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Forensic Science, Medicine, and... Jun 2019To describe the technical characteristics of fatal diving mishaps and to elucidate the causes of death using a sequence analysis and a multidisciplinary investigation of...
To describe the technical characteristics of fatal diving mishaps and to elucidate the causes of death using a sequence analysis and a multidisciplinary investigation of diving-related fatalities. All cases of diving deaths recorded on the coast of Girona (Spain) between January 2009 and May 2018 were analyzed. Most data were obtained from the police technical reports and the forensic pathology service. Each accident was analyzed in order to identify the trigger, disabling agent, disabling injury, and cause of death. During the study period 25 diving-related fatalities were recorded. Most of the victims were males aged 50-69 years, and 11 were experienced divers. Almost all victims were using open-circuit SCUBA to breathe with compressed air as their sole gas supply. None of the victims were diving alone. The most common identified triggers included exertion, panic, buoyancy problems, disorientation and confusion. The main factors identified as disabling agents were rapid ascent, a cardiac incident, panic and entrapment. Asphyxia, lung over expansion, and myocardial ischemia were the most frequent disabling injuries. Finally, drowning represented the main cause of death, followed by arterial gas embolism and natural causes or internal diseases. A differential diagnosis, performed in the setting of a multidisciplinary investigation, is essential for elucidating the cause of death in diving-related fatalities. The proposed sequence analysis allows to clarify underlying problems in these cases and to identify risk factors and unsafe behaviors in diving.
Topics: Accidents; Adult; Age Distribution; Aged; Asphyxia; Barotrauma; Confusion; Diving; Drowning; Embolism, Air; Female; Humans; Lung Injury; Male; Middle Aged; Myocardial Ischemia; Panic; Physical Exertion; Pulmonary Edema; Sex Distribution; Young Adult
PubMed: 30915609
DOI: 10.1007/s12024-019-00109-2 -
Environment International Oct 2023Future warming is projected to increase the heat-related mortality burden, especially for vulnerable populations. However, most previous studies focused on...
BACKGROUND
Future warming is projected to increase the heat-related mortality burden, especially for vulnerable populations. However, most previous studies focused on non-accidental morbidity or mortality, with far less research on heat-related accidental events.
METHODS
We collected individual accidental death records among all residents in Chinese mainland from June to August during 2013-2019. Accidental deaths were further divided into several subtypes by different causes. We used an individual-level, time-stratified, case-crossover study design to estimate the association between daily mean temperature and accidental deaths, and estimate its variation in seven geo-climatic zones, age (5-64, 65-74, ≥75), and sex (male, female). We then estimated the temperature-related excess accidental deaths under global warming scenarios of 1.5, 2, and 3℃.
FINDINGS
A total of 711,929 accidental death records were included in our study. We found that higher temperatures were associated with increased risks of deaths from the total accidental events and four main subtypes, including traffic, falls, drowning, and unintentional injuries. We also found that younger individuals (ages 5-64) and males faced a higher risk of heat-related mortality due to total accidents, traffic incidents, and drowning. For future climate scenarios, even under the 1.5℃ climate change scenario, 6,939 (95% eCI (empirical Confidence Interval): 6,818-7,067) excess accidental deaths per year are attributed to higher summertime daily temperature over mainland China, and the number of accidental deaths would increase by 16.71% and 33.59% under the 2℃ and 3℃ climate change scenarios, respectively. For residents living in southern coastal and northwest inland regions, the projected increase in accidental death is higher.
CONCLUSIONS
This nationwide study confirms that higher summer temperatures are linked to an increased risk of accidental deaths. Younger age groups and males face a higher risk. This indicates that current estimates of the health effects of climate change might be underestimated, particularly for younger populations.
Topics: Female; Humans; Male; China; Climate Change; Cross-Over Studies; Drowning; Hot Temperature; Temperature; Child, Preschool; Child; Adolescent; Young Adult; Adult; Middle Aged; Aged
PubMed: 37778287
DOI: 10.1016/j.envint.2023.108231 -
Critical Care Clinics Jan 2016Trauma continues to be a leading cause of nonobstetric maternal and fetal mortality worldwide. Caring for the pregnant trauma patient requires a systematic and... (Review)
Review
Trauma continues to be a leading cause of nonobstetric maternal and fetal mortality worldwide. Caring for the pregnant trauma patient requires a systematic and multidisciplinary approach. It is important to understand the anatomic and physiologic changes that occur during pregnancy. Accepted trauma guidelines for imaging and interventions should generally not be deviated from just because a patient is pregnant. Focus should be placed on injury prevention and education of at risk patients to decrease the morbidity and mortality associated with traumatic injuries in pregnant patients.
Topics: Accidental Falls; Accidents, Traffic; Cesarean Section; Female; Fetal Death; Fetal Diseases; Humans; Intimate Partner Violence; Patient Care Team; Patient Education as Topic; Pregnancy; Pregnancy Complications; Reproductive Physiological Phenomena; Risk Factors; United States; Wounds and Injuries; Wounds, Penetrating
PubMed: 26600448
DOI: 10.1016/j.ccc.2015.08.008 -
Perspectives in Public Health Jan 2023Drowning deaths are a leading cause of unintentional deaths worldwide. Few studies have analysed the role of meteorology in drowning, and with inconclusive results. The... (Review)
Review
AIMS
Drowning deaths are a leading cause of unintentional deaths worldwide. Few studies have analysed the role of meteorology in drowning, and with inconclusive results. The aim of this work is to analyse the temporal and geographical distribution of deaths by accidental drowning and submersion in Spain over 20 years, and to assess the relationship between accidental drowning and main atmospheric circulation patterns.
METHODS
An ecological study was performed, in which drowning and submersion mortality data from 1999 to 2018, considering demographic variables, were analysed. To study the association with atmospheric circulation we used an ERA5 reanalysis product over the whole European continent and the Climatic Research Unit Time Series (CRU TS) data set.
RESULTS
The annual average rate of deaths by accidental drownings was 11.86 deaths per million of habitants in Spain. The incidence in males was four times higher than in females, and when comparing age groups, the rate in the eldest group was the highest. Unintentional drowning deaths were not equally distributed around the country; the provinces with the highest registered standardized drowning death rates were touristic waterfront provinces either in Eastern Spain or in one of the archipelagos. There was a significant relationship between accidental drowning and meteorological variables during summer months, and drowning deaths were spatially correlated with sea-level pressure over the Mediterranean basin.
CONCLUSION
Although the mortality rate registered a statistically significant decreasing tendency over the studied period, our results must be taken into consideration to improve the prevention strategies in the country since most of these deaths are avoidable.
Topics: Male; Female; Humans; Infant; Drowning; Spain; Cause of Death; Incidence
PubMed: 34284665
DOI: 10.1177/17579139211007181 -
Medicine, Science, and the Law Jul 2022Izmir is a city in Turkey where both tourists and refugees concentrate, making it home to many foreign nationals. In recent years, many refugees have tried to reach...
Izmir is a city in Turkey where both tourists and refugees concentrate, making it home to many foreign nationals. In recent years, many refugees have tried to reach Europe via Izmir and the Aegean Sea. In this study, we examine autopsy reports on foreigners who died in Izmir between 2015 and 2020, and we compare the data with relevant international studies. This study analysed the autopsy reports of foreign nationals in Izmir, in terms of demographic data, date of death, place of death, manner of death, source of death, histopathology and toxicology results and exact cause of death. A total of 9951 autopsies were performed between 2015 and 2020 in Izmir, of which 538 (5.4%) were on foreign nationals. Of the autopsy cases in our study, 55.4% were performed on males and 44.6% were performed on females; 32.5% of the cases died between the ages of 0 and 10 years. Syrian nationals comprise 29.7% of the total cases. Of the autopsies of Syrian nationals, 80% died between the ages of 0 and 10. The cause of death was determined to be drowning in 42.4% of all cases. Information gathered from autopsies performed on foreign nationals can contribute to an understanding of the common problems of refugees, which can aid in the alleviation of some migration issues by drawing attention to the mass deaths of refugees in the Aegean Sea, the health problems experienced by children during their journey, and the deaths of refugee children.
Topics: Autopsy; Child; Child, Preschool; Drowning; Emigrants and Immigrants; Female; Humans; Infant; Infant, Newborn; Male; Refugees; Turkey
PubMed: 35164581
DOI: 10.1177/00258024221079100 -
Journal of Nippon Medical School =... Mar 2022In Japan, deaths in bathtubs or bathtub deaths are frequently investigated as unnatural deaths. About 19,000 bathtub deaths occur annually in Japan. This pattern of...
In Japan, deaths in bathtubs or bathtub deaths are frequently investigated as unnatural deaths. About 19,000 bathtub deaths occur annually in Japan. This pattern of death has become a social issue in forensic pathology and emergency medicine and public health. It is assumed that the death of an adult by drowning in a bathtub cannot be avoided due to disturbance of consciousness. The PubMed database was used for literature search using the retrieval words, "bathing "OR" bathtub "AND" submersion "OR" drowning "OR" death "OR" cardiopulmonary arrest". From the epidemiological characteristics and pathophysiological findings of bath mortality in Japan, three etiologies of impaired consciousness have been proposed: acute ischemic heart failure, heatstroke, and blood pressure fluctuation. Moreover, other causes such as epilepsy and alcohol or drug intake cannot be ignored as potential risks for death in a bathtub. It is also important to note the possibility of suicide and, although extremely rare, homicide in a bathtub. Despite research, the exact causal relationship between bathtub bathing and death remains unclear. Further, the cause of death by postmortem investigation is not always easily determined. Hence, it is desirable to carry out a field survey of causes of death, including bathing conditions, and, wherever possible, a complete autopsy survey. An exclusion of critical cases such as crime-related death, suicide, drug poisoning, and carbon monoxide poisoning is optimal. Of the many hypotheses about the causes of bathtub mortality, the most consistent hypothesis will be medically inferred from the death history, case findings, and test results.
Topics: Adult; Autopsy; Drowning; Epilepsy; Forensic Pathology; Humans; Japan
PubMed: 34840209
DOI: 10.1272/jnms.JNMS.2022_89-119 -
Forensic Science International Jan 2022Drowning is a significant public health problem worldwide and the WHO reported that drowning is the world's third leading unintentional injury death. Nevertheless, there...
INTRODUCTION
Drowning is a significant public health problem worldwide and the WHO reported that drowning is the world's third leading unintentional injury death. Nevertheless, there is still uncertainty regarding the estimate of local and global drowning deaths. In addition, the postmortem diagnosis of drowning is challenging and the physiological mechanisms of death by drowning are complex and not very well understood.
PURPOSE
To analyze a large series of bodies retrieved from the water in Connecticut (U.S.) in order to compare epidemiologic and toxicological data with those of the literature, as well as to examine the weights of the lungs and brains in drowning deaths.
MATERIAL AND METHOD
We conducted a descriptive, retrospective, population-based analysis of all bodies retrieved from the water and subjected to a forensic autopsy at the Office of the Chief Medical Examiner in Connecticut (2008-2020, n = 500). Variables collected were sex, age, date of death, location of drowning, season, type of water, cause of death, manner of death, circumstances of death, signs of decomposition, BMI, brain weight, lung weight, presence of pulmonary edema, stomach contents, and toxicological analysis.
RESULTS
The death rates of drownings in Connecticut ranges from 0.75 to 1.28/100,000/year. They occurred predominantly in males (73.4%) and most were accidents (75.6%), though this gender difference diminishes in suicides (55.4% of males). Sex distribution is also different in bathtub drownings, where women drown more frequently (67.3%). Weights of the brains (p = 0.013) and lungs (p < 0.001) were higher in saltwater drownings.
CONCLUSIONS
Drowning is more frequently an accident involving men, except for suicides where there is only a slight difference among sex. Heavy lungs and cerebral edema continue to be identified in numerous drowning deaths. These anatomic findings, however, must still be interpreted in the context of the entire case investigation. Weights of the brains and lungs are higher in salt water, although these organs' weights are mostly dependent on other variables such as BMI and decomposition.
Topics: Autopsy; Drowning; Female; Humans; Male; Retrospective Studies; Suicide; Water
PubMed: 34894613
DOI: 10.1016/j.forsciint.2021.111137 -
The Medico-legal Journal Dec 2023In the USA, intentional and accidental injuries are the most frequent causes of death in children. Many of these deaths could be avoided through preventive measures, and...
In the USA, intentional and accidental injuries are the most frequent causes of death in children. Many of these deaths could be avoided through preventive measures, and aetiological studies are needed to reduce fatalities. The leading causes of accidental death vary by age. We analysed all paediatric accidental deaths recorded by a busy urban Medical Examiner"s Office in Chicago, Illinois (USA). We searched the electronic database for accidental deaths in children aged under 10 between 1 August 2014 and 31 July 2019. 131 deaths were identified with a preponderance of males and African Americans. This is consistent with ratios of other deaths recorded for this age group (during the same period and area). The leading causes of death were asphyxia due to an unsafe sleeping environment (in subjects <1-year-old), and road traffic accidents/drowning (in subjects >1-year-old). Behaviours, risk factors and environments most likely to contribute to fatal injuries are discussed. Our study highlights the role of forensic pathologists and medico-legal death investigators who identify the causes and circumstances surrounding these deaths. The research results may help from an epidemiological perspective to implement age-specific preventive strategies.
Topics: Male; Child; Humans; Infant; Accidents, Traffic; Drowning; Asphyxia; Illinois; Accidental Injuries; Cause of Death; Wounds and Injuries; Suicide
PubMed: 37318061
DOI: 10.1177/00258172231178421 -
American Family Physician Jan 2023
Topics: Humans; Vision Disorders; Accidental Falls; Death; Hearing Disorders
PubMed: 36689978
DOI: No ID Found -
The American Journal of Forensic... Sep 2020Otorrhagia is generally associated with basilar skull fractures or diving accidents. In routine forensic medical practice, an accurate knowledge of the etiology of...
Otorrhagia is generally associated with basilar skull fractures or diving accidents. In routine forensic medical practice, an accurate knowledge of the etiology of otorrhagia may have a key role to distinguish between traumatic and atraumatic causes and accidental, homicidal, or suicidal manners. The authors present the case of an unusual cause of atraumatic otorrhagia occurred in an elderly farmer found dead in a barn. He remained entrapped in a narrow tunnel created by some hay bales. The autopsy findings revealed only an intense polyvisceral congestion and subpleural petechiae, with no signs of traumatic injuries and no fractures of skull base or temporal pyramid. The cause of death was determined to be positional asphyxia, and the manner of death was deemed accidental. In fact, the head-down position resulted in diaphragm compression causing respiratory failure in combination with the stasis of the upper venous circle districts. Mechanical and gravitational forces related to upside-down position and increased vascular pressure also caused postmortem otorrhagia. In this case, the death scene investigation and circumstantial information allowed for reconstruction of the unique dynamics of the death. At the death scene, the position of the corpse must be accurately investigated because it can explain some cadaveric findings such as the ear bleeding or other markers of increased cephalic venous pressure like pink teeth, facial and conjunctival petechiae, or Tardieu spots. Therefore, forensic pathologists should consider that ear bleeding in dead bodies is not always the evidence of severe head blunt trauma or diving accidents, but it might be a postmortem phenomenon mostly related to body position.
Topics: Accidents, Occupational; Aged, 80 and over; Asphyxia; Conjunctiva; Ear; Edema; Farmers; Head-Down Tilt; Hemorrhage; Humans; Male; Purpura
PubMed: 32452862
DOI: 10.1097/PAF.0000000000000559