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Toxicological Findings in Fatal Road Traffic Accidents in Cape Town: A Pilot Study
Introduction: Road traffic accidents (RTAs) and associated morbidity and mortality are a global public health burden. Literature reports on an association between drugs and/or alcohol intoxication and traffic collisions. In South Africa (SA), where drug use and abuse are prevalent, annual RTAs rates...
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| Format: | Thesis |
| Language: | English |
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Division of Forensic Medicine and Toxicology
2020
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| _version_ | 1867613308769533952 |
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| access_status_str | Open Access |
| author | Shongwe, Nondumiso Khetsiwe Ntombi |
| author2 | Davies, Bronwen |
| author_browse | Davies, Bronwen Shongwe, Nondumiso Khetsiwe Ntombi |
| author_facet | Davies, Bronwen Shongwe, Nondumiso Khetsiwe Ntombi |
| author_sort | Shongwe, Nondumiso Khetsiwe Ntombi |
| collection | Thesis |
| description | Introduction: Road traffic accidents (RTAs) and associated morbidity and mortality are a global public health burden. Literature reports on an association between drugs and/or alcohol intoxication and traffic collisions. In South Africa (SA), where drug use and abuse are prevalent, annual RTAs rates are higher than the average global burden. Toxicological analyses in cases of RTA fatalities are not performed routinely in SA (apart from alcohol analysis), thus understanding the burden of other drug impairment on road traffic deaths is limited. Aim: A prospective toxicological analysis was performed in a cohort of road traffic fatality cases (drivers, passengers, pedestrians, motorcyclists and cyclists) from Salt River Mortuary in Cape Town, SA. The objectives were to perform drug screening in these cases to preliminary investigate detected substances as well as to evaluate the demographics and circumstances of death of the aforementioned cases. Methods: A systematic review was first performed to investigate the prevalence of drugs in internationally reported RTA fatalities. For the prospective study, post-mortem specimens including blood, vitreous humor, urine and bile were collected from cases in which next-of-kin consent was obtained. All samples were analysed using liquid chromatography-quadrupole time-of -flight mass spectrometry (LC/QTOF-MS). Results: Thirty cases were analysed over 3 months, of which most were male, pedestrians and between the age group of 31-40 years. The most prevalent cause of death was multiple blunt force injuries to the body. Single vehicle crashes were predominant particularly among the pedestrians and motorcyclists whereas drivers were mostly involved in multiple vehicle crashes. Substances (other than ethanol) were detected in 90% (n=27) of the cases. A broad range of drug groups were detected, and the most prevalent specific legal substances were caffeine (66.7%) and nicotinamide (53.3%) and illegal substances were methaqualone (10.0%) and methamphetamine (6.67%). Multiple cases indicated the detection of impairing substances even if consumed therapeutically, such as codeine, chlorpheniramine, diphenhydramine and zopiclone. Discussion: This study was the first to the author’s knowledge to report on prospective toxicological findings in road traffic accident cases in Cape Town. Although this was a pilot study, the results were in line with findings from other international studies, together with findings of prominent abused drugs within Western Cape (e.g. methaqualone and methamphetamine). While this study made no inferences of drug intoxication to cause of death, it has set a basis for future research in this topic and the development of a standardised protocol for the routine analyses of such cases in SA. |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/31238 |
| institution | University of Cape Town (South Africa) |
| language | eng |
| last_indexed | 2026-06-10T12:34:03.682Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2020 |
| publishDateRange | 2020 |
| publishDateSort | 2020 |
| publisher | Division of Forensic Medicine and Toxicology |
| publisherStr | Division of Forensic Medicine and Toxicology |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/31238 Toxicological Findings in Fatal Road Traffic Accidents in Cape Town: A Pilot Study Shongwe, Nondumiso Khetsiwe Ntombi Davies, Bronwen Auckloo, Kathrina Biomedical Forensic Science Introduction: Road traffic accidents (RTAs) and associated morbidity and mortality are a global public health burden. Literature reports on an association between drugs and/or alcohol intoxication and traffic collisions. In South Africa (SA), where drug use and abuse are prevalent, annual RTAs rates are higher than the average global burden. Toxicological analyses in cases of RTA fatalities are not performed routinely in SA (apart from alcohol analysis), thus understanding the burden of other drug impairment on road traffic deaths is limited. Aim: A prospective toxicological analysis was performed in a cohort of road traffic fatality cases (drivers, passengers, pedestrians, motorcyclists and cyclists) from Salt River Mortuary in Cape Town, SA. The objectives were to perform drug screening in these cases to preliminary investigate detected substances as well as to evaluate the demographics and circumstances of death of the aforementioned cases. Methods: A systematic review was first performed to investigate the prevalence of drugs in internationally reported RTA fatalities. For the prospective study, post-mortem specimens including blood, vitreous humor, urine and bile were collected from cases in which next-of-kin consent was obtained. All samples were analysed using liquid chromatography-quadrupole time-of -flight mass spectrometry (LC/QTOF-MS). Results: Thirty cases were analysed over 3 months, of which most were male, pedestrians and between the age group of 31-40 years. The most prevalent cause of death was multiple blunt force injuries to the body. Single vehicle crashes were predominant particularly among the pedestrians and motorcyclists whereas drivers were mostly involved in multiple vehicle crashes. Substances (other than ethanol) were detected in 90% (n=27) of the cases. A broad range of drug groups were detected, and the most prevalent specific legal substances were caffeine (66.7%) and nicotinamide (53.3%) and illegal substances were methaqualone (10.0%) and methamphetamine (6.67%). Multiple cases indicated the detection of impairing substances even if consumed therapeutically, such as codeine, chlorpheniramine, diphenhydramine and zopiclone. Discussion: This study was the first to the author’s knowledge to report on prospective toxicological findings in road traffic accident cases in Cape Town. Although this was a pilot study, the results were in line with findings from other international studies, together with findings of prominent abused drugs within Western Cape (e.g. methaqualone and methamphetamine). While this study made no inferences of drug intoxication to cause of death, it has set a basis for future research in this topic and the development of a standardised protocol for the routine analyses of such cases in SA. 2020-02-21T13:57:28Z 2020-02-21T13:57:28Z 2019 2020-02-21T11:52:42Z Master Thesis Masters MPhil http://hdl.handle.net/11427/31238 eng application/pdf Division of Forensic Medicine and Toxicology Faculty of Health Sciences |
| spellingShingle | Biomedical Forensic Science Shongwe, Nondumiso Khetsiwe Ntombi Toxicological Findings in Fatal Road Traffic Accidents in Cape Town: A Pilot Study |
| thesis_degree_str | Master's |
| title | Toxicological Findings in Fatal Road Traffic Accidents in Cape Town: A Pilot Study |
| title_full | Toxicological Findings in Fatal Road Traffic Accidents in Cape Town: A Pilot Study |
| title_fullStr | Toxicological Findings in Fatal Road Traffic Accidents in Cape Town: A Pilot Study |
| title_full_unstemmed | Toxicological Findings in Fatal Road Traffic Accidents in Cape Town: A Pilot Study |
| title_short | Toxicological Findings in Fatal Road Traffic Accidents in Cape Town: A Pilot Study |
| title_sort | toxicological findings in fatal road traffic accidents in cape town a pilot study |
| topic | Biomedical Forensic Science |
| url | http://hdl.handle.net/11427/31238 |
| work_keys_str_mv | AT shongwenondumisokhetsiwentombi toxicologicalfindingsinfatalroadtrafficaccidentsincapetownapilotstudy |