Epidemiology and autopsy findings of 500 drowning deaths

Girela-López, Eloy; Beltrán-Aroca, Cristina M.; Dye, A. L.; Gill, James R.

doi:10.1016/j.forsciint.2021.111137

Cited by 20 publications

(9 citation statements)

References 20 publications

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“…A submersion death’s physiological mechanisms are complex and largely unknown, with many only speculatively described [ 2 , 7 ]. During drowning, the lung is the most vulnerable organ [ 40 ].…”

Section: Discussionmentioning

confidence: 99%

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Combining Oxidative Stress Markers and Expression of Surfactant Protein A in Lungs in the Diagnosis of Seawater Drowning

Legáz

Barrera-Pérez²,

Sibon³

et al. 2023

Life

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Background and Objectives. The diagnosis of seawater drowning (SWD) remains one of the most complex and contentious. It is one of the leading causes of unintentional death around the world. In most cases, the forensic pathologist must reach an accurate diagnosis from the autopsy findings and a series of complementary tests such as histopathological, biological, and chemical studies. Despite the lung being the most affected organ in death by submersion, there are few studies on this type of death’s impact on this organ. The aim was to investigate human lung cadavers of forensic cases due to different causes of death, the concentration of the oxidative stress markers malondialdehyde (MDA) and γ-glutamyl-l-cysteinyl glycine (GSH), and the relationship with the expression of surfactant protein A (SP-A) to try to discriminate SWD from other types of causes of death. Materials and Methods. A total of 93 forensic autopsy cases were analyzed. Deaths were classified into three major groups based on the scene, cause of death, and autopsy findings (external foam, frothy fluid in airways, overlapping medial edges of the lungs): (a) drowning in seawater (n = 35), (b) other asphyxia (n = 33), such as hangings (n = 23), suffocations (n = 6), and strangulation (n = 4), and (c) other causes (n = 25), such as multiple suffocations. Oxidative stress markers (MDA and GSH) and the immunohistochemical expression of SP-A were determined in both lungs. Results. MDA levels were statistically higher in both lungs in cases of SWD than in other causes of death (p = 0.023). Similarly, significantly higher levels of GSH were observed in SWD compared to the rest of the deaths (p = 0.002), which was more significant in the right lung. Higher immunohistochemical expression of SP-A was obtained in the cases of SWD than in the other causes of death, with higher levels in both lungs. The correlation analysis between the levels of oxidative stress (MDA and GSH) in the lung tissue and the expression level of SP-A showed positive and significant results in SWD, both in the alveolar membrane and the alveolar space. Conclusions. Determining the levels of MDA and GSH in lung tissue and the expression level of SP-A can be of great importance in diagnosing SWD and the circumstances of death. A better understanding of the physiology of submersion is essential for its possible repercussions in adopting measures in the approach to patients who have survived a submersion process. It is also necessary for forensic pathology to correctly interpret the events that lead to submersion.

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Section: Discussionmentioning

confidence: 99%

“…The diagnosis of seawater drowning (SWD) remains one of the most complex and controversial deaths and represents one of the leading causes of unintentional death worldwide [ 1 , 2 , 3 ]. Drowning is appropriately defined as submerging or immersing oneself in a liquid that causes breathing collapse [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Combining Oxidative Stress Markers and Expression of Surfactant Protein A in Lungs in the Diagnosis of Seawater Drowning

Legáz

Barrera-Pérez²,

Sibon³

et al. 2023

Life

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show abstract

“…From 2008 to 2020, Connecticut researchers [ 15 ] conducted autopsies on 500 bodies retrieved from the water categorised by age, gender, location, type of water body, cause of death, method of death, decomposition symptoms, body mass index (BMI), brain weight, lung weight, pulmonary oedema, stomach contents, and toxicological tests. Men more frequently drown than women (excluding cases of suicide).…”

Section: Drowning Behaviour Signs and Statisticsmentioning

confidence: 99%

Enhancing Water Safety: Exploring Recent Technological Approaches for Drowning Detection

Jalalifar,

Belford,

Erfani

et al. 2024

Sensors

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Drowning poses a significant threat, resulting in unexpected injuries and fatalities. To promote water sports activities, it is crucial to develop surveillance systems that enhance safety around pools and waterways. This paper presents an overview of recent advancements in drowning detection, with a specific focus on image processing and sensor-based methods. Furthermore, the potential of artificial intelligence (AI), machine learning algorithms (MLAs), and robotics technology in this field is explored. The review examines the technological challenges, benefits, and drawbacks associated with these approaches. The findings reveal that image processing and sensor-based technologies are the most effective approaches for drowning detection systems. However, the image-processing approach requires substantial resources and sophisticated MLAs, making it costly and complex to implement. Conversely, sensor-based approaches offer practical, cost-effective, and widely applicable solutions for drowning detection. These approaches involve data transmission from the swimmer’s condition to the processing unit through sensing technology, utilising both wired and wireless communication channels. This paper explores the recent developments in drowning detection systems while considering costs, complexity, and practicality in selecting and implementing such systems. The assessment of various technological approaches contributes to ongoing efforts aimed at improving water safety and reducing the risks associated with drowning incidents.

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“…Overall, an average healthy adult can hold his or her breath for approximately 30 s, but for children, the duration is less [21]. Therefore, there is only a short time to take action to save a potential victim of drowning.…”

Section: System Designmentioning

confidence: 99%

A Smart Multi-Sensor Device to Detect Distress in Swimmers

Jalalifar

Kashizadeh

Mahmood

et al. 2022

Sensors

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Drowning is considered amongst the top 10 causes of unintentional death, according to the World Health Organization (WHO). Therefore, anti-drowning systems that can save lives by preventing and detecting drowning are much needed. This paper proposes a robust and waterproof sensor-based device to detect distress in swimmers at varying depths and different types of water environments. The proposed device comprises four main components, including heart rate, blood oxygen level, movement, and depth sensors. Although these sensors were designed to work together to boost the system’s capability as an anti-drowning device, each could operate independently. The sensors were able to determine the heart rate to an accuracy of 1 beat per minute (BPM), 1% SpO2, the acceleration with adjustable sensitivities of ±2 g, ±4 g, ±8 g, and ±16 g, and the depth up to 12.8 m. The data obtained from the sensors were sent to a microcontroller that compared the input data to adjustable threshold values to detect dangerous situations. Being in hazardous situations for more than a specific time activated the alarming system. Based on the comparison made in the program and measuring the time of submersion, a message indicating drowning or safe was sent to a lifeguard to continuously monitor the swimmer’ condition via Wi-Fi to an IP address reachable by a mobile phone or laptop. It is also possible to continuously monitor the sensor outputs on the device’s display or the connected mobile phone or laptop. The threshold values could be adjusted based on biometric parameters such as swimming conditions (swimming pool, beach, depth, etc.) and swimmers health and conditions. The functionality of the proposed device was thoroughly tested over a wide range of parameters and under different conditions, both in air and underwater. It was demonstrated that the device could detect a range of potentially hazardous aquatic situations. This work will pave the way for developing an effective drowning sensing system that could save tens of thousands of lives across the globe every year.

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Epidemiology and autopsy findings of 500 drowning deaths

Cited by 20 publications

References 20 publications

Combining Oxidative Stress Markers and Expression of Surfactant Protein A in Lungs in the Diagnosis of Seawater Drowning

Combining Oxidative Stress Markers and Expression of Surfactant Protein A in Lungs in the Diagnosis of Seawater Drowning

Enhancing Water Safety: Exploring Recent Technological Approaches for Drowning Detection

A Smart Multi-Sensor Device to Detect Distress in Swimmers

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