Fatal fall from Height Cases in Shanghai, China, 2002-2011

Abstract

Death due to fall from height is a complex forensic issue. It could occur in suicide, accident or even homicide. Study of fall from height in China seems to be rare. In this study, 250 individuals died in fall from height cases in Shanghai were collected retrospectively from the files of SPSB from 2002 to 2011. We evaluated the demographic data, the manner of death, forensic examination findings, and toxicological test results. Overall 250 individuals, 176 were male and 74 were female. 223 individuals were identified. Ages ranged from 1 year old to 86 year old. The average age was about 33.4 ± 15.3 years. The proportion of age from 18 to 29 was the highest. Among 223 identified individuals, 170 were Chinese and 53 were foreigners from 17 countries. Manner of death was mainly suicide (46%, 115/250) and accident (18%, 45/250), while the proportion of homicide was low (3.6%, 9/250). The proportion of undetermined was high (32.4%, 81/250). Forensic full autopsies were done in 87 cases. Ethanol and drugs detection were done in 118 individuals. Individuals' psychiatric history was not collected in the files. In conclusion, the characteristics of fall from height cases in Shanghai, China, are summarized to these: manner of death was mainly suicide and accident, low proportion of homicide, and high proportion of undetermined cases. Males were more than females. Individuals were mainly young adults. The injuries recorded in forensic examination files were common to occur in the exposing areas of body.

A 13-Year Study of Fatal Falls From Height in Northern Tunisia

“…In keeping with findings from other parts of the world, the majority of our casualties were men (87.7%) 8,9 . This was true for all manners of death, with a sex ratio male/female of 10.8 in accidents, 2.6 in suicides, and 1.3 in homicides.…”

“…It was determined that the rate of accident-related falls was lower than the studies by Türkoğlu 13 (80.3%), Murthy et al 2 (88.5%), and Behera et al 15 (97.7%), and higher than (43.8%) Peng et al, 20 and Li et al 9 (51.8%). The discrepancy in rates of accidental falls was mainly attributed to the effectiveness of prevention policies adopted by the societies to counter falls from height 13,21 …”

“…This was true for all manners of death, with a sex ratio male/female of 10.8 in accidents, 2.6 in suicides, and 1.3 in homicides. This may be explained by men taking more risks and working in unsafe employment sectors like maintenance, construction and other outdoor jobs 9 . In fatal suicidal falls, the male predominance is also commonly reported by authors, who confirm that men tend to use violent and lethal methods of suicide, more often than women 10 .…”

“…The large surface of the liver, the important mobility and "rib danger" for the spleen may explain the high injury incidence for these organs. 9 Discriminating falls from high heights from other types of blunt injury by their higher frequency of liver and spleen injuries could influence the triage and management of patients. 3 The kidneys showed a low injury prevalence (10.1%) in our population.…”

“…Previous studies confirmed the significant involvement of the chest and the lower ends in longer falls. 6,9,39,[42][43][44] Low heights were associated with head soft tissue. Our results corroborate the fact that height of fall could be predictor of the set and extent of injuries.…”