Evaluation of organ weights and ventricular thicknesses in electrocution related deaths based on autopsy reports: A biophysical approach.

OBJECTIVE: To evaluate autopsy reports of the deaths due to electrocution in terms of body mass index, body surface area, and organ weights with a biophysical perspective. METHODS: The retrospective study was conducted in Malatya, Turkiye, and comprised autopsy reports of electrocution cases that were obtained from the local branch of the Council of Forensic Medicine related to the period from 2012 to 2019. Organ weights and ventricular thicknesses were compared in terms of body mass index and body surface area. Electrical marks were also evaluated in detail. Data was analysed using SPSS 18. RESULTS: Of the 45 cases, 36(%) were male and 9(%) were female. The overall mean age was 39±13 years (range: 20-71 years). There were no significant differences in organ weights and ventricular thicknesses in different body mass index groups (p>0.05). The weights of head and heart were significantly different in relation to body surface area (p<0.05), but no significant difference were found for other organs and ventricular thickness (p>0.05). CONCLUSIONS: Comparing the organ weights in electrocution autopsies to normal organ weights may help decide the cause of death. During autopsy, electrical marks should be evaluated by considering the characteristics of the electrical current.

Intramuscular hemorrhages in the pathway of an electric current through the body - two case reports.

Intramuscular hemorrhages at autopsy can have a variety of traumatic as well as non-traumatic causes, but their recognition in electrical deaths is almost a rarity. We report on two autopsy cases of electrical fatalities, the first relating to a portion of the right upper human extremity, consisting (only) of the forearm and hand, while the other case relates to a female child who died after a high voltage electrical shock. In both cases, layered dissection of the upper limb revealed fresh intramuscular hemorrhages in the skeletal muscles that could be topographically related to the path taken by the current through the body. Externally visible electric marks were present in both cases. The hemorrhages were most likely caused by current-induced tetanic muscle contractions, producing an internal muscle trauma with rupture of fibers and bleedings. In complex situations, such as inconspicuous marks or a complete lack of visible signs on the body, the finding may be helpful in solving the case in consideration of the case history and circumstances. The vitality, topography, and pattern of the hemorrhages are discussed in the light of the available literature.

Electrocution - post-mortem presentations, problems and pitfalls.

Deaths due to electrocution occur when there has been passage of an electric current through the body. Lethal mechanisms may involve the heart with ventricular fibrillation, or the respiratory muscles or brainstem respiratory centres with respiratory paralysis/cessation. The size of the current that flows through the body is directly dependent on the potential difference of the circuit and the resistance of the tissues. The majority of deaths are accidental, with suicides being less common and homicides being very rare. Problems arising in the evaluation of cases include situations where electrocution has clearly occurred from the scene findings, but no injuries are detectable at autopsy, or when electrical burns are found at autopsy with no defective equipment/circuitry identified at the death scene.

Issues of electric shock in forensic medical practice.

The authors summarize the current state of knowledge of electric shock as a minority group of injuries in forensic practice. Initially, they deal with electric current as a physical quantity and its effect on the human body, how it enters and moves in the body, which tissues due to their electrical activity and properties are the best conductors and which, on the contrary, due to their high resistance, practically do not conduct current. Subsequently, different pathways of current passage through the body are mentioned, leading to different types of damage, the most serious of which appears to be damage to the cardiovascular system, which can lead to immediate death due to disturbed heart rhythm with subsequent arrest, but is also likely to leave permanent effects leading to late health complications. The effect of electric current at the cellular level is demonstrated in experimental animal models exposed to both low- and high-voltage electric current, with damage described not only at the site of entry but also by microscopic examination in organs distant from the site of direct electric current. Since the effect of electric current on the organism is not fully understood and experimental studies have produced results indicating damage mainly to the cardiovascular system, this opens up certain possibilities for improving not only the diagnosis of deaths due to electric shock but also the follow-up care of patients who survive these injuries.

Identifying and mitigating the impacts on primates of transportation and service corridors.

Most primate populations are declining; 60% of species face extinction. The expansion of transportation and service corridors (T&S) (i.e., roads and railways and utility and service lines) poses a significant yet underappreciated threat. With the development of T&S corridors predicted to increase across primates' ranges, it is necessary to understand the current extent of its impacts on primates, the available options to mitigate these effectively, and recognize research and knowledge gaps. By employing a systematic search approach to identify literature that described the relationship between primates and T&S corridors, we extracted information from 327 studies published between 1980 and 2020. Our results revealed that 218 species and subspecies across 62 genera are affected, significantly more than the 92 listed by the IUCN Red List of Threatened Species. The majority of studies took place in Asia (45%), followed by mainland Africa (31%), the Neotropics (22%), and Madagascar (2%). Brazil, Indonesia, Equatorial Guinea, Vietnam, and Madagascar contained the greatest number of affected primate species. Asia featured the highest number of species affected by roads, electrical transmission lines, and pipelines and the only studies addressing the impact of rail and aerial tramways on primates. The impact of seismic lines only emerged in the literature from Africa and the Neotropics. Impacts are diverse and multifaceted, for example, animal-vehicle collisions, electrocutions, habitat loss and fragmentation, impeded movement and genetic exchange, behavioral changes, exposure to pollution, and mortality associated with hunting. Although several mitigation measures were recommended, only 41% of studies focused on their implementation, whereas only 29% evaluated their effectiveness. Finally, there was a clear bias in the species and regions benefiting from research on this topic. We recommend that government and conservation bodies recognize T&S corridors as a serious and mounting threat to primates and that further research in this area is encouraged.

Identificación y Mitigación de los Impactos de los Corredores de Transporte y Servicio sobre los Primates Resumen La mayoría de las poblaciones de primates están declinando; el 60% de las especies enfrentan la extinción. La expansión de los corredores de transporte y servicios (T&S) (es decir, carreteras y ferrocarriles, así como líneas de servicio y utilidad) representa una amenaza significativa pero subestimada. Con el pronóstico de que el desarrollo de corredores T&S incrementará a lo largo de la distribución de los primates, es necesario entender hasta dónde llega actualmente su impacto sobre los primates, las opciones disponibles para mitigar estos impactos de manera efectiva y reconocer las brechas entre la investigación y el conocimiento. Mediante una estrategia de búsqueda sistemática para identificar la literatura que describe la relación entre los primates y los corredores T&S, extrajimos información de 327 estudios publicados entre 1980 y 2020. Nuestros resultados revelaron que 218 especies y subespecies de 62 géneros están siendo afectadas, una cifra significativamente mayor que las 92 especies publicadas en la Lista Roja de Especies Amenazadas de la UICN. La mayoría de los estudios fueron realizados en Asia (45%), seguida de África (31%), los Neotrópicos (22%) y Madagascar (2%). Brasil, Indonesia, Guinea Ecuatorial, Vietnam y Madagascar arrojaron el mayor número de especies de primates afectadas. Asia contó con el número más alto de especies afectadas por carreteras, líneas de transmisión eléctrica y tuberías, así como los únicos estudios que abordaron el impacto del ferrocarril y el tranvía aéreo sobre los primates. El impacto de las líneas sísmicas sólo emergió en la literatura proveniente de África y los Neotrópicos. Los impactos son diversos y multifacéticos; por ejemplo, colisiones entre animales y vehículos, electrocuciones, pérdida y fragmentación del hábitat, impedimento del movimiento y el intercambio genético, cambios etológicos, exposición a la contaminación y mortalidad asociada con la caza. Aunque varias medidas de mitigación aparecían como recomendaciones, sólo el 41% de los estudios se enfocó en su implementación, mientras que sólo el 29% evaluó su efectividad. Finalmente, fue evidente un sesgo hacia las especies y regiones beneficiadas por las investigaciones sobre este tema. Recomendamos que los órganos gubernamentales y de conservación reconozcan a los corredores T&S como una amenaza seria y creciente para los primates y promovemos que se realicen más investigaciones en esta área.

Better utilisation and transparency of bird data collected by powerline companies.

There is in an ongoing expansion of powerlines as a result of an increasing global demand for energy. Powerlines have the potential to negatively impact wild bird populations through collisions and/or electrocution, and reducing bird powerline collision and electrocution risk is a priority for companies running high-voltage powerlines (known as Transmission System Operators (TSOs)). Most TSOs are legally required to assess any potentially significant impacts via Enivronmental Impact Assessments, and so potentially collect a significant amount of data on the presence of species, species behaviour, and observed mortality rates. The value of such data, if available, for reducing and preventing bird casualties could be enhanced by increasing availability across TSOs and other decision-makers. We review the extent to which the sharing of data is happening across Europe, and how the quality, scope and availability of bird data collected by European TSOs could be improved, through use of a questionnaire and workshop with TSOs, conservationists and academics. Sixteen European TSOs responded to the questionnaire and 30 stakeholders attended the workshop. There was wide recognition of the value of different types of data on birds at powerlines, and a positive attitude to working together to share and enhance data across stakeholders to achieve the shared goal of reducing bird mortalities. Key barriers to the sharing of data included a lack of a centralised database, the lack of standardised methods to collect bird data and concerns over the confidentiality of data and reports. In order to overcome these barriers and develop a collaborative approach to data sharing, and ultimately inform best practice to reduce significant negative impacts on bird populations, we suggest a stepwise approach that (1) develops guidance around the field methods and data to be collected for mitigation effectiveness and (2) shares meta-data/bibliography of studies of powerline impacts/mitigation effectiveness for birds. In time, a more structured approach to the sharing of data and information could be developed, to make data findable, accessible, interoperable and reusable.

An instance of homicide by electrocution with hand-made electrode plates.

Homicide by electrocution is rare in forensics, and the identification of the cause of death can be quite difficult when the electric device is removed from the scene. We present an instance where the police were unsure of homicide in the initial investigation. The offender used hand-made electrode plates for electrocution, which produced unique electric marks different from those produced by common electric devices such as electric wires. To the best of our knowledge, this is the first report of homicide by electrocution with electrode plates. We believe that the macroscopic and microscopic findings in this instance are quite valuable for forensic practitioners.

Risk factors for amyotrophic lateral sclerosis: A regional United States case-control study.

Most amyotrophic lateral sclerosis (ALS) cases are considered sporadic, without a known genetic basis, and environmental exposures are thought to play a causal role. To learn more about sporadic ALS etiology, we recruited n = 188 ALS patients from northern New England and Ohio and matched controls 2:1 from the general population of the same regions. Questionnaires evaluated the association between a variety of lifestyle, behavioral (ie, hobbies and activities), and occupational factors and the risk of ALS, including the duration of time between exposure and ALS onset, and exposure frequency. Head trauma was associated with increased ALS risk (adjusted odds ratio [OR] 1.60 95% confidence interval [CI] 1.04-2.45), with significantly greater effects for injuries occurring 10 or more years prior to symptom onset (P = .037). ALS risk was increased for those reporting severe electrical burns (adjusted OR 2.86, 95% CI 1.37-6.03), with odds ratios highest for burns after age 30 (OR 3.14), and for burns 10 or more years prior to symptom onset (OR 3.09). Hobbies involving lead were the most strongly associated with ALS risk (adjusted OR 2.92, 95% CI 1.45-5.91). Exposures to lead 20 or more years prior to diagnosis had larger effect sizes compared to those occurring more recently. Holding a job in mechanics, painting, or construction was associated with ALS. The identification of these specific environmental factors associated with ALS highlight the need for future prospective and laboratory studies to assess causality, biological mechanisms, and find prevention or treatment opportunities.

Blood analytes of electrocuted mantled howler monkeys (Alouatta palliata) in the Nicoya peninsula of Costa Rica.

BACKGROUND: Several species of Costa Rican wildlife are suffering terrible injuries along the power lines in rural areas of the country due to the increasing human development in rural areas, but this has also brought the problem of poorly designed electric infrastructure, where arboreal mammals find their normal tree routes cut down so that the only way for them to cross is on the power lines where they can get electrocuted. METHODS: Blood samples for complete blood count (CBC) and biochemistry panels (alkaline phosphatase, aspartate aminotransferase, amylase, total bilirubin, plasma urea, Ca, P, creatinine, glucose, Na, K, total protein, globulins, and albumin) were collected from 34 electrocuted mantled howler monkeys (Alouatta palliata) individuals that arrived at the Nosara Refuge for Wildlife between May 2018 and May 2019. RESULTS: From the total sample, 18 were males (11 juveniles and eight adults), and 16 were females (six juveniles and 10 adults). From those individuals, 13 animals survived: five females (three juveniles and two adults) and eight males (six juveniles and two adults). Then, 22 animals died after the event from 1 to 102 days (22.41 ± 31.17) after they arrived at the center. Of these 22 animals, 11 were females (three juveniles and eight adults), and 11 were males (six juveniles and five adults). CONCLUSIONS: The preliminary results showed significant differences in the plasma glucose, with adults being significantly higher than the juveniles, and there was also a significant difference in the plasma urea with the deceased ones being higher than the ones that survived the incident. These results may provide a better way to understand and predict the possible outcome of an electrical accident with these primates and assist with returning them back to their natural environment in the least time possible.

Just another railway fatality.

We report on a 56-year-old male who was found dead on railroad tracks, equipped with overhead high-voltage power lines (15,000 V AC). Apparently, the body had been hit by a passing train and completely severed at the mid-abdominal level. Based on this apparently unequivocal finding, the police initially assumed a fatal railway accident or suicide. However, close examination of the deceased's clothes revealed heat damage to at least four overlying layers of clothing in different locations. The rubber soles of his heavy leather shoes showed small holes in blackened areas underneath the toes. Furthermore, both socks revealed tears and fabric defects with burnt rims, again most prominent in the area of the toes. Skin burns, consistent with electric burns, and blistering were detected on the deceased's hands and feet. A broken fishing rod was found in the proximity. On autopsy, multiple injuries caused by severe blunt force with subsequent skull fracture and brain laceration as well as multiple injuries to the spinal column and rib fractures were found and visceral organs displayed multiple lacerations. However, the lack of relevant hematomas argues that these injuries were inflicted postmortem. Histological examination confirmed the presence of electric burns from electrocution. Based on the results of the forensic-pathological examination and additional investigations carried out at the scene of death, we could demonstrate that this highly unusual death was caused by an electrocution after contact of the fishing rod with the high-voltage power line and not by overrunning by the train.

Electric shock-induced cardiac injuries requiring surgical intervention: Case series and a brief review.

BACKGROUND: Electric shock-induced cardiac injuries, such as myocardial infarction, thrombosis, and dissection, are rare. Few cases have been previously reported. The right coronary artery is most often affected because of its proximity to the chest wall. AIMS: To study the extend of electrical injuries on cardiac tissues and its surgical management. MATERIALS AND METHODS: We conducted a retrospective study on our patients in the last five years, looking for cardiac electrical injuries treated surgically in our department, we identified three cases. RESULT: Our three-case series, reported herein, showed that multiple cardiac tissues are susceptible to electrical injuries, specifically the left coronary artery, inferior vena cava, and right ventricular free wall. In our series, the first patient was a 32-year-old man with triple vessel thrombosis and dissection who survived the electric shock. The second patient was a 23-year-old man who had an inferior vena cava burn and bruising; his heart was used for transplantation. After the transplant, the recipient had a left coronary artery dissection and underwent coronary artery bypass grafting. The third patient was a 30-year-old man (potential heart donor) who had a hematoma of the right ventricular free wall, possible coronary artery dissection, inferior vena cava bruising, and tissue damage. His heart was not used for transplant because of quality concerns. CONCLUSION: We recommend that any person who sustains high voltage (500 V or more) electric shock should be evaluated carefully in the emergency department, including with echocardiography and cardiac catheterization, if indicated, to determine the extent of the injury and the viability of the heart, for patients who do not survive as a donor organ.

Shields on Electric Posts Prevent Primate Deaths: A Case Study at Polonnaruwa, Sri Lanka.

When monkeys, such as the toque macaques (Macaca sinica) of Sri Lanka, seek food on the ground near human habitation, they may use electrical posts to escape aggression from conspecifics, dogs, or humans. Shields mounted on electrical posts prevented monkeys from reaching the electrical wires, thereby averting their electrocution: the frequency of electrocutions (n = 0) was significantly less (p < 0.001) in the 12 years after installation of the shields than in the 12 years before (n = 18). Electric shocks were either fatal (n = 14) or caused permanent injury (n = 4) (collectively referred to as electrocutions hereafter). The shields may find broader applications in other primate species and environments wherever monkeys are attracted by human food near electrical posts. Primates and other arboreal mammals also accessed live wires from trees; at known electrocution hotspots, short spans of exposed wires were insulated by encapsulating them in PVC water pipes. It was impossible, however, to prevent electrocutions from all electric supply infrastructures that put monkeys at risk. A wider use of insulated electric conductors in planning power distribution in habitats frequented by wild animals would be desirable in preventing electric shocks to wildlife.

"Selfie"-related electrocution.

Electrical injuries contribute a small but significant fraction to all burn trauma cases, and an even smaller proportion to those that are lethal. Accidental death rates among teenagers are the highest of all age-groups, and taking a "selfie" has been a practice that has, on rare occasions, led to such a death, often from electrocution. The case of a young man and his friend, who were electrocuted after climbing onto the roof of a parked railway wagon to take selfies is reported. One died at the scene, while the other survived. This case demonstrates that electrocution may occur with parked railway wagons, and in the young may be associated with selfie taking.

Successful, Full-Thickness Skin Graft in a Bald Eagle (Haliaeetus leucocephalus).

A subadult, male bald eagle (Haliaeetus leucocephalus) was evaluated after being found unable to fly, with large eschars on the dorsal head and right stifle. Because of the appearance and location, the lesions were believed to be caused by an electrical injury. Treatment included oral antibiotics, nonsteroidal anti-inflammatory drugs, pain medication, surgical debridement of the eschars, and trephining of the affected inner table of the cranium. A full-thickness skin graft was performed to expedite wound healing and minimize holding time. After 6 weeks, the bird had new feather growth on its dorsal head and was released. This is the first report, to our knowledge, of a nonmesh, full-thickness skin graft in an avian species. Full-thickness skin grafts should be considered as a surgical option in juvenile or adult avian patients with large dorsal head wounds.

Cardiac and skeletal muscle effects of electrical weapons : A review of human and animal studies.

Conducted Electrical Weapons (CEWs) are being used as the preferred non-lethal force option for police and special forces worldwide. This new technology challenges an exposed opponent similarly to the way they would be challenged by physical exercise combined with emotional stress. While adrenergic and metabolic effects have been meta-analyzed and reviewed, there has been no systematic review of the effects of CEWs on skeletal and cardiac muscle. A systematic and careful search of the MedLine database was performed to find publications describing pathophysiological cardiac and skeletal muscle effects of CEWs. For skeletal muscle effects, we analyzed all publications providing changes in creatine kinase, myoglobin and potassium. For cardiac effects, we analyzed reported troponin changes and arrhythmias related to short dart-to-heart-distances. Conducted electrical weapons satisfy all relevant electrical safety standards and there are, to date, no proven electrocution incidents caused by CEWs. A potential cardiovascular risk has been recognized by some of the experimental animal data. The effects on the heart appear to be limited to instances when there is a short dart-to-heart-distance. The effect on the skeletal muscle system appears to be negligible. A responsible use of a CEW on a healthy adult, within the guidelines proposed by the manufacturer, does not imply a significant health risk for that healthy adult.

Electric fences and accidental death.

Deaths which occur in association with agricultural electric fences are very rare. In fact, electric fences have undoubtedly saved numerous human and animal lives by safely and reliably keeping livestock confined to their fields and enclosures and thus preventing motor vehicle incidents when livestock get onto roads and highways. Accidental and intentional human contact with electric fences occurs regularly and causes little more than transient discomfort, however, on exceptional occasions, contact with electric fences appears to be directly related to the death of the individual. The precise pathophysiological cause of these deaths is unclear. We present two cases of deaths associated with electric fences, discuss the possible pathophysiological mechanisms in these cases, and suggest a universal approach to the medico-legal investigation and documentation of these deaths.

Electrical Injuries in Animals: Causes, Pathogenesis, and Morphological Findings.

Electrical injuries in animals occur most often accidentally. They comprise contact to various forms of currents, including alternating, rotary, or direct currents. Depending on various parameters of the current (including the type of circuit, voltage, current and duration of exposure) and conditions of the animal (such as wet or dry hair coat and pathway of current through the body), lesions may be absent or may include early or localized development of rigor mortis, signs of acute circulatory failure, or severe thermoelectrical burns. Such burns may present as external current marks, singed hair or feathers, metallization of the skin, or occasionally internal electroporation injury resulting in muscle necrosis, hemolysis, vascular damage with thrombosis, injury to brain and spinal cord, or skeletal fractures. Furthermore, lightning strikes occur regularly in grazing animals, which have greater risk of death from step potentials (ground current) in addition to direct strike and contact injury. Such cases may have no lesions, external signs of linear or punctate burns, keraunographic markings, or exit burns on the soles of the hooves or the coronary bands. Besides detailed information about the circumstances at the location where the animal was found, electrical injuries in animals require a thorough morphological workup, including additional investigations in conjunction with certain knowledge about the possible lesion spectrum.

Seasonal electrocution fatalities in free-range rhesus macaques (Macaca mulatta) of Shivalik hills area in northern India.

BACKGROUND: The arboreal nature of rhesus macaques makes them vulnerable to electrocution from high-voltage industrial supply as well as low-tension domestic wires. The data on pattern of electrocution injuries and electrocution mortalities in free-ranging rhesus macaques are rarely reported. METHODS: From January 2011 to 2013, the cases of accidental electrocution injuries were recorded in difference to sex, age group, season, body region distribution, contact details, and extent of injuries in free-ranging rhesus macaques (Macaca mulatta) of Shivalik hill areas. RESULTS: electrocution injuries were highest in juveniles (52.05%), followed by adults (30.13%) and old (10.95%) rhesus macaques. Of the 73 cases recorded, 23 (31.50%) succumbed to death following severe electrocution and associated injuries. The intensity and body region distribution of electrocution injuries was recorded. CONCLUSION: High-voltage current is the most common factor for fatal injuries. Strategies to avoid such electrocutions include burying all lines and transformers, shielding and insulating all high-tension lines, installing bridges that monkeys, and other arboreal species can use to move around.

Assessment of electrocardiographic parameters in patients with electrocution injury.

BACKGROUND: Electrocution injury (EI) is a major problem in developing countries. The aim of this study is to investigate the effect of EI on electrocardiographic (ECG) parameters. METHODS: A total of 43 patients hospitalized with diagnosis of EI were prospectively enrolled. Admission ECGs were compared with follow-up ECGs obtained one month after the event. RESULTS: Maximum P wave duration (Pmax), minimum P wave duration (Pmin), P wave dispersion (PWD), PR interval, QRS complex duration, corrected QT duration (QTc), QT dispersion (QTD), T peak to T end (Tp-e) interval were longer and Tp-e interval/QT and Tp-e interval/QTc ratios were higher on admission ECGs compared to follow-up ECGs. Frontal QRS-T angle and frequency of patients with fragmented QRS were also higher on admission ECGs. CONCLUSION: Our study revealed that EI causes significant deterioration of admission ECG parameters. The clinical use of these parameters in prediction of arrhythmias after EI warrants further studies.

A Consequence of an Electrical-Burn Injury: Atrial Fibrillation.

Cardiac arrhythmias following electrocution injuries can accompany high-voltage or high- intensity currents. Contributing factors to electrical hazard are the type of current, voltage, resistance, and duration of contact and pathway through the body. It is important to monitor for delayed arrhythmias in patients with an electrical injury. We describe a case of a 52-year-old man who presented after an electrical shock injury while grabbing a 5,000-voltage wire at work. In this case report, we discuss the presentation, management, and follow-up recommendations for this type of injury.