[An autopsy case of carbon dioxide intoxication]

A 44-year-old male, engaged in the transportation of dry ice, was found dead on the floor of the freezer of his refrigerator car which was parked in front of the place where he was scheduled to make a delivery. Autopsy was performed to investigate the cause of death. Apart from the signs of acute death, no other significant findings were obtained, either macro or microscopically; carbon dioxide poisoning was thus strongly suspected. We created a simulation experiment by using the refrigerator car to reproduce the events of the accident. The oxygen concentration in the freezer was 21.0% as indicated by oxygen sensors, but decreased to 17.1-17.4% when the engine was stopped. This decrease in oxygen concentration supposedly results from the production of carbon dioxide by the vaporization of dry ice. Carbon dioxide concentration in the air could be calculated from the change in the oxygen concentration in the closed space of the freezer. The concentration was assessed at 17.1-18.6%. An oxygen concentration of 17.1-17.4% does not of itself cause serious hypoxia, but a carbon dioxide concentration of 17.1-18.6% probably causes serious intoxication, because this value is beyond that of intoxication levels published in references. Therefore, we concluded that the cause of death in this case was carbon dioxide intoxication.