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PubMed1993

Electric injury with cerebral venous thrombosis. Case report and review of the literature.

BACKGROUND AND PURPOSE: A case of accidental electrocution with previously unreported arteriographic evidence of cerebral vein thrombosis is presented. A brief description of early and late neurological complications and current theories attempting to explain the histopathological findings of electric injury are reviewed. The occurrence and persistence of late neurological complications are elucidated. CASE DESCRIPTION: A report of an accidental electrocution with 800 V of alternating current in a young man is presented. Cerebral angiography showed a cerebral vein thrombosis. The immediate complications included loss of consciousness, confusion, memory loss, and headache. Late complications of right-sided clumsiness, sensory loss, hemianopsia, and neglect persisted for more than 1 year despite the brain being outside the current pathway. CONCLUSIONS: High-voltage electric injury may cause cerebral vein thrombosis with significant early and delayed brain injury even when the brain lies outside the current pathway.

Adult↗
PubMed2002

Study on the specificity of fibronectin for post-mortem diagnosis of early myocardial infarction.

In order to investigate the specificity of fibronectin (Fn) in the post-mortem diagnosis of myocardial infarction, the changes of Fn staining in normal, infarcted and other non-infarcted myocardial injuries resulting from myocarditis, mechanical asphyxia, electrocution, hemorrhagic shock, cardiac contusion and organophosphate poisoning were studied with an immunohistochemistry and image analysis system. The results showed that positive Fn staining could only be observed in groups of myocardial infarction and myocarditis, but could not be found in groups of mechanical asphyxia, electrocution, hemorrhagic shock, cardiac contusion, and organophosphate poisoning. Our findings indicate that positive staining of Fn in cardiomyocytes could be affected only by myocarditis, so it is quite specific for the diagnosis of myocardial infarction.

Adolescent↗
PubMed1994

Occupational injury deaths of 16- and 17-year-olds in the United States.

Data from the National Traumatic Occupational Fatalities surveillance system were used to analyze occupational injury deaths of civilian 16- and 17-year-olds during 1980 through 1989. There were 670 deaths; the rate was 5.11 per 100,000 full-time equivalent workers. The leading causes of death were incidents involving motor vehicles and machines, electrocution, and homicide. Workers 16 and 17 years old appear to be at greater risk than adults for occupational death by electrocution, suffocation, drowning, poisoning, and natural and environmental factors. Improved enforcement of and compliance with federal child labor laws, evaluation of the appropriateness of currently permitted activities, and education are encouraged.

Accidents, Occupational↗
PubMed1987

Myocardial injury after electrical burns: short and long term study.

Miscellaneous cardiac abnormalities can occur after electrical burns. The long term outcomes are still unknown. We studied 10 patients, 9 of whom suffered high-voltage electrocution, and one of whom was struck by lightning. Serial electrocardiograms (ECG) and serum MB creatine phosphokinase isoenzyme (MB-CPK) activities were obtained during their stay in hospital. ECG and thallium 201 cardiac scintigraphy at rest, as well as echocardiograms were obtained in all patients 4 to 48 months after discharge. In hospital, 9 patients showed one or more abnormal findings at physical examination (4 cases), ECG (8 cases), MB-CPK (1 case). At long term follow-up, 5 patients had one or more myocardial functions or conduction abnormalities, with or without symptoms. One patient had compensated heart failure. Nine patients were asymptomatic. Abnormal ECG findings persisted in 3 patients. Three cardiac scans showed evidence of regional myocardial hypoperfusion. Decreases in left ventricular indices measured by echocardiogram were found in 3 patients. We conclude that high-voltage electrocution is associated with a high incidence of cardiac abnormalities, which may persist. Long term evaluation, requiring cardiac T1 201 scintigraphy and echocardiogram, may be justified.

Adult↗
PubMedDate not supplied

Theories of the causes of death from electricity in the late nineteenth century.

During the period 1880-1900, the first studies were conducted to aid in understanding the effects of electricity on the human body. Commercial electrical systems were being developed, with the first central station for incandescent lighting placed in operation in 1882. The proliferation of these new stations and their distribution systems inevitably led to accidental electrocutions. The early investigators of electrical death were primarily physicians who were troubled by the incomplete electrical knowledge of that time as they evaluated the different effects of direct and alternating currents and high and low currents. Most of the studies used animals, while postmortem examinations of electrocuted criminals provided some information, though of little practical value, concerning high-current shocks. Various theories concerning suspended animation and concerning the action of electricity on the nervous system were proposed and discarded. In 1899, Prevost and Battelli in Europe, and Cunningham working independently in the United States, showed that ventricular fibrillation was the usual mode of death for low-voltage shocks. The possibility of electrical defibrillation of the heart was clearly described by Prevost and Battelli in 1899.

Animals↗
PubMed2001

Effect of electrocautery vs. scalpel on fascial mechanical properties after midline laparotomy incision in rats.

BACKGROUND: The method of midline laparotomy incision and closure remains a complex surgical problem. OBJECTIVE: To compare the mechanical properties at the interface of midline laparotomy incision made by scalpel versus electrocuting current in rats. METHODS: A sharp midline laparotomy incision was made in 60 Wistar female rats using a scalpel or electrocautery to open the fascia. The fascial and skin wounds were closed separately with a continuous nylon. Fascial specimens were analyzed for mechanical properties at the midline incision using a loading machine. The load-extension curve was recorded during tensile loading at a steady extension rate of 15 mm/min. RESULTS: There was no statistically significant difference between the two groups in either wound-bursting force (PPEAK) or the strain energy spent until the point of measured PPEAK. Each load-extension curve showed a characteristic pattern in all rats. Tissue stiffness was greater in the scalpel group than in the electrocautery group (P = 0.02). Correlations were found between tissue stiffness and strain energy, between tissue stiffness and bursting force, and between bursting force and strain energy. CONCLUSIONS: While tissue stiffness was greater when a scalpel was used compared to electrocuting to incise the midline abdominal fascia in rats, there was no difference in the bursting force required to disrupt the wound.

Abdomen↗
PubMed2000

Alfred P. Southwick, MDS, DDS: dental practitioner, educator and originator of electrical executions.

The search for a modern, humane method of criminal execution was triggered by a freak accident which occurred in Buffalo, New York in 1881. Dr. Alfred P. Southwick (a former steam-boat engineer, noted dentist and dental educator) happened to witness an intoxicated man die after he inadvertently touched a live generator terminal. Southwick's initial reaction was shock. Later, as he pondered this tragic event, he concluded that electrocution was, at least, a quick and seemingly painless way to depart from this earth. As his thoughts turned to common methods of capital punishment, Alfred concluded that death by electrocution could become a more humane alternative, as compared with the more grisly methods (e.g., hanging, beheading by guillotine, garroting, suffocation and flaying). Working through the governor of New York and the state legislature, Southwick originated and successfully promoted the passage of laws which mandated electrical executions in New York and in approximately 20 other states. During 1888-1889, Southwick served on the state's three-person Electrical Death Commission, a group who reported that electrical execution was superior to all other methods. On January 1, 1889, the world's first electrical execution law went into effect. On August 6, 1890, William Francis Kemmler, who had murdered his mistress, was the first person to die in the electric chair. However, this public event became an amateurish spectacle: the initial surge of current did not cause Kemmler's immediate death and a second jolt was needed. Those who witnessed this bungled execution were stunned. Graphic and detailed criticism from both the press and the general public ran high. However, Dr. Southwick vigorously continued to support and finally achieve his goal--to humanize capital punishment through the legal use of electrical execution.

Capital Punishment↗
PubMed2001

[Study on the specificity of complement C5 for the postmortem diagnosis of myocardial infarction].

In order to explore the specificity of complement C5 in the postmortem diagnosis of myocardial infarction, changes of C5 staining in normal, infarcted and other non-infarcted myocardia with direct or indirect myocardial injuries (myocarditis, mechanical asphyxia, electrocution, hemorrhagic shock, cardiac contusion and organophosphate poisoning) were studied with immunohistochemistry and image analysis. The results showed that positive C5 staining could be observed in groups of myocardial infarction and myocarditis, but not in groups of mechanical asphyxia, electrocution, hemorrhagic shock, cardiac contusion, and organophosphate poisoning. It is indicated that positive reaction of C5 could only be affected by myocarditis, which means that it was more specific for the diagnosis of myocardial infarction.

Adolescent↗
PubMed1976

[Quantitative K and Na levels in different parts of the heart in cases of sudden death from coronary disease, acquired heart valve defects and violent death].

The quantitative potassium and sodium contents in the separate regions of the heart and m. rectus abdominis in cases of sudden and violent death were investigated. The disturbances of the electrolyte metabolism of potassium and sodium were established to be the earliest changes in coronary disease (acute coronary insufficiency resulting from functional disturbances of the coronary circulation and myocardial infarction). The decrease of the quantitative potassium contents and sodium increase in myocardium depend on the ischemia duration and the stage of the myocardial lesion. The highest potassium decrease was observed in the left ventricle and right auricle. Not very high but even decrease of potassium and sodium contents in the separate heart regions was observed in the deceased by electrocution and strangulation, the decrease being most negligible in the deceased by electrocution. The changes observed in potassium and sodium contents are not pathognomic signs of coronary disease. Only the sharp, focal decrease of the contents of those element is a reliable sign of myocardial infarction.

Abdominal Muscles↗
PubMed2004

The analysis of the causative factors and types of traumas in disabled inhabitants of rural areas in Poland.

Traumas, accidents and intoxications are one of the main medical as well as social problems of the end of the previous and the present century. The number of accidents in the rural areas has been rising for the past 20 years. Little or lack of knowledge on protection of the own health against traumas, accidents and intoxications, as well as incidents such as electrocution or drowning, is a considerable problem. The study comprised 3,853 disabled persons and was carried out on the basis of physical examination (File of medical examination, File of environmental studies, File of the disabled). There were carried out statistical analyses concerning relationships of age, gender, employment, level of education and health state. The results of the studies conducted in the years 1987-2000 testify to the fact that among numerous reasons of trauma, there predominate falls, accidents connected with operating machines and appliances, mainly electric, road accidents, blows and crushes, contact with farm animals as well as electrocution and resulting burns. The most common sequels of accidents is trauma to lower extremities, upper extremities, head, thorax, spine, multiple trauma and general contusion.

Accidents↗
PubMedDate not supplied

[Fatalities in the bathtub].

A retrospective analysis concerning deaths in the bathtub was carried out in the Institute of Legal Medicine in Hamburg. The study includes 245 death cases between 1971 and 1988 (1% of all autopsies). 66 cases proved to be natural deaths, 76 were classified as suicides, 39 as accidents and 13 as homicides; 51 fatalities remained unclear with respect to one of these groups. Among the natural deaths sudden cardiac deaths were dominating (n = 39), among the suicides the intoxications (n = 37) and electrocutions (n = 20), and among the accidents the intoxications by carbon monoxide (n = 17) and electrocutions (n = 12). Out of 13 homicides only 2 were committed directly in the bathtub: One by drowning of a child and one by electric current via a hair dryer; in the other cases the dead body was put into the bathtub post mortem. About 50% of the victims were alcoholized. Signs of drowning were present in about 40% of all cases; the most frequent finding was emphysema aquosum.

Accidents, Home↗
PubMed1987

Death from electrical arc flash burns. A report of 2 cases.

Two cases of fatal accidental electrocution involving high-tension cables are reported in which autopsy revealed the presence of flash burns and, more significantly, multiple circumscribed and cavitated lesions associated with arcing. Attention is drawn to the danger of 'near-contact' with high-tension cables. The autopsy findings of severe internal injuries, which may be associated with the blast of the electrical discharge or occur secondary to a fall are discussed. In the absence of an adequate history, the autopsy findings may help to elucidate more accurately the circumstances of death and the type of electrical injury involved in fatal electrocution.

Adult↗
PubMed1979

[Arterial thrombosis caused by electric injury].

A thrombosis of the axillary artery was discovered in a 36 year old man, four days after electrocution. It was treated successfully by venous bypass. The case was then compared with five similar cases in the literature. The damaged arteries were situated in the area crossed by the electric current. The artery was normal above and below the thrombosis. The thrombosis was accompanied by parietal lesions. The development of the collateral circulation explains the absence of signs of acute ischemia. The pathogenic medico-legal and therapeutic aspects of these thromboses by electrocution are then discussed.

Adult↗
PubMed1994

Violent suicide in South Yorkshire, England.

Differences in the characteristics of those individuals choosing violent methods of suicide in South Yorkshire were studied. With the exception of jumping from a height, these methods were more frequently used by males, with a particular male predominance in deaths due to self-immolation, railway collision, hanging, firearms, and electrocution. The most potentially painful/disfiguring methods of suicide, jumping from a height, self-immolation, and railway deaths, were favored by the young. Drowning, stabbing and cutting and electrocution were common among the elderly. Severe mental illness was common amongst those choosing some of the most painful or disfiguring modes of death (jumping from a height; self-immolation; cutting/stabbing and road traffic "accidents") particularly when compared to the principal alternative of hanging. The same group of causes of death was associated with a high proportion of individuals who had previously attempted suicide. Severe mental illness was not so obviously a feature of the railway or firearm deaths. Hanging represented more than half the cases included in the study and showed a sex ratio of over 4 to 1 in favor of males. However, all seven individuals of non-European origin, six of whom were female, chose to hang themselves. Whereas half of the females aged under 40 jumped from a height, hanging was the method of choice in the age group 40 to 59. Among males, hanging was particularly favored by those with what might be considered an impulsive reason for suicide, namely, the end of a relationship with a member of the opposite sex. A high proportion of these were intoxicated with alcohol and a high proportion left a suicide note.

Adolescent↗
PubMed1996

Traumatic occupational fatalities in the U.S. and Australian construction industries.

The occupational injury experience of the U.S. and Australian construction industries for 1988-1991 was compared to identify similarities and differences in risk and to share information vital for planning strategies for prevention. There were 4,158 deaths in the U.S. and 264 in the Australian construction industries. Workers in both countries, particularly laborers, were at high risk, with mean annual rates of 13.8/100,000 and 11.6, respectively, more than double the national averages. Falls, motor vehicles, electrocutions, and machinery were the leading causes of death in both countries, and accounted for 69% of the fatalities in the U.S. and 71% in Australia. International collaborations focusing injury and fatality prevention efforts on the common leading causes and high risk groups, and sharing successful prevention experiences between countries could save the lives of many construction workers world wide.

Accidents, Occupational↗
PubMed1999

Mortality patterns among electrical workers employed in the U.S. construction industry, 1982-1987.

BACKGROUND: Studies of electrical workers in the utility and manufacturing industries have reported excess site-specific cancer. No previous studies of electrical workers in the construction industry have been conducted. METHODS: Our study evaluated the mortality patterns of 31,068 U.S. members of the International Brotherhood of Electrical Workers who primarily worked in the construction industry and died 1982-1987. RESULTS: Comparison to the U.S. population by using the NIOSH life table showed significantly elevated proportionate mortality for many causes. Excess mortality for leukemia (proportionate mortality ratio (PMR)=115) and brain tumors (PMR=136) is similar to reports of electrical workers with occupational exposure to electric and magnetic fields in the electric utility or manufacturing industry. Excess deaths due to melanoma skin cancer (PMR=123) are consistent with findings of other PCB-exposed workers. A significantly elevated PMR was observed for the diseases caused by asbestos: lung cancer (PMR=117), asbestosis (PMR=247), and malignant mesothelioma (PMR=356) and from fatal injuries, particularly electrocutions (PMR=1180). The findings of statistically significant excess deaths for prostate cancer (PMR=107), musculoskeletal disease (PMR=130), suicide (PMR=113), and disorders of the blood-forming organs (PMR=141) were unexpected. CONCLUSIONS: Results suggest that more detailed investigations of occupational risk factors and evaluation of preventive practices are needed to prevent excess mortality in this hazardous occupation. Am. J. Ind. Med. 36:630-637, 1999. Published 1999 Wiley-Liss, Inc.

Adult↗
PubMed2000

Expanded analysis of injury mortality among unionized construction workers.

BACKGROUND: To evaluate the utility of expanding the number and precision of injury categories used in previous occupational mortality studies, this study reanalyzed data from four previous studies of unionized construction workers (construction laborers, ironworkers, sheet metal workers, and operating engineers), by expanding the number of injury categories from 6 to 33. METHODS: Proportionate mortality ratios (PMRs) were computed using the distribution of deaths from the National Occupational Mortality Surveillance System, a mortality surveillance system from 28 states, as a comparison. A blue collar comparison group was also used in additional analyses to adjust for socioeconomic and other factors. RESULTS: This reanalysis identified significantly elevated PMRs in at least one of the four worker groups for falls, motor vehicle crashes, machinery incidents, electrocutions, being struck by falling objects, being struck by flying objects, explosions, suffocation, and water transport incidents. Limiting the comparison population to deaths among blue collar workers did not change the results substantially. CONCLUSIONS: This study demonstrates that increasing the precision of categories of death from injury routinely used in mortality studies will provide improved information to guide prevention. Am. J. Ind. Med. 37:364-373, 2000. Published 2000 Wiley-Liss, Inc.

Accidental Falls↗
PubMed2003

External cause-specific summaries of occupational fatal injuries. Part I: an analysis of rates.

BACKGROUND: Industries and occupations vary with respect to the incidence of fatal injuries and their causes. METHODS: Fatalities from the National Traumatic Occupational Fatality database (years 1983-1994) serve as the basis for examining external cause of death code specific rates. Industries and occupations are compared with respect to rate and frequency of fatal injuries. In addition, external causes of injury (E-codes) are examined across all industries and occupations as well as within industries and occupations to evaluate which events would be identified by frequency ordered comparisons versus injury rate ordered comparisons. RESULTS: Machinery, electric current, homicide, falls, and transportation-related events are identified by high frequency and rate of occurrence. CONCLUSIONS: The external cause categories of homicide, machinery-related, motor-vehicle-related, electric current, and falls, account for over one-half of all occupational fatal injuries. Targeted interventions in homicide may be especially warranted in sales and service occupations and in the retail trade and services industries. In addition, younger workers might be targeted for special interventions designed to identify hazardous practices, procedures, and solutions to reduce fatalities associated with electrocution or falls from buildings.

Accidental Falls↗