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Pedal cycle injuries and mortality in Victoria
Pathology (2017) 49(S1), pp. S21–S27
Forensic Pathology
PEDAL CYCLE INJURIES AND MORTALITY IN VICTORIA Khamis Almarzooei
FIRE DEATHS – A REVIEW AND AN EXPERIMENTAL INVESTIGATION OF POST-MORTEM FORMATION OF CARBOXYHAEMOGLOBIN Claire Sully
In Australia, cycling has gained popularity manifested in the increasing number of cyclists in the last few years. Despite the health and environmental benefits of cycling, cyclists are at increased risk of injury and death compared to other road users. In this study, all pedal cycle fatalities from 2004 to 2013 in Victoria, Australia, where post-mortem examinations were performed were studied retrospectively. Different epidemiological variants including the cause and mechanism of deaths were studied. During this period, there were 87 deaths representing 2.8% of the total road fatalities over the same time. Of this number of deaths, more males (72, 82%) than females (15, 18%) died from pedal cycle injuries. Most fatalities occured during the early hours of the day. The majority of these fatalities were accidental and resulted from blunt force trauma to the head, neck and chest secondary to colliding with moving and static objects. In very few cases, natural diseases contributed to death. In conclusion, the majority of deaths from pedal cycle injuries in Victoria during the period from 2004–2013 were accidental. The number peaked in the years from 2006 to 2008, followed by a decrease in deaths, owing to the effective road safety measures. MORTUARY OCCUPATIONAL HEALTH AND SAFETY: POTENTIAL PITFALLS AND THE EFFECTS ON MENTAL HEALTH Essa Saeedi Maintaining occupational health and safety standards within a mortuary is an ongoing, daily challenge to mortuary managers in a forensic setting. The range of hazards that mortuary staff are subjected to on a daily basis is diverse and can be under estimated by the staff as a consequence of becoming complacent. Occasional, unusual, and highly risky incidents are encountered in the forensic setting where grievous consequences could have affected the staff members involved. The daily exposure to cases and stories of deceased people coming through the mortuary in a forensic setting have a variable, and overall sad tone, with cases involving children, elderly in nursing homes, accidents, suicides and homicides, making the mental impact on the staff inevitable. Some of the unusual cases that have been encountered in the forensic setting that have slipped through the daily occupational health and safety precaution measures are discussed. The pitfalls associated and potential measures that need to be taken to avoid the possible consequences are presented. We also review the literature to look into the mental health effect of working in the mortuary in a forensic setting.
Print ISSN 0031-3025/Online ISSN 1465-3931
The forensic investigation of deceased retrieved following a fire includes determining if death occurred before or during the event. A blood carboxyhaemoglobin level above 10% is considered indicative of respiration during a fire, implying that an individual was not deceased before the event. Previous spectroscopic studies have revealed that oxygen can passively diffuse through the skin and re-oxygenate haemoglobin. It was therefore questioned if carbon monoxide could also dermally diffuse and elevate post-mortem blood carboxyhaemoglobin levels, which could falsely insinuate that an individual had been alive and respired during a fire. Exposing both oxygenated and deoxygenated forms of haemoglobin to carbon monoxide converted them to carboxyhaemoglobin. This was measured using an ISP-REF Integrating sphere coupled to a USB spectrometer by fibre optic probe. Stillborn piglets were exposed to carbon monoxide to show that the gas can passively diffuse through the skin, resulting in formation of carboxyhaemoglobin in hypostasis, which was confirmed by observing a shift in the absorption spectrum. Piglets with significant cavity breaches, as could be found in cases with extensive stab/bullet wounds or heat defects, exposed to carbon monoxide demonstrated cavity carboxyhaemoglobin levels above 10% which could falsely suggest respiration of carbon monoxide had occurred. GROSS AND MICROSCOPIC EVALUATION OF INFANT AND YOUNG CHILD FRACTURES AT AUTOPSY Andrew M. Baker Hennepin County Medical Examiner, Hennepin County, Minnesota, United States The finding of fractures in children, particularly the very young, can have profound medicolegal implications if the fractures are suggestive of inflicted injury. The clinical, radiological, and histological aspects of the fracture may provide useful information as to the mechanism and/or age of the injury. Correlation with published studies and the expertise of the paediatric and radiological communities may prove vital in assessing whether a fracture might be accidental, or whether the child may have a medical condition predisposing to—or mimicking—fractures. The traditional autopsy is limited in its ability to detect some of the most common abusive bony injuries. Integration of suitable imaging, followed by resection and proper handling of bony abnormalities, is key in assessing osseous trauma in the infant and small child. At the end of this presentation, attendees will understand the need for adequate postmortem radiography in the evaluation of
Forensic Pathology
PEDAL CYCLE INJURIES AND MORTALITY IN VICTORIA Khamis Almarzooei
FIRE DEATHS – A REVIEW AND AN EXPERIMENTAL INVESTIGATION OF POST-MORTEM FORMATION OF CARBOXYHAEMOGLOBIN Claire Sully
In Australia, cycling has gained popularity manifested in the increasing number of cyclists in the last few years. Despite the health and environmental benefits of cycling, cyclists are at increased risk of injury and death compared to other road users. In this study, all pedal cycle fatalities from 2004 to 2013 in Victoria, Australia, where post-mortem examinations were performed were studied retrospectively. Different epidemiological variants including the cause and mechanism of deaths were studied. During this period, there were 87 deaths representing 2.8% of the total road fatalities over the same time. Of this number of deaths, more males (72, 82%) than females (15, 18%) died from pedal cycle injuries. Most fatalities occured during the early hours of the day. The majority of these fatalities were accidental and resulted from blunt force trauma to the head, neck and chest secondary to colliding with moving and static objects. In very few cases, natural diseases contributed to death. In conclusion, the majority of deaths from pedal cycle injuries in Victoria during the period from 2004–2013 were accidental. The number peaked in the years from 2006 to 2008, followed by a decrease in deaths, owing to the effective road safety measures. MORTUARY OCCUPATIONAL HEALTH AND SAFETY: POTENTIAL PITFALLS AND THE EFFECTS ON MENTAL HEALTH Essa Saeedi Maintaining occupational health and safety standards within a mortuary is an ongoing, daily challenge to mortuary managers in a forensic setting. The range of hazards that mortuary staff are subjected to on a daily basis is diverse and can be under estimated by the staff as a consequence of becoming complacent. Occasional, unusual, and highly risky incidents are encountered in the forensic setting where grievous consequences could have affected the staff members involved. The daily exposure to cases and stories of deceased people coming through the mortuary in a forensic setting have a variable, and overall sad tone, with cases involving children, elderly in nursing homes, accidents, suicides and homicides, making the mental impact on the staff inevitable. Some of the unusual cases that have been encountered in the forensic setting that have slipped through the daily occupational health and safety precaution measures are discussed. The pitfalls associated and potential measures that need to be taken to avoid the possible consequences are presented. We also review the literature to look into the mental health effect of working in the mortuary in a forensic setting.
Print ISSN 0031-3025/Online ISSN 1465-3931
The forensic investigation of deceased retrieved following a fire includes determining if death occurred before or during the event. A blood carboxyhaemoglobin level above 10% is considered indicative of respiration during a fire, implying that an individual was not deceased before the event. Previous spectroscopic studies have revealed that oxygen can passively diffuse through the skin and re-oxygenate haemoglobin. It was therefore questioned if carbon monoxide could also dermally diffuse and elevate post-mortem blood carboxyhaemoglobin levels, which could falsely insinuate that an individual had been alive and respired during a fire. Exposing both oxygenated and deoxygenated forms of haemoglobin to carbon monoxide converted them to carboxyhaemoglobin. This was measured using an ISP-REF Integrating sphere coupled to a USB spectrometer by fibre optic probe. Stillborn piglets were exposed to carbon monoxide to show that the gas can passively diffuse through the skin, resulting in formation of carboxyhaemoglobin in hypostasis, which was confirmed by observing a shift in the absorption spectrum. Piglets with significant cavity breaches, as could be found in cases with extensive stab/bullet wounds or heat defects, exposed to carbon monoxide demonstrated cavity carboxyhaemoglobin levels above 10% which could falsely suggest respiration of carbon monoxide had occurred. GROSS AND MICROSCOPIC EVALUATION OF INFANT AND YOUNG CHILD FRACTURES AT AUTOPSY Andrew M. Baker Hennepin County Medical Examiner, Hennepin County, Minnesota, United States The finding of fractures in children, particularly the very young, can have profound medicolegal implications if the fractures are suggestive of inflicted injury. The clinical, radiological, and histological aspects of the fracture may provide useful information as to the mechanism and/or age of the injury. Correlation with published studies and the expertise of the paediatric and radiological communities may prove vital in assessing whether a fracture might be accidental, or whether the child may have a medical condition predisposing to—or mimicking—fractures. The traditional autopsy is limited in its ability to detect some of the most common abusive bony injuries. Integration of suitable imaging, followed by resection and proper handling of bony abnormalities, is key in assessing osseous trauma in the infant and small child. At the end of this presentation, attendees will understand the need for adequate postmortem radiography in the evaluation of