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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 -
Traffic Injury Prevention 2021Convertible cars have existed since among the first automobiles, and the lack of substantial roof structure creates some safety concerns. Though crash tests have...
OBJECTIVE
Convertible cars have existed since among the first automobiles, and the lack of substantial roof structure creates some safety concerns. Though crash tests have demonstrated that convertibles can resist excessive intrusion in front and side crashes and that strong A-pillars and roll bars can help maintain survival space in rollovers, little work has been done examining the real-world crash experience of these vehicles. The objective of this study was to compare the crash experience of recent convertibles with nonconvertible versions of the same cars using the most recent crash data.
METHODS
Crash and exposure data were obtained from the U.S. Department of Transportation and IHS Markit, respectively. Rates of driver deaths and police-reported crash involvements were compared for 1- to 5-year-old convertible cars and their nonconvertible versions during 2014-2018. Exposure measures included registered vehicle years (RVY) and vehicle miles traveled (VMT). These rates were compared using the standardized mortality ratio to account for possible differences in exposure distribution. Crash circumstances (e.g., point of impact, rollover, ejection) and behavioral outcomes (e.g., speeding, alcohol impairment, seat belt use) were compared for drivers killed in crashes.
RESULTS
Convertibles had lower driver death rates and police-reported crash involvement rates on the basis of both RVY and VMT. However, the differences in driver death rates were not statistically significant. Driver deaths per 10 billion VMT were 11% lower for convertibles, and driver involvement in police-reported crashes per 10 million VMT was 6% lower. On average, convertibles were driven 1,595 fewer miles per year than the nonconvertible versions of these cars. Among fatally injured drivers, convertibles had slightly higher rates of ejection, and behavioral differences were minimal. The number of rollovers was small and their rate did not substantially differ between convertibles and their nonconvertible versions.
CONCLUSIONS
Safety concerns associated with convertibles' retractable roof structures were not supported by the results of this study.
Topics: Accidental Injuries; Accidents, Traffic; Automobiles; Child, Preschool; Consumer Product Safety; Humans; Infant; Police; Risk Assessment; Seat Belts; Travel; United States
PubMed: 33709841
DOI: 10.1080/15389588.2021.1888084 -
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 -
Injury Prevention : Journal of the... Dec 2022Drowning is a complex health issue, where global agendas call for greater emphasis on multisectoral action, and engagement with sectors not yet involved in prevention... (Review)
Review
BACKGROUND
Drowning is a complex health issue, where global agendas call for greater emphasis on multisectoral action, and engagement with sectors not yet involved in prevention efforts. Here, we explored the conceptual boundaries of drowning prevention in peer-review and grey literature, by reviewing the contexts, interventions, terminologies, concepts, planning models, and sector involvement, to identify opportunities for multisectoral action.
METHODS
We applied scoping review method and have reported against Preferred Reporting Items for Systematic Reviews and Meta-analyses Extension for Scoping Reviews checklist. We searched four electronic databases for peer-reviewed articles published on 1 January 2005 and 31 December 2020 and five databases for grey literature published on 1 January 2014 and 31 December 2020. We applied the search term "drowning," and charted data addressing our research questions.
RESULTS
We included 737 peer-reviewed articles and 68 grey documents. Peer-publications reported situational assessments (n=478, 64.86%) and intervention research (n=259, 35.14%). Drowning was reported in the context of injury (n=157, 21.30%), commonly in childhood injury (n=72, 9.77%), mortality studies (n=60, 8.14%) and in grey documents addressing adolescent, child, environmental, occupational and urban health, refugee and migrant safety and disaster. Intervention research was mapped to World Health Organization recommended actions. The leading sectors in interventions were health, leisure, education and emergency services.
CONCLUSION
Although drowning is often described as a major health issue, the sectors and stakeholders involved are multifarious. The interventions are more often initiated by non-health sectors, meaning multisectoral action is critical. Framing drowning prevention to reinforce cobenefits for other health and development agendas could strengthen multisectoral action. Greater investment in partnerships with non-health sectors, encouraging joint planning and implementation, and creating systems for increased accountability should be a priority in future years.
Topics: Child; Adolescent; Humans; Drowning; Urban Health; Refugees
PubMed: 36270791
DOI: 10.1136/ip-2022-044712 -
CJEM Apr 2022
Topics: Drowning; Humans; Resuscitation; Societies, Medical
PubMed: 35129831
DOI: 10.1007/s43678-022-00271-7 -
Fa Yi Xue Za Zhi Feb 2022Diatom detection is an important method for identifying drowning and throwing corpses after death and inferring the drowning sites in forensic examination of corpses in... (Review)
Review
Diatom detection is an important method for identifying drowning and throwing corpses after death and inferring the drowning sites in forensic examination of corpses in water. In recent years,high-throughput sequencing technology has achieved rapid development and has been widely used in research related to diatom taxonomic investigations. This paper reviews the research status and prospects of high-throughput sequencing technology and its application in forensic diatom detection.
Topics: Cadaver; Diatoms; Drowning; Forensic Pathology; High-Throughput Nucleotide Sequencing; Humans; Lung; Technology
PubMed: 35725700
DOI: 10.12116/j.issn.1004-5619.2021.410807 -
The American Journal of Emergency... Aug 2021Identification of predictors of outcome at the scene of drowning events could guide prevention, care and resource utilization. This review aimed to describe where, what... (Review)
Review
BACKGROUND
Identification of predictors of outcome at the scene of drowning events could guide prevention, care and resource utilization. This review aimed to describe where, what and how scene predictive factors have been evaluated in drowning outcome studies.
METHODS
We reviewed studies reporting scene drowning predictors published between 2003 and 2019. Data extraction included study populations, data sources, predictor factors (victim, incident, rescue, resuscitation and hospital-related), outcome measures and type of analyses.
RESULTS
Of 49 studies, 87.6% were from high-income countries, 57.1% used data from only one source (92.9% of these from either hospital or EMS), 73.5% included cases who received medical care and 53.1% defined outcomes as survival or death. A total of 78 different factors were studied; the most commonly studied group of factors described victim demographics, included in 42 studies (85.7%), followed by resuscitation factors, included in 30 studies (61.2%). Few studies described rescue (6.1%). The most frequent statistically significant single predictors of outcome known at the scene were submersion duration (evaluated in 19, predictor in 14) and age (evaluated in 31, predictor in 16). Only 38.7% of studies employed multivariable methods.
CONCLUSIONS
Gaps to be addressed in drowning outcomes research include data from low- and middle-income countries, standardized definition of factors to allow evaluation across studies, inclusive study populations that can be generalized beyond those receiving medical care, study rescue and resuscitation factors, use of more meaningful outcomes (survival with good neurologic status) and advanced analyses to identify which factors are true predictors versus confounding variables.
Topics: Age Factors; Drowning; Humans; Near Drowning; Prognosis; Resuscitation; Risk Factors; Survival Analysis; Time Factors
PubMed: 33069542
DOI: 10.1016/j.ajem.2020.10.011 -
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 -
The New England Journal of Medicine Oct 2022
Review
Topics: Drowning; Emergencies; Emergency Medical Services; Emergency Service, Hospital; Humans; Near Drowning
PubMed: 36198180
DOI: 10.1056/NEJMra2202392