An increase in electrical burns during the covid lockdown in Western Cape, South Africa

BACKGROUND

A severe Covid lockdown in South Africa may have changed burn patterns due to the downturn of the economy and stay-at-home policies. We describe the volume and type of burn admitted to a tertiary hospital before and during the Covid lockdown.

MATERIALS AND METHODS

This was a retrospective study from before (April 2019-March 2020) and during (April 2020-March 2021) the Covid pandemic. Patient demographics, burn etiology, and clinical outcomes were described. Logistic regression was used to model associations between burn etiology and the Covid period.

RESULTS

Of 544 burns, 254 (46.7%) occurred before and 290 (53.3%, p = 0.051) during Covid. The proportion of electrical burns doubled during Covid n = 20, 32.3% vs n = 42, 67.7%, (p = 0.053) periods. At least half were associated with suspected cable or copper theft. On multivariate analysis, flame burns (OR=2.42, p < 0.001), electrical burns (OR=4.88, p < 0.001), and paying patients (OR=4.21, p < 0.001) were more likely to be associated with the Covid period.

CONCLUSION

Electrical burns doubled during Covid, potentially related to an increase in cable and copper wire theft, a phenomenon described during hard economic times in other settings. More studies to understand this potential relationship are indicated to prepare burn centers during future pandemics and/or economic hardship.

Acute myocardial infarction due to accidental electrocution — A case report of a 26-year-old African male patient

We report a case of fatal myocardial infarction (MI) after electrocution in a 26-year-old male patient without cardiovascular risk factors. The patient was admitted to the Emergency Department of the University Clinics of Lubumbashi for management of accidental electrocution on a high-voltage power line. The admission ECG showed lesions consistent with myocardial infarction. Despite treatment, the patient died 30 minutes after admission.

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.

The Investigation of an Accident Site With an Atypical Electrocution Exit Wound and Burn in an Unusual Location: A Rare Case Report and Review of Literature

Cases involving electrocution burns are tough to investigate for the clinical forensic practitioner. Burns from high-voltage electrocution might seem like burns from other sources, especially if the victim is in an unconscious state. In this situation, circumstantial evidence in addition to clinical symptoms may be used to exclude other burns. Furthermore, the investigation of accident site results to aid in explaining the pattern of injuries discovered during a clinical evaluation. In this case study, we reported a case of a 33-year-old male who came in contact with a high-voltage transmission wire and was burned over both hands and lower back region. The exit wound was atypical in appearance, with a scorched area of peeling blistering skin, charring, and severe scorching over the lower back region which were correlated with the accident site, and the circumstances that led to electrocution injury.

The electrophysiology of electrocution

Electrocution is a death caused by an application of electrical current to the human body. Our present understanding of electrocution-as the induction of ventricular fibrillation (VF)-followed a nearly century-long path of misunderstandings and speculation primarily focused on hypotheses of asphyxia as well as central nervous system trauma. It is hard for us today to appreciate the past mystery of an unexpected sudden death usually bereft of visible trauma. Even today, a false dogma exists that direct-current shocks can cause asystole instead of VF. A lightning discharge (up to 500 megavolts) is differentiated because it can cause substantial acute and chronic neural effects leading to other cardiac arrest rhythms. The human heart is exquisitely sensitive to alternating currents, and VF can be induced with currents of one-eighth that required for mere pacing. Because of these low currents, this effect obtains only in the TQ interval, and low-power electrocution does not involve the vulnerable period. If a current is strong enough to electrocute, generally it will do so in 1-2 seconds; longer shocks do not tend to be more dangerous. Regardless of concomitant drug dosing, the electrocution cardiac arrest rhythm is still VF, suggesting that electrocution is a stand-alone cause of death; the electrical current does not potentiate the effects of the drug. The experimental and clinical data supporting VF as the mechanism for electrocution are provided.

Electrocuted to death: A case of an autoerotic fatality with body wrapping, anal masochism, and low abdomen mechanical stimulation

Autoerotic paraphilic manipulations may be not only incredibly unusual but also hazardous and possibly fatal. Autoerotic experimenters sometimes combine several paraphilic mechanisms, both potentially lethal and non-lethal. A tragic outcome is usually a direct consequence of the life-threatening paraphilic mechanism(s); however, it may also result from an accidental complication arising from the constellation of the paraphilic realization. In this report, we present a case of an autoerotic death of a 30-year-old man who applied two potentially lethal paraphilic mechanisms-body wrapping and foreign body anal insertion-together with two other non-lethal paraphilic activities, autofetishism and transvestitism. However, the man's death ultimately occurred due to another associated autoerotic activity-stimulation of the lower abdomen with an electric massager, which accidentally short-circuited and caused fatal electrocution. Such autoerotic fatalities constitute a distinct subcategory of accidental autoerotic death.

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.

One-stage Flexor Reconstruction With Anterolateral Thigh and Fascia Lata Rolls After High-Voltage Trauma: A Case Report

Background

Electrical injuries from high-voltage power lines are unique forms of trauma that can create challenging wounds for reconstructive surgeons. Our patients, a man in his late thirties (Patient 1) and a man in his early twenties (Patient 2), both sustained upper extremity injuries after contact with a high-voltage line.

Methods

Despite minimal superficial damage, both patients required fasciotomies and debridement of the volar forearm, revealing segmental defects in most digital tendons as well as the distal median nerve. Free fasciocutaneous anterolateral thigh (ALT) flaps were harvested to ensure adequate wound coverage. Additionally, fascia lata grafts were taken from the free flap donor site and rolled into tubes to transfer available flexor digitorum superficialis proximal tendon stumps to the distal stumps of flexor digitorum profundus. The rolls were also used to bridge segmental tendon defects in flexor pollicis longus, while cadaveric nerve allografts were used to bridge the median nerve defects.

Results

Nine months postoperatively, Patient 1 had premorbid function with activities of daily living (ADLs), and Patient 2 required only minimal assistance with instrumental ADLs. Within a year following reconstruction, Patient 1 mostly regained range of motion in his digits with some rigidity, and Patient 2 regained full range of motion in his digits with minimal rigidity.

Conclusions

These cases have demonstrated that the use of an ALT free flap combined with rolled fascia lata graft tubes may be an effective choice for reconstruction and functional restoration in cases of severe high-voltage electrical trauma.

The various pathological manifestations of a lightning strike exemplified in a single four-fatality incident - A case report and review of a literature

The lightning strike is one of leading cases of weather-related death worldwide. We present an unusual case of four fatality-lightning strike with various pathological manifestations. All victims died from a single lightning strike in the mountains that also caused injury to 156 other people. All victims had mechanical damage and rock damage that are typical for lightning strikes in the mountainside. Another lesions indicative of lightning strike and electrical damage were, among others: burnt and torn clothes (all cases) current marks (Cases 1, 2 and 3) and Lichtenberg figures along with flashover marks on Case 1. In the review we described the pathophysiological mechanisms of lightning-induced lesions and injuries and epidemiological trends of lightning-strike deaths. Our study exemplifies various manifestations of lightning strikes on forensic examination and underlines the necessity to take lightning strike into consideration when investigating open-air deaths of unclear origin.

Wildlife is imperiled in peri-urban landscapes: threats to arboreal mammals

Urbanization and deforestation impose severe challenges to wildlife, particularly for forest-living vertebrates. Understanding how the peri-urban matrix impacts their survival is critical for designing strategies to promote their conservation. We investigated the threats faced by brown howler monkeys (Alouatta guariba clamitans) in peri-urban regions of Rio Grande do Sul (RS) and Santa Catarina (SC) states, southern Brazil, by compiling negative interaction events (hereafter NIE) reported over more than two decades. We assessed the major NIEs, their distribution among age-sex classes, and the predictors of NIE-related mortality. After 20+ years of monitoring, we compiled 540 NIEs (RS = 248 and SC = 292). Electrocution by power lines was the most frequent cause of death or injury (37%), followed by dog attack (34%), vehicle collision (17%), and human mistreatment (12%). The occurrence of lethal injuries ranged from 5% to 69% depending on the type of NIE and on which state it occurred in. The overall post-NIE mortality was 56%. Adults of both sexes were the most affected individuals in both study regions. The minimal adequate GLM model explained 83% of the variation in NIE-related mortality. State, NIE type, and age-sex class were the main predictors of mortality. Overall, mortality was lower in SC and higher among adult females than in the other classes. We found that the survival of brown howler monkeys in the forest-urban interface is constrained by both the urban infrastructure and the growing interactions with humans and domestic and stray dogs (Canis familiaris). We propose the placement of aerial bridges, road signs and speed bumps in areas of frequent animal crossing, the sterilization of stray dogs, and the sensitization of local inhabitants on the importance of respecting and protecting wildlife to reduce their NIEs with humans and domestic animals in the forest-urban interface.

Rare survival of high-tension electrocution shock in a crossbred Jersey cattle: a complete profile on critical care monitoring

Background

Accidental electrocution was more common in animals and death was mostly due to shock and cardiac arrest. Survival of animals or humans could be possible if victims receive immediate medical support.

Case description

A 3-year-old crossbred Jersey heifer was presented to the Emergency and Critical Care Medicine Referral Clinic of the Veterinary College and Research Institute, Orathanadu, with a history of accidental electrocution by broken high-tension overhead power transmission line during grazing in the paddy fields. The animal was dull and depressed, dark red, and some areas were charred in appearance on the dorsum and limbs. The animal showed difficulty walking due to the electrocution burn injury and was poorly responding to the surroundings. Clinical examination revealed subnormal temperature, polypnea, pale mucous membranes, ruminal atony, and arrhythmias on auscultation.

Findings/treatment and outcome

On point of care (PoC) hematology testing, leukocytosis, neutrophilia, and microcytosis were observed. PoC electrolyte analysis revealed hypocalcemia (ionized calcium 0.89 mmol/L), mild hypochloremia, and severe hypokalemia (2.81 mmol/L). PoC biochemistry revealed hypoglycemia (41 mg/dl). PoC elevated levels of serum cardiac troponin (0.33 ng/dl) indicated cardiac damage. Aspartate aminotransferase (1794 U/L), CK-MB (699 U/L) and LDH (6.7 U/L) were also elevated. On PoC urinalysis, proteinuria, myoglobinuria, and glucosuria were observed. Evident clinical recovery, wound healing, and improvement in animal activities were observed.

Conclusion

High-voltage electrocution injury is a serious type of accident with the potential risk of multi-organ damage and death. Early diagnosis of electrocution and immediate management enhances the expectancy of complete recovery.

Unusual cases of suicidal electrocution using a homemade device

BACKGROUND

The common methods of suicide are hanging and poisoning. Suicidal electrocution using a homemade device is very rare. Victims usually possess knowledge of electrical circuits. Here, we report two cases of suicide by electrocution using a homemade device.

CASE PRESENTATION

Case 1: A retired electrical technician was found unresponsive in his bedroom, with two bare copper wires; one encircling the index finger of the left hand, and the other placed in the mouth. The other ends of the wires were connected to a wall plug supplying 220 V current. Forensic autopsy and microscopic findings attributed death to suicidal electrocution.Case 2: A 51-year-old-man was found dead in the bathroom with bare copper wires encircling both wrists and connected to a wall plug carrying 220 V current. Death scene investigation, necropsy, histological tests and toxicological screening indicated suicide by electrocution.

Electricity induced burns and lung injury: A rare autopsy observation

Electrocutions injuries are frequently encountered in a domestic setting or as an occupational hazard. Electrocutions injuries sustained in occupational settings are often associated with significant morbidity and mortality globally. Autopsy diagnosis of electrocution is mostly based on gross and histopathological changes in the entry and exit wounds. Gross changes in form of entry and exit wounds, however, may not be present in all cases of electrocution. In such cases, histopathological changes in the internal organs along the path of current can be useful. We report a case of fatal electrocution involving a 23-year-old young male in which remarkable gross and microscopic changes were appreciated in the lung due to the passage of electric current through it. Such observations are rarely reported in literature and highlight on the significance of autopsy pathology in the diagnosis of electrocution.

Water heating immersion rod fatalities and their injury pattern characteristics

Immersion rod is a very low-cost electrical device. It is based on simple working principle and widely used in developing nations to heat water for various domestic needs. However, the literature about electrocution caused by it is nearly absent. This is despite its usage being potentially hazardous, with almost sure fatal outcome in cases of mishandling. Data was gathered from 2011 to 2020, via inquest and autopsy reports, regarding electrocution deaths related to it. 6 cases were identified. All consisted of females in domestic settings, as the unique epidemiology in stark contrast to the existing literature on electrocution fatalities worldwide. Injury patterns in a few cases resembled those typical of high voltage electrocution, in these low voltage fatalities. Characteristics of joule burns showed sub-patterns, deviant from electrocution related to other appliances and was again unreported previously. Spark burns and scalds were patterns, quite diagnostic of immersion rod fatalities. A typical pattern for a multitude of injuries in each case is brevity of this study. Injury patterns are presented as a classical guide for further growth of the literature on these types of fatalities.

Early intervention mechanism for preventing electrocution in construction engineering

The aim of this study is to establish an effective early intervention mechanism for construction engineering to prevent electrocution while improving labor safety and reducing the casualty risk. This study used narrative text analysis and the Haddon Matrix for data collection, and analyzed the causes from the 113 electrocution deaths among in the construction industry, the exhaustive chi-square automatic interaction detector algorithm was employed the segmentation of the correlations. Based on the theory of inventive problem solving, through IDEF0 (ICAM DEFinition) for function modeling was designed the early intervention mechanism. This study revealed the operating features related to electric shock hazards. Early intervention was introduced to reduce the relevant risks and establish safety mechanisms. The first contribution of this study is the determination of hazard correlations between operating features and conductive media, and entry point for the prevention of electrocutions. The second contribution is the suggestion of the establishment of inspection stations for electric tools, thereby ensuring that the portable power tools are safe. The final contribution is the joint application of TRIZ (Teoriya Resheniya Izobreatatelskikh Zadatch) and IDEF0, which establishing the pre-entry testing, strengthening safety mechanisms.

Morphological cardiac changes in electrocution deaths: A literature review

Electrical injury may lead to damage to the conducting tissue, myocardial changes and even sudden cardiac death. Victims of low-voltage electrocution may have no electric marks, burns or other signs typical of electrical injuries. In these cases, the absence of other specific findings could make the identification of the cause of death very difficult. A broad spectrum of cardiac changes in cases of electrocution has been described in the literature, including the break-up of myocardial fibres, cardiomyolysis, haemorrhagic areas, the separation of myofibres and alternating hypercontracted-hyperdistended myocytes. All the described alterations, however, cannot be exclusively attributed to electrocution, since no specific morphological cardiac findings have so far been identified in electrocution. However, a few histological patterns recur, and their knowledge may be important for the forensic pathologist. This literature review describes the main pathological patterns observed in cases of fatal electrocution based on a literature search carried out up to September 2019 in the databases PubMed and Scopus. The search criteria included the keywords for cardiac lesions and electrocution. On the grounds of the literature data, a list of major and minor diagnostic markers for the passage of the electrical current through the heart tissue was created.

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.

High-voltage electrocution-induced pulmonary injury and cerebellar hemorrhage with fractures in atlas

Background

Electrocution is a common cause of mild to severe multisystem injuries leading to high rate of mortality and morbidity. Low to high-voltage injury may be clinically manifested from a simple unpleasant sensation to multiple soft tissue injury which may cause instant death. The severity of injury depends on intensity of the electrical current, voltage of the source, resistance in the victims' body and the duration of the contact.

Case presentation

A 20-year-old young male experienced with an accidental high-voltage electrocution injury from a blasted electrical transformer while passing across the road. He lost his consciousness and immediately hospitalized. Bilateral pulmonary infiltrates and right cerebellar hemorrhage with fractures in anterior and posterior arch of the first cervical vertebrae (C1) were diagnosed, and there was no history of electrical burn. He stayed in hospital for three days and completely treated with initial oxygen supplementation and immobilization of his head and neck with a Philadelphia collar for 6 weeks. Electrocution is a serious public health concern and reported worldwide with few fatal ending. Accidental high-voltage electrocution injury is a serious type of unfortunate accidental injuries which in most of times, ends with immediate or delayed sequelae or even death. In this case, the victim with high-voltage-associated electrical injuries in his lungs and brain was completely recovered because of early hospitalization.

Conclusions

Electrocution injury is an accidental event with high mortality and morbidity rate. Mild to severe electrical current-induced injuries including burn can be treated successfully in most of the cases, but early hospitalization is highly required.

High tension electrocution death: New histopathological cardiac tools by Confocal Laser Scanning Microscope

In deaths due to electrocution intraepidermal separation, vacuolation of epidermal cells, "swiss cheese" aspect of the superficial part of epidermis (swollen and with multiple vescicles), metallization, necrosis of collagenous fibers, cardiomyocytes alterations are microscopically described. No cardiac nerve damage due to electricity is actually reported in literature. In this work we tried to find new morphological signs in the hearts of deaths due to electrocution. In three cases of deaths due to electrocution, in which forensic autopsies were performed within 36 h of the death, heart specimens were taken at the level of common trunk of the left coronary artery. The myocardium histological examination at optical microscope and Confocal Laser Scanning Microscope (CLSM) revealed fragmentation of cardiomyocytes, nerve trunks damage with hydropic swelling of the nerve fibers, interstitial and sub-nerve-sheath edema, very dishomogenous distribution of the natural fluorescence of the neurofilaments, coarctation of epicardial gangliar cells with cytoplasmic cleft and irregular fluorescence pattern. Identification of S-100 protein by immunohistochemistry can help to better observe the hydropic swelling of the nerve fibers and the central cytoplasmic clefts. These alterations could be used in future as specific signs of the passage of the electrical current through the heart. We recommend heart specimens at the level of common trunk of the left coronary artery in all the cases of suspected electrocution, to better evaluate cardiac nerve trunks damages and alterations.

Direct current electrical injuries: A systematic review of case reports and case series

BACKGROUND

Direct current (DC) powered equipment and devices, including photovoltaic systems, high-voltage direct current power lines and novel concepts in electromobility have become increasingly popular in recent years. However, under adverse circumstances by malfunction or mishandling of these applications electrical injuries may occur when electric current passes through the human body. This review aimed at systematically summarizing the medical consequences of DC electrical injuries described in case reports and case series.

METHODS

The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guided the methodological conduct and reporting.

RESULTS

Sixteen case reports and 3 case series were eligible for this review and included 70 patients. The reviewed articles were very heterogeneous regarding sources of DC electrical injuries and the reported medical consequences, including burns and skin lesions (n=67), neurological consequences (n=11), unconsciousness (n=10), cardiac consequences (n=8) and bone fractures (n=6). Seventeen individuals did not survive the electrical injuries.

CONCLUSION

From the few available data and partly incomplete documentations of cases we could gather hints of DC medical consequences, however, it was not possible to identify well-defined medical consequences for various circumstances of DC electrical injuries in occupational and non-occupational settings. To achieve this goal, additional studies are required, each providing a comprehensive description of the medical consequences and the circumstances of the electrical injuries.

Alarming rise in fatal electrocutions in Bangladesh: Comparison of two national surveys

BACKGROUND AND OBJECTIVES

Electrical injuries are major contributor to burn-related mortality and morbidity. Mortality data were compared from the two largest community-based health and injury surveys in Bangladesh conducted thirteen years apart to investigate the changes in epidemiological features of this adverse health event.

METHODS

The nationwide Bangladesh Health and injury surveys (BHIS) were conducted among 819,429 people in 2003 and 299,216 in 2016 using a pretested semi-structured questionnaire at the household level. History of electrocution death events in previous one year in the household was determined by verbal autopsy method in both surveys. Thus, each survey result represents the scenario of the year before. Descriptive and comparative analysis was done to investigate the changes in the distribution of electrocution deaths.

RESULTS

The incidence of electrocution deaths was 1.7 and 4.3 per 100,000 population respectively in the 2003 and 2016 survey. The majority of the cases were aged between 18 to 59 years in both years. The comparison of the two survey results shows that the death rates increased in every age group those were examined. The rates were persistently higher in rural areas compared to the urban. Moreover, the rural mortality rate increased strikingly in 2015. The highest proportion of fatal electrocution events occurred at workplaces and males had a higher mortality rate in contrast to females in both the surveys. The death rate in males doubled in 2015 (6.0 per 100,000) from 2002 rate (3.1 per 100,000).

CONCLUSION

Electrocution mortality rates have raisen alarmingly between 2002 and 2015. Working persons and males have a higher susceptibility to deaths from electrocution. Rural areas pose greater threats compared to urban Bangladesh. Being derived from a nationwide survey, these facts provide with useful direction to set priorities for prevention of this emerging unnatural cause of death in the country.

Extensive study on electrocution at the Bureau of Legal Medicine of Milan (1993-2017): Determination of the current mark with scanning electron microscope/energy-dispersive X-ray analysis on paraffin-embedded samples

Literature on electrocution in Italy is limited. The authors have focused their attention on the use of scanning electron microscope/energy-dispersive X-ray analysis in order to evaluate the current mark even on paraffin-embedded samples. A total of 24,104 autopsies were performed at the Section of Legal Medicine of Milan (1993-2017); all cases of death caused by electrocution (low and high voltage) were selected. We assessed a regular histological examination, a toxicological examination and detected metallisation with energy-dispersive X-ray spectroscopy analysis on paraffin-embedded tissues of typical current marks. We collected 27 high-voltage fatalities and five cases of low-voltage suicide electrocution; the technique revealed itself as sensitive. In all cases, microscopic examination highlighted the typical signs of electric current and thermal damage but the histochemical specific stainings for copper and iron gave negative results. Scanning electron microscope/energy-dispersive X-ray analysis, assessed on these same samples, even when paraffin-embedded, however, enabled us to detect these elements and differentiate between the various metal residues involved in the electrocution process. Based on their experience, authors advise the use of scanning electron microscope/energy-dispersive X-ray analysis on electrocution deaths to provide information for forensic diagnosis.

Bird on the wire: Landscape planning considering costs and benefits for bird populations coexisting with power lines

Power-line grids are increasingly expanding worldwide, as well as their negative impacts on avifauna, namely the direct mortality through collision and electrocution, the reduction of breeding performance, and the barrier effect. On the other hand, some bird species can apparently benefit from the presence of power lines, for example perching for hunting purposes or nesting on electricity towers. In this perspective essay, we reviewed the scientific literature on both costs and benefits for avifauna coexisting with power lines. Overall, we detected a generalized lack of studies focusing on these costs or benefits at a population level. We suggest that a switch in research approach to a larger spatio-temporal scale would greatly improve our knowledge about the actual effects of power lines on bird populations. This research approach would facilitate suitable landscape planning encompassing both mitigation of costs and promotion of benefits for bird populations coexisting with power lines. For example, the strategic route planning of electricity infrastructures would limit collision risk or barrier effects for threatened bird populations. Concurrently, this strategic route planning would promote the range expansion of threatened populations of other bird species, by providing nesting structures in treeless but potentially suitable landscapes. We suggest establishing a collaborative dialogue among the scientific community, governments, and electricity companies, with the aim to produce a win-win scenario in which both biodiversity conservation and infrastructure development are integrated in a common strategy.

Myocardial Stunning After Electrocution With Complete Reversibility Within 24 Hours: Role of Repeat Transthoracic Echocardiograms in Potential Cardiac Transplant Donors

Despite the development of ventricular assist devices, cardiac transplantation remains an important procedure for patients with advanced heart failure. The number of transplants done annually has remained stable because of lack of of donors. Left ventricular systolic dysfunction remains one of the most important reasons for seeking a donor heart. Myocardial stunning is an important cause of reversible systolic dysfunction. Electrical injury is a recognized cause of myocardial stunning with variable duration ranging from days to weeks. Repeating the transthoracic echocardiogram to look for reversibility of left ventricular dysfunction can be a cost-effective method to improve the selection of heart donors. This can significantly help to decrease critical organ shortage. We present a case of myocardial stunning after electrocution which was completely reversible within a few hours, thus meeting cardiac transplant donor criteria.

Spatial Patterns of Primate Electrocutions in Diani, Kenya

Electrocution from power infrastructure threatens many primate species, yet knowledge of effective evidence-based mitigation strategies is limited. Mitigation planning requires an understanding of the spatial distribution of electrocutions to prioritize high-risk areas. In Diani, a coastal Kenyan town, electrocution is an important cause of death for five primate species. In this study we aim to describe the spatial patterns of electrocutions and electric shock incidents (collectively referred to as electrocutions hereafter) and identify electrocution hotspots to guide an effective primate conservation approach in Diani. Colobus Conservation, a not-for-profit organization, has recorded electrocutions and annual primate census data since 1998. We georeferenced 329 electrocution data points and analyzed them using QGIS. We identified and compared hotspots across species, seasons, and time using kernel density estimation and Getis-Ord-Gi*. We employed spatial regression models to test whether primate population density and power line density predicted the location of electrocution hotspots. Electrocutions occurred in hotspots that showed little variation in location between species and seasons. The limited variation in hotspot location over time likely occurred as a result of new building development in Diani and variability in primate detection rates by community members. Primate density and power line density were significant predictors of electrocution density for Angolan black-and-white colobus (Colobus angolensis palliatus) and Sykes monkeys (Cercopithecus mitis albogularis), but the relationship was weak, suggesting the presence of additional risk factors. This study provides a framework for systematic spatial prioritization of power lines that can be used to reduce primate electrocutions in Diani, and can be adopted in other areas of the world where primates are at risk from electrocution.

Wildfires as collateral effects of wildlife electrocution: An economic approach to the situation in Spain in recent years

The interaction between wildlife and power lines has collateral effects that include wildfires and Carbon Dioxide (CO₂) emissions. However, currently available information is scarce and so new approaches are needed to increase our understanding of this issue. Here, we present the first analysis of wildfires and their incidence as a result of this interaction in Spain during the period 2000-2012. Amongst the 2788 Power-Line Mediated Wildfires (PLMW recorded) during this period, 30 records of Fauna Mediated Wildfires (FMW) were found, with an average affected vegetation cover of 9.06ha. Our findings suggest that no significant differences were observed between the amount of affected surface area due to fauna mediated wildfires and power-line mediated wildfires. In both cases, a space-grouping trend was observed. In terms of changing trends over time, after the first incident detected in 2005, the number of incidents increased until 2008, year in which the percentage of wildfires caused by wildlife stabilized at approximately 2.4% of all power-line-induced wildfires. Population density and road abundance were variables that better explained PLMW whereas for FMW, the models that included land use and raptor abundance. In the multivariate model, FMW emergence was positively related with population density, percentage of grazing areas and Natura 2000 cover, and predatory abundance; and negatively with the percentage of forested area. No significant differences were observed between the species of birds that caused wildfires and the species of ringed birds killed by electrocution. The economic and environmental impact due to necessary repairs, the loss of biodiversity and CO₂ emissions represent an estimated net value of €7.6-12.4M for the period 2000-2012, which indicates the importance of the economic and environmental costs associated with wildfires.

Diagnosis of electrocution: The application of scanning electron microscope and energy-dispersive X-ray spectroscopy in five cases

INTRODUCTION

Deaths from electricity, generally, do not have specific findings at the autopsy. The diagnosis is commonly based on the circumstances of the death and the morphologic findings, above all the current mark. Yet, the skin injury due to an electrocution and other kinds of thermal injuries often cannot be differentiated with certainty. Therefore, there is a great interest in finding specific markers of electrocution. The search for the metallization of the skin through Scanning Electron Microscope equipped with Energy Dispersive X-Ray Spectroscopy (EDS) probe is of special importance in order to achieve a definite diagnosis in case of suspected electrocution.

MATERIALS AND METHODS

We selected five cases in which the electrocution was extremely likely considering the circumstances of the death. In each case a forensic autopsy was performed. Then, the skin specimens were stained with Hematoxylin Eosin and Perls. On the other hand, the skin lesions were examined with a scanning electron microscope equipped with EDS probe in order to evaluate the morphological ultrastructural features and the presence of deposits on the surface of the skin.

RESULTS

The typical skin injury of the electrocution (current mark) were macroscopically detected in all of the cases. The microscopic examination of the skin lesions revealed the typical spherical vacuoles in the horny layer and, in the epidermis, the elongation of the cell nuclei as well as necrosis. Perls staining was negative in 4 out 6 cases. Ultrastructural morphology revealed the evident vacuolization of the horny layer, elongation of epidermic cells, coagulation of the elastic fibers.

EDS-MICROANALYSIS

In the specimens collected from the site of contact with the conductor of case 1 and 2, the presence of the Kα peaks of iron was detected. In the corresponding specimens taken from cases 2, 4, 5 the microanalysis showed the Kα peaks of titanium. In case 3, titanium and carbon were found.

CONCLUSIONS

In the suspicion of electrocution, the integrated use of different tools is recommended, including macroscopic observation, H&E staining, iron-specific staining, scanning electron microscopy and EDS microanalysis. Only the careful interpretation of the results provided by all these methods can allow the pathologist to correctly identify the cause of the death. Particularly, the present study suggests that the microanalysis (SEM-EDS) represents a very useful tool for the diagnosis of electrocution, allowing the detection and the identification of the metals embedded in the skin and their evaluation in the context of the ultrastructural morphology.

Electric or traumatic injury? The role of histopathological investigations

Analysis of wounds is crucial in forensic medicine to prove how an injury was caused. In many cases, microscopic analysis may be decisive. It is often difficult to distinguish macroscopic skin lesions resulting from electrical, mechanical and from thermal trauma where these occur simultaneously and to formulate a correct differential diagnosis. We report two cases in which the injuries found on the bodies and the manner of death raised uncertainty. An autopsy was performed. External examination of the bodies showed skin injuries that needed histopathological analysis to reconstruct the dynamics and the manner of death which has an important role in doubtful cases.

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.

A special type of scald caused by prolonged exposure to slowly heated water

When skin is subjected to water temperatures gradually rising from moderate to critical ranges for a prolonged period of time, the resulting scalds will initially present as reddening, followed by blistering and at last by full-thickness burns. On changing from second- to third-degree burn, the blisters stop to become enlarged and solidify due to heat-induced coagulation necrosis. Such gradually intensifying tissue damage results in multiple firm skin blisters together with third-degree burn of the affected area. The initially serous blister fluid assumes a jelly-like consistency as the proteins undergo denaturation. Scalds of this special type may occur in persons taking a bath and becoming incapable to act so that the warm water tap remains turned on or a hairdryer continues to work after having been dropped into the bath water. On the basis of two relevant fatalities (suicidal electrocutions in bathtubs by means of hairdryers), the macroscopic and histological appearance of blisters which only secondarily turned into a full-thickness scald is compared with blisters in genuine second-degree scalds. The blister fluid of the latter ones was also investigated as to their protein composition and hemoglobin concentration.

The effect of elapsed time on cardiac troponin-T (cTnT) degradation and its dependency on the cause of death

PURPOSE

The aim of the present study is to evaluate the effect of elapsed time on cardiac troponin-T degradation and its dependency on the cause of death.

METHODS

The cases included in this study were divided into six groups depending upon the cause of death without any prior history of disease that died in the hospital and their exact time of death was known. The analysis involves extraction of the protein, separation by denaturing gel electrophoresis and visualization by Western blot.

RESULTS

Western blot data shows the rate of degradation of cTnT into lower molecular weight fragments with respect to time. In cases of control group the greatest amount of protein breakdown was observed within the first 64 h while in MI cases within first 6 h, the original band of cTnT (42 kDa) decreased markedly into seven major fragments, with 25 kDa & 20 kDa fragments being the most prominent. In burn group, at 41.40 h blot shows maximum fragmentation. In electrocution group the greatest amount of protein breakdown was observed within the first 50 Hrs. Within asphyxia cases, the original band of cTnT (42 kDa) decreased markedly into many major and minor fragments which continues up to 210 Hrs while the original band of cTnT (42 kDa) in poisoning cases decreased markedly into many major & minor fragments up to 140 h but after it blot shows only intact protein of very less intensity with few minor fragments.

CONCLUSION

It can be observed that in case of death due to MI, the intact cTnI fragmented at a much faster rate than in burn, electrocution, control, poisoning and asphyxia group. Thus, the rate of fragmentation of intact cTnT into lower molecular weight fragments depends upon the cause of death.

The effect of elapsed time on cardiac troponin-T (cTnT) degradation and its relation to postmortem interval in cases of electrocution

BACKGROUND

The estimation of postmortem interval (PMI) is of paramount importance for the police in their investigation when arriving at the scene of a questionable death. The aim of present study is to evaluate the effect of elapsed time on cardiac Troponin-T degradation and its association with PMI in cases of death due to electrocution.

METHODS

Cardiac tissue samples were collected from medico-legal autopsies, after informed consent from the relatives. The cases included were the subjects of electrocution without any prior history of disease who died in the hospital and their exact time of death was known. The analysis involves extraction of the protein at room temperature for different time periods (∼5, 26, 50, 84, 132, 157, 180, 205 and 230 Hrs), separation by SDS-PAGE and visualization by Western blot using cTnT specific monoclonal antibodies.

RESULTS

The results specify a characteristic banding pattern amongst human cadavers (n = 5), a pseudo-linear relationship between percent cTnT degraded and the time since death (R(2) = 0.87, p = 0.0001) was observed. The area of the bands within a lane was quantified by scanning and digitizing the image using Gel Doc (Universal Hood II).

CONCLUSIONS

The post-mortem Troponin-T fragmentation observed in this study reveals a sequential, time-dependent process with the potential for use as a predictor of PMI in cases of electrocution.

Cardiac pathology in fatal electrocution

Electrocution is mostly unintentional and occurs in domestic environment or in form of an occupational hazard. Electrical burns sustained in domestic environment or otherwise are associated with significant morbidity and mortality. The present report describes the pathological changes in the heart as observed in a case of fatal electrocution.

Electrothermic damage to the nail due to arcing in high-voltage discharge

The burn effects in high-voltage electrocutions are manifold ranging from inconspicuous marks to deep charring. Apart from lesions caused by direct contact with a live conductor, the victim's body may suffer flash burns from arcing resulting in extensive scattered or confluent heat damage of the skin. In such cases, the nail plates of fingers and toes may undergo thermal changes which up to now have not been mentioned in the pertinent literature. Macroscopically, the nail shows a yellowish discoloration with tiny and closely arranged verruciform elevations. Histologically, the uppermost layer of the nail plate is interspersed with small vacuoles resembling micro-blisters as seen in the corneal layer of common electric marks. The surface of the nail is coated with a thin film of carbonaceous material. Based on an accidental high-voltage electrocution recently observed by the authors, attention is also drawn to the possible occurrence of contact burns from metal objects heated by the current as this finding is usually described only in victims of lightning strikes and not in the context of high-voltage discharges of technical electricity.

Brugada-type electrocardiographic pattern induced by electrocution

Heart is one of the most frequently affected organs in electrocution. Electrical injury can cause life-threatening cardiac complications such as asystole, ventricular fibrillation, and myocardial rupture. In this case report, we describe a 22-yr-old male patient who sustained electric burn injury and presented with electrocardiogram showing transient Brugada type pattern.

Nematode electrocution

The effects of electric shock on Panagrellus redivivus adults and larvae and Meloidogyne incognita acrita larvae were studied. The nematodes were placed in tap water between two stainless steel electrodes, spaced 2 mm apart and cemented to a glass slide. Electric potentials of 1, 5, 10, 15, 20, 30, and 60 vdc/mm and vac/mm were applied for periods of 1 sec to 5 rain at 0.05 to 77 ma. The results demonstrated that ac or dc electric shocks as low as 5 v/mm for larvae and 10 v/mm for adults can be lethal. Some larvae and eggs within the body of P. redivivus females were not affected at 600 v/ram. Potentials of 20 and 60 vdc/mm for 2-sec stimulated hatch of Meloidogyne eggs.