Evaluation of fall from height cases in terms of forensic medicine who applied to the Akdeni̇z University forensic medicine department in Antalya between 2007-2016 years

Trauma seen as a result of a fall from height has become a public health problem with high rates of morbidity and mortality. Despite all the modern developments, lives are lost or individuals are injured or are left disabled due to carelessness or safety precautions not being implemented. In addition to treatment services, preventative measures are extremely important on this subject. Determining the epidemiological characteristics of cases of a fall from height may be useful in preventing these falls and in treatment. Approval for this study was granted by the Clinical Research Ethics Committee of Akdeniz University Medical Faculty. A review was made of the reports of 26245 forensic cases who presented at the Forensic Medicine Polyclinic of Akdeniz University Hospital in the 10-year period of 01 January 2007 – 31 December 2016, and 258 cases were identified as injured following a fall from height. Evaluation of these cases who presented with injuries resulting from a fall from height was made in respect of age, gender, the month and season of the accident, form of injury, location of the incident, the height of the fall, body area injured, level of injury in respect of forensic medicine, and frequency of disability. It was aimed to review precautions which could be taken. A total of 258 cases were evaluated, comprising 206 (79.8%) males and 52 (20.2%) females with a mean age of 27.9 years. The mean height of the fall was determined as 7.03m, with those jumping with the intention of suicide determined at greater heights. The most common site of the event was on a construction site in 72 (27.9%) cases, followed by from a building window (n:71, 27.5%), a balcony (n:29, 11.2%), inside the house (n:22, 8.5%), from stairs (n:13, 5.0%) and from a tree (n:9, 3.5%). According to the information in the patient records, the falls occured most often by accident (94.9%). The most common bone fractures were of the spine in 78 (30.2%) cases, the most frequently injured region was the head and neck in 127 (49.2%) cases, and injuries to the liver were determined in 12 (4.6%) cases and to the spleen in 12 (4.6%) cases. The time of the fall was recorded as between 1201 and 1800 hours in 84 (32.6%) cases, and the seasons in which the falls occurred were determined as most often in spring (n:71, 27.5%), followed by summer (n:64, 24.8%), autumn (n:62, 24.1%) and winter (n:61, 23.6%). In 55% of cases, the incident occurred between April and July. There was seen to be a greater number of fractures of the chest, spine and upper extremities in falls where the mean height of the fall was increased. There were determined to be mean 2.2 areas of injury, ranging from 0-7. The number of areas with fractures was mean 1.5, ranging from 0-6. The majority of accidental falls from height are the result of carelessness, lack of precautions and negligence. Therefore, the necessary precautions must be taken in working environments and all areas of life. Care must be taken that appropriate working clothes are worn, safety helmets must be used in required areas, and there must be correct use of equipment and materials. Those with chronic diseases should be more careful and/or more closely supervised to be able to reduce the possibility of falls. Understanding that various factors are responsible for falls from height and implementing precautions will be helpful in reducing morbidity, mortality and the burden on healthcare institutions. It must not be forgotten that it is possible to reduce the incidence of falls from height with education of children in particular and by implementing precautions, and to thereby prevent injuries, disability and death.