acute Gas Toxicity at Work: A Tale of Two Cases with Review of Literature

Hydrogen sulphide [ H2S] is created when sewage material breaks down. The well-known "rotten egg" odour is linked to H2S at low quantities. It is a colourless and odourless gas that, at greater quantities, can cause cerebral and respiratory depression, fast unconsciousness, and impending death. As a sad occupational accident, worker deaths in septic tanks or sewage systems are not unusual in medico-legal practice. Death is attributed to poisoning with hazardous gases, particularly hydrogen sulphide, but the depletion of oxygen in the air due to an excess of carbon dioxide is not mentioned. Colleague fatalities are frequently linked to deaths in similar situations. Two tragic accidents that resulted in victim deaths are detailed in this paper. Here, the morphological findings—pulmonary diseases, submucosal/sub-serosal congested haemorrhage, and discolouration from postmortem staining—were discovered in both cases. A detailed scene investigation about the potential for life-threatening H2S poisoning for the assistants, the characteristic rotten egg smell that may be detected on the corpses, and the previously described morphological results should be the foundation for any suspicion of a deadly H2S poisoning. A qualitative and, if feasible, quantitative study of H2S should be performed to confirm the diagnosis.