Suicidal and criminal immolations: an 18-year study and review of the literature.

We aimed to examine our autopsy data in order to analyze epidemiological and injury characteristics in criminal and suicidal immolation cases. During the 18-year period, we recorded 29 suicides and three homicides due to fire burns. In suicide group there was a majority of men (gender ratio: 3.1:1) and the mean age was 42.8 years (range 20-72). In the homicide group, the victims were two men and one woman. Their mean age was 44 years (range 39-54). The location of self-immolation was mostly the deceased's car or home and most suicides happened during the evening and the night. The main frequent motives for self-immolation were affective problems, financial problems, or both. One or several flammable fluids, usually petrol or alcohol, were used in 18 suicide cases and in one homicide. The median total body surface area burnt was 79.3% (range 10-100%) in self inflicted group and 83.3% (range 50-100%) in assault group. The sole of the feet was spared in all suicide cases. Blood CO-Hb level was measured in 27 self-immolation cases. It ranged between 1% and 10% in 11 cases and was superior to 10% in the remaining. Twenty-three self-immolation victims and one homicide victim had soot in their respiratory tracts. Soot in the respiratory tracts was associated to soot in the digestive tracts in six cases. Alcohol and drugs intoxication played a minor role. In six cases, the victim associated self incineration with one or more other methods of suicide (complex suicides). The presence of associated trauma raises the problem of vitality and interpretation of the lesions in determining the manner of death.