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 Table of Contents  
ORIGINAL ARTICLE
Year : 2018  |  Volume : 4  |  Issue : 4  |  Page : 179-183

Deaths due to electrocution: An evaluation of death scene investigations and autopsy findings


1 Forensic Medicine, Graduate School, University of Maryland, Maryland, USA
2 Forensic Medicine, Graduate School, University of Maryland; Forensic Medicine, Office of the Chief Medical Examiner, Baltimore, Maryland, USA; Evidence Science, Sino-US Forensic Science Research Center, Collaborative Innovation Center of Judicial Civilization, China University of Political Science and Law, Beijing, China

Date of Web Publication27-Dec-2018

Correspondence Address:
Dr. Ling Li
Sino-US Forensic Evidence Science Research Center, Collaborative Innovation Center of Judicial Civilization, 900 West Baltimore Street, Baltimore, Maryland 21223

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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jfsm.jfsm_57_18

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  Abstract 


The purpose of the study was to delineate the epidemiological characteristics of electrocution deaths in Maryland, identify any potential risks, and address preventive measures. A retrospective review of all the deaths due to electrocution was conducted at the Office of the Chief Medical Examiner in the State of Maryland from 2005 to 2015. During the 11-year period, a total of 55 electrocution deaths were identified from the autopsy cases at the statewide medical examiner system. More males died of electrocution than females with its ratio of (M: F) = 9:1. Of the 55 cases, 67.3% were White, 18.2% were African-American, 12.7% were Hispanic, and 1.8% were other races. The age of the victims ranged from 4 to 83 years with mean age of 40 years. >96% deaths due to accidents and 3.4% were suicide. The majority of deaths (70.9%) were caused by high-voltage circuits. Approximately 64% of fatalities were work-related accidents. The study indicated that electrocution deaths frequently affected young male workers who were in contact with a high-voltage currents while on the job. The detailed death scene investigation and autopsy findings are presented. The potential hazards of electricity must continue to be addressed in public safety campaigns to prevent such deaths. Strategies should ensure safe work environments for any contact with electric currents.

Keywords: Death investigation, electrocution, fatality, forensic autopsy, work-related death


How to cite this article:
Massey BK, Sait MA, Johnson WL, Ripple M, Fowler DR, Li L. Deaths due to electrocution: An evaluation of death scene investigations and autopsy findings. J Forensic Sci Med 2018;4:179-83

How to cite this URL:
Massey BK, Sait MA, Johnson WL, Ripple M, Fowler DR, Li L. Deaths due to electrocution: An evaluation of death scene investigations and autopsy findings. J Forensic Sci Med [serial online] 2018 [cited 2019 Jul 16];4:179-83. Available from: http://www.jfsmonline.com/text.asp?2018/4/4/179/248703




  Introduction Top


Electricity is an important energy source for our modern society to which many workers and household occupants are exposed to during their daily life activities. Electrocution is the cause of death for approximately 400 people in the United States every year.[1] While the majority of electrocution fatalities are accidents, there are occasional suicides, and very rarely, homicides.[2],[3],[4] The severity of electrical injuries is dependent upon several factors including voltage, type and amount of current flow, intensity of the electrical current, electrical source, and length of exposure to that source.[5],[6] Electrocution is a relatively uncommon cause of death for both domestic and work-related accidents as well as those in other contexts.[7],[8],[9],[10],[11],[12] Electrocution may occur when someone is exposed to a lethal amount of electric energy, mainly due to carelessness, misuse, or improper maintenance of equipment or wiring.[8],[9],[10]

Fatal electrical injuries may occur in various ways: Direct contact with electricity, electrical arcs, and flash burns created by an electrical arc, or flame burns. They are mainly preventable with simple safety measures in most situations.[1],[7],[8] Almost two-thirds of work-related electrocutions in the U.S involves 600 volts or more.[8] Studies have shown the highest proportion of electrocution deaths are occupation related accidents, accounting for up to 3% of all deaths in the population in 2014.[1] Fatal electrical injuries occurred commonly among young males between ages 20 and 40, who worked as electricians and electrical helpers.[2],[7],[11],[13],[14],[15],[16] In contrast, childhood electrocution is rare in the developed countries. The majority of childhood deaths occur in the home environment. Few studies and statistics have been released compared to occupationally related accidents.[2]

Deaths due to electrical energy is a “functional” death-type in most cases, because fatalities may happen as a result of cardiac arrhythmia/ventricular fibrillation, asphyxia, or electrically induced respiratory muscle contractions.[8],[9],[11],[17],[18] Internal findings are nonspecific and may include bone fractures, nerve damage, tissue burns, and kidney injury. Therefore, autopsy findings from sudden ventricular fibrillation may substantially overlap with those of sudden death.[8],[9],[11],[18],[19],[20]

The only indication of electric injuries is a burn mark. It presents in all cases of high-voltage electrocution whereas only 50% of low-voltage electrical deaths have a burn mark. Electric marks have an irregularly rounded shape. However, it is not uncommon to see other forms. Sometimes, they can be hidden by either folds of skin, hair, hand calluses, or by the same skin burns such as those caused by an arc or related to clothing fire.[8],[9],[18]

The purpose of this study was to evaluate the incident circumstances of fatal electrocution cases investigated by the Office of the Chief Medical Examiner (OCME) for the State of Maryland in order to better assess potential risk factors as well as safety precautions that may potentially reduce or prevent electrocution fatalities.


  Materials and Methods Top


According to the State of Maryland legislation, a forensic autopsy is compulsory in any case where an electrocution death is suspected. The OCME is responsible for investigating all cases of electrocution in the state of Maryland. This study was a retrospective review of records of all the autopsied individuals who died from electrocution in Maryland from 2005 to 2015. Cases accepted for this study included occupational and household electrocutions as well as individuals who died from lightning. Incarcerated individuals who died from electrocution via the electric chair will not be included in this study. The cases were analyzed based on the following information: (1) demographic information of the individual including age, race, and gender; (2) scene investigation information such as witness interviews, indoor versus outdoor location, month/season of death, place of death (i.e. work, home); (3) medical and social history; (4) autopsy and toxicology findings.

Because electrical voltage is one of the criterions evaluated and voltage standards differ by country, a breakdown of voltage ranges is necessary. By convention, a voltage source <1000 volts is considered low voltage, while sources >1,000 volts are considered high voltage. Primary distribution power lines have voltages between 2300 and 23,000 volts. High-tension power lines carry voltages from approximately 60,000–100,000 V or greater.[9]


  Results Top


Fifty-five electrocution deaths were identified in Maryland over an 11-year period from 2005 to 2015, averaging 5.5 cases per year, with an average annual rate of 0.092 per 100,000 people [Figure 1]. The majority of electrocution victims were whites (67.3%, n = 37). >90% of the victims were male (90.9%, n = 50) [Table 1]. The age range of the victims was from 4 to 83 years old [Figure 2] with a mean age of 40. The average age of male victims was 40 and that of female victims was 30. The majority of electrocution deaths (70.1%, n = 39) were due to high voltage [Table 2]. Work-related fatalities accounted for 63.7% (n = 35) of electrocutions. Most fatalities (76.4%, n = 42) occurred in an outdoor location. [Figure 3] showed the main causes of work related electrocutions. More than 70% deaths were due to direct contact with electric power while working on power lines. While the nonwork related electrocutions were caused by direct contact with power line (29%), followed by electronic machinery (21%), and house hold electronic cord/wire (17%) [Figure 4].
Figure 1: Number and rate of electrocution deaths in Maryland (2005–2015)

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Table 1: Electrocution deaths by race and gender in Maryland

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Figure 2: Age distribution of electrocution deaths in Maryland (2005–2015)

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Table 2: Electrocutions due to high voltage/low voltage, work related/non-work related and locations of incidents

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Figure 3: Causes of work related electrocution deaths in Maryland (2005–2015)

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Figure 4: Causes of non-work related electrocution deaths in Maryland (2005–2015)

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The upper extremities were the most common site for electrical burns [Table 3] and [Figure 5]. It was also noted that many fatalities occurred during the summer months (June-August) [Figure 6]. Postmortem toxicological analysis revealed that 13 (24%) victims were tested positive for drugs, including cocaine and opioid, and seven victims were positive for alcohol (12.7%). Of the 7 alcohol positive cases, 3 had a blood alcohol concentration >0.08%.
Table 3: Burn locations among high and low voltage electrocutions

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Figure 5: Electrocution burns. (a) High voltage electrocution burns. (b) Low voltage electrocution burns

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Figure 6: Number of electrocution deaths by months in Maryland (2005–2015)

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  Discussion Top


Although the use of electricity has increased steadily during the last century, the incidence of electricity-related fatalities has significantly decreased in the United States.[11],[12],[15],[19],[20] In 1990, the National Safety Council reported that electrocutions were the fourth leading cause of work-related traumatic death.[10] Also, the US Bureau of Labor Statistics declared 334 cases of electrocution death in 1992. This number declined to only 134 cases in 2015. In contrast, other countries have experienced more occurrence of electricity-related fatalities each year.[2] The significant decrease in electrocution cases in the US were mainly due to the National Institute for Occupational Safety and Health (NIOSH) regulations and prevention program.[13] In our study, the number of electrocution deaths in Maryland ranged from 2 to 8 cases from 2005 to 2015.

Electrocution deaths occurred mostly among males, with the highest number of death found among Caucasians. The proportions of occupational electrocution deaths, which were similar to the findings of NIOSH and other studies in the US, showed that >90% of electrocution deaths involved males with the highest percentage of death among those aged 25–44 during the summer season.[3],[5],[7],[11],[13],[14],[15],[16],[17],[21],[22] This is likely due, in part, to the prevalence of males in the workplace with greater exposure to electrical sources, especially during the summer. In our study, over 80% of cases presented with an electrical burn at autopsy. One reason for this finding may be due to decreased skin resistance. Skin resistance decreases when the skin becomes wet. In the summertime, which is when the majority of the electrocutions occurred, individuals who work outdoor will sweat more often because of increased temperatures. The sweat will then decrease the resistance of the skin. Therefore, if one were to come in contact with an electrical source, for this reason, one would be more likely to have an electrical burn.[23]

In previous studies done outside of the United States, which focused on deaths related to electrocution, cases due to low voltage injury were more frequent.[7],[17],[20] However, in research series conducted by Mellen et al.[16] and Tugcu et al.,[24] which contained cases predominantly of military origin, high voltage electrocutions were more frequent with 51% and 50% respectively. In the United States, a study of work-related electrocution deaths was conducted using data from the Occupational Safety and Health Administration (OSHA) and the Integrated Management Information System. Their study identified 944 work-related electrocutions for the period 1984–1986. Sixty-one percent of these fatalities were caused by contact with a high-voltage source.[10] Most of these fatalities were due to failing to utilize required personal protective equipment (gloves, sleeves, mats, blankets, etc.). Laborers, who receive little or no electrical training, were the next highest classification. In our study, 39 electrocution deaths (64%) were due to high voltage. Specifically, 25 work related fatalities (71%) were caused by high voltage.

Work-related electrocution deaths were the most common form of accidents (n = 35, 64%) in our study. Sheikhazadi et al. have reported similar results. To the best of our knowledge, there are no published statistics or research papers comparing the incidence of electrocution between workers and nonworkers in the United States. Most of these studies included only work-related electrocution.[1],[5],[10],[11]

Not surprisingly, and in accordance with previous studies,[10],[11],[12],[15] the most common cause of occupational electrocution death was due to contact with a power line. In this study, 71% of occupational related electrocutions were due to contact with a power line and only 29% of nonwork-related electrocution deaths were caused by contact with a power source. This observation presents an opportunity for targeted prevention efforts. A previous study by US Department of Health and Human Services analyzed 224 incidents of electrocution evaluated by the FACE program. At least one of the following five factors was present: (1) established safe work procedures were either not implemented or not followed; (2) no adequate or required personal protective equipment was provided or worn; (3) no lockout/tag-out procedures were either implemented or followed; (4) no compliance with existing OSHA, regulations; and (5) no adequate training for worker and supervisor in electrical safety.[10]

Exposure to electrical currents may cause a variety of cutaneous injuries ranging from local erythema to full-thickness burns. A characteristic feature of the electric mark, which is the most useful indicator of the nature of the burns, is the common occurrence of an areola of blanched skin at the periphery. Typical types of electric burns were identified in 64% of victims due to low voltage electrocution and nonspecific electrical burns were identified at autopsy in all the high voltage electrocution cases (100%). Considering the location of electrical burn marks, we found that the upper extremity was the most common site involved, which was similar to previous studies by other authors.[9],[15],[17]

Suicide by electrocution is an unusual method of self-destruction and is even rarer in children.[3],[8],[9],[15] However, Wick et al. reported a higher rate of suicide (29%). In our study, only two cases (3.6%) out of total 55 cases were due to suicide. Lucas et al. suggested two plausible explanations for the rarity of suicide by electrocution. The one explanation is that many people have had an unpleasant experience with electricity, such as a painful shock, in the past.

Intoxications are well-known contributors to all kinds of accidents including electrocution. The use of alcohol contributed significantly through acute inebriation, but possibly through hangover effects in a few cases. Lindström et al.[15] and Mellen et al.[16] reported that 20% and 31% of the evaluated cases had alcohol in either blood or urine. In a study conducted by Tugcu et al.,[24] alcohol was detected in 6% of the electrocution cases that were among military personnel. In the present study, 13 cases (24%) presented with drugs detected postmortem including cocaine and opioid, and seven victims were positive for alcohol (12.7%). Of the 7 alcohol positive cases, 3 had a blood alcohol concentration >0.08%. Based on investigation, three individuals were reportedly under the influence of alcohol with postmortem blood alcohol concentration of >0.08% while on the job.


  Conclusion Top


Most of the electrocution fatalities were caused by high-voltage electrical currents which were due to direct contact with a power line. The majority of the victims were young, Caucasian males who experienced their electrical injuries while on the job. Most all of the electrocution deaths are preventable, this study indicates a need for continuous vigilance on safety training. Diligent enforcement of existing safety regulations is necessary to increase workers' and nonworkers' keen understanding of the lethal potential of electricity and adherence to these rules.

Acknowledgments

Authors would like to thank the University of Maryland Baltimore Graduate School, and the staff members of the Office of the Chief Medical Examiner for their assistance and support throughout the duration of this research project.

Supported in part by the funds for “2011 Plan” of Collaborative Innovation Center of Judicial Civilization China, China University of Political Science and Law and the Science.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

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US Bureau of Labor Statistics. National Census of Fatal Occupational Injuries, 1999. Report No. USDL-00-236. Washington, DC: US Department of Labor; 2000.  Back to cited text no. 1
    
2.
Sheikhazadi A, Kiani M, Ghadyani MH. Electrocution-related mortality: A survey of 295 deaths in Tehran, Iran between 2002 and 2006. Am J Forensic Med Pathol 2010;31:42-5.  Back to cited text no. 2
    
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Tirasci Y, Goren S, Subasi M, Gurkan F. Electrocution-related mortality: A review of 123 deaths in Diyarbakir, Turkey between 1996 and 2002. Tohoku J Exp Med 2006;208:141-5.  Back to cited text no. 3
    
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Liu S, Yu Y, Huang Q, Luo B, Liao X. Electrocution-related mortality: A review of 71 deaths by low-voltage electrical current in Guangdong, China, 2001-2010. Am J Forensic Med Pathol 2014;35:193-6.  Back to cited text no. 5
    
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Mellen PF, Weedn VW, Kao G. Electrocution: A review of 155 cases with emphasis on human factors. J Forensic Sci 1992;37:1016-22.  Back to cited text no. 16
    
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Byard RW, Hanson KA, Gilbert JD, James RA, Nadeau J, Blackbourne B, et al. Death due to electrocution in childhood and early adolescence. J Paediatr Child Health 2003;39:46-8.  Back to cited text no. 17
    
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    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6]
 
 
    Tables

  [Table 1], [Table 2], [Table 3]



 

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