IJCRR - Vol 06 Issue 17, September
Date of Publication: 11-Sep-2014
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STRATEGIC ANALYSIS OF ELECTROCUTION FATALITIES IN RURAL SOUTH INDIA OBSERVED IN A YEAR
Author: Ananda Reddy, Sengottuvel P, Balaraman R
Abstract:Background: This study was performed to analyse the frequency, profile and pattern of injuries among electrocution fatalities. Materials and Methods: Cross sectional study of all electrocution deaths autopsied at Puducherry during the calendar year 2013. We gathered incident information from the relatives and investigating officers, autopsy findings are interpreted and data were analyzed for results. Results: Electrocution deaths have accounted for 1.29% of all medicolegal autopsies (n=1320) conducted at our study centre during the study period. The chief victims are males and adults in their third and fourth decade of life. The majority of the victims are Hindus, literates, agricultural workers and from rural background. The prime body part injured in electrocution are hands and fingers (65%), followed by soles and toes. Entry marks and exit marks alone were noticed in 47% and 18% respectively, but both marks were noticed in 30% of cases. Most electrocution incidents were occurred during summer season and during the day times. All the cases are accidental in nature. Conclusions: Electrocution deaths are only a small proportion of unnatural deaths and they are prevalent in domestic and occupational places. Health education and safety precautions are in need to reduce the electrocution mortalities.
Keywords: Electrocution fatalities, Autopsy, Entry and Exit marks, Domestic
Electric current is of greatest importance at domestic and occupational places in today’s human life. The amount of body damage caused by the electric current depends upon the type, strength and duration of exposure. Electrical injuries are responsible for considerable morbidity and mortality in developed countries, even with significant improvement in product safety1 and implementation of rules and regulations. In low income countries electrocution deaths are emerging into an public health problem because of lack of awareness and poor safety issues.2 Indian national data on accidental deaths and suicides for calendar year 2010 and 2011 has reported 9059 and 8945 electrocution deaths respectively, with a share of 2.4% of total accidental deaths.3 Almost every electrocution death is an accidental one, but very rarely it is either suicidal or homicidal.4 Puducherry has reported the highest rate of accidental deaths as compared to the national average. This study was designed to know the frequency, victim’s profile, pattern of electrical injuries and manner of death among the study population.
MATERIALS and METHODS
This autopsy oriented, cross-sectional study was conducted at the department of Forensic Medicine, Indira Gandhi Government General Hospital and Postgraduate Institute (IGGGH and PGI), Puducherry during the calendar year 2013 (from 1st January to 31st December). All cases of electrocution deaths autopsied at the study centre were considered. We gathered detailed history of electrocution incident, demographic profile and thereof of each case by personal interview with family members / accompanying person, police officers and by referring hospital records. The medicolegal autopsy was conducted meticulously from head to toe. The deceased was examined thoroughly for electrical injuries and any other mechanical injuries over the body. Ethical principles were upheld by maintaining confidentiality and by obtaining consent from the relatives and medical record department. Finally the deceased profile, examination findings and ancillary investigation (histopathological, chemical analysis) data were collected, entered into Microsoft Excel (2007) sheet, and analyzed for frequencies and percentages. The results were interpreted by using tables and bar diagrams.
1320 medico-legal autopsies were conducted in the study center during the calendar year 2013, among that 17 (1.29%) were on electrocution fatalities. The chief victims were males (gender ratio of 3.2:1) and adults in the age group of 21-40 years (53%) (Table 1). Demographically most victims belonged to Hindu religion (82%), Rural background (53%), Married (53%), Literates (70%) and lower socioeconomic status (59%) (Table 2). The occupation of the victims was categorized as follows; agricultural workers (29%), laborer (18%), students (18%) and housewives (12%) (Figure 1). To a great extent these incidents were occurred in the summer seasons, (Figure 2) and during day times between 6 AM to 6 PM (76%) (Figure 3). It was remarkable that victims were electrocuted while handling domestic appliances in the house (47%), industrial machines (18%) and electric wires (12%). It was noticed that 65% cases were found dead at the scene of crime and the rest were declared dead at the hospital. The frequent location for entry and
exit wounds of electrical injuries are hands and fingers (65%) of upper extremities and soles and toes (17%) of lower extremities respectively (Table 3). The manner of death was accidental in nature in all cases and no suicidal or homicidal death was reported. DISCUSSIONS We noticed, the low frequency of electrocution deaths (1.29%) in this region compared to studies conducted in various parts of India and abroad (1.9 to 3.3%).5,6,7,8 The frequency of electrocution fatalities in each territory depends upon multiple factors like weather non-uniformity, education status and awareness of electrocution in general public, safety measures adopted by the public and also rules and regulations followed by the government. Males are predominantly victimized than females, having a resemblance to the conclusions of studies conducted in Coimbatore, South Delhi, Nagpur and Manipur on electrocution deaths. 4,5,6,9 The adults of second to fourth decade are in a vulnerable position to electrocution deaths, but these incidents were rare in extremes of ages. The age findings of the present study are in more congruous with Rautji work (21-40 years). 5 Age group in danger was narrowed to 21-30years in few studies 4,9 and quite wider in most other studies (20-50 years). 6,10 Adult males are more often actively engaged in electricity dependent occupations, either at their workplace or home during their second to fourth decades, hence they are prone to electrocution hazards. Demographically most deceased are Hindus (82%), Rural people (53%), Married (53%), Literates (70%) and low socioeconomic status (59%). The main occupation of the victims was reported to be agriculture (30%), laborer (18%), students (18%) and housewives (12%). These people are at greater risk of electrocution because of their poor level of education, lack of awareness of electrical hazards and wrong handling of electric appliances at work places. Higher incidents of electrocution deaths during summer may be due to increased humidity and high usage of electric appliances, and these findings are in consistent with Tirasci study.8 Nearly threefourth of electrocution accidents were occurred during day time, which is in harmony with highest usage of domestic appliances and industrial machines actively during day times. Approximately three-fourth of the victims were found dead at the scene of the crime and the rest were declared dead at the hospital. The maximal deaths are due to AC current used for domestic purposes (AC, 220-240 Volts) and due to it’s “catch on effect”. 61% of victims were found dead at the scene of crime in Tehran study11 and 80% died immediately after electrocution in Manipur study.9 The distinct injury marks produced at the site of contact with electric wire (entry mark) and joule burns in electrocution cases can be considered as a classical external sign of electrocution. Entry mark alone were seen in nearly half of the autopsied cases, comparatively the exit mark alone were less than one-fourth of cases, but both marks were noticed nearly in one-third of cases. Previous studies have reported much higher percentage of entry marks varying from 72% to 86.27%.5,8,9 The hands and fingers of the upper extremities are the most frequent sites for electrical injuries (entry marks), while exit wounds were commonly located on the soles and toes of lower extremities, because extremities are the most common sites of contact with the source of electric current. Similar findings were reported from other studies.5,8,9
The chemical investigations were carried out in nine cases and it was found positive for alcohol consumption in three cases. The histological examination of the skin from suspected electrical injury marks were useful for diagnosis in eleven cases. The chemical analysis of the viscera and histopathological examination of the skin from the injury site may be useful in deriving the cause and manner of death in suspected electrocution deaths. It was remarkable that the manner of death in all the studied cases was determined to be accidental in nature, no suicidal or homicidal cases were reported. Suicidal and homicidal electrocution deaths are very rare to occur. History, visit to the scene of crime, circumstantial evidences, autopsy findings and accessory investigations methods will be very useful to determine the cause of death. Limitations and suggestions of this study- small sample size, not able to arrive at the exact cause of death based on autopsy findings alone, hasn’t visited the scene of crime in most cases and thus manner of death was declared based on the history and autopsy findings. Ancillary investigations were not performed in all cases, but it was useful in deciding the cause and manner of death in investigated cases. Data of electrocution deaths among Puducherry may be useful for statistics, preventive steps and remedies.
Most of the electrocution deaths were overwhelmingly occurred in middle aged males and during the daytimes, when they are actively involved in the home or workplace activities. These incidents are preventable by endorsing simple safety precautions at work place and home, and also by imparting health education at community levels. Almost all incidents are accidental in nature, but it is difficult to distinguish the manner of death in certain circumstances.
Authors would like to express their gratitude to all the faculty members of the Departments of Forensic Medicine, Indira Gandhi Government General Hospital and PostGraduate Institute and Sri Manakula Vinayagar Medical College, Puducherry. The authors acknowledge the immense help received from the scholars whose articles are cited and included in references of this manuscript. The authors are also grateful to authors / editors / publishers of all those articles, journals and books from where the literature for this article has been reviewed and discussed.
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