Evaluati̇on of autopsy cases due to occupati̇onal acci̇dents between 2013-2017 years i̇n Antalya

According to recent estimates; more than two point three million people die due to occupational diseases or work related accidents every year and every day more than six thousand workers die whilst six hundred and ninety thousand of people get injured at work, around the world. Occupational diseases and injuries can create significant social and economical problems especially in developing countries like Turkish Republic. In recent years occupation related deaths and injuries are increasing in our country as well as around the world and becoming a serious public health issue. Work related deaths and injuries are very important for practising forensic medicine, as all of these cases would be considered as criminal and judicial situations. In this study, we will analyse the occupational deaths, which had the post-mortem examination in Antalya so that the frequency and the characteristics of work related deaths in this region would be exposed. This will also aim to evaluate occupational health applications in consideration with region's features. In this study, autopsy reports of 4296 forensic autopsies, which are performed in the Mortuary Department of Forensic Medicine Council's Antalya Branch in a five- year period including 2013-2017 years, are retrospectively reviewed. In all 4296 cases, 201 cases (%4,7) were detected of occupational accidental deaths and 93 cases (%2,2) were deaths from non-traumatic natural causes while working. These cases examined by socio-demographic characteristics including age, gender, nationality, and also by location and working hours (distribution of the cases by hours of the day, days of the week, months and seasons) of the accidents; as well as the type of the accident, economic sectorial activity, autopsy findings, toxicological analysis, type of the job, the working period of the employee, place of death and causes of death. Occupational accidental deaths and non-traumatic natural origin deaths occurred on duty has been discussed separately, because of the differences of the origins and forensic medical aspects. According to data obtained in this study, the male/female ratio of the 201 cases who had post-mortem examination in Antalya after occupational accidental death, were found 12,4 (M/F:186/15) and average age of the cases were 41,8 (min:15, max:83, SD: 14,0). In detail of all 201 cases, the male average age was 41,8, min:16, max:83, SD:13,7) and the female average age was 42,0 (min:15, max:69, SD:16,9). Only 3 cases (%1,5) were under the age of 18, and when we look at the age groups, most of the cases the ages were between 31-40 (n:46, %22,9) and 41-50 ages (n:49, %24,4). In terms of nationality; most of the cases were Turkish nationals (n:191, %95,0) with only 10 foreign national deaths and 6 of the 10 foreigner occupational death cases were Syrian (%6,0). Occupational accidents of 166 cases (%82,6) occurred in Antalya province, other 34 cases (%16,9) were sent to Antalya Morgue Department of Forensic Medicine Council, from the provinces around Antalya and 1 case (%0,5) was unknown. Majority of the occupational accidental deaths occurred in June (n:25, %12,4) and in summer season (n:64, %31,8), a few were found in March (n:8, %3,9) and winter season (n:36, %17,9). Most of the fatal occupational accidents were occurred on Sundays (n:37, %18,4), and majority took place between 16:00-19:59 hours. Occupational accidental death cases were mostly at construction (n:41, %20,4), agriculture (n:31, %15,4) and tourism/hospitality (n:24, %11,9) sectors. Most of the fatal occupational accidents occurred on the motorway (n:40, %19,9), construction/building sites (n:35, %17,4) and the agricultural occupational activity sites like garden/field/greenhouse (n:35, %17,4), and the accidental deaths are mostly by falling from a high place (n:41, %20,4), electrical injuries (n:33,%16,4) and being stuck under a big tool/object (n:30, %14,9), and also traumatic injuries (n:106, %52,7), electrocutions (n:31, %15,4) and asphyxia due to drowning in water (n:14, %7,0) were most of the causes of deaths in work-related accidents. The exact cause of death couldn't be determined in 14 cases (%7,0). The big percentage of the traumatic fatal injuries were head and neck (n:83, %41,3), thorax (n:80, %39,8) and abdominal injuries (n:55, %27,4). Additionally, the profession of people who died as a result of their occupation were mostly construction workers (n:35, %17,4) and farmers (30, %14,9). In 93 cases (%2,2), where the cause of the work related death was found to be due to non-traumatic natural causes; the male/female ratio was 22,2 (M/F:89/4). The average age for all of the non-traumatic cases was 51,6 (min:20, max:82, SD:13,3). In detail, the average age for females was 59,0 (min:48, max:75, SD:13,3), and for males it was 51,2 (min:20, max:82, SD:13,3). The nationality distribution of the death cases from non-traumatic natural causes were mostly Turkish (n:91,%97,8) and 2 foreign cases were Syrian (%2,2). The age distribution of the cases were mostly between 41-50 years (n:28, %30,1). Majority of the non-traumatic deaths at work were happened on Saturdays (n:19, %20,4), in August (n:14, %15,0) and in autumn season (n:26, %28,0), and the timing of the deaths were mostly between 08:00-11:59 (n:26, %28,0) hours of the day. The area of profession of people who died due to non-traumatic cases was in agriculture (n:25, %26,9) and in tourism/hospitality (n:16, %17,2) sectors. The most common causes of deaths were found as cardiac arrest (n:66, %71,0) and deaths due to coronary artery disease/myocardial infarction (n:51, %77,3). Accidents mostly come from low-cost and preventable reasons but their consequences deeply affect both the individuals and the society. Keeping records early and accurately in forensic investigations, related to the occurrence of occupational accidents and performing forensic medical applications quickly and carefully to explain the cause of the deaths have an important role in correct management of this process and prevention of grievances. Key words: Death, occupational accidents, forensic medicine