A Pilot Study on the Diagnosis of Fatal Electrocution by the Detection of Myocardial Microhemorrhages

In electrocutions, death may be caused by alterations in the heart conduction system provoking ventricular fibrillation. This study aims to identify histological cardiac markers of high- and low-voltage electrocution. Two groups of decedents were evaluated: group A included 14 fatalities caused by high- or low-voltage electrocution and group B (control) included 14 fatalities due to other traumatic or disease causes. Myocardial sampling with microscopic examination was performed on all the hearts using the hematoxylin and eosin and Masson's trichrome stains to investigate morphological characteristics that could indicate the damage caused by high- and low-voltage electrocutions. Interstitial myocardial hemorrhagic infiltration was the only differentiating finding, which was shown only in high-voltage electrocution. This pathological finding has not been previously reported, and it may be specific to high-voltage electrocution deaths. Further studies are warranted.     

Homicidal electrocution disguised as an accidental death

Deaths due to electrocution are mostly accidental. Homicide by electrocution is rarely reported in the literature. However, the location and pattern of the electrocution wound can raise concern for a possible homicidal manner of death. We are reporting an unusual case wherein the dead body of a middle-aged man was found lying in a suspicious condition on the roadside of desolated area. There were circumferential, grooved electrocution lesions over the left and right second toes with oval electrocution lesions on the medial aspects of both the left and right third toes. There were split lacerations over the right high parietal region, right pinna, and forehead. There was avulsion of the nail of the left thumb. Pressure abrasion was consistent with a ligature mark on the lower part of the left leg. The locations and pattern of these injuries raised the possibility of torture infliction. Death was attributed to electrocution, which was confirmed by histopathology. Autopsy findings and possible inferences were furnished to the police. This case highlights the careful observation of different characterizations and locations of the wounds and deducing inferences about the possible manner of death. This information can be useful to investigating agencies.     

Metallization at the Exit Wound—An Unusual Finding in Fatal Electrocution

Electrocution injuries represent a severe occupational hazard. Those at work usually ignore the importance of safety training and safe practices while the electric source is nearby the work area. Death due to electrocution can occur with or without any electric mark on the body. Limbs are the commoner site for electric entry and exit wounds. Various uncommon sites for electric exit wounds have also been reported in the literature. We report a rare case of fatal electrocution, where a 28-year-old male carpenter sustained electric injuries at the worksite. Multiple exit wounds were present over the back of the chest, an uncommon site for the exit wounds, and notably, both entry and exit wounds showed evidence of metallization. The present case emphasizes on the significance of death scene investigations in the reconstruction of events and need for complete autopsy supplemented with chemical and histopathological examination of the electric wounds.     

Occupational injury and illness recording and reporting requirements. Occupational Safety and Health Administration (OSHA), U.S. Department of Labor. Final rule

The Occupational Safety and Health Administration (OSHA) is revising its rule addressing the recording and reporting of occupational injuries and illnesses (29 CFR parts 1904 and 1952), including the forms employers use to record those injuries and illnesses. The revisions to the final rule will produce more useful injury and illness records, collect better information about the incidence of occupational injuries and illnesses on a national basis, promote improved employee awareness and involvement in the recording and reporting of job-related injuries and illnesses, simplify the injury and illness recordkeeping system for employers, and permit increased use of computers and telecommunications technology for OSHA recordkeeping purposes. This rulemaking completes a larger overall effort to revise Part 1904 of Title 29 of the Code of Federal Regulations. Two sections of Part 1904 have already been revised in earlier rulemakings. A rule titled Reporting fatalities and multiple hospitalization incidents to OSHA, became effective May 2, 1994 and has been incorporated into this final rule as Section 1904.39. A second rule entitled Annual OSHA injury and illness survey of ten or more employers became effective on March 13, 1997 and has been incorporated into this final rule as Section 1904.41. The final rule being published today also revises 29 CFR 1952.4, Injury and Illness Recording and Reporting Requirements, which prescribes the recordkeeping and reporting requirements for States that have an occupational safety and health program approved by OSHA under Section 18 of the Occupational Safety and Health Act (the "Act" or "OSH Act").     

Patterns of Ecchymoses Caused by Manner of Death and Collateral Injuries Sustained in Bruising Incidents: Decedent Injuries,Profiles, Comparisons,and Clinicopathologic Significance

Abstract: We investigated how ecchymoses could be used to predict other injuries, or help establish the cause of death. Ecchymoses, fractures, lacerations, abrasions, and other data were recorded. Eleven percent of decedents had ecchymoses. Motor vehicle accident by car (MVA‐C) was the most common cause of ecchymoses and showed the most collateral injuries. Decedents of natural causes were more likely to have ecchymoses without collateral injuries. There appeared to be two groups of decedents with ecchymoses: one group is younger, comprised of victims of MVA‐C and homicides, with more injuries related to ecchymoses than others; another is an older group of victims of other accidents, natural causes, and suicide. There were no indeterminate causes of death among decedents with ecchymoses. Therefore, ecchymoses may be a surrogate marker to direct the pathologist to continue to seek a cause of death should be seen, even if the case, otherwise, appears to be indeterminate.     

Suicidal hanging on high-voltage line pylon

Hanging is one of the most frequent methods for suicides among young males. This report presents two cases of suicide by hanging on pylons carrying high-voltage power lines. The male victims suffered electrocution while committing suicide. Electrocution was the cause of death in both cases, however in one case blunt force injuries from hanging contributed to death. In these two cases hanging was the intentional method of suicide and it was followed by electrocution. The cases demonstrate that scene investigation, a detailed autopsy with histology, and amamnestic data are essential in the evaluation of suicides by hanging and that the determination of the cause of death remains a challenge in investigating such cases.     

Fatal Electrocution by a Support Metal Wire

Abstract: Electrocution is not an uncommon cause of death. A case of fatal electrocution by a metal wire that was used as a support for the insulated television cable wire is reported. Electric current flowed through the metal wire when it touched the residential power line. Electrical injury caused because of contact with the live metal wire is described with histopathological findings. This case reports the circumstances that led to accidental fatal electrocution in an outdoor setting during the rainy season. Significance of death scene investigation to confirm the cause and manner of death in cases of fatal electrocution is highlighted. Public awareness programs to lay emphasis on electrical safety in domestic environment need to be introduced to prevent fatalities resulting from ignorance and/or negligence.     

Suicidal electrocution in Sydney: a 10-year case review

A retrospective study was undertaken of all cases of death due to suicidal electrocution in Sydney, Australia between 1996 and 2005. A total of 25 cases were identified with 20 cases (80%) as a result of direct attachment to an electrical outlet and five cases (20%) as a result of immersion in a body of water with an electrical appliance. Twenty of the 25 individuals were men (mean age = 57 years, range 22-90) and five were women (mean age 67, range 53-88). At least 35% of decedents were either currently working or had worked as electricians. Electrical timers had been used in eight (32%) cases, the fuse blown in one case, but the remaining 16 (64%) bodies were "live" on arrival of witnesses or electricity personnel. This study demonstrates the phenomenon of electrical suicide as a regular occurrence in Sydney. We highlight the need for investigators and emergency workers to remain vigilant upon discovery of electrical suicides, due to the fact that most bodies remain electrically active after death.     

Inside the Black Box: How do OSHA Inspections Lead to Reductions in Workplace Injuries?*

We examine different models of employers’ responses to OSHA inspections. The “detection/correction” model assumes that responses are limited to correcting the violations that inspectors cite. The “behavioral shock” model assumes that firms respond by paying more attention to safety issues, even those unrelated to OSHA standards. We test whether some injury types are more affected by inspections than others, or by citations of particular OSHA standards. We conclude that, although citing particular standards can reduce injury types specifically related to those hazards, inspections also affect a wider range of injuries, suggesting a broader impact on managerial attention to safety.     

Study on electrocution death by low-voltage

Seven cases of electrocution death by low voltage (<80 V) were studied. Autopsy was carried out and the death scene was investigated. The conditions for low-voltage electrocution death, the state of the victim at the time of electrocution, postmortem examination and the nature of the electricity is discussed. It was pointed out that low-voltage electrocution was related to the nature of electricity, individual characteristics and environment conditions.     

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.     

Electrocution by arcing: a nonfatal case study

Accidental electrocution during working activities account for a considerable amount of morbidity and mortality. Workers often misjudge the danger of electric wires or high-tension power cables, thereby exposing themselves to electrocution hazard. This article describes a nonfatal case of injuries by arcing from high-tension power-line cables involving a young farmer who was thrashing an olive tree by means of aluminum ladder. The circumstances surrounding the manner of electrocution and the features of electric injuries are presented and discussed.     

Connexin 43, angiotensin II, endothelin 1, and type III collagen alterations in heart of rats having undergone fatal electrocution

Death due to accidental electrocution occurs frequently. The aim of this study was to investigate alterations in cardiac connexin 43 (Cx43), angiotensin II (Ang II), endothelin 1 (ET-1), and type III collagen associated with fatal electrocution.Twenty-four Sprague-Dawley rats were divided into control, fatal electrocution (220 V, 50 Hz, 60 seconds), and electrical injury (220 V, 50 Hz, 60 seconds) groups. Animals were deeply anesthetized with sodium pentobarbital before each treatment, with the anode connected to the left foreleg and the cathode to the right hindleg, followed by cervical dislocation. Control animals received cervical dislocation alone. Immunohistochemical analysis was performed to evaluate the cardiac protein expression of Cx43, Ang II, ET-1, and type III collagen. Sections were analyzed by digital image analysis.The expression of Cx43 was significantly reduced after fatal electrocution, with the integrated optical density also lower when compared with control (P < 0.05). Expression of both Ang II and ET-1 was significantly increased after fatal electrocution, supported by integrated optical density when compared with control (P < 0.05). But no significant difference was found in type III collagen expression between the fatal electrocution group and the control group.In summary, cardiac protein expression of Cx43, Ang II, and ET-1 was found to be significantly altered with fatal electrocution, suggesting that these 3 proteins may be important underlying mechanisms of death during fatal electrocution. The current findings indicate that such alterations would be reflected in abnormal cardiac function and a possible cause of sudden death.     

上海地区非法行医致孕妇死亡案例回顾性研究

目的研究上海地区非法行医致孕妇死亡案例并分析其特点,探究其形成原因及预防机制。方法收集本研究所2001～2005年接受上海市公安机关委托非法行医致孕妇死亡案例11例,按照孕妇情况、死亡原因及非法行医者的诊疗措施等进行分类整理分析。结果非法行医致孕妇死亡的原因多为产后大出血、羊水栓塞,多伴软产道裂伤。孕妇多未进行正规产前检查,到缺乏必要医疗条件的个体非法行医者处或者家中分娩,非法行医者往往存在不正当应用催产素,强行分娩,未采取及时有效抢救措施。     

生前电击与死后电击骨骼肌肌小节的长度变化

目的研究生前电击与死后电击的肌小节长度变化,为生前电击与死后电击的鉴别提供新的方法。方法12只兔随机分为对照I组、对照II组、电击死组和死后电击组。每组3只。对照I、II组与死后电击组兔分别从耳缘静脉注射空气30m l处死。对照I组处死后,于死后即刻取其后肢股四头肌;对照II组死后24h于相同部位取材;电击死组兔通220V交流电,通电致兔死后即刻取材;死后电击组于死后即刻通220V交流电4m in后,在相同部位取材。用透射电镜观察骨骼肌肌小节长度变化,对所得结果进行统计学分析。结果生前电击与死后电击骨骼肌肌小节均缩短,与对照组I相比,前者较后者缩短程度更甚(P=0.000);死后电击组与对照I组相比,仅轻微缩短(P=0.000),对照II组相比,缩短较为明显(P=0.000);对照II组较对照I组的肌小节显著伸长(P=0.000)。结论研究骨骼肌肌小节的长度变化有助于鉴别生前电击与死后电击。     

Endothelial cell membrane perforation of aorta and pulmonary artery in the electrocution victims

Some electrocution deaths occur without detectable current marks on the skin, making forensic examination to determine the true cause of death more difficult. Because arterial thrombosis was a frequent finding in victims of electrocution, we investigated injury to the endothelium of the aorta and pulmonary artery with a scanning electron microscope in five cases of death known to be caused by electrocution. We found large pores on the surface of endothelial cells of the aorta and pulmonary artery in those who died of electrocution, but no endothelial membrane perforation was found in those who died of cardiac diseases. These findings were present within 12h after death. Therefore, scanning electron microscopic evidence of endothelial perforation in the aorta and pulmonary artery could be a useful marker to identify electrocution for those victims without detectable current marks on the skin.     

Occupational exposure to bloodborne pathogens: request for information--OSHA. Request for information

OSHA requests information and comment on engineering and work practice controls used to eliminate or minimize the risk of exposure to bloodborne pathogens due to percutaneous injuries from contaminated needles and o ther contaminated sharps in occupational environments. Percutaneous injuries continue to be a concern in work settings where employees are exposed to bloodborne pathogens. The Agency is considering possible actions that it can undertake to assist in addressing this issue. Consequently, OSHA is interested in strategies for reducing percutaneous injury rates that have been successfully implemented in the work environment, including work practices and, in particular, the use of devices designed to limit the risk of such injuries. The information received in response to this notice will be carefully reviewed and will assist OSHA in determining effective approaches to reducing percutaneous injury rates and what role the Agency may have in these approaches.     

电击伤与电击死的法医学研究进展

电击伤和电击死是法医实践工作中常遇到的案例,尽管有许多学者从电击伤(死)后各个组织器官的形态学以及分子水平的变化进行了大量的研究,但实际检案中,法医工作者对其诊断(主要是对无电流斑的死因推断)仍没有统一的标准和直接客观的特异性指标,且对电击工具的推断、生前电击和死后电击的鉴别以及电击死后死亡时间的判断都有一定的困难,故其一直是法医学研究的热点。本文针对以上问题对电击伤(死)的法医学研究进展做一综述,为对其进一步研究提供一些思路。     

Adolescent death: a 15-year retrospective review

Adolescents comprise an eclectic mix of people vitally important to society yet long-term comprehensive studies on the circumstances of their deaths are lacking in the pediatric forensic literature. The authors reviewed all forensic cases referred to the Medical University of South Carolina Forensic Pathology section over the fifteen years between January 1989 and December 2003. In accordance with the World Health Organization (WHO) definition of adolescents, only decedents 10-19 years of age were included. The authors examined the cause and manner of death, age, gender, and race of the victims in all cases. The toxicology results, perpetrator, death scenario and location, and victim traits were analyzed when available. For all adolescents, the most common manner of death was accident followed by homicide, suicide, natural, and undetermined. Within the adolescent population two distinct groups, 10-14 years old and 15-19 years old, were identified. Though both groups were similar in that they experienced a high number of accidental deaths, decedents of older age group suffered a higher percentage of violent deaths while decedents of the younger group were more likely to die of natural causes. Many of the accidental deaths in this review were preventable, including deaths due to motor vehicle collisions and drowning. In deaths due to homicide, the perpetrator was often known to the victim, whether as an acquaintance or family member. Toxicology testing was often positive in decedents of the older age group, while only rarely positive in decedents of the younger age group. With a solid understanding of the circumstances, it may be possible to predict, and hopefully prevent, future cases of adolescent death. The authors present their findings in this 15-year retrospective study to better aid forensic pathologists, death investigators, law enforcement, and epidemiologists.     

Computerized Image Analysis in Differentiation of Skin Lesions Caused by Electrocution, Flame Burns, and Abrasion

Abstract:  In the practice of forensic science, sometimes, it is not easy to understand whether skin lesion is due to electrocution and to differentiate the thermal burns and abrasion-type lesions, especially when electricity source cannot be revealed by death science investigation. Based on the causes of the lesions, cases were classified into three groups. Group 1 included 30 deaths from electrocution. Group 2 included 30 deaths with flame burns. Group 3 included 30 deaths from traffic accident cases, which had abrasions. In this study, epidermal nuclear area, perimeter, nuclear form factor, nuclear minimum axes, nuclear maximum axes, and minimum axes/maximum axes ratio were measured. As a result, we think that computerized image analysis beside light microscopic examination can be useful in the differentiation of the electrocution, flame burn, and abrasion type lesions.