PubMed · 14767380
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Jean A Proehl. 2004. Accidental amputation.. https://doi.org/10.1097/00000446-200402000-00021
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We analysed deaths certified as due to poisoning in England & Wales, 1968-2000, in children aged <10 years by age, sex, circumstances of death, intent, and agents involved. The number of deaths fell from 165 (20.6 per million children) in 1968 to 30 (4.6 per million) in 2000, a decrease of approximately 80%. The age-specific death rates were similar in boys and girls. The rate was initially much higher, and fell more, in those aged <5 years. Most deaths (n=1923) occurred in fires, and had been attributed to inhaling combustion products. A small number (n=104) occurred in fires resulting from motor vehicle and other transport accidents. From 1979 (use of ICD-9) the coding of some of these deaths changed from poisoning with carbon monoxide to poisoning with 'other gases, fumes or vapours'. These 'fire deaths' do not appear as poisonings in mortality statistics based on a single underlying cause of death, and cannot be tabulated as poisoning in many countries. Fire deaths and deaths coded to accidental, deliberate, or undetermined poisoning (n=702) decreased substantially with time, and by 2000 numbered 14 and 10, respectively. Accidental deaths declined from 151 in 1968 to 23 in 2000, but homicides and open verdicts varied from 5 to 20 per year, with no clear trend. Deaths attributed to carbon monoxide and to 'other gases, fumes or vapours' (mostly fire-related) totalled 2431 (84% of all poisoning deaths). Overall, 10% of these deaths were either certified as homicides or open verdicts. However, homicide or open verdict was recorded in half of the 47 fatal opiate poisonings. Opioids have now superseded antidepressants as the commonest agents encountered in fatal poisoning with drugs in children.
On January 6, 2005, two freight trains collided in Graniteville, South Carolina (approximately 10 miles northeast of Augusta, Georgia), releasing an estimated 11,500 gallons of chlorine gas, which caused nine deaths and sent at least 529 persons seeking medical treatment for possible chlorine exposure. The incident prompted the Agency for Toxic Substances and Disease Registry (ATSDR) to review data from its Hazardous Substances Emergency Events Surveillance (HSEES) system and update an analysis of 1993-1998 railroad events. The HSEES system is used to collect and analyze data concerning the public health consequences (e.g., morbidity, mortality, and evacuations) associated with hazardous-substance--release events that occur in facilities or during transportation. This report describes the event in South Carolina, which is not part of the HSEES system, and two others from HSEES, and summarizes all rail events reported to HSEES from 16 state health departments during 1999-2004. Local government agencies, employers, and first responders can help reduce morbidity and mortality from transit-associated hazardous-substance releases by examining historical spill data for planning purposes, developing emergency response plans, undergoing proper hazardous materials (HazMat) training, and reviewing epidemiologic investigation data.
AIM: To examine demographic, morbidity, and mortality findings in a population of mountain climbers in New Zealand. METHODS: A baseline survey and a 4-year follow-up took place among a population of mountain climbers. The purpose of this survey was to determine the frequency and characteristics of mountain-climbing accidents and to estimate the climbing-related death rate. RESULTS: Forty-nine climbers enrolled in the study. Baseline findings revealed that 44 (90%) climbers had been involved in the sport for more than 5 years and 23 (47%) climbers had been involved in a total of 33 accidents. At 4-year follow-up, results were available on 46 (94%) climbers. There were nine further accidents and four deaths from climbing misadventure. CONCLUSION: Mountain climbing is associated with a high risk of serious injury and mortality.