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��ࡱ�>��	���������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������_�)��0Rbjbj,E,E	4 N/N/�I5�������8	8	������������8�T2���.f�t�<%.'.'.'.'.'.'.$0��2XK.����K.���`.!!!�6���&F!�%.!!:s%,�%�����[�RY9������^�%
�&v.0�.�%R3U �3�%3��%���!�����K.K.!����.������������������������������������������������������������������������3���������8	 X:	)Electric shock in patients administered to hospital: A DESCRIPTIVE STUDY
Babak Mostafazadeh, MD1, Esmaeil Farzaneh, MD2, Maryam Moshfegh, MD1, Seyed Ali Mohtarami, MD1
Department of Forensic Medicine and Toxicology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Forensic Medicine and Toxicology, Ardabil University of Medical Sciences, Tehran, Iran.
Coresponding Author: Babak Mostafazadeh, MD
Associate Professor, Department of Forensic Medicine and Toxicology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Email: mstzbmd@sbmu.ac.ir

Abstract:
Introduction:
This information may provide a better insight for the treatment and management of these patients, as well as better preventive strategies for those at higher risk. 
Materials and Methods:
We performed a descriptive study on 95 patients attending the Hafte tir hospital, with the complaint of electrical shock. The study was conducted from January 2011 to January 2013.
Results:
There were 95 patients, mostly between 26-45 years old. Most of the accidents took place out of home and due to illegal exposure to electricity. The gap between the accident and hospital admission was between 30 minutes to 2 hours. The entrance anatomy was the hand the exit anatomy was the hand in most of the participants.  The patients had mostly normal GCS on admission, (63/95), were mostly male (91/95) and were 0-7 admitted in the hospital. One of the patients who reached the hospital, died during the admission. 
Discussion:
Our findings from patients admitting to the hospital due to electrical injury showed that young people are at a higher risk of electrical injury compared to other age population. 

Key Words: Electric shock, hospital

Introduction:
Electric shock is one of the major causes of death in developing countries ADDIN EN.CITE  ADDIN EN.CITE.DATA ( HYPERLINK \l "_ENREF_7" \o "Ergor, 2003 #20" Ergor et al. 2003;  HYPERLINK \l "_ENREF_14" \o "Zeng, 2010 #11" Zeng et al. 2010). It results from the direct contact of any source of electricity with human body that causes sufficient current through the skin, muscle or hair. The expression is described as injurious exposure to electricity.  Large current passing through the body may cause paralysis, fibrillation of the heart and damage to tissues and death ADDIN EN.CITE <EndNote><Cite><Author>Bernstein</Author><Year>1975</Year><RecNum>72</RecNum><DisplayText>(Bernstein 1975)</DisplayText><record><rec-number>72</rec-number><foreign-keys><key app="EN" db-id="ws9td5rz92t2fhear29x009m29w2p020sd5s">72</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Bernstein, T.</author></authors></contributors><titles><title>Theories of the causes of death from electricity in the late nineteenth century</title><secondary-title>Med Instrum</secondary-title></titles><periodical><full-title>Med Instrum</full-title></periodical><pages>267-73</pages><volume>9</volume><number>6</number><edition>1975/11/01</edition><keywords><keyword>Animals</keyword><keyword>Dogs</keyword><keyword>Electric Countershock/history</keyword><keyword>Electric Injuries/ history</keyword><keyword>Electricity/history</keyword><keyword>Europe</keyword><keyword>History, 19th Century</keyword><keyword>Humans</keyword><keyword>Resuscitation/history</keyword><keyword>United States</keyword><keyword>Ventricular Fibrillation/physiopathology</keyword></keywords><dates><year>1975</year><pub-dates><date>Nov-Dec</date></pub-dates></dates><isbn>0090-6689 (Print)&#xD;0090-6689 (Linking)</isbn><accession-num>1102874</accession-num><urls></urls><remote-database-provider>NLM</remote-database-provider><language>eng</language></record></Cite></EndNote>( HYPERLINK \l "_ENREF_1" \o "Bernstein, 1975 #72" Bernstein 1975). This type of injury is mostly classified as the work related fatalities and injuries, whether legal or illegal works  ADDIN EN.CITE  ADDIN EN.CITE.DATA ( HYPERLINK \l "_ENREF_2" \o "Brown, 1997 #40" Brown et al. 1997;  HYPERLINK \l "_ENREF_6" \o ", 1992 #54" Electrocutions in the construction industry involving portable metal ladders--United States, 1984-1988  1992) ADDIN EN.CITE <EndNote><Cite><Author>Byard</Author><Year>2003</Year><RecNum>21</RecNum><DisplayText>(Byard et al. 2003)</DisplayText><record><rec-number>21</rec-number><foreign-keys><key app="EN" db-id="ws9td5rz92t2fhear29x009m29w2p020sd5s">21</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Byard, R. W.</author><author>Hanson, K. A.</author><author>Gilbert, J. D.</author><author>James, R. A.</author><author>Nadeau, J.</author><author>Blackbourne, B.</author><author>Krous, H.</author></authors></contributors><auth-address>Forensic Science Centre, Adelaide, South Australia, Australia. byard.roger@saugov.sa.gov.au</auth-address><titles><title>Death due to electrocution in childhood and early adolescence</title><secondary-title>J Paediatr Child Health</secondary-title></titles><periodical><full-title>J Paediatr Child Health</full-title></periodical><pages>46-8</pages><volume>39</volume><number>1</number><edition>2003/01/25</edition><keywords><keyword>Accidents, Home/statistics &amp; numerical data</keyword><keyword>Adolescent</keyword><keyword>Child</keyword><keyword>Child, Preschool</keyword><keyword>Electric Injuries/ mortality/physiopathology</keyword><keyword>Electric Wiring</keyword><keyword>Female</keyword><keyword>Humans</keyword><keyword>Infant</keyword><keyword>Male</keyword><keyword>South Australia/epidemiology</keyword><keyword>Suicide</keyword></keywords><dates><year>2003</year><pub-dates><date>Jan-Feb</date></pub-dates></dates><isbn>1034-4810 (Print)&#xD;1034-4810 (Linking)</isbn><accession-num>12542812</accession-num><urls></urls><remote-database-provider>NLM</remote-database-provider><language>eng</language></record></Cite></EndNote>( HYPERLINK \l "_ENREF_4" \o "Byard, 2003 #21" Byard et al. 2003).  To date we are unaware of any study describing the demographic and characteristics of electrical shock victims attending the hospitals in Iran. This information may provide a better insight for the treatment and management of these patients, as well as better preventive strategies for those at higher risk. 
Materials and Methods: 
We performed a descriptive study on 95 patients attending the Hafte tir hospital, with the complaint of electrical shock. The study was conducted from January 2011 to January 2013. Inclusion criteria were the admission due to electrical shock. Exclusion criteria were, past history of other disease, drug or alcohol abuse. Demographic and anthropometric information of all participants including, age, sex, route of exposure, entrance site, exit site were recorded for all participants. A questionnaire studying the underlying factors for the accident as well Glasgow Coma Scale (GCS), outcome, type of electricity and admission duration was filled for all participants. Illegal exposure to electricity including suicide, murdered and during stealing from other places was also recorded. The patient�s guardian was asked for written informed consent before participation. The patients were also asked for inclusion in the study before participation. The study was approved by the local ethics committee of the hospital. All the procedures and steps of the study were performed according to the declaration of Helsinki.
Results:
 The primary characteristics of participants are presented in table 1. There were 95 patients, mostly between 26-45 years old. Most of the accidents took place out of home and due to illegal exposure to electricity. The gap between the accident and hospital admission was between 30 minutes to 2 hours.The entrance anatomy was the hand the exit anatomy was the hand in most of the participants.  The patients had mostly normal GCS on admission, (63/95), were mostly male (91/95) and were 0-7 days admitted in the hospital. One of the patients who reached the hospital, died during the admission. 
Discussion:
Our findings from patients admitting to the hospital due to electrical injury showed that young people are at a higher risk of electrical injury compared to other age population. We also showed that the death rate was nearly 1% among the admitted patients.
In 1993 there were 550 electrocutions in the US, which caused 2.1 deaths per million inhabitants ADDIN EN.CITE <EndNote><Cite><Year>2009</Year><RecNum>13</RecNum><DisplayText>(Work-related fatalities associated with tree care operations--United States, 1992-2007  2009)</DisplayText><record><rec-number>13</rec-number><foreign-keys><key app="EN" db-id="ws9td5rz92t2fhear29x009m29w2p020sd5s">13</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors></contributors><titles><title>Work-related fatalities associated with tree care operations--United States, 1992-2007</title><secondary-title>MMWR Morb Mortal Wkly Rep</secondary-title></titles><periodical><full-title>MMWR Morb Mortal Wkly Rep</full-title></periodical><pages>389-93</pages><volume>58</volume><number>15</number><edition>2009/04/25</edition><keywords><keyword>Accidental Falls/mortality</keyword><keyword>Accidents, Occupational/ mortality</keyword><keyword>Adult</keyword><keyword>European Continental Ancestry Group/statistics &amp; numerical data</keyword><keyword>Female</keyword><keyword>Gardening</keyword><keyword>Hispanic Americans/statistics &amp; numerical data</keyword><keyword>Humans</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword><keyword>National Institute for Occupational Safety and Health (U.S.)/statistics &amp;</keyword><keyword>numerical data</keyword><keyword>Population Surveillance</keyword><keyword>Retrospective Studies</keyword><keyword>Trees</keyword><keyword>United States/epidemiology</keyword><keyword>Wounds and Injuries/epidemiology</keyword><keyword>Young Adult</keyword></keywords><dates><year>2009</year><pub-dates><date>Apr 24</date></pub-dates></dates><isbn>1545-861X (Electronic)&#xD;0149-2195 (Linking)</isbn><accession-num>19390505</accession-num><urls></urls><remote-database-provider>NLM</remote-database-provider><language>eng</language></record></Cite></EndNote>( HYPERLINK \l "_ENREF_13" \o ", 2009 #13" Work-related fatalities associated with tree care operations--United States, 1992-2007  2009). The incidence of electrocutions was decreasing,  electrocutions in the workplace make up the majority of these fatalities, and new jobs provide more hazard for the workers  ADDIN EN.CITE  ADDIN EN.CITE.DATA ( HYPERLINK \l "_ENREF_7" \o "Ergor, 2003 #20" Ergor et al. 2003;  HYPERLINK \l "_ENREF_14" \o "Zeng, 2010 #11" Zeng et al. 2010;  HYPERLINK \l "_ENREF_8" \o "Janicak, 2008 #15" Janicak 2008;  HYPERLINK \l "_ENREF_9" \o "Lipscomb, 2000 #30" Lipscomb et al. 2000;  HYPERLINK \l "_ENREF_10" \o "McCann, 2003 #2" McCann 2003;  HYPERLINK \l "_ENREF_11" \o "Rodgers, 2012 #8" Rodgers and Garland 2012;  HYPERLINK \l "_ENREF_12" \o "Vergara, 2012 #10" Vergara et al. 2012). From 1980�1992, an average of 411 workers were killed each year by electrocution ADDIN EN.CITE <EndNote><Cite><Author>Budnick</Author><Year>1984</Year><RecNum>68</RecNum><DisplayText>(Budnick 1984)</DisplayText><record><rec-number>68</rec-number><foreign-keys><key app="EN" db-id="ws9td5rz92t2fhear29x009m29w2p020sd5s">68</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Budnick, L. D.</author></authors></contributors><titles><title>Bathtub-related electrocutions in the United States, 1979 to 1982</title><secondary-title>JAMA</secondary-title></titles><periodical><full-title>JAMA</full-title></periodical><pages>918-20</pages><volume>252</volume><number>7</number><edition>1984/08/17</edition><keywords><keyword>Adolescent</keyword><keyword>Adult</keyword><keyword>Baths</keyword><keyword>Child</keyword><keyword>Child, Preschool</keyword><keyword>Electric Injuries/etiology/ mortality</keyword><keyword>Female</keyword><keyword>Household Articles</keyword><keyword>Humans</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword><keyword>United States</keyword></keywords><dates><year>1984</year><pub-dates><date>Aug 17</date></pub-dates></dates><isbn>0098-7484 (Print)&#xD;0098-7484 (Linking)</isbn><accession-num>6748192</accession-num><urls></urls><remote-database-provider>NLM</remote-database-provider><language>eng</language></record></Cite></EndNote>( HYPERLINK \l "_ENREF_3" \o "Budnick, 1984 #68" Budnick 1984). Large funded are provided to prevent fatality by electrocauion  ADDIN EN.CITE <EndNote><Cite><Author>Chaumont Menendez</Author><Year>2012</Year><RecNum>7</RecNum><DisplayText>(Chaumont Menendez et al. 2012)</DisplayText><record><rec-number>7</rec-number><foreign-keys><key app="EN" db-id="ws9td5rz92t2fhear29x009m29w2p020sd5s">7</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Chaumont Menendez, C.</author><author>Castillo, D.</author><author>Rosenman, K.</author><author>Harrison, R.</author><author>Hendricks, S.</author></authors></contributors><auth-address>National Institute for Occupational Safety and Health, Division of Safety Research, Morgantown, WV 26505, USA. cmenendez@cdc.gov</auth-address><titles><title>Evaluation of a nationally funded state-based programme to reduce fatal occupational injuries</title><secondary-title>Occup Environ Med</secondary-title></titles><periodical><full-title>Occup Environ Med</full-title></periodical><pages>810-4</pages><volume>69</volume><number>11</number><edition>2012/08/07</edition><keywords><keyword>Accidental Falls/mortality/ prevention &amp; control</keyword><keyword>Accidents, Occupational/mortality/ prevention &amp; control</keyword><keyword>Cause of Death</keyword><keyword>Electric Injuries/mortality/ prevention &amp; control</keyword><keyword>Financing, Government</keyword><keyword>Humans</keyword><keyword>Longitudinal Studies</keyword><keyword>National Institute for Occupational Safety and Health (U.S.)</keyword><keyword>Occupational Health/economics</keyword><keyword>Occupational Injuries/mortality/ prevention &amp; control</keyword><keyword>Program Evaluation</keyword><keyword>United States</keyword></keywords><dates><year>2012</year><pub-dates><date>Nov</date></pub-dates></dates><isbn>1470-7926 (Electronic)&#xD;1351-0711 (Linking)</isbn><accession-num>22864251</accession-num><urls></urls><electronic-resource-num>10.1136/oemed-2011-100213</electronic-resource-num><remote-database-provider>NLM</remote-database-provider><language>eng</language></record></Cite></EndNote>( HYPERLINK \l "_ENREF_5" \o "Chaumont Menendez, 2012 #7" Chaumont Menendez et al. 2012). 
The principal limitation of the present study was its cross sectional nature which precludes the determination of the direction of causality, however we took advantage of a large sample size and close similarity between groups in most of the potentially confounding variables. 
References:
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Chaumont Menendez C, Castillo D, Rosenman K, Harrison R, Hendricks S (2012) Evaluation of a nationally funded state-based programme to reduce fatal occupational injuries. Occup Environ Med 69 (11):810-814. doi:10.1136/oemed-2011-100213
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Table 1: Presenting the characteristics of participants


Age groupsFrequencyPercentValid PercentCumulative Percent6-201111.612.012.021-251818.919.631.526-352627.428.359.836-452526.327.287.046-5566.36.593.556-10066.36.5100.0Hospital admission Emergency7578.978.978.9Private2021.121.1100.0Place of accidentHome 1111.611.611.6Out of Home8488.488.4100.0The route of accident Car crash3132.632.632.6Legal 2930.530.563.2Illegal 3536.836.8100.0Place of exposureHome 2627.427.427.4Between cities2425.325.352.6In cities4547.447.4100.0Season of the accidentSpring3031.631.631.6Summer2930.530.562.1Autumn1313.713.775.8Winter2324.224.2100.0Time gap between accident and hospital admissionLess than 30 days77.47.47.430d to 2months8286.386.393.7More than 2 months66.36.3100.0Being AliveAlive9498.998.998.9Dead11.11.1100.0Entrance Anatomy Head and Neck1818.919.119.1Hand6467.468.187.2Chest and abdomen99.59.696.8Legs33.23.2100.0Exit anatomy Hand3031.647.647.6Chest and Abdomen1414.722.269.8Legs1920.030.2100.0GCS8>99.510.510.58-101010.511.622.111-1344.24.726.714-156366.373.3100.0Gendermale9195.895.895.8female44.24.2100.0Admission Duration 0-73334.734.734.78-142627.427.462.115-211313.713.775.822-301111.611.687.431-100001212.612.6100.0
















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D<EndNote><Cite><Author>Ergor</Author><Year>2003</Year><RecNum>20</RecNum><DisplayText>(Ergor et al. 2003; Zeng et al. 2010)</DisplayText><record><rec-number>20</rec-number><foreign-keys><key app="EN" db-id="ws9td5rz92t2fhear29x009m29w2p020sd5s">20</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Ergor, O. A.</author><author>Demiral, Y.</author><author>Piyal, Y. B.</author></authors></contributors><auth-address>Department of Public Health, School of Medicine, Dokuz Eylul University, Izmir, Turkey.</auth-address><titles><title>A significant outcome of work life: occupational accidents in a developing country, Turkey</title><secondary-title>J Occup Health</secondary-title></titles><periodical><full-title>J Occup Health</full-title></periodical><pages>74-80</pages><volume>45</volume><number>1</number><edition>2003/11/08</edition><keywords><keyword>Accidents, Occupational/ statistics &amp; numerical data</keyword><keyword>Adolescent</keyword><keyword>Adult</keyword><keyword>Chi-Square Distribution</keyword><keyword>Developing Countries</keyword><keyword>Female</keyword><keyword>Humans</keyword><keyword>Logistic Models</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword><keyword>Risk Factors</keyword><keyword>Turkey/epidemiology</keyword></keywords><dates><year>2003</year><pub-dates><date>Jan</date></pub-dates></dates><isbn>1341-9145 (Print)&#xD;1341-9145 (Linking)</isbn><accession-num>14605434</accession-num><urls></urls><remote-database-provider>NLM</remote-database-provider><language>eng</language></record></Cite><Cite><Author>Zeng</Author><Year>2010</Year><RecNum>11</RecNum><record><rec-number>11</rec-number><foreign-keys><key app="EN" db-id="ws9td5rz92t2fhear29x009m29w2p020sd5s">11</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Zeng, S.</author><author>Powers, J. R.</author><author>Newbraugh, B. H.</author></authors></contributors><auth-address>Division of Safety Research, National Institute for Occupational Safety and Health, USA. szeng@cdc.gov</auth-address><titles><title>Effectiveness of a worker-worn electric-field sensor to detect power-line proximity and electrical-contact</title><secondary-title>J Safety Res</secondary-title></titles><periodical><full-title>J Safety Res</full-title></periodical><pages>229-39</pages><volume>41</volume><number>3</number><edition>2010/07/16</edition><keywords><keyword>Accidents, Occupational/prevention &amp; control</keyword><keyword>Computer Simulation</keyword><keyword>Electric Injuries/ prevention &amp; control</keyword><keyword>Electricity/ adverse effects</keyword><keyword>Electromagnetic Fields/ adverse effects</keyword><keyword>Feasibility Studies</keyword><keyword>Humans</keyword><keyword>National Institute for Occupational Safety and Health (U.S.)</keyword><keyword>Occupational Health</keyword><keyword>Safety Management</keyword><keyword>United States</keyword><keyword>Wrist Injuries/prevention &amp; control</keyword></keywords><dates><year>2010</year><pub-dates><date>Jun</date></pub-dates></dates><isbn>1879-1247 (Electronic)&#xD;0022-4375 (Linking)</isbn><accession-num>20630274</accession-num><urls></urls><electronic-resource-num>10.1016/j.jsr.2010.02.011</electronic-resource-num><remote-database-provider>NLM</remote-database-provider><language>eng</language></record></Cite></EndNote>�
D<EndNote><Cite><Author>Ergor</Author><Year>2003</Year><RecNum>20</RecNum><DisplayText>(Ergor et al. 2003; Zeng et al. 2010)</DisplayText><record><rec-number>20</rec-number><foreign-keys><key app="EN" db-id="ws9td5rz92t2fhear29x009m29w2p020sd5s">20</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Ergor, O. A.</author><author>Demiral, Y.</author><author>Piyal, Y. B.</author></authors></contributors><auth-address>Department of Public Health, School of Medicine, Dokuz Eylul University, Izmir, Turkey.</auth-address><titles><title>A significant outcome of work life: occupational accidents in a developing country, Turkey</title><secondary-title>J Occup Health</secondary-title></titles><periodical><full-title>J Occup Health</full-title></periodical><pages>74-80</pages><volume>45</volume><number>1</number><edition>2003/11/08</edition><keywords><keyword>Accidents, Occupational/ statistics &amp; numerical data</keyword><keyword>Adolescent</keyword><keyword>Adult</keyword><keyword>Chi-Square Distribution</keyword><keyword>Developing Countries</keyword><keyword>Female</keyword><keyword>Humans</keyword><keyword>Logistic Models</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword><keyword>Risk Factors</keyword><keyword>Turkey/epidemiology</keyword></keywords><dates><year>2003</year><pub-dates><date>Jan</date></pub-dates></dates><isbn>1341-9145 (Print)&#xD;1341-9145 (Linking)</isbn><accession-num>14605434</accession-num><urls></urls><remote-database-provider>NLM</remote-database-provider><language>eng</language></record></Cite><Cite><Author>Zeng</Author><Year>2010</Year><RecNum>11</RecNum><record><rec-number>11</rec-number><foreign-keys><key app="EN" db-id="ws9td5rz92t2fhear29x009m29w2p020sd5s">11</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Zeng, S.</author><author>Powers, J. R.</author><author>Newbraugh, B. H.</author></authors></contributors><auth-address>Division of Safety Research, National Institute for Occupational Safety and Health, USA. szeng@cdc.gov</auth-address><titles><title>Effectiveness of a worker-worn electric-field sensor to detect power-line proximity and electrical-contact</title><secondary-title>J Safety Res</secondary-title></titles><periodical><full-title>J Safety Res</full-title></periodical><pages>229-39</pages><volume>41</volume><number>3</number><edition>2010/07/16</edition><keywords><keyword>Accidents, Occupational/prevention &amp; control</keyword><keyword>Computer Simulation</keyword><keyword>Electric Injuries/ prevention &amp; control</keyword><keyword>Electricity/ adverse effects</keyword><keyword>Electromagnetic Fields/ adverse effects</keyword><keyword>Feasibility Studies</keyword><keyword>Humans</keyword><keyword>National Institute for Occupational Safety and Health (U.S.)</keyword><keyword>Occupational Health</keyword><keyword>Safety Management</keyword><keyword>United States</keyword><keyword>Wrist Injuries/prevention &amp; control</keyword></keywords><dates><year>2010</year><pub-dates><date>Jun</date></pub-dates></dates><isbn>1879-1247 (Electronic)&#xD;0022-4375 (Linking)</isbn><accession-num>20630274</accession-num><urls></urls><electronic-resource-num>10.1016/j.jsr.2010.02.011</electronic-resource-num><remote-database-provider>NLM</remote-database-provider><language>eng</language></record></Cite></EndNote>�D<EndNote><Cite><Author>Brown</Author><Year>1997</Year><RecNum>40</RecNum><DisplayText>(Brown et al. 1997; Electrocutions in the construction industry involving portable metal ladders--United States, 1984-1988  1992)</DisplayText><record><rec-number>40</rec-number><foreign-keys><key app="EN" db-id="ws9td5rz92t2fhear29x009m29w2p020sd5s">40</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Brown, M.</author><author>Parker, D.</author><author>Seeland, E.</author><author>Boyle, D.</author><author>Wahl, G.</author></authors></contributors><auth-address>Minnesota Department of Health, USA.</auth-address><titles><title>Five years of work-related injuries and fatalities in Minnesota. Agriculture: a high-risk industry</title><secondary-title>Minn Med</secondary-title></titles><periodical><full-title>Minn Med</full-title></periodical><pages>29-32</pages><volume>80</volume><number>8</number><edition>1997/08/01</edition><keywords><keyword>Accidents, Occupational/ mortality/prevention &amp; control</keyword><keyword>Adolescent</keyword><keyword>Adult</keyword><keyword>Agriculture/ statistics &amp; numerical data</keyword><keyword>Causality</keyword><keyword>Cross-Sectional Studies</keyword><keyword>Female</keyword><keyword>Humans</keyword><keyword>Incidence</keyword><keyword>Male</keyword><keyword>Minnesota</keyword><keyword>Population Surveillance</keyword><keyword>Risk Factors</keyword><keyword>Wounds and Injuries/etiology/ mortality/prevention &amp; control</keyword></keywords><dates><year>1997</year><pub-dates><date>Aug</date></pub-dates></dates><isbn>0026-556X (Print)&#xD;0026-556X (Linking)</isbn><accession-num>9265823</accession-num><urls></urls><remote-database-provider>NLM</remote-database-provider><language>eng</language></record></Cite><Cite><Year>1992</Year><RecNum>54</RecNum><record><rec-number>54</rec-number><foreign-keys><key app="EN" db-id="ws9td5rz92t2fhear29x009m29w2p020sd5s">54</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors></contributors><titles><title>Electrocutions in the construction industry involving portable metal ladders--United States, 1984-1988</title><secondary-title>MMWR Morb Mortal Wkly Rep</secondary-title></titles><periodical><full-title>MMWR Morb Mortal Wkly Rep</full-title></periodical><pages>187-9</pages><volume>41</volume><number>11</number><edition>1992/03/20</edition><keywords><keyword>Accidents, Occupational/ statistics &amp; numerical data</keyword><keyword>Adult</keyword><keyword>Electric Injuries/etiology/ mortality</keyword><keyword>Humans</keyword><keyword>Metals</keyword><keyword>United States/epidemiology</keyword></keywords><dates><year>1992</year><pub-dates><date>Mar 20</date></pub-dates></dates><isbn>0149-2195 (Print)&#xD;0149-2195 (Linking)</isbn><accession-num>1542293</accession-num><urls></urls><remote-database-provider>NLM</remote-database-provider><language>eng</language></record></Cite></EndNote>�D<EndNote><Cite><Author>Brown</Author><Year>1997</Year><RecNum>40</RecNum><DisplayText>(Brown et al. 1997; Electrocutions in the construction industry involving portable metal ladders--United States, 1984-1988  1992)</DisplayText><record><rec-number>40</rec-number><foreign-keys><key app="EN" db-id="ws9td5rz92t2fhear29x009m29w2p020sd5s">40</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Brown, M.</author><author>Parker, D.</author><author>Seeland, E.</author><author>Boyle, D.</author><author>Wahl, G.</author></authors></contributors><auth-address>Minnesota Department of Health, USA.</auth-address><titles><title>Five years of work-related injuries and fatalities in Minnesota. Agriculture: a high-risk industry</title><secondary-title>Minn Med</secondary-title></titles><periodical><full-title>Minn Med</full-title></periodical><pages>29-32</pages><volume>80</volume><number>8</number><edition>1997/08/01</edition><keywords><keyword>Accidents, Occupational/ mortality/prevention &amp; control</keyword><keyword>Adolescent</keyword><keyword>Adult</keyword><keyword>Agriculture/ statistics &amp; numerical data</keyword><keyword>Causality</keyword><keyword>Cross-Sectional Studies</keyword><keyword>Female</keyword><keyword>Humans</keyword><keyword>Incidence</keyword><keyword>Male</keyword><keyword>Minnesota</keyword><keyword>Population Surveillance</keyword><keyword>Risk Factors</keyword><keyword>Wounds and Injuries/etiology/ mortality/prevention &amp; control</keyword></keywords><dates><year>1997</year><pub-dates><date>Aug</date></pub-dates></dates><isbn>0026-556X (Print)&#xD;0026-556X (Linking)</isbn><accession-num>9265823</accession-num><urls></urls><remote-database-provider>NLM</remote-database-provider><language>eng</language></record></Cite><Cite><Year>1992</Year><RecNum>54</RecNum><record><rec-number>54</rec-number><foreign-keys><key app="EN" db-id="ws9td5rz92t2fhear29x009m29w2p020sd5s">54</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors></contributors><titles><title>Electrocutions in the construction industry involving portable metal ladders--United States, 1984-1988</title><secondary-title>MMWR Morb Mortal Wkly Rep</secondary-title></titles><periodical><full-title>MMWR Morb Mortal Wkly Rep</full-title></periodical><pages>187-9</pages><volume>41</volume><number>11</number><edition>1992/03/20</edition><keywords><keyword>Accidents, Occupational/ statistics &amp; numerical data</keyword><keyword>Adult</keyword><keyword>Electric Injuries/etiology/ mortality</keyword><keyword>Humans</keyword><keyword>Metals</keyword><keyword>United States/epidemiology</keyword></keywords><dates><year>1992</year><pub-dates><date>Mar 20</date></pub-dates></dates><isbn>0149-2195 (Print)&#xD;0149-2195 (Linking)</isbn><accession-num>1542293</accession-num><urls></urls><remote-database-provider>NLM</remote-database-provider><language>eng</language></record></Cite></EndNote>P.D<EndNote><Cite><Author>Ergor</Author><Year>2003</Year><RecNum>20</RecNum><DisplayText>(Ergor et al. 2003; Zeng et al. 2010; Janicak 2008; Lipscomb et al. 2000; McCann 2003; Rodgers and Garland 2012; Vergara et al. 2012)</DisplayText><record><rec-number>20</rec-number><foreign-keys><key app="EN" db-id="ws9td5rz92t2fhear29x009m29w2p020sd5s">20</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Ergor, O. A.</author><author>Demiral, Y.</author><author>Piyal, Y. B.</author></authors></contributors><auth-address>Department of Public Health, School of Medicine, Dokuz Eylul University, Izmir, Turkey.</auth-address><titles><title>A significant outcome of work life: occupational accidents in a developing country, Turkey</title><secondary-title>J Occup Health</secondary-title></titles><periodical><full-title>J Occup Health</full-title></periodical><pages>74-80</pages><volume>45</volume><number>1</number><edition>2003/11/08</edition><keywords><keyword>Accidents, Occupational/ statistics &amp; numerical data</keyword><keyword>Adolescent</keyword><keyword>Adult</keyword><keyword>Chi-Square Distribution</keyword><keyword>Developing Countries</keyword><keyword>Female</keyword><keyword>Humans</keyword><keyword>Logistic Models</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword><keyword>Risk Factors</keyword><keyword>Turkey/epidemiology</keyword></keywords><dates><year>2003</year><pub-dates><date>Jan</date></pub-dates></dates><isbn>1341-9145 (Print)&#xD;1341-9145 (Linking)</isbn><accession-num>14605434</accession-num><urls></urls><remote-database-provider>NLM</remote-database-provider><language>eng</language></record></Cite><Cite><Author>Zeng</Author><Year>2010</Year><RecNum>11</RecNum><record><rec-number>11</rec-number><foreign-keys><key app="EN" db-id="ws9td5rz92t2fhear29x009m29w2p020sd5s">11</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Zeng, S.</author><author>Powers, J. 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H.</author></authors></contributors><auth-address>Division of Safety Research, National Institute for Occupational Safety and Health, USA. szeng@cdc.gov</auth-address><titles><title>Effectiveness of a worker-worn electric-field sensor to detect power-line proximity and electrical-contact</title><secondary-title>J Safety Res</secondary-title></titles><periodical><full-title>J Safety Res</full-title></periodical><pages>229-39</pages><volume>41</volume><number>3</number><edition>2010/07/16</edition><keywords><keyword>Accidents, Occupational/prevention &amp; control</keyword><keyword>Computer Simulation</keyword><keyword>Electric Injuries/ prevention &amp; control</keyword><keyword>Electricity/ adverse effects</keyword><keyword>Electromagnetic Fields/ adverse effects</keyword><keyword>Feasibility Studies</keyword><keyword>Humans</keyword><keyword>National Institute for Occupational Safety and Health (U.S.)</keyword><keyword>Occupational Health</keyword><keyword>Safety Management</keyword><keyword>United States</keyword><keyword>Wrist Injuries/prevention &amp; control</keyword></keywords><dates><year>2010</year><pub-dates><date>Jun</date></pub-dates></dates><isbn>1879-1247 (Electronic)&#xD;0022-4375 (Linking)</isbn><accession-num>20630274</accession-num><urls></urls><electronic-resource-num>10.1016/j.jsr.2010.02.011</electronic-resource-num><remote-database-provider>NLM</remote-database-provider><language>eng</language></record></Cite><Cite><Author>Janicak</Author><Year>2008</Year><RecNum>15</RecNum><record><rec-number>15</rec-number><foreign-keys><key app="EN" db-id="ws9td5rz92t2fhear29x009m29w2p020sd5s">15</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Janicak, C. 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A.</author></authors></contributors><auth-address>Indiana University of Pennsylvania, Department of Safety Sciences, 136 Johnson Hall, Indiana, PA 15705, USA. cjanicak@iup.edu</auth-address><titles><title>Occupational fatalities due to electrocutions in the construction industry</title><secondary-title>J Safety Res</secondary-title></titles><periodical><full-title>J Safety Res</full-title></periodical><pages>617-21</pages><volume>39</volume><number>6</number><edition>2008/12/10</edition><keywords><keyword>Accidents, Occupational/ mortality/statistics &amp; numerical data</keyword><keyword>Adolescent</keyword><keyword>Adult</keyword><keyword>Aged</keyword><keyword>Construction Materials</keyword><keyword>Electric Injuries/ epidemiology/prevention &amp; control</keyword><keyword>Female</keyword><keyword>Humans</keyword><keyword>Industry</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword><keyword>Occupational Health</keyword><keyword>Pilot Projects</keyword><keyword>Risk Factors</keyword><keyword>Young Adult</keyword></keywords><dates><year>2008</year></dates><isbn>0022-4375 (Print)&#xD;0022-4375 (Linking)</isbn><accession-num>19064047</accession-num><urls></urls><electronic-resource-num>10.1016/j.jsr.2008.10.007</electronic-resource-num><remote-database-provider>NLM</remote-database-provider><language>eng</language></record></Cite><Cite><Author>Lipscomb</Author><Year>2000</Year><RecNum>30</RecNum><record><rec-number>30</rec-number><foreign-keys><key app="EN" db-id="ws9td5rz92t2fhear29x009m29w2p020sd5s">30</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Lipscomb, H. J.</author><author>Dement, J. M.</author><author>Rodriguez-Acosta, R.</author></authors></contributors><auth-address>Division of Occupational and Environmental Medicine, Duke University Medical Center, Durham, North Carolina, USA.</auth-address><titles><title>Deaths from external causes of injury among construction workers in North Carolina, 1988-1994</title><secondary-title>Appl Occup Environ Hyg</secondary-title></titles><periodical><full-title>Appl Occup Environ Hyg</full-title></periodical><pages>569-80</pages><volume>15</volume><number>7</number><edition>2000/07/14</edition><keywords><keyword>Accidental Falls</keyword><keyword>Accidents, Occupational/ mortality/statistics &amp; numerical data</keyword><keyword>Adolescent</keyword><keyword>Adult</keyword><keyword>Aged</keyword><keyword>Alcoholism</keyword><keyword>Cause of Death</keyword><keyword>Female</keyword><keyword>Humans</keyword><keyword>Industry</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword><keyword>Motor Vehicles</keyword><keyword>North Carolina/epidemiology</keyword><keyword>Retrospective Studies</keyword><keyword>Risk Assessment</keyword></keywords><dates><year>2000</year><pub-dates><date>Jul</date></pub-dates></dates><isbn>1047-322X (Print)&#xD;1047-322X (Linking)</isbn><accession-num>10893793</accession-num><urls></urls><electronic-resource-num>10.1080/10473220050028394</electronic-resource-num><remote-database-provider>NLM</remote-database-provider><language>eng</language></record></Cite><Cite><Author>McCann</Author><Year>2003</Year><RecNum>2</RecNum><record><rec-number>2</rec-number><foreign-keys><key app="EN" db-id="ws9td5rz92t2fhear29x009m29w2p020sd5s">2</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>McCann, M.</author></authors></contributors><auth-address>The Center to Protect Workers&apos; Rights, 8484 Georgia Avenue, Suite 1000, Silver Spring, MD 20910, USA. michael.mccann@att.net</auth-address><titles><title>Deaths in construction related to personnel lifts, 1992-1999</title><secondary-title>J Safety Res</secondary-title></titles><periodical><full-title>J Safety Res</full-title></periodical><pages>507-14</pages><volume>34</volume><number>5</number><edition>2004/01/22</edition><keywords><keyword>Accidents, Occupational/ mortality/ statistics &amp; numerical data</keyword><keyword>Cause of Death/ trends</keyword><keyword>Construction Materials/statistics &amp; numerical data</keyword><keyword>Databases as Topic</keyword><keyword>Elevators and Escalators/ statistics &amp; numerical data</keyword><keyword>Humans</keyword><keyword>United States</keyword><keyword>Workplace/ statistics &amp; numerical data</keyword></keywords><dates><year>2003</year></dates><isbn>0022-4375 (Print)&#xD;0022-4375 (Linking)</isbn><accession-num>14733984</accession-num><urls></urls><remote-database-provider>NLM</remote-database-provider><language>eng</language></record></Cite><Cite><Author>Rodgers</Author><Year>2012</Year><RecNum>8</RecNum><record><rec-number>8</rec-number><foreign-keys><key app="EN" db-id="ws9td5rz92t2fhear29x009m29w2p020sd5s">8</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Rodgers, G. B.</author><author>Garland, S.</author></authors></contributors><auth-address>Directorate for Economic Analysis, US Consumer Product Safety Commission, Bethesda, MD, USA. grodgers@cpsc.gov</auth-address><titles><title>The impact of immersion protection requirements on hair dryer electrocutions in the USA</title><secondary-title>Inj Prev</secondary-title></titles><periodical><full-title>Inj Prev</full-title></periodical><pages>371-6</pages><volume>18</volume><number>6</number><edition>2012/05/17</edition><keywords><keyword>Accidents, Home/ mortality/prevention &amp; control</keyword><keyword>Adolescent</keyword><keyword>Child</keyword><keyword>Child, Preschool</keyword><keyword>Electric Injuries/ mortality/prevention &amp; control</keyword><keyword>Electrical Equipment and Supplies/adverse effects/ statistics &amp; numerical data</keyword><keyword>Female</keyword><keyword>Hair</keyword><keyword>Humans</keyword><keyword>Immersion/adverse effects</keyword><keyword>Infant</keyword><keyword>Infant, Newborn</keyword><keyword>Male</keyword><keyword>Protective Devices/ statistics &amp; numerical data</keyword><keyword>United States/epidemiology</keyword><keyword>Water/adverse effects</keyword></keywords><dates><year>2012</year><pub-dates><date>Dec</date></pub-dates></dates><isbn>1475-5785 (Electronic)&#xD;1353-8047 (Linking)</isbn><accession-num>22589363</accession-num><urls></urls><electronic-resource-num>10.1136/injuryprev-2011-040215</electronic-resource-num><remote-database-provider>NLM</remote-database-provider><language>eng</language></record></Cite><Cite><Author>Vergara</Author><Year>2012</Year><RecNum>10</RecNum><record><rec-number>10</rec-number><foreign-keys><key app="EN" db-id="ws9td5rz92t2fhear29x009m29w2p020sd5s">10</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Vergara, X. P.</author><author>Kheifets, L.</author><author>Silva, M.</author><author>Bracken, T. 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