Plastic bag asphyxia in southeast Scotland

Death resulting from plastic bag asphyxia has been recognized for >40 years , but relatively little is known about either its epidemiology or its patho physiology. Over 15 years (1984-1998), 30 deaths were attributed to plastic bag asphyxia among the 14,560 autopsies performed in the Forensic Medicine Unit in Edinburgh. These 30 deaths involved 20 male and 10 female subjects , with an age range of 13 to 81 years. Eleven had some alcohol measurable i n the blood, with four having levels >80 mg/dl. Only one individual appeare d to have ingested a drug overdose, but inhaled substances within the plast ic bag may have contributed to death in five cases. The absence of childhoo d accidental deaths may reflect successful preventive measures. The 3 accid ental deaths involved adults (including 2 who died of autoerotic asphyxia), and the remaining deaths were 27 suicides. Of those who committed suicide, most (59%) had chronic psychiatric illness rather than chronic debilitatin g or terminal physical illness. In contrast with reports from the United St ates, publicity associated with "self-deliverance" did not result in an inc reased number of deaths from plastic bag asphyxia (4 deaths in this series) . Analysis of the circumstances of all the deaths revealed them to be diffi cult to predict and hence prevent.