Electrical injury
Classification and external resources
File:Lighteninginjury.JPG
A person who was affected by a nearby lightning strike. Note the slight branching redness travelling up his leg from the effects of the current.
ICD-10 T75.4
File:Grounded hotdog.JPG

1700 volts burns a grounded hot dog

Electric shock occurs upon contact of a (human) body with any source of electricity that causes a sufficient current through the skin, muscles or hair. Typically, the expression is used to denote an unwanted exposure to electricity, hence the effects are considered undesirable.[1] The minimum current a human can feel is thought to be about 1 milliampere (mA), but this is highly dependent on the frequency of the signal. The current may cause tissue damage or fibrillation if it is sufficiently high. Death caused by an electric shock is referred to as electrocution. Generally, currents approaching 100 mA are lethal if they pass through sensitive portions of the body.[2]

If the voltage is less than 200 V, then the human skin, more precisely the stratum corneum, is the main contributor to the impedance of the body in the case of a macroshock— the passing of current between two contact points on the skin. The characteristics of the skin are non-linear however. If the voltage is above 450–600 V, then dielectric breakdown of the skin occurs.[3]

If an electrical circuit is established by electrodes introduced in the body, bypassing the skin, then the potential for lethality is much higher if a circuit though the heart is established. This is known as a microshock. Currents of only 10 µA can be sufficient to cause fibrillation in this case. This is a concern in modern hospital settings when the patient is connected to multiple devices.

Signs and symptoms

Burns

Heating due to resistance can cause extensive and deep burns. Voltage levels of 500 to 1000 volts tend to cause internal burns due to the large energy (which is proportional to the duration multiplied by the square of the voltage divided by resistance) available from the source. Damage due to current is through tissue heating. It is a relatively unknown fact that more electrical workers die from burns than from an electric shock, in fact only around 20% die from the effects of shock.[4]

Ventricular fibrillation

A domestic power supply voltage (110 or 230 V), 50 or 60 Hz AC current through the chest for a fraction of a second may induce ventricular fibrillation at currents as low as 60 mA. With DC, 300 to 500 mA is required. If the current has a direct pathway to the heart (e.g., via a cardiac catheter or other kind of electrode), a much lower current of less than 1 mA (AC or DC) can cause fibrillation. If not immediately treated by defibrillation, fibrillations are usually lethal because all the heart muscle cells move independently instead of in the coordinated pulses needed to pump blood to maintain circulation. Above 200 mA, muscle contractions are so strong that the heart muscles cannot move at all.

Neurological effects

Current can cause interference with nervous control, especially over the heart and lungs. Repeated or severe electric shock which does not lead to death has been shown to cause neuropathy. Recent research has found that functional differences in neural activation during spatial working memory and implicit learning oculomotor tasks have been identified in electrical shock victims.[5]

When the current path is through the head, it appears that, with sufficient current[clarification needed], loss of consciousness almost always occurs swiftly. (This is borne out by some limited self-experimentation by early designers of the electric chair[citation needed] and by research from the field of animal husbandry, where electric stunning has been extensively studied.)[6]

Arc-flash hazards

One major corporationTemplate:Which? found that up to 80 percent of its electrical injuries involve thermal burns due to arcing faults.[7] The arc flash in an electrical fault produces the same type of light radiation from which electric welders protect themselves using face shields with dark glass, heavy leather gloves, and full-coverage clothing.[8] The heat produced may cause severe burns, especially on unprotected flesh. The blast produced by vaporizing metallic components can break bones and irreparably damage internal organs. The degree of hazard present at a particular location can be determined by a detailed analysis of the electrical system, and appropriate protection worn if the electrical work must be performed with the electricity on.

Issues affecting lethality

The lethality of an electric shock is dependent on several variables:

1) Current (the higher the current, the more likely it is lethal - current NOT voltage kills) 2) Duration (the longer the duration, the more likely it is lethal - safety switches limit time of current flow) 3) Pathway (if current flows through the heart muscle, it is more likely to be lethal) 4) Frequency (maximum lethality unfortunately occurs at 50 to 60 Hz, both DC and higher frequencies are safer than the mains)

Other issues affecting lethality are frequency, which is an issue in causing cardiac arrest or muscular spasms, and pathway—if the current passes through the chest or head there is an increased chance of death. From a main circuit or power distribution panel the damage is more likely to be internal, leading to cardiac arrest.[citation needed].

The comparison between the dangers of alternating current and direct current has been a subject of debate ever since the War of Currents in the 1880s. DC tends to cause continuous muscular contractions that make the victim hold on to a live conductor, thereby increasing the risk of deep tissue burns. On the other hand, mains-magnitude AC tends to interfere more with the heart's electrical pacemaker, leading to an increased risk of fibrillation. AC at higher frequencies holds a different mixture of hazards, such as RF burns and the possibility of tissue damage with no immediate sensation of pain. A common misconception is that higher frequency AC current tends to run along the skin rather than penetrating and touching vital organs such as the heart due to the skin effect. This is false, as the human body has far too high a resistance for this effect to occur. While there will be severe burn damage at higher frequencies, it is normally not fatal.

It is sometimes suggested that human lethality is most common with alternating current at 100–250 volts; however, death has occurred below this range, with supplies as low as 32 volts. Shocks above 2700 volts are often fatal, with those above 11000 volts being usually fatal.[citation needed] Shocks with voltages over 40,000 volts are almost invariably fatal. However, Harry F. Mcgrew came into direct contact with a 340,000 volt transmission line in Huntington Canyon, Utah, and survived. According to the Guinness Book of World Records, this is the largest known electric shock that was survived. Brian Latasa also survived a 230,000 volt shock in Griffith Park, Los Angeles, according to Guinness.

Body resistance

The voltage necessary for electrocution depends on the current through the body and the duration of the current. Ohm's law states that the current drawn depends on the resistance of the body. The resistance of human skin varies from person to person and fluctuates between different times of day. The NIOSH states "Under dry conditions, the resistance offered by the human body may be as high as 100,000 Ohms. Wet or broken skin may drop the body's resistance to 1,000 Ohms," adding that "high-voltage electrical energy quickly breaks down human skin, reducing the human body's resistance to 500 Ohms."[9]

The International Electrotechnical Commission gives the following values for the total body impedance of a hand to hand circuit for dry skin, large contact areas, 50 Hz AC currents (the columns contain the distribution of the impedance in the population percentile; for example at 100 V 50% of the population had an impedance of 1875Ω or less):[10]

Voltage 5% 50% 95%
25 V 1,750 Ω 3,250 Ω 6,100 Ω
100 V 1,200 Ω 1,875 Ω 3,200 Ω
220 V 1,000 Ω 1,350 Ω 2,125 Ω
1000 V 700 Ω 1,050 Ω 1,500 Ω

Point of entry

  • Macroshock: Current across intact skin and through the body. Current from arm to arm, or between an arm and a foot, is likely to traverse the heart, therefore it is much more dangerous than current between a leg and the ground. This type of shock by definition must pass into the body through the skin.
  • Microshock: Very small, current source with a pathway directly connected to the heart tissue. The shock is required to be administered from inside the skin, directly to the heart i.e. a pacemaker lead, or a guide wire, conductive catheter etc. connected to a source of current. This is a largely theoretical hazard as modern devices used in these situations include protections against such currents.

Epidemiology

There were 550 electrocutions in the US in 1993, which translates to 2.1 deaths per million inhabitants. At that time, the incidence of electrocutions was decreasing.[11] Electrocutions in the workplace make up the majority of these fatalities. From 1980–1992, an average of 411 workers were killed each year by electrocution.[9]

Deliberate uses

Medical uses

Electric shock is also used as a medical therapy, under carefully controlled conditions:

  • Electroconvulsive therapy or ECT is a psychiatric therapy for mental illness. The objective of the therapy is to induce a seizure for therapeutic effect. There is no sensation of shock because the patient is anesthetized. The therapy was originally conceived of after it was observed that depressed patients who also suffered from epilepsy experienced some remission after a spontaneous seizure.[citation needed] The first attempts at deliberately inducing seizure as therapy used not electricity but chemicals; however electricity provided finer control for delivering the minimum stimulus needed. Ideally some other method of inducing seizure would be used, as the electricity may be associated with some of the negative side effects of ECT including amnesia. ECT is generally administered three times a week for about 8-12 treatments.
  • As a surgical tool for cutting or coagulation. An "Electrosurgical Unit" (or ESU) uses high currents (e.g. 10 amperes) at high frequency (e.g. 500 kHz) with various schemes of amplitude modulation to achieve the desired result - cut or coagulate - or both. These devices are safe when used correctly.
  • As a treatment for fibrillation or irregular heart rhythms: see defibrillator and cardioversion.
  • As a method of pain relief: see Transcutaneous Electrical Nerve Stimulator (more commonly referred to as a TENS unit).
  • As an aversive punishment for conditioning of mentally handicapped patients with severe behavioral problems. This method is highly controversial and is employed at only one institution in the United States, the Judge Rotenberg Educational Center; The institute also uses electric shock punishments on non-handicapped children with behavioral problems, and whether this constitutes legitimate medical treatment or abusive discipline is currently the subject of litigation.[citation needed]

Law enforcement and personal defence

Electroshock weapons are incapacitant weapons used for subduing a person by administering electric shock to disrupt superficial muscle functions. One type is a conductive energy device (CED), an electroshock gun popularly known by the brand name "Taser", which fires projectiles that administer the shock through a thin, flexible wire. Although they are illegal for personal use in many jurisdictions, Tasers have been marketed to the general public.[12] Other electroshock weapons such as stun guns, stun batons ("cattle prods"), and electroshock belts administer an electric shock by direct contact.

Torture

Electric shocks have been used as a method of torture, since the received voltage and current can be controlled with precision and used to cause pain while avoiding obvious evidence on the victim's body. Such torture usually uses electrodes attached to parts of the victim's body: most typically, while wires are wound around the fingers, toes, and/or tongue to provide a return circuit, the voltage source (typically a cattle prod) of precisely controllable pressure is applied to the testicles.

Electrical torture has been used in war and by repressive regimes since the 1930s:[13] The US Army is known to have used electrical torture during World War II;[14] Amnesty International published an official statement that Russian military forces in Chechnya tortured local women with electric shocks by connecting electric wires to their bra straps;[15] Japanese serial killer Futoshi Matsunaga used electric shocks for controlling his victims.[16]

Advocates for the mentally ill and some psychiatrists such as Thomas Szasz have asserted that electroconvulsive therapy is torture when used without a bona fide medical benefit against recalcitrant or non-responsive patients. See above for ECT as medical therapy. These same arguments and oppositions apply to the use of extremely painful shocks as punishment for behavior modification, a practice that is openly used only at the Judge Rotenberg Institute.[17][18][19]

Capital punishment

Electric shock delivered by an electric chair is sometimes used as an official means of capital punishment in the United States, although its use has become rare in recent times. Although some original proponents of the electric chair considered it to be a more humane and modern execution method than hanging, shooting, poison gassing, etc., it has now generally been replaced by lethal injections in countries that practice capital punishment. Modern reporting has claimed that it sometimes takes several shocks to be lethal, and that the condemned person may actually catch fire before the process is complete. The brain is always severely damaged and inactivated.

Other than in parts of the United States, only the Philippines reportedly has used this method, and only for a few years. It is legal in at least 10 states of USA.[20]

See also

References

  1. Reilly, J. Patrick (1998). Applied Bioelectricity: From Electrical Stimulation to Electropathology (2nd ed.). Springer. p. 1. ISBN 978-0387984070. OCLC 38067651. Template:LCCN. http://books.google.com/?id=o7iGY-KCmk4C.
  2. Electric Current Needed to Kill a Human
  3. Reilly, p. 30
  4. http://www.arcflash.com.au/arc_flash_statistics.php
  5. Mechanism of Electrical Injury Chicago Electrical Trauma Research Institute Accessed April 27, 2010
  6. Electric Stunning of Pigs and Sheep
  7. "Industry Backs IEEE-NFPA Arc Flash Testing Program with Initial Donations of $1.25 Million". IEEE. 14 July 2006. http://standards.ieee.org/announcements/pr_FINArc.html. Retrieved 2008-01-01.
  8. Arc Flash Protection
  9. 9.0 9.1 "Publication No. 98-131: Worker Deaths by Electrocution". National Institute for Occupational Safety and Health. http://www.cdc.gov/niosh/docs/98-131/overview.html. Retrieved 2008-08-16.
  10. Reilly, p. 43
  11. Folliot, Dominigue (1998). "Electricity: Physiological Effects". Encyclopaedia of Occupational Health and Safety, Fourth Edition. Archived from the original on 2007-02-28. http://web.archive.org/web/20070228084602/http://www.ilo.org/encyclopedia/?doc&nd=857100207&nh=0. Retrieved 2006-09-04.
  12. International Association of Chiefs of Police, Electro Muscular Disruption Technology: A Nine-Step Strategy for Effective Deployment, 2005
  13. Technological Invention and Diffusion of Torture Equipment The Strange Case of Electric Torture Instruments in the Early 20th Century
  14. Rejali, Darius (2007-12-16). "Torture, American style: The surprising force behind torture: democracies". Boston Globe. http://www.boston.com/bostonglobe/ideas/articles/2007/12/16/torture_american_style/. Retrieved 2008-01-01.
  15. Russian Federation Preliminary briefing to the UN Committee against Torture 1 April 2006, statement by Amnesty International
  16. "Serial killer's death sentence upheld". Asahi Shimbun. 2007-09-27. http://www.asahi.com/english/Herald-asahi/TKY200709270058.html. Retrieved 2008-03-21.[dead link]
  17. Israel, Matthew. "History and Basic Principles of JRC". http://www.judgerc.org/history.html. Retrieved 2007-12-22.
  18. Gonnerman, Jennifer (20 August 2007). "School of Shock". Mother Jones Magazine. http://www.motherjones.com/news/feature/2007/09/school_of_shock.html. Retrieved 2007-12-22.
  19. Wen, P (2008-01-17). "Showdown over shock therapy". The Boston Globe. http://www.boston.com/news/local/articles/2008/01/17/showdown_over_shock_therapy/. Retrieved 2008-01-26.
  20. Death Penalty Information Center

External links

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