# RETRACTED: Systematic Review of Fatal Sodium Nitrite Ingestion Cases: Toxicological and Forensic Implications

## TL;DR

This retracted review examines fatal sodium nitrite poisonings, highlighting the need for better detection methods and public health measures.

## Contribution

The paper systematically reviews forensic and toxicological challenges in sodium nitrite poisoning cases.

## Key findings

- Most studies were case reports, with 53 fatal sodium nitrite intoxication cases reviewed.
- Current diagnostic methods lack uniform cutoffs for blood nitrite and nitrate levels.
- More research is needed on other matrices and the impact of postmortem time on results.

## Abstract

Documented cases of sodium nitrite toxicity are almost exclusively caused by accidental ingestion; however, self-poisoning with sodium nitrite represents an increasing trend in nitrate-related deaths. This systematic review summarizes the most crucial evidence regarding the fatal toxicity of sodium nitrite. It identifies gaps and differences in the diagnostic forensic approaches and the detection methods of sodium nitrite intoxication. A total of eleven research articles were selected for qualitative and quantitative data. Most of the studies (6/11) were case reports. Fifty-three cases of fatal intoxication with sodium nitrite were chosen for the review. More research is required to develop cost-effective techniques and uniform cutoffs for blood nitrite and nitrate levels in the event of deadly sodium nitrite poisoning. There is still a lack of critical information on other matrices and the impact of time since death on toxicological results in such situations. The available evidence provides useful recommendations for forensic pathologists and health practitioners engaged in instances of sodium nitrite poisoning or death. The data should also set off alarm bells in the public health system, in prosecutor’s offices, and for policymakers so that they may undertake preventative measures to stop and restrict the unregulated market for these substances.