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PubMed2002

Accidental injuries in agriculture in the UK.

The rate of occupational accidents in British agriculture is higher than in most other industries. The most common fatal accidents are those involving vehicles and machinery, falls from a height and electrocution. A substantial proportion of reported non-fatal injuries in agricultural employees is attributable to manual handling, but among self-employed farmers the contribution is much smaller. Few data are available on longer-term determinants of risk, but accidental deaths are most frequent in July, August and September. The main approaches to preventing agricultural accidents are through engineering improvements, and education and training of the workforce. The introduction of roll-over protection structures for tractors has been an important development in recent decades. Other engineering controls include guards for power take off shafts, guard rails to prevent falls, better handling facilities for animals and closed transfer systems for pesticides. Training on safety is available from several sources, but its effectiveness in reducing accidents is uncertain.

Accidents, Occupational↗
PubMed1995

Injury mortality among Iowa farmers, 1980-1988: comparison of PMR and SMR approaches.

State and provincial proportional mortality studies in the United States and Canada have found increased ratios of overall injury mortality among farmers, including occupational injuries and other unintentional injuries, such as those from motor vehicle crashes and fires, as well as suicides. In contrast, Scandinavian standardized mortality (morbidity) studies have found no increase in the injury fatality or morbidity ratios of farmers in comparison with the rest of the population. This study reviews the injury mortality of Iowa farmers for the years 1980-1988. Among white male farmers, we found an increased proportional mortality ratio for all injuries of 1.26 (95% confidence interval (CI) 1.21-1.31). In part, this was a result of the increased proportional mortality ratio for at-work injuries of 3.77 (95% CI 3.35-4.24), but there were also elevated proportional mortality ratios for such nonoccupational injuries as suicides, 1.20 (95% CI 1.09-1.32), motor vehicle crashes, 1.23 (95% CI 1.12-1.34), and electrocutions, 1.78 (95% CI 1.08-2.95). For younger farmers aged 20-64 years, we calculated standardized mortality ratios as well. The standardized mortality ratios were generally within 10% of the proportional mortality ratios, which suggests that the differences between North America and Scandinavia are not the result of methodological differences, but are more likely related to differences in environmental exposures and safety practices.

Accidents, Occupational↗
PubMed2000

Influence of flooring type during transport and holding on bacteria recovery from broiler carcass rinses before and after defeathering.

Four trials were conducted to determine whether conventional solid or elevated wire mesh flooring, during transport and holding of broilers prior to slaughter, influenced the number of bacteria recovered from feathered and defeathered carcasses. After 4 h off feed, 7-wk-old broilers were placed at commercial density into a modified commercial transport dump-coop on either fiberglass sheeting or 2.54x2.54 cm wire mesh flooring that allowed feces to fall through. Broilers were transported for 1 h and then held for 13 h under a covered shed before processing. Broilers were killed by electrocution, and the vents were plugged to prevent escape of feces. External carcass rinses were obtained twice (from the same carcass) from eight broilers per flooring treatment per trial, before scalding and defeathering and again after defeathering and removal of the head and feet. Greater numbers of total aerobes, coliforms, and Escherichia coli were recovered from feathered carcasses than from defeathered carcasses. Campylobacter count was also less for defeathered than feathered carcasses from the solid flooring treatment but did not significantly decrease following defeathering of carcasses from the wire flooring. The incidence of Campylobacter-positive carcasses was reduced following defeathering for both flooring treatments, but the percentage of Salmonellae-positive carcasses remained constant. Coliform (log10 6.20 vs. 5.63 cfu/mL of rinse) and E. coli (log10 5.93 vs. 5.36) counts in the feathered rinses were significantly higher for the solid flooring compared with wire flooring, respectively. After defeathering, the number of coliforms (log10 3.12) and E. coli (log10 2.91) recovered did not differ between flooring treatments. Aerobic plate count (log10 7.06 and 4.02), Campylobacter count (log10 2.49 and 1.80), and the incidence of Campylobacter-positive (44 and 11%) and Salmonellae-positive (52 and 50%) carcasses for feathered and defeathered rinses, respectively, did not differ between flooring treatments. These results indicate that although broilers transported and held on solid flooring had noticeably dirtier breast feathers and higher coliform and E. coli counts prior to scalding and defeathering, bacteria recovery from external carcass rinses did not differ between the solid and wire flooring treatments after defeathering.

Animals↗
PubMed2000

Unappreciated agenesis of cerebellum in an adult: case report of a 38-year-old man.

An unexpected finding at autopsy of almost complete agenesis of the cerebellum in an apparently functional, mentally subnormal 38-year-old man who died as the result of an accidental electrocution is reported. The posterior fossa was normal in appearance despite nearly complete absence of the cerebellum. A number of syndromes of cerebellar atrophy or dysgenesis have been reported, but congenital agenesis is considered a very rare condition. It does not resemble most common cerebellar malformations or acquired conditions, especially in an adult, who apparently had reasonable motor and coordinative function. The relevant literature is reviewed.

Adult↗
PubMedDate not supplied

Infant monitoring resulting in burns-tissue damage: literature review and case report.

Noninvasive infant monitoring occasionally results in burns and tissue damage. The medical literature now contains 14 isolated reports that were summarized for this review. All 14 victims were less than 24 months of age, and of these 14, two died by electrocution. Burns and tissue damage resulted from infant respiratory monitors (six), pulse oximeters (four), electrocardiographic monitors (two), an anal myoneural junction monitor (one), and a fetal scalp monitor (one). Infant extremities were injured most often (40%), and the trunk was burned somewhat less frequently (23%). Infants were burned in the hospital (57%) only slightly more often than at home (43%). Household burns involved only infant cardiorespiratory monitors. The most common mechanism of injury was the misapplication or improper connection of electrode lead wires (57%). A full one third of infants with burns required a reconstructive surgical procedure, usually a skin graft. Risk factors related to monitor-induced burns and tissue damage have been identified and presented. Injury prevention principles are also outlined.

Burns, Electric↗
PubMedDate not supplied

Auditory and neuropsychiatric behavior patterns after electrical injury.

Major electrical injury causes widespread tissue destruction. Slow and incomplete functional recovery after electrocution-type injury has led clinicians to suspect residual brain damage. One hundred and one consecutive patients who were admitted to the hospital because of electrical injury were studied. Forty-eight had electric-current injury. The other 53 had flash, contact, or arcing burns (electrical injury without passage of current). A primary study cohort of 16 patients with electric-current injury and 18 patients who had electrical injury without passage of current received specialized trauma-based psychiatric treatment, which was coordinated with serial auditory and neurologic studies. This strategy served to highlight discrepancies between preinjury and postinjury performance. Twelve of 16 patients with electric-current injury showed neurobehavioral (organic) dysfunction after 1 year, which implied brain damage; eight showed persistent auditory changes. Four of 18 patients who had electrical injury without passage of current met criteria for post-traumatic stress disorder after 1 year; none had neurobehavioral or auditory dysfunction. These findings indicate that patients with electric-current injury are at risk for permanent auditory dysfunction and brain damage, whereas those with other types of electrical burns are not.

Adult↗
PubMed1998

Questioning the chains of habit.

This paper could also be titled, "Fortunately, I Was Not Electrocuted." Dr Winslow candidly discusses her bathing and toileting research as well as her more recent research. Because she believes that failure is a good teacher, she describes her blunders as well as her accomplishments. In addition, she provides criteria helpful in selecting a good clinical problem for study and stresses the importance of identifying and investigating nursing rituals. Approaches that enhance the likelihood of success in research, public speaking, publishing, and in life are also shared.

Cardiovascular Diseases↗
PubMed1980

Effects of laser, scalpel, and electrosurgical excision on wound contracture and graft "take".

Current literature recommends the use of a carbon dioxide laser for excision of lesions where minimal damage and wound contracture are desirable. The extent of tissue damage is evaluated as a correlate of percentage of split-thickness skin graft "take" following excision of full-thickness skin with scalpel, electrocutting current, or carbon dioxide laser. The poorest overall percentage "take" is apparent following laser excision, while the highest overall percentage "take" occurs following scalpel excision. Wound contracture, an inherent part of wound healing, is reportedly minimal or clinically inapparent with laser excision. On the contrary, this experimental evaluation suggests that wound contracture following laser excision is at least as great if not greater than that following other methods of excision when a split-thickness skin graft is applied to the wound bed.

Animals↗
PubMed1995

Residual problems in chest donor sites after microtia reconstruction: a long-term study.

The rib cartilage has been the most popular autogenous tissue for microtia reconstruction. In this study, 88 chest donor sites were evaluated in 80 patients examined in the outpatient clinic at least 1 year after tissue removal. Microtia reconstruction usually was initiated between the ages of 2 and 3 years (42 percent), at which time an axial half of the sixth rib was harvested along with all of the seventh and eighth rib cartilages with their attached perichondrium. During this procedure, there were 19 uneventful pleural perforations (22 percent), and early in the series, 2 patients (2 percent) required a chest tube. Postoperative atelectasis without evidence of pneumothorax occurred in 7 patients (8 percent). Chest scars were classified by impartial observers as excellent (25 percent), good (33 percent), acceptable (28 percent), and poor (14 percent). Better scars were experienced in the cold-knife group than in incision by electrocutting. The younger group and the longer postoperative interval group showed better chest scars. Chest topography deformities were rated as normal (75 percent), mild retrusion (19 percent), and severe retrusion (6 percent). Costal margin contours improved as the postoperative interval lengthened.

Adolescent↗
PubMed1994

Injury hazards in the construction industry.

Although many occupational injury studies have been conducted on the construction industry, fatal injuries and lost work time injuries in this industry continue to rank among the highest in the nation. This paper presents an analysis of nonfatal (1981 through 1986) and fatal (1980 through 1989) traumatic occupational injuries in the construction industry using the Supplementary Data System and the National Traumatic Occupational Fatalities data bases. The lost workday case rate in construction was 10.1 per 100 full-time workers, which was nearly 2.5 times the occupational injury rate for all industries combined. The construction industry had an overall fatality rate of 25.6 per 100,000 full-time workers. This rate was more than 3.5 times the occupational fatality rate for all industries in the United States for the same period. To prevent occupational injuries and fatalities in the construction industry, intervention measures need to target specific occupations: machine operators, transportation workers, and crafts-people. Intervention measures also need to target such causes of injury as falls, electrocutions, and motor vehicle incidents.

Accidental Falls↗
PubMed1997

Risk differences in fatal occupational injuries among construction laborers in the United States, 1980-1992.

Over 3700 occupational fatalities among all US construction laborers 16 years of age and older during 1980-1992 were analyzed from death certificates to identify differences in mortality rates, higher risk groups, and leading causes of death to be targeted for prevention and monitored over time. Female laborers had an average fatality rate (17.4 deaths/100,000 workers) similar to that for all male construction workers (17.3 deaths/100,000 workers), and ten times higher than for all female construction workers. On average, nonwhite laborers had 27% greater mortality than white laborers. Women were at a higher risk (10.8 deaths/100,000 workers) for motor vehicle injury than were men (6.1 deaths/100,000 workers). The smallest percentage annual decline in cause-specific mortality rates was from motor vehicle for construction laborers (0.1%) and all construction workers (1.4%). Environmental-related fatality rates for laborers rose an average of 0.8% annually. The average years of potential life lost (to age 65) ranged from 27.4 years from explosion to 34.3 years from electrocution. Prevention measures aimed at addressing the highest risk areas, along with research needs, are discussed. With over a quarter of construction fatalities occurring among laborers, occupational injury research on laborers should become a priority.

Adolescent↗
PubMed1999

Fatal harmful substances or environmental exposures in agriculture, 1992 to 1996.

Data from the Census of Fatal Occupational Injuries surveillance system from 1992 through 1996 were analyzed to allow a better understanding of exposures to harmful substances or environments that resulted in agricultural work fatalities. There were 357 fatalities as a result of these exposures in the agriculture production and agriculture services sectors, representing 10% of all work-related deaths that occurred in these industry sectors during this period. Contact with electric current represented 52.9% of these fatalities. Agricultural services reported 87 electrocutions, 50 of which occurred among tree trimmers. The events most likely to result in fatalities were contact with overhead power lines (26.3%) and drowning (17.1%). The overall fatality rate was 2.1 deaths per 100,000 workers. The development of appropriate hazard-awareness training for workers, such as that for electrical and drowning-related hazards, may help prevent future deaths in these industry sectors.

Accidents, Occupational↗
PubMed1999

Fatal injuries in the United States construction industry involving cranes 1984-1994.

There is little published information concerning the epidemiology of injuries in the construction industry involving cranes other than for electrical injury from power line contact. For the 11-year period of 1984 through 1994, the US Occupational Safety and Health Administration (OSHA) investigated 502 deaths in 479 incidents involving cranes in the construction industry. Electrocution was the largest category, with 198 deaths (39%) reported. Other major categories were assembly/dismantling (58 deaths, 12%), boom buckling (41 deaths, 8%), crane upset/overturn (37 deaths, 7%), and rigging failure (36 deaths, 7%). The majority of the deaths during assembly/dismantling involved removal of the boom pins from lattice boom cranes. Only 34% of the construction firms employing the fatally injured workers had ever been inspected by OSHA. OSHA cited the employer for safety violations in 436 deaths (83%). Additional worker training, increased OSHA inspections, and crane inspection programs could prevent many crane-related deaths.

Accidents, Occupational↗
PubMed2000

Fatal occupational injuries in a new development area in the People's Republic of China.

Fatal occupational injuries in a new development region in Shanghai in east China are described. All occupational deaths in the East Pujiang New Area during the period 1991 through 1997 were abstracted from multiple, overlapping source documents. There were 426 deaths and a crude mortality rate of 9.1 per 100,000 workers. The death rate was highest in 1995 (14.6%), when expansion in the area was most rapid. The construction sector accounted for 55% of the deaths, followed by manufacturing (23%) and transport, storage, and telecommunications (11%). Falls, collisions, struck by/against incidents, and electrocutions accounted for 80% of all deaths. Falls led all other causes of deaths (33%) and were particularly prevalent in the construction industry (46% of all deaths in construction). The development of ongoing, comprehensive injury surveillance systems in the People's Republic of China will be essential to target and evaluate injury prevention activities in the future.

Accidents, Occupational↗
PubMed2001

Bilateral posterior shoulder dislocation: the importance of the axillary radiographic view.

Whilst posterior shoulder dislocation is rare, it remains a frequently missed diagnosis. In all patients with a history of seizure, electrocution or similar trauma, where external rotation of the shoulder is limited, we recommend that an axillary or modified axillary view be added to the standard two radiographic shoulder views as routine protocol, to avoid missing a posterior dislocation.

Accidents, Occupational↗
PubMed2003

Death during theft from electric utilities.

Utilities that supply power are subject to theft of service and theft of hardware used to provide service. Individuals who try to steal from a power utility risk electrocution. We conducted a retrospective study of all individuals examined by the Jefferson County Coroner Medical Examiner Office from January 1981 through December 2001 and found that 8 individuals died trying to steal from a power utility. All decedents were men, with an average age of 33 years. Seven decedents were stealing copper, and 1 was stealing electricity. Only 1 decedent survived long enough to be admitted to a hospital. Five decedents were intoxicated, 3 with ethanol, 1 with cocaine, and 1 with both cocaine and ethanol. Seven decedents sustained electrical burns in keeping with the high voltage to which they were subjected. The unburned decedent died of laceration of the aorta at its origin from the heart, an injury sustained when the decedent fell from the power pole. All 8 decedents attempted their theft during daylight. Items found in the decedent's pockets, the presence of a ladder nearby, or the presence of electrical tools around the body may help to establish the attempted act of theft.

Adolescent↗
PubMed2005

Atypical autoerotic death: part II.

Autoerotic fatalities encompass a wide array of means and mechanisms used to attain sexual gratification. The most commonly encountered autoerotic practice, specifically, autoerotic asphyxia, denotes death resulting from failure of a release mechanism of the apparatus designed to attain cerebral hypoxia for heightened arousal. Historically, the majority of victims of autoerotic death are Caucasian males under the age of 30. While autoerotic death is most often associated with a constrictive cervical ligature tied to either other parts of the victim's body or to an inanimate object such as a door, several other methods have been reported. These modalities include ligature around the thorax or abdomen, plastic bags covering the face, electrical current, inhalation of a toxic gas or chemicals, or partial or total submersion, known as aquaerotic asphyxiation. This study highlights 11 cases of atypical autoerotic death, including asphyxia with a plastic bag, electrocution, and inhalation of butane and nitrous oxide (N2O). Whereas the manner of death in the majority of autoerotic death cases is deemed accidental, we present and analyze unique and equivocal cases representing 4 different manners of death: accident, natural, suicide, and homicide. The 11 victims were all Caucasian and between the ages of 17 and 55. Ten decedents were males, 1 female. A comprehensive investigation incorporating a thorough scene analysis, gathering of the victim's history, and complete postmortem examination is necessary to elucidate both the cause and manner of death in these atypical cases.

Adolescent↗
PubMed2005

A 25-year retrospective review of deaths due to pediatric neglect.

Neglect, defined as the failure of a caregiver to adequately provide safety, food, clothing, shelter, education, protection, medical/dental care, and supervision for a child in his/her care, is a relatively uncommon but important cause of child mortality. A retrospective review of pediatric deaths (age 18 years or less) referred to the Medical University of South Carolina Forensic Pathology Office for autopsy over the past 25 years revealed 16 deaths due to some type of pediatric neglect. Cases were analyzed as to age, sex, race, cause and manner of death, autopsy findings, ancillary studies, past medical history, social/family history, and caregiver. Six cases of malnutrition/starvation and/or dehydration were identified, composing the most common cause of death in the neglect cases identified and the majority of the homicides due to neglect. Other deaths in which neglect contributed significantly included toxic ingestions (2 cases), hyper-/hypothermia (2 cases), unusual drowning/aspiration (4 cases), electrocution (1 case), and delayed/absent medical therapy (2 cases, including one of the previously mentioned ingestions). Of these additional cases, 7 were certified as accidental manner, 2 as natural, and 1 as a homicide. Cases which fell into a "gray zone" in which the appropriateness of invoking neglect was a matter of opinion or societal convention were excluded from the review; examples included conventional accidental drowning, choking on food or aspiration of foreign body, overlying/wedging during sleep, accidental hanging, and motor-vehicle traffic accidents (pedestrians, unrestrained passengers). The findings of this review reinforce the fact that malnutrition/starvation and dehydration compose the most common form of lethal pediatric neglect while highlighting less common forms of neglect and the difficulty of determining manner of death in cases in which neglect plays a more questionable role than in seemingly clear-cut malnutrition/starvation and dehydration cases. We demonstrate the typical victim and scenario that investigators will encounter in cases of fatal pediatric neglect, often a child under the age of 1 year who has been deprived of food and/or drink for some time, or an older, more independently mobile child who has not been adequately supervised. These children may or may not have a demonstrable prior history of maltreatment or (nonfatal) neglect, and review of medical records is an important part of the investigation. We additionally discuss key gross autopsy findings, appropriate specimen collection, helpful ancillary studies, microscopic findings of significance, potential mimickers of neglect, and other special considerations in cases of pediatric neglect.

Cause of Death↗