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Deaths and injuries as a result of lightning strikes to aircraft.

Aircraft are at risk of being struck by lightning or triggering lightning as they fly through clouds. Commercial and private airplanes have been struck, with resultant deaths and injuries to passengers and crew. We were interested in learning how large a problem existed to the American public from lightning strikes to airplanes. We analyzed data from the National Transportation Safety Board (NTSB) on lightning-related accidents in the United States from 1963-89. NTSB recorded 40 lightning-related aircraft accidents. There were 10 commercial airplane accidents reported, 4 of which were associated with 260 fatalities and 28 serious injuries. There were 30 private aircraft accidents that accounted for 30 fatalities and 46 serious injuries. While lightning remains a potential risk to aircraft passengers and crew, modern airplanes are better equipped to lessen the dangers of accidents due to lightning.

Accidents, Aviation↗

[Lightning injuries: case report of a 17-year-old man and a brief review of the literature].

Lightning injury is one of the most frequent injuries caused by a natural phenomenon, but the risk of being struck by lightning is low. The most vulnerable subjects for lightning injuries are individuals who work in open fields. Although lightning injuries may involve all organ systems, injuries to the cardiovascular system and central nervous system are the most frequent. Burns, tinnitus, blindness and secondary blunt trauma have also been reported. Even though immediate death through lightning-induced cardiac arrest is well documented, the majority of cases reported in the literature describe infrequent and enormously disparate sequelae.A 17-year-old man was admitted to our hospital approximately 3 h after a lightning strike. The Glasgow coma scale was recorded as 15/15 and partial thickness burns totaling of 11% were present on the chest, stomach and right and left lower leg. The entry point was approximately the right side of the neck and the current exited through the right foot. On arrival, the patient's vital signs were normal. Cardiac and pulmonary examinations were within normal limits. The patient suffered transient symptoms, including pain, loss of consciousness, tinnitus, iritis and paresthesia. The laboratory data obtained on admission were within normal limits except serum for WBC, CK, CK-MB, troponin and CRP. We postulate that the mechanism by which lightning caused injury to this patient was a flash discharge (side splash). During his stay in hospital, a debridement of the burn surface following graft coverage and Z-plasty to close the dehiscent wound on the right neck was performed. The patient was discharged from the hospital after 14 days.

Adolescent↗

Spectra of simulated lightning on Venus, Jupiter, and Titan.

Laser-induced plasmas in various gas mixtures were used to simulate lightning in other planetary atmospheres. This method of simulation has the advantage of producing short-duration, high-temperature plasmas free from electrode contamination. The laser-induced plasma discharges in air are shown to accurately simulate terrestrial lightning and can be expected to simulate lightning spectra in other planetary atmospheres. Spectra from 240 to 880 nm are presented for simulated lightning in the atmospheres of Venus, Earth, Jupiter, and Titan. The spectra of lightning on the other giant planets are expected to be similar to that of Jupiter because the atmospheres of these planets are composed mainly of hydrogen and helium. The spectra of Venus and Titan show substantial amounts of radiation due to the presence of carbon atoms and ions and show CN Violet radiation. Although small amounts of CH4 and NH3 are present in the Jovian atmosphere, only emission from hydrogen and helium is observed. Most differences in the spectra can be understood in terms of the elemental ratios of the gas mixtures. Consequently, observations of the spectra of lightning on other planets should provide in situ estimates of the atmospheric and aerosol composition in the cloud layers in which lightning is occurring. In particular, the detection of inert gases such as helium should be possible and the relative abundance of these gases compared to major constituents might be determined.

Ammonia↗

Ball lightning from atmospheric discharges via metal nanosphere oxidation: from soils, wood or metals.

The slow (diffusion-limited) oxidation of metal nanoparticles has previously been proposed as the mechanism for ball lightning energy release, and argued to be the result of a normal lightning strike on soil. Here this basic model of networked nanoparticles is detailed further, and extended to lightning strikes on metal structures, and also to the action of other storm-related discharges or man-made discharges. The basic model predicted the important properties of "average" observed ball lightning, and the extension in this paper also covers high-energy examples of ball lightning. Laboratory checks of the theory are described, and predictions given of what conditions are necessary for observing ball lightning in the laboratory. Key requirements of the model are a sheltered region near the strike foot and starting materials which can generate a metal vapour under intensive heating, including soil, wood or a metal structure. The evolution of hydrocarbons (often plastics) along with metal vapour can ensure the local survival of the metal vapour even in an oxidizing atmosphere. Subsequent condensation of this vapour to metallic nanoparticles in networks provides the coherence of a ball structure, which also releases light over an extended time. Also discussed is the passage of ball lightning through a sheet of building material, including glass, and its occasional charring of flesh on close contact.

Atmosphere↗

Lightning injuries and acute renal failure: a review.

Lightning strikes cause multimodal injuries in victims, and although the number of deaths due to lightning is reportedly in the area of 1,000 deaths per year, they cause significant morbidity in many others. A major complication of a lightning strike is acute renal failure (ARF). The true incidence of ARF due to lightning injuries worldwide is difficult to ascertain because of significant underreporting, due in large measure to cultural and sociodemographic factors. Its incidence is reportedly rare in some literature and significant in others. However, lightning's potential to cause ARF due to myoglobinuria has been noted by many authors. Prompt treatment of myoglobinuric patients prevents the development of ARF. ARF due to direct organ damage by lightning is virtually unheard of. In this article, the current mechanisms of lightning injuries leading to muscle damage, myoglobinuria, and subsequent ARF are discussed, as well as signs and symptoms, laboratory investigations, and patient management.

Acute Kidney Injury↗

Lightning-related mortality and morbidity in Florida.

Cases of lightning-related deaths and injuries that occurred in Florida in 1978-87 were reviewed to determine the factors involved, to quantify the morbidity and mortality related to lightning strikes, and to describe epidemiologically the injuries and circumstances involved. Statewide information on deaths was obtained from death certificates, autopsy reports, and investigative reports. Information about morbidity was obtained from the Florida Hospital Cost Containment Board data base and the National Climatic Data Center data base for all Florida counties, as well as from hospitals in selected counties. Lightning-related deaths totaled 101 in Florida during the period 1978-87, an annual average of 10.1. Eight percent of the victims were from other States. The overall yearly death rate for State residents was 0.09 per 100,000 population, with the highest rate being that for men aged 15-19 years, 0.38 per 100,000. Thirteen percent of victims were females. The ratio of lightning-related injuries to deaths in Florida was estimated at about four to one. Thirty percent of all deaths were occupationally related. The first strikes of lightning from a thunderstorm may be the most dangerous, not in terms of impact, but because of the element of surprise. During thunderstorms, people may seek shelter under isolated trees because they believe erroneously that a tree offers protection from lightning, or perhaps because their top priority is to escape from rain rather than lightning. People may not seek adequate shelter during thunderstorms because they do not know the dangers of remaining outdoors or their judgment is impaired by drugs or alcohol.

Adolescent↗

A model lightning safety policy for athletics.

OBJECTIVE: The purpose of this paper is to present a model policy on lightning safety for athletic trainers. BACKGROUND: Among college athletic programs in the United States there is a serious lack of written policy on lightning safety. Available evidence shows that most National Collegiate Athletic Association (NCAA) Division I institutions, even though they are located in high lightning activity areas of the country, do not have formal, written lightning safety policies. CLINICAL ADVANTAGES/ RECOMMENDATIONS: The policy presented herein, which is at the forefront of such policies, is the lightning safety policy written as part of a policies and procedures manual for the division of sports medicine at a public NCAA Division I university. This is a policy based on practicality that utilizes the "flash-to- bang" method for determining the distance of lightning activity from the observer. The policy begins with the importance of prevention, including the daily monitoring of weather reports. The policy defines a "safe shelter" and specifies the chain of command for determining who removes a team or individuals from an athletic site in the event of dangerous lightning activity.

Journal Article↗

Safety in the presence of lightning.

Not enough emphasis is usually placed on the proactive ability to recognize the lightning hazard. Instead, most literature and training materials treat the reactive mode. The latter approach emphasizes the posture to take when a person is caught by surprise in the open by a thunderstorm when the lightning threat is at its greatest; in other words, it is too late for precautions. The same reactive approach concentrates on what a person is wearing or holding when lightning is overhead instead of how the person came to be in this situation in the first place. Rather than focusing on these last-minute factors, the primary issue must be on the ability of a person, whether in a baseball game, riding a bike, or on a golf course, to recognize in advance the existence of a major lightning threat. This proactive approach emphasizes advance planning and recognition of a potential threat from lightning. A complete plan involves a sequence of decisions on a time scale from days to seconds. Although most of the available information in pamphlets and safety guidelines is correct concerning the reactive phase of lightning safety, the hazard remains important because of the lack of emphasis on planning and awareness.

Humans↗

Lightning injuries: prevention and on-site treatment in mountains and remote areas. Official guidelines of the International Commission for Mountain Emergency Medicine and the Medical Commission of the International Mountaineering and Climbing Federation (ICAR and UIAA MEDCOM).

Lightning is a hazard during outdoor activities, especially for hikers and mountaineers. Specific preventive measures include staying off ridges and summits, and away from single trees. If possible, stay close to a wall but keeping a distance of at least 1m away from the wall. All metal objects (carabiners, crampons, ice-axe, ski poles, etc.) should be removed and stored away safely. Lightning currents can follow wet ropes. To prevent blunt trauma the helmet should not be removed. Move as quickly as possible away from wire ropes and iron ladders. The crouch position should be adopted immediately if there is a sensation of hair "standing on end". Crackling noises or a visible glow indicate an imminent lightning strike. Rescue of lightning victims may be hazardous. Airborne helicopters can be struck by lightning with disastrous effects. It is prudent to wait until the danger of further strikes has passed. Treatment of lightning victims is based upon the ABCs - (Assessment) airway, breathing and circulation. Victims who are not breathing can often be resuscitated and should be helped first. Respiratory arrest may be prolonged, but the prognosis can be excellent if breathing is supported. Standard Advanced Life Support (ALS), if necessary, should be given at the scene.

Camping↗

Electrical shock and lightning strike.

Cardiac arrest from electrical shock or lightning strike is associated with significant mortality and requires modification and extension of standard advanced life support measures to achieve successful resuscitation. Patients who experience electrical shock or lightning strike may sustain cardiac and respiratory arrest secondary to the direct effects of current. However, the majority of victims have associated multisystem involvement, including neurologic complications, cutaneous burns, and associated blunt trauma. As a result, a combination of advanced cardiac life support measures and advanced trauma life support techniques is indicated. Victims with cardiac arrest from electrical shock or lightning strike require prompt, aggressive resuscitation using standard methods for airway control, ventilation, and chest compressions, as well as usual measures for defibrillation and cardiac pharmacotherapy. Unique considerations include vigorous fluid resuscitation and spinal immobilization for victims of electrical shock and reversal of normal multiple casualty triage priorities when managing several lightning strike victims. Because the majority of victims are relatively young and seldom have significant underlying cardiac disease, the chance for successful resuscitation may be greater for patients who experience sudden death from electrical shock or lightning strike than for those with other causes of cardiac arrest, even among patients with initial rhythms traditionally unresponsive to therapy. Although numerous specialized aspects are required for the successful management of victims of electrical shock and lightning strike, the following article focuses on the unique considerations necessary for immediate care of cardiac arrest victims, with emphasis on the underlying mechanisms of sudden death and currently recommended guidelines for resuscitation.

Electric Injuries↗

Generation of lightning in Jupiter's water cloud.

Lightning is a familiar feature of storms on the Earth, and has also been seen on Jupiter and inferred indirectly to occur on Venus and Neptune. On Jupiter, lightning may be important as a source of energy to drive chemical reactions in the atmosphere, perhaps determining the abundances of molecules such as CO, HCN and C2H2. Lightning may be generated in Jupiter's water clouds by a mechanism similar to that which operates in terrestrial thunderstorms. Here we investigate the development of lightning by modelling the thunderstorm separation of electrical charge on precipitating ice particles at varying depths in Jupiter's atmosphere. We find that lightning can indeed be generated in the jovian water clouds, and that--in agreement with estimates from the analysis of Voyager images--it is most likely to occur at the 3- or 4-bar pressure level. Our model also predicts that a condensed-water abundance in the range of at least 1-2 g m-3 is required for lightning to occur in jovian thunderstorms--a prediction that may be tested when the Galileo probe arrives at Jupiter on 7 December 1995.

Electricity↗

Emergent care of lightning and electrical injuries.

High-voltage electrical injuries may be devastating, with extensive burns, cardiac arrest, amputations, and long, complicated hospitalizations. Low-voltage injuries, after other pathologic and high-voltage sources are ruled out, tend to be rather benign acutely although they may have significant long-term morbidity, including chronic pain syndromes. Lightning injuries affect 800 to 1000 persons per year. In lightning injury, cardiac arrest is the main cause of death, burns tend to be superficial, ad injuries often are what one would expect of short-circuiting or overloading the body's electrical systems (tinnitus, blindness, confusion, amnesia, cardiac arrhythmias, and vascular instability). Although high-voltage injuries may require the services of trauma surgeons, in general, therapy for low-voltage and lightning injury is supportive and involves cardiac resuscitation for the more seriously injured and supportive care for the less severely injured. Long-term problems from sleep disturbances, anxiety attacks, pain syndromes, peripheral nerve damage, fear of storms (for lightning patients), and diffuse neurologic and neuropsychologic damage may occur in both electrical and lightning patients. Other sequelae--such as seizures or severe brain damage from hypoxia during cardiac arrest and spinal artery syndrome from vascular spasm--are indirect results of electrical and lightning injury.

Clinical Laboratory Techniques↗

Autonomic nervous system disorders and reflex sympathetic dystrophy in lightning and electrical injuries.

Both lightning and electrical injuries can cause autonomic nervous system (ANS) symptoms and signs (Table 1). Published descriptions of ANS involvement occurring with lightning and electrical injuries are rare. The most often reported neurologic complications of lightning injuries involve the central nervous system. ANS abnormalities have been documented with lightning, although the descriptions are scant. There is a lack of complete clinical information or ANS testing data in these cases. This is usually a result of the transient nature of ANS complications. In electrical injuries, ANS involvement is less well described than for lightning. Electrical injuries can be associated with peripheral nerve damage. As a result of peripheral nerve damage, reflex sympathetic dystrophy (RSD) may occur in patients with electrical injuries. Various treatment strategies for RSD associated with electrical injuries are found in single case reports. This article summarizes ANS involvement, predominantly in lightning injuries, and describes RSD and its treatment, predominantly in electrical injuries.

Autonomic Nervous System Diseases↗

Lightning fatalities on the South African Highveld: a retrospective descriptive study for the period 1997 to 2000.

A review of the Southern Africa medical literature shows a paucity of published data regarding lightning fatalities. The South African Highveld has a lightning ground flash density of 6 to 9 flashes/km/year, with a high incidence of thunderstorm days per year (some 40-70). The Highveld has a largely urban population, many of whom have low socioeconomic status and poor education, housing, and other infrastructures and hence (possibly) are at greater exposure risk. Thirty-eight victims of lightning-related death were identified from the records of the 6 large medicolegal mortuaries on the South African Highveld, serving a population of approximately 7 million, for the period 1997 to 2000. Analysis of the records revealed that 95% of all victims were black, 79% were male, and the average age was 36 years. Lightning strikes occurred from September through to April (normal summer rainfall period), and the most strikes took place in the late afternoon (3:00 pm to 6:00 pm). All except 1 case occurred outdoors. In the autopsy reports, mention was made of singeing of hair in 68% of cases, and mention of damage to clothing was made in 26% of cases. Cutaneous thermal injuries were noted in 34 of the 38 cases, with apparent electrothermal injuries of the feet noted in 4 cases. Fifty-two percent of victims sustained some form of associated blunt-force injury (including abrasions, contusions, etc). Specific keraunopathologic injuries were described in only 2 of the cases. Twenty-one cases had some form of internal organ injury. This study serves to illustrate the relatively high incidence of lightning strikes in the region and calls for a more systematic and detailed investigative protocol in lightning-related deaths.

Adolescent↗

Ball lightning burn.

Ball lightning is a rare physical phenomenon, which is not yet completely explained. It is similar to lightning but with different, peculiar characteristics. It can be considered a mix of fire and electricity, concentrated in a fireball with a diameter of 20-cm that most commonly appears suddenly, even in indoor conditions, during a thunderstorm. It moves quickly for several meters, can change direction, and ultimately disappears. During a great storm, a 28-year-old man and his 5-year-old daughter sustained burn wounds after ball lightning came from the outdoors through a chimney. These two patients demonstrated signs of fire and electrical injuries. The father, who lost consciousness, sustained superficial second-degree burn wounds bilaterally on the zygomatic area and deep second-degree burn wounds on his right hand (total body surface area, 4%). His daughter demonstrated superficial second-degree burn wounds on the left part of the face and deep second-degree and third-degree burn wounds (total body surface area, 30%) on the left neck, both upper arms, and the back. In this article, the authors report the first two cases of burn injuries resulting from ball lightning contact indoors. The literature on this rare phenomenon is reviewed to elucidate the nature of ball lightning. Emphasis is placed on the nature of injuries after ball lightning contact, the therapy used, and the long-term complications.

Adult↗

Laboratory-scale evidence for lightning-mediated gene transfer in soil.

Electrical fields and current can permeabilize bacterial membranes, allowing for the penetration of naked DNA. Given that the environment is subjected to regular thunderstorms and lightning discharges that induce enormous electrical perturbations, the possibility of natural electrotransformation of bacteria was investigated. We demonstrated with soil microcosm experiments that the transformation of added bacteria could be increased locally via lightning-mediated current injection. The incorporation of three genes coding for antibiotic resistance (plasmid pBR328) into the Escherichia coli strain DH10B recipient previously added to soil was observed only after the soil had been subjected to laboratory-scale lightning. Laboratory-scale lightning had an electrical field gradient (700 versus 600 kV m(-1)) and current density (2.5 versus 12.6 kA m(-2)) similar to those of full-scale lightning. Controls handled identically except for not being subjected to lightning produced no detectable antibiotic-resistant clones. In addition, simulated storm cloud electrical fields (in the absence of current) did not produce detectable clones (transformation detection limit, 10(-9)). Natural electrotransformation might be a mechanism involved in bacterial evolution.

Culture Media↗

Lightning-associated injuries and deaths among military personnel--United States, 1998-2001.

After flooding, lightning is the second leading cause of weather-related death in the United States; approximately 300 injuries and 100 deaths are associated annually with lightning strikes in the United States. To characterize lightning-associated injuries and deaths among U.S. Armed Forces personnel, the U.S. Army and CDC analyzed data from the Defense Medical Surveillance System (DMSS). This that the highest lightning-related injury rates during 1998-2001 occurred among male U.S. military members who were aged <40 years, single, with a high school education or less, stationed near the Gulf of Mexico or the East Coast, and in the U.S. Army. The findings suggest that the risk for lightning-associated injury depends primarily on the frequency, timing, duration, and nature of outdoor exposure to thunderstorms. Military personnel should be aware of severe weather onset and take reasonable precautions to protect themselves and their companions from exposure to lightning.

Female↗

Deaths caused by lightning.

Though a rare cause of death, lightning is reported to be responsible for more fatalities each year in this country than any other type of natural disaster. Lightning injuries differ significantly from other high voltage electrical injuries because of the high current flow, but extremely short duration, of the lightning stroke. We present a series of cases over the period of 1985 to 1991 in Cook County, Illinois in which lightning was the direct cause of death. Our discussion reviews the nature of lightning, the effects it may have on humans, and the ways in which deaths due to lightning might be prevented.

Adolescent↗