Cognition and mental wellbeing after electrical accidents: a survey and a clinical study among Swedish male electricians

Low-voltage electrical accidents, immediate reactions and acute health care associated with self-reported general health 4 years later

BACKGROUND AND AIMS

Electricians frequently experience low-voltage electrical accidents. Some such accidents involve long-term negative health consequences. Early identification of victims at risk for long-term injury may improve acute medical treatment and long-term follow-up. This study aimed to determine acute exposure, health effects and treatment associated with general health ≥ 2 years after low-voltage electrical accidents.

METHODS

In a cross-sectional study, 89 male electricians who had experienced an electrical accident between 1994 and 2001 participated in a 2003 follow-up health examination. They were identified from a registry of low-voltage electrical accidents and included in the study. Based on exposure descriptions in the original accident reports, they were stratified into the following three groups: a current arc accident group (N = 34, mean age 38.8 years [standard deviation, SD = 12.2, range = 21-59]) and two groups with the passage of current through the body, either fixed to the current source ("no-let-go" group; N = 35, mean age 34.0 years [SD = 10.5, range = 21-57]) or not ("let-go" group; N = 20, mean age = 38.7 years [SD = 10.3, range = 21-63]). They retrospectively described acute reactions and assessed their current general health at the health examination. Multivariate linear regression, ordinal logistic regression and Fisher's exact test were used to compare acute reactions with health at follow-up in each exposure group.

RESULTS

The multivariate analysis indicated that after accidents with the passage of current through the body, severe acute headache (β = - 0.56, p = 0.013), years since the accident (β = - 0.16, p = 0.017) and the accident being perceived as frightening (β = - 0.48, p = 0.040) were negatively associated with general health ≥ 2 years later (R² = 0.25, p = 0.002). If the exposure included a no-let-go experience, then acute severe body numbness (β = - 0.53, p = 0.029) was also negatively associated with general health (R² = 0.38, p = 0.002). Without such experience, only acute confusion (β = - 0.90, p = 0.029) was negatively associated with the health at follow-up (R² = 0.24, p = 0.029). In univariate analyses, after the passage of current through the body, acute dizziness (p = 0.029), apathy (p = 0.028), confusion (p = 0.007) and irregular heartbeat (p ≤ 0.05) were associated with poor long-term general health. The no-let-go group, more often than the let-go group, reported panic (p = 0.001), fear of death (p = 0.029), confusion (p = 0.014), exhaustion (p = 0.009), bodily numbness (p = 0.013) and immediate unconsciousness (p = 0.019). Acute symptoms beyond the first day after a current arc accident were associated with poor long-term general health (p = 0.015).

DISCUSSION AND CONCLUSIONS

The acute reactions negatively associated with general health ≥ 2 years after low-voltage electrical accidents should alert the clinician in the acute phase after an electrical accident to the risk of developing negative long-term health effects. Future studies should specify long-term health beyond the concept of general health.

Electricians' Health After Electrical Shocks: A Prospective Cohort Study

OBJECTIVES

To examine whether demographic and health factors are associated with risk of electrical shocks and compared mental and physical health before and after an electrical shock.

METHODS

A 6-month cohort study of 6960 electricians involved weekly questionnaires regarding exposure to electrical shocks, and health. We examined the association between health and demographic factors and the risk of eventual electrical shocks and health before and after a shock.

RESULTS

Youth and poor health were associated with risk of shocks. Reporting of numbness, cramps/spasms, tremors, tinnitus, dizziness, and flashbacks increased in the week of the shock, but only tinnitus and flashbacks persisted, as other symptoms receded. Severity, high voltage, cross-body exposure, wet entry/exit points, and direct current as well as health worries and/or neuroticism increased some estimates.

CONCLUSION

Electrical shocks are common, but rarely result in health effects.

Mental disorders following electrical injuries-A register-based, matched cohort study

Introduction

Electrical injuries happen every day in homes and workplaces. Not only may these injuries cause physical damage and disability, they may also cause mental disorders. The aim of this study was to investigate if persons with an electrical injury suffer from mental disorders in the following years.

Material and methods

In a prospective matched cohort design, we identified 14.112 electrical injuries in two Danish registries and matched these with persons with dislocation/sprain injuries or eye injuries, respectively, as well as with persons from the workforce from the same occupation, using year of injury, sex and age as matching variables. We identified possible outcomes in terms of mental diagnoses in the Danish National Patient registry, based on literature, including reviews, original studies and case-reports as well as experiences from clinical praxis. The associations were analyzed using conditional cox- and logistic regression.

Results

We found that the following of the examined outcomes were associated with exposure to an electrical injury compared to the matched controls. Some of the outcomes showed the strongest associations shortly after the injury, namely ‘mental disorders due to known physiological condition’, ‘anxiety and adjustment disorders’, and especially the ‘Post Traumatic Stress Disorder (PTSD)’ subgroup. The same pattern was seen for ‘Depression’ although the associations were weaker. Other conditions took time to develop (‘Somatoform disorders’), or were only present in the time to event analysis (‘other non-psychotic mental disorders’ and ‘sleep disorders’). The findings were consistent in all three matches, with the highest risk estimates in the occupation match.

Conclusion

Electrical injuries may result in mental disorders, both acute and several years after. However, the absolute risk is limited as most of the outcomes are rare.