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PubMed1987

Fatal injuries in the construction industry in Washington State.

Two hundred thirty-one deaths occurred in the construction industry in Washington State between 1973 and 1983, an average annual mortality rate of 27.5 per 100,000 workers. Falls, cave-ins, and electrocutions resulting from heavy equipment (boom type) contacting overhead power lines together accounted for 45.4% of the fatalities. Heavy construction had a death rate twice that of the other two construction subgroups (building and special trades construction). There was a significant trend towards increasing mortality with decreasing company size (p = 0.03). Drilling machine operators, welders, flamecutters, reinforcing-iron workers, and heavy-equipment operators had the highest proportionate mortality ratios (PMRs). PMRs for workers generally increased with age. Many of these fatal construction injuries would not have occurred had existing safety regulations been observed.

Accidents, Occupational↗
PubMed1991

Work-related deaths in children.

An analysis of OSHA fatality investigations for 1984-1987 found 104 work-related deaths in children. The largest category (30%) involved industrial vehicles and equipment, followed by electrocution (17%) and falls (11%). Forty-three deaths (41%) occurred while engaged in types of work prohibited for children by the Fair Labor Standards Act (FLSA). Three deaths involved work with conveyors, an activity currently permitted for child workers under FLSA. OSHA issued citations for safety violations in 70% of deaths. Since OSHA investigates only some work-related deaths, the actual number of child labor fatalities during the four year period was probably higher. Using information from OSHA and from death certificate data, we estimate that there are at least 100 work-related deaths in the United States in children under 18 each year. Hazardous child labor continues to occur even in industries regulated by OSHA and FLSA.

Accidents, Occupational↗
PubMed2003

Tongue tremor in a patient with coma after electrical injury.

We report on the case of a patient with transient tongue tremor and coma after electrical injury, probably due to a reversible brainstem dysfunction. We then reviewed the differential diagnosis of abnormal involuntary movements of the tongue as well as movement disorders related to electrocution.

Accidents, Occupational↗
PubMed1975

[Medical opinions on fatal auto-erotic accidents for insurance purposes (author's transl)].

The problematic nature of medico-legal opinions on fatal auto-erotic accidents made for private accident insurance companies is outlined in a survey based on our own records. Taking the "General Insuranc Terms for Accident Insurance" (AUB) into consideration, guidelines for the forming of such opinions are given. One is warned not to form summary opinions. Decisive is the insured's state of conciousness when the accident was triggered. Only in exceptional cases can an insurance covered accident be rejected because of a body injury inflicted by the insured on himself (see article). These actions do not usually result in external injury to the body. Experience proves that "ideal conditions" for forming an opinion are rarely given. Also, the nature of the death situation is such that often the corpse is discovered only days after death. From the outset, forming a medical opinion is beset with varying degrees of difficulty depending upon which category of auto-erotic activities the accident falls into: 1. direct stimulation of the erotic regions, 2. stimulation of sexual centers in the central nervous system, 3. the creation of fear and anguish in the context of masochistic perversion. According the presently valid insurance terms (AUB), cases of auto-erotic electrocution are to be regarded as covered. A disturbance of consciousness--with the exception of such disturbances following the influence of alcohol, medicines or narcotics--cannot be assumed for the moment in which the accident was triggered. At this moment body "integrity" was also intact. Accidents through strangulation, respectively asphyxiation (plastic bags etc.), usually occur during a disturbance of consciousness of the victim. This disturbance is the result of cerebral hypoxia, that is a result of strangulation, respectively external respiratory obstruction. The forming of a medical opinion for insurance purposes on auto-erotic accidents with clearly recognizable masochistic tendency is particularly difficult. A medical decision is only possible when an exact examination and description of the scene of the accident are available. In these instances, mechanical devices rigged by the victim often do not permit with sufficient probability to exclude the possibility of an accident without disturbance of consciousness on the part of the insured.

Asphyxia↗
PubMed1984

Percutaneous antegrade electropapillotomy. Study in dogs.

Antegrade electropapillotomy using the percutaneous transcystic approach was successfully performed in 11 of 16 dogs. When the intervention was effective, the pressure gradient between common bile duct and duodenum decreased from 6 to 1.3 mm Hg on average and returned to gradients slightly below the initial values after 4 weeks, owing to reactivation of the sphincter mechanism. Ineffective cutting, however, resulted in a temporary pressure rise. In one dog a papillary stenosis developed and was relieved by antegrade electrocutting. Irrespective of the success of the papillotomy, rises in levels of serum glutamine oxaloacetic and pyruvic transaminase, alkaline phosphatase, serum amylase and leukocytes were seen. Although the method is technically feasible, its clinical significance is not so much for antegrade papillotomy but rather for transhepatic incision of stenoses after hepaticojejunostomy.

Alanine Transaminase↗
PubMed2007

House sparrows benefit from the conservation of white storks.

As with many farmland bird species, the house sparrow Passer domesticus is declining in Europe, mainly due to intensification of agriculture reducing nest sites and food supplies. During 2002-2005, we studied the population size and nest site characteristics of house sparrows breeding within white stork Ciconia ciconia nests in a large area of agricultural landscape within western Poland. To explain sparrow density within stork nests, we examined characteristics of white stork nests (position, age, productivity) and the farm type around the nest. House sparrow density was greatest in the longest established (and hence larger) white stork nests located on traditionally managed farms. Two recent changes appear to have adverse effects on house sparrows. The first is the intensification of farming and the second is active management of white stork nests on electric poles to reduce nest size and thus avoid both disruption to the electrical supply and electrocution of white storks. Because the white stork has such a high profile in Poland, there are numerous schemes to conserve and enhance this species. In conclusion, we clearly show that protecting one species can have valuable, although unplanned, benefits to another species of conservation interest, the house sparrow.

Aging↗
PubMed2003

Mercury residues in livers of bald eagles (Haliaeetus leucocephalus) found dead or dying in British Columbia, Canada (1987-1994).

Postmortem examinations were conducted on 82 bald eagles (Haliaeetus leucocephalus) found dead or dying in British Columbia, Canada, from 1987 to 1994. As part of the examination, livers were analyzed for total mercury (Hg) content, as well as methylmercury (meHg) and selenium (Se) in selected individuals. In total, 67 eagles were classed as having low Hg exposure [total Hg liver residues ranging from 0.5 to 17.2 mg/kg dry weight (dw)]. Fourteen eagles were moderately exposed (liver residues ranging from 19.2 to 36.8 mg/kg Hg dw). One eagle was judged to have died of Hg poisoning, with a total liver Hg content of 130.3 mg/kg dw, of which approximately 77% was meHg. The poisoned eagle and most of the exposed eagles were found in locations where effluent from pulp and paper processing plants is discharged along the British Columbia coast. In total, 6% of eagles examined died as a result of acute metal toxicosis (one from Hg poisoning, four from lead poisoning), in comparison to 72% dying from trauma (electrocution, vehicle/power line collision, eagle attack, trap, gunshot, drowning, and asphyxiation) and 11% from disease. The cause of death was undetermined in the remaining 11% of eagles.

Animals↗
PubMed2000

Immunohistochemical expression of E-selectin in sepsis-induced lung injury.

The vascular endothelium controls leukocyte extravasation into tissue by the induction and modulation of endothelial cell adhesion molecules, such as E-selectin (CD62E). E-selectin is not expressed by non-stimulated endothelium, but is activated by cytokines and initiates neutrophil recruitment in sepsis-induced lung injury. The aim of the present study was to assess the value of the immunohistochemical expression of endothelial E-selectin for the post-mortem differentiation between death due to sepsis and death due to other causes. The immunohistochemical expression of E-selectin was investigated in lung specimens obtained at autopsy from sepsis-associated fatalities (n = 6), possible sepsis-associated fatalities (n = 7), non-sepsis group I (death due to unnatural causes, e.g. trauma, electrocution, drowning, hanging n = 17) and non-sepsis group II fatalities (death due to natural causes, e.g. myocardial infarction, intracerebral bleeding n = 7). E-selectin was detected in paraffin sections using the ABC technique and the expression was scored semiquantitatively by evaluating the intensity and incidence of positively stained endothelium of the interstitial pulmonary microvasculature. E-selectin was strongly expressed in all cases of the definite sepsis group, in 29% of the possible sepsis-associated fatalities and in only 4% of the cases in the non-sepsis groups I and II. In comparison to all other study groups, E-selectin expression in the definite sepsis group differed significantly (p < 0.05). Cases with inflammatory and mechanical lung tissue alterations from the control groups showed no positive immunohistochemical reaction for E-selectin; therefore, false positive results should not be expected in non-sepsis cases. Our findings suggest that the immunohistochemical detection of an intense expression of E-selectin in lung tissue may prove to be a valuable diagnostic tool in the forensic post-mortem elucidation of death due to sepsis.

Adult↗
PubMed1998

Chemical composition of smoke produced by high-frequency electrosurgery in a closed gaseous environment. An in vitro study.

BACKGROUND: High-frequency (HF) electrocoagulation and cutting procedures produce smoke by high-temperature pyrolysis of tissues. As distinct from the experience of conventional surgery, electrosurgical smoke is produced in a closed gaseous environment during laparoscopic operations. As a result, toxic chemicals may be absorbed into the circulation. The effects of this absorption are not known. Furthermore, the chemical composition of electrosurgical smoke produced in an anoxic environment may be different from that produced in air. METHODS: Smoke was produced in vitro by HF electrocutting of fresh porcine liver in helium, CO2, and air-saturated closed environments. Smoke samples were collected and analyzed by gas chromatography-mass spectrometry (GC-MS). RESULTS: The chemical constituents of electrosurgical smoke produced in air, CO2, and helium were similar. To date, 21 chemicals, some highly toxic, have been identified in the electrosurgical smoke produced in a closed environment. These consist of hydrocarbons, nitriles, fatty acids, and phenols. CONCLUSIONS: Electrosurgical smoke produced in a closed environment contains several toxic chemicals. The effects of these on cell viability, macrophage, and endothelial cell activation are not known but are being investigated. Meantime, measures to reduce smoke and evacuate it during endoscopic surgery are advisable.

Air Pollutants↗
PubMedDate not supplied

Accidental childhood death and the role of the pathologist.

The following study provides an overview of accidental childhood death. This study is based on a review of 369 cases of fatal childhood accidents taken from the records of the Department of Histopathology, Women's and Children's Hospital, Adelaide, Australia, over a 34-year period from 1963 to 1996. Data provide information on deaths due to motor vehicle accidents, drownings, accidental asphyxia, burns, poisonings, electrocution, and miscellaneous trauma. In addition, certain categories have undergone further examination, including asphyxial deaths due to unsafe sleeping environments and unsafe eating practices, drowning deaths, and deaths on farms, following identification of significant child safety problems in these areas as part of the "Keeping Your Baby and Child Safe" program. Previously unrecognized dangers to children detected through this program include mesh-sided cots, V-shaped pillows, and certain types of stroller-prams. The production of information pamphlets and packages for parents and the recall of certain dangerous products following recommendations made by pathologists demonstrate that pediatric and forensic pathologists have an important role to play in preventive medicine issues and in formulating public health strategies.

Accident Prevention↗
PubMed1985

Fatal and nonfatal accidents on the railways--a study of injuries to individuals, with particular reference to children and to nonfatal trauma.

This paper reports a five-year total population study of fatal railroad accidents involving individuals (that is, not including train crashes or derailments); and a consecutive unselected series of nonfatal isolated injuries in Queensland, Australia. There were 84 fatalities and 211 cases of significant nonfatal traumata. Fatal railway accidents involving children under 15 years of age are now more common in Australia than childhood poisonings and electrocutions. Two syndromes occur--(a) toddlers living near the tracks who simply wander onto the line; and (b) young teenage boys who are run down on level crossings, either as pedestrians or cyclists. Adult fatalities include (a) occupational deaths among railway workers (20%), (b) car-train collisions at level crossings (19%), (c) drunk pedestrians who walk into trains (17%), suicides (12%), and old folk who walk into trains (12%). Of 211 nonfatal cases studied, falls in and from both moving and stationary trains were the most common type of accident. Sudden jolting of the train (probably unpreventable) contributed to 26% of all falls. Twenty-two percent of nonfatal accidents resulted from a person being struck by a train. All persons who survived being struck by a train received serious injuries and required hospital admission. Fatalities involving adults include a high proportion of suicides. Some accidents, such as fingers being caught in windows and doors, can and are being overcome through improved design.

Accidents↗
PubMed1995

Electrical injuries: current concepts.

Electrical injuries are often dramatic accidents and are potentially fatal. The systemic involvement which characterizes many of these injuries, requires familiarity with the broad spectrum of clinical manifestations and possible complications. While many victims of electrocution are killed before help can be provided, survivors may suffer severe injuries that need proper treatment. The pathophysiological aspects of electrical injuries and therapeutic principles are therefore discussed in this review as well as preventive measures.

Cardiovascular System↗
PubMed1990

An analysis of pediatric trauma deaths in Indiana.

From June 1986 to May 1988, there were 1,931 childhood deaths recorded in Indiana. Eight hundred six children (0 to 18 years old) died as a result of trauma (41.4% of all deaths). Seventy percent of all traumatic deaths occurred in boys. Blunt trauma accounted for 54% of deaths, asphyxia or drowning 26%, penetrating trauma 15%, electrocution 3%, and burns 1%. Sixty percent of deaths occurred in rural areas and 40% occurred in urban centers; however, state-wide demographics define the population as 70% urban. The percentage of deaths due to trauma within a given race was: hispanic 71%, caucasian 42%, black 35%, and others 50%. However, when deaths occurring in infants less than 30 days of age were eliminated, the percentages changed: hispanics 70%, caucasian 45%, black 45%, and others 50%. Traumatic deaths were 1.6 times as likely to occur during the months of June through October (n = 85 deaths/mo) as opposed to November through May (n = 53 deaths/mo) (P less than .05). Mortality from burns was limited to children less than 5 years of age and penetrating trauma mortality was twice as likely to occur in children over 15 years (10% v 20%). Fifty-two percent of all traumatic deaths in children occurred between 15 and 18 years of age. Major burns account for only 1% of traumatic deaths in this state. Asphyxia and drowning were more common in young children, and blunt traumatic deaths more common in older children. In 1988, the first state-wide accident awareness program was instituted.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1994

Outcome of severe anoxic/ischemic brain injury in children.

The outcome of 25 children who had anoxic or ischemic brain injuries at 2 months to 14 years of age is reported. Follow-up was from 1 to 14 years after injury; causes were near-drowning, 11; suffocation, 7; cardiac arrest, 3; electrocution with cardiac arrest, 2; strangulation, 1; aborted sudden infant death syndrome, 1. All patients were unconscious for at least 24 hours. Of 11 remaining in vegetative states, 5 died. Seven children regained some language skills and are in special education or self-contained classrooms. Seven are profoundly impaired and show only a social smile. Cognitive and motor outcomes were correlated with the severity of injury as indicated by the duration of unconsciousness. All children who regained language skills or the ability to walk were unconscious less than 60 days. Dystonic rigidity was observed in all children who were nonambulatory. Outcome was also correlated with the cause of injury; mortality, cognitive outcome, feeding outcome, and duration of unconsciousness were all worse in children with near-drowning.

Adolescent↗
PubMed2005

The use of sentinel injury deaths to evaluate the quality of multiple source reporting for occupational injuries.

PURPOSE: This study sought to develop an efficient method for evaluating the validity and completeness of routinely available sources of occupational injury fatality data. METHODS: Deaths due to falls from elevations, machinery, and electrocutions were selected as sentinel injuries likely to have occurred at work. Deaths from these injuries were identified from Maryland vital statistics over 7 years. The work-relatedness of these injuries and sensitivity of reporting were determined from death certificates, medical examiner reports, the National Traumatic Occupational Fatality System (NTOF), the Maryland Occupational Safety and Health Administration (MOSH), and Workers' Compensation (WC) data. RESULTS: A total of 527 deaths were identified for ages 16 and above, of which, 45% were work-related. Identification of work-related deaths varied by source: medical examiner (100%), death certificates (89%), NTOF (68%), MOSH (59%), and WC (44%). Reporting differed by age, cause of injury, year, occupation, and industry. CONCLUSIONS: Examination of work-relatedness for deaths from certain causes is an efficient means of evaluating the quality of occupational injury reporting source data. These sentinel injuries uncovered significant underreporting in sources used by national surveillance systems, resulted in improved NTOF reporting, and suggest the need to make more use of medical examiner data when available.

Accidents, Occupational↗
PubMed2005

Application of atomic absorption spectroscopy for detection of multimetal traces in low-voltage electrical marks.

Application of atomic absorption spectroscopy to detect multimetal traces in injured skin is a promising tool for investigation of fatalities caused by electrocution. The present paper is aimed at testing the reliability of this method for metal traces detection in electric current marks and is focused on study of peculiarities of metal penetration into the skin exposed to a current impact. Bare aluminum wire, tin-lead coated copper multistrand wire, and zinc-plated steel rope were used to make electrical marks on pig skin. It is demonstrated that amount of copper, zinc, lead, and iron may serve as statistically reliable indicators for the type of wire, which caused the electrical mark, in spite of the background content of these metals in the skin without injury. Different penetration rates for different metals contained in the wire inflicting an electrical mark were observed.

Animals↗
PubMed2005

Myocardial disarray: an architectural disorganization linked with adrenergic stress?

BACKGROUND: Myocardial disarray is a structural abnormality found in specific zones of the normal heart. In some conditions, such as hypertrophic cardiomyopathy (HCM), its occurrence represents a pathological process leading to myocardial asynergy. The incidence of "pathological" myocardial disarray in humans is still not known. It has been suggested that a link exists between adrenergic overactivity and myocardial disarray. The aim of the present study is to compare heart findings in conditions with and without chronic sympathetic overtone for evidence of possible linkage in humans. MATERIALS AND METHODS: A total of 340 hearts were studied. They were divided into seven groups: sudden/unexpected coronary death; sudden/unexpected death in silent Chagas' disease; brain haemorrhage following berry aneurysm rupture; transplanted hearts; congestive heart failure, AIDS and cocaine abuse. Findings in these hearts were compared with anatomic changes in 92 control hearts, where the decedent had died from head trauma, electrocution, or carbon monoxide intoxication. The frequency and presence of myocardial disarray were recorded and correlated to heart weight, extent of myocardial fibrosis, and contraction band necrosis (CBN). RESULTS: Hearts from patients with conditions that increased sympathetic tone showed an association of myocardial disarray and contraction band necrosis without any relationship to heart weight. CONCLUSIONS: Myocardial disarray was observed in cardiac areas where it is not found normally. It was associated with adrenergic myocardial stress morphologically expressed by a higher number of foci (p<0.01) and myocells (p<0.001) with CBN versus findings in normal subjects. The condition deserves further study as a possible myocardial asynergic and arrhythmogenic factor especially in sudden/unexpected death.

Adrenocortical Hyperfunction↗
PubMed2003

Deaths in construction related to personnel lifts, 1992-1999.

PROBLEM: This study examined deaths of construction workers due to personnel lifts (boom-supported and scissor lifts, suspended scaffolds, and crane platforms). METHODS: Deaths of construction workers for 1992-1999 were examined using data from the Census of Fatal Occupational Injuries, a Bureau of Labor Statistics database. RESULTS: The study identified 339 deaths: 42% from boom-supported lifts; 26% from suspended scaffolds; 19% from scissor lifts; 5% from crane platforms; and 7% from unapproved lifts (e.g., forklift platforms). The main causes of death were falls (36%), collapses/tipovers (29%), and electrocutions (21%). DISCUSSION: Recommendations include: following OSHA regulations, wearing personal fall protection equipment, adequate maintenance, inspection before use, and training on the model of lift used. Precautions are also needed to prevent contact with overhead power lines. IMPACT ON INDUSTRY: The increasing popularity of boom-supported lifts and scissor lifts, both in construction and other industries, make their safety an important issue.

Accidents, Occupational↗