A Lethal Dose of Water

By Deborah Blum

One of the most famous sayings in toxicology is this: The dose makes the poison.

In other words, a milligram of the notorious poison arsenic is unlikely to kill you. Make that 200 milligrams and a cemetery plot awaits. Seems obvious, right? But, what if we're talking about something that is not a poison, a benign substance--say, a drink of cold water? Let's make it really pure water, free of arsenic and any other toxic substances.

If the size of the drink increases enough, for example, if instead of drinking a standard 8-ounce glass of water, you gulp down 160 ounces, then can we call water a poison? Wonderful, healthy water? Absolutely yes.

People have been convicted of homicide in water poisoning cases. Children have died after being punished by parents, or even babysitters, who forced them to drink more than a gallon of water in less than an hour. Athletes have died after gulping down too much water. Fraternity pledges have been killed by water poisoning (also called water intoxication) after hazing events.

A year ago, a jury awarded more than $16 million to the family of a young woman who died of water poisoning after entering a Sacramento radio station contest called "Hold your wee for a Wii." The 28-year-old contestant had been trying to win the game console for her children. She died at home several hours after coming in second in the contest. The jury noted that even callers to the radio show had warned against the stunt.

What happens in a water overdose? The kidneys are overwhelmed by the tidal wave of incoming fluid and cannot cycle the excess away. The cells in the body begin to bloat with excess fluid. Electrolyte balances are disrupted, meaning that normal chemical metabolism falters. Tissues start to swell, most disastrously in the brain. The radio show contest even complained during the show of a blinding headache. A coma follows and, if the imbalances cannot be corrected, then comes death.

So the dose does make the poison rather dramatically in the case of water, changing it from a safe and healthy substance to a lethal one. With a classic poison like arsenic, the point is a little different. Put simply, a person is more likely to survive a low dose than a high one.

I recently read a piece by a physician urging athletes to be careful not to drink too much water when they're rehydrating. He titled his piece "The Balancing Act." But, it's really just another way of saying that the dose makes the poison.

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Forensics Expert Susan Vondrake Stops By

by Andrea Campbell

Today I would like to introduce Susan Vondrake, director of the Research and Development Laboratory with the Illinois State Police. A Renaissance woman in the field of forensic science, Vondrake is also a new fiction writer whose first book will debut shortly.

Q.: What is your book with Oak Tree Press about? Is it finished?

A.: Yes, the book is completed and the first of a series. I plan to publish under S. Connell Vondrake. The book is a completely fictional work not based on any actual case or agency. The book, No Evidence of a Crime, is set in Washington, D. C., and begins with two detectives investigating the murder of a young woman, a murder which appears on the surface to be straightforward, but subtle discrepancies with the evidence start to become apparent. The murder weapon is identified as a Glock handgun, but an eyewitness places the shooter too far from the victim.  

Toxicology finds a high level of alcohol and cocaine in victim’s system, but not in the fetus she is carrying, and DNA links the victim to a gang member -- but she had no apparent gang connections. The detectives ask a forensic scientist to help retest the samples. The new test results soon lead the detectives to realize forensic evidence is being altered.

In No Evidence of a Crime, the clues point to one direction, but there are inconsistencies. The detectives try to force the pieces to fit into the puzzle. When they actually figure out the truth, everything fits together. The same is true in real life. If a control is outside the expected result, or a latent print matches the top of a print on a print card but not the bottom of the print, or a shoe print matches but is the wrong size, all of these things are telling you something. Things like this will gnaw at a good forensic scientist until they figure out what the evidence is telling them, and when they do, they grow as a forensic scientist and the field of forensics grows.

Q.: How did the book come about?

A.: In my current job, I have to drive to different labs around Illinois. I can be in the car six, seven, eight hours in a day. Rather than listening to the radio, I would make up stories in my mind as entertainment for me. A few years ago, I started to put these stories down on paper. Oak Tree Press has been wonderful. In January, I turned the first of three books over to them, and they were very quick in saying they wanted to publish it. I don’t have an agent, just me.

Q.: Can you tell us something about your background, and give us a few words about your crime lab?

A.: I was a forensic toxicologist for ten years with the Illinois State Police (ISP). I then trained people in forensic toxicology for eight years, also with the ISP. In 2003, I became the Director of Training, overseeing training in all areas of forensics, including Latent Prints, DNA, Firearms, Toxicology, Questioned Documents, and Drug and Trace Chemistry. In January of 2009, I was appointed the Director of Research and Development, in addition to continuing my training duties, overseeing the Statewide Training Program.

The Illinois State Police is a very large system, second only to the FBI in size within the US. We have approximately 350 forensic scientists and about 500 total staff. Both the Statewide Training Program and the Research and Development Laboratory have statewide responsibilities within ISP’s Forensic Sciences Command.

Q.: Last year, Congress completed an investigation and report on the state of forensic science; since there is no standardization for all forensic disciplines, do you think the needs of criminal justice are being met?

A.: Let me start by saying, I do believe the needs of the criminal justice system have been met. Throughout my career, I have watched the forensic science community work hard to address most of the issues delineated in the National Academy of Sciences's report, with limited resources and funding. Whether it is through laboratory accreditation, training workshops at technical meetings or individual certification, the forensic community has striven to better themselves as forensic examiners. The IAI certification program of latent print examiners is an excellent example of the spirit of that dedication.  It is a challenging test which is one way of demonstrating the competency of a latent print examiner. 

However, I will also add, I have read the NAS report from cover to cover, recognize the issues it articulates, and believe these issues should not be taken lightly or brushed aside. Our challenges are the new technologies always being developed, which allow us to give better and better answers but cause us to be constantly learning, changing and adapting past practice. How we incorporate these new technologies into our laboratories is paramount to our success as a vital service to the citizens we serve. It is also what drives agencies to submit more and more evidence to take advantage of better techniques and greater sensitivity of results.

I see the NAS review as similar to going to the doctor’s office for a physical, just to see how your body’s holding up; maybe there have been a few aches and pains that caused some concern. If you went to a doctor, and the doctor said you need to eat better and exercise more because you may be on the road to a heart attack, most people would not reply, “No, I’m not.” They would assess what they could do better and how they might improve, maybe eat an apple instead of a candy bar or walk a little more at the mall. The same is true in forensics when reviewing the NAS report. Each individual, their agencies and the community as a whole should assess how they are doing and what they can do better.  If I were a latent prints examiner but had not taken the IAI certification test, that might be an apple I would be chewing on, now.

Q.: How would you suggest that young people interested in a forensic science career proceed?

A.: When I started in 1985, few knew what forensic science was. Now, we can easily have 700 people apply for a forensic scientist position each year so, the interest in the field is there. As long as you have a strong science background, you can become a forensic scientist. If you are interviewing for the job, show your interest in the field (this is not reciting episodes of CSI). Forensic work can be tedious and meticulous. Most scientists are capable of becoming a forensic scientist but, to become a great forensic scientist you need the ability to never give up until all the questions in a case are answered.

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Toxicology: Poison, Drugs, and Chemicals

by Andrea Campbell

Q: Can you tell me more about toxicology and what a forensic toxicologist is all about?

A: The busiest department in a crime lab, hands down, has to be forensic toxicology. This science is essentially a specialty area of analytical chemistry, so think vials, jars, and lots of machinery to test them when you consider this area's discipline.

Toxicology, per se, is the science of adverse effects of chemicals, either natural or man-made, on living organisms. The job of a toxicologist is to detect and identify foreign chemicals in the body, with a particular emphasis on toxic or hazardous substances. There are several sub-groups of toxicology expert: a descriptive toxicologist performs toxicity tests to evaluate the risk that exposure poses to humans; a mechanistic toxicologist attempts to determine how substances exert deleterious effects on living organisms; and the regulatory toxicologist judges whether or not a substance has low enough risk to justify making it available to the public.

Toxins then, are materials that threaten the life of living things. Poisons are a subgroup of toxins. Toxic materials can come in many forms such as gas, liquids, solids, animal, mineral and vegetable. Toxins can be ingested, inhaled or absorbed through the skin and organs. Some toxins have medicinal value and, if this is the case, the amount that is taken is significant to health, but—if abused, may cause irreparable damage. Toxins may have antidotes, but some do not.

Some toxins may disguise or mask themselves, whereas some are identifiable by their symptoms. Here are a couple of examples of toxins and their symptoms:

Acids (nitric, hydrochloric, sulfuric) = Burns around mouth, lips, nose
Aniline (hypnotics, nitrobenzene) = Skin of face and neck quite dark
Atropine (Belladonna, Scopolamine) = Pupil of eye dilated
Arsenic (metals, mercury, copper, etc.) = Severe, unexplained diarrhea
Carbon Monoxide = Skin is bright cherry red
Cyanide = Quick death, red skin, odor of peach
Nicotine = Convulsion
Opiates = Pupil of eye contracted
And so forth.

The true incidence of poisoning in the United States is unknown. Approximately 2 million cases are voluntarily reported to poison control centers each year, and officially, a rather steady figure of about 700 deaths by poisoning is reported each year. Children under age 6 account for the majority of poisonings reported, but adults account for the majority of deaths by poisoning, most of which is intentional rather than accidental.

Some common reported poisons are: household cleaning supplies, antidepressant medications, analgesics (aspirin, acetaminophen), street drugs, cough and cold remedies, cardiovascular drugs, plants, alcohol, gases and fumes, pesticides, asthma therapies, industrial chemicals, sedatives, food poisoning, insects and other animals.

It is not easy to distinguish toxic from nontoxic substances. A key principle in toxicology is the dose-response relationship. The toxic effects of substances are not side effects. "Side effects" are defined as non-deleterious, such as dry mouth, for example. Toxic effects are the undesirable results of a direct effect, like the result of too much stress on the body; in other words, the body is upset by physical, chemical or biological agents and it manifests itself as a reaction. Toxic reactions are classified as one of three reactions: pharmacological—with injury to the central nervous system; pathological—with injury to the liver; and genotoxic—causing the creation of benign or malignant neoplasms or tumors.

For certification as a toxicologist, an individual must possess a Ph.D. or doctorate in one of the natural sciences. Undergraduate degrees must also be in either biology or chemistry, usually. Certification is bestowed by the American Board of Forensic Toxicology and the expert may use the title of “Diplomate,” which must be renewed every three years. Board-certified toxicologists will never face difficulties qualifying as an expert witness. State crime laboratories may not have a toxicologist on staff, their functions being performed by a criminalist, a biochemist, a forensic biologist or other technician. These personnel would typically have a Bachelor’s or Master’s degree in any of the sciences.

A forensic toxicologist is normally presented with preserved samples of body fluids, stomach contents, and organ parts. They will have access to the coroner’s report which should contain information on various signs and symptoms as well as other postmortem data. The toxicologist needs a thorough knowledge of how the body alters or metabolizes drugs because few substances leave the body in the same state as when they entered.

Hooray for toxicologists, an overworked group and a much needed discipline in the realm of forensic science.

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