Tiemensma M

Fitzpatrick RW

Raven MD

Byard RW

2020-02-25

A 56-year-old man died following a fall resulting in complete submersion into a deep pit containing insulation material, expanded perlite. The most striking finding at autopsy was of impacted, moist pale yellow perlite that extended from the epiglottis into the main bronchi resulting in complete obstruction of the larger and smaller airways with cast formation. Perlite inhalation differs from inhalation of inert materials such as sand and wheat due to its hygroscopic properties and ability to expand forming an occlusive cast. Subsequent analyses of perlite from the worksite and within the airways indicated that hydration of perlite and adsorption of organic molecules into the perlite glass flakes had formed an interlocking, three-dimensional structure that was likely responsible for triggering a coagulation-flocculation process causing strong cohesion between the aggregates of glass flakes. This unique mechanism was likely responsible for the formation of the plug of perlite that obstructed the upper airway.

Forensic Pathology Unit, Royal Darwin Hospital, 105 Rocklands Drive, Tiwi, Northern Territory, 0810, Australia.. College of Medicine and Public Health, Flinders University, GPO Box 2100, Adelaide, South Australia, 5001, Australia..

Centre for Australian Forensic Soil Science, The University of Adelaide, Locked Bag No 2, Glen Osmond, South Australia, 5064, Australia.. Centre for Australian Forensic Soil Science, CSIRO Land and Water, Locked Bag No 2, Glen Osmond, South Australia, 5064, Australia..

Centre for Australian Forensic Soil Science, CSIRO Land and Water, Locked Bag No 2, Glen Osmond, South Australia, 5064, Australia..

The University of Adelaide, Frome Rd, Adelaide, South Australia, 5005, Australia.. Forensic Science SA, 21 Divett Place, Adelaide, South Australia, 5000, Australia..

Journal of forensic sciences 2020-02-25

https://pubmed.ncbi.nlm.nih.gov/32096877/?otool=iaurydwlib

https://hdl.handle.net/10137/8237

autopsy

cast formation

energy dispersive x-ray spectrometry

forensic pathology

hygroscopic

industrial accident

perlite

powder x-ray diffraction

scanning electron microscopy

upper airway occlusion

Acute Respiratory Obstruction due to Accidental Inhalation of Perlite: A Novel Mechanism for Upper Airway Occlusion with Cast Formation.

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