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Clothing may both cause death and contribute to ongoing lethal mechanisms by a variety of quite disparate mechanisms. The manner of death may be accidental, suicidal, or homicidal. Accidental deaths include burning from clothing catching on fire, strangulation from clothing tangling in vehicle wheels or exposed machinery, and drowning. Entanglement of clothing in machinery may also result in significant injuries, which are not uncommon in farming communities. Excessive clothing, or its absence, may significantly alter body temperature, and hanging from clothing is a feature in the young or in mentally or physically handicapped adults, or in adults who are intoxicated with alcohol or drugs. In previous years, potentially lethal amounts of arsenic were present in clothing and accessories from dyes. Clothing may also be used to form nooses or to pad ropes in suicides and may be used in cases of strangulation, suffocation, or choking in homicides. The contribution of clothing to mortality has changed over the years with changes in fashions and in manufacturing techniques. Geographical differences in clothing-related deaths persist because of variable social and cultural practices and legislative frameworks.