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Electrical injury
Physiological reaction or injury caused by electric current From Wikipedia, the free encyclopedia
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An electrical injury (electric injury) or electrical shock (electric shock) is damage sustained to the skin or internal organs on direct contact with an electric current.[2][3]
The injury depends on the density of the current, tissue resistance and duration of contact.[4] Very small currents may be imperceptible or only produce a light tingling sensation. However, a shock caused by low and otherwise harmless current could startle an individual and cause injury due to jerking away or falling. A strong electric shock can often cause painful muscle spasms severe enough to dislocate joints or even to break bones. The loss of muscle control is the reason that a person may be unable to release themselves from the electrical source; if this happens at a height as on a power line they can be thrown off.[5][6] Larger currents can result in tissue damage and may trigger ventricular fibrillation or cardiac arrest. If death results from an electric shock the cause of death is generally referred to as electrocution.
Electric injury occurs upon contact of a body part with electricity that causes a sufficient current to pass through the person's tissues. Contact with energized wiring or devices is the most common cause. In cases of exposure to high voltages, such as on a power transmission tower, direct contact may not be necessary as the voltage may "jump" the air gap to the electrical device.
Following an electrical injury from household current, if a person has no symptoms, no underlying heart problems, and is not pregnant, further testing is not required. Otherwise an electrocardiogram, blood work to check the heart, and urine testing for signs of muscle breakdown may be performed.
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Signs and symptoms
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Burns
Damage from electrical injury occurs through two primary mechanisms: the heating of tissue (Joule heating) and the non-thermal breakdown of cell membranes by electrical forces (electroporation).[7]
Heating due to resistance can cause extensive and deep burns. Electrical injuries are often called "iceberg injuries" because the visible skin wounds can mask extensive destruction of deeper tissues.[8] For most cases of high-energy electrical trauma, the Joule heating in deeper tissues will reach damaging temperatures within a few seconds.[9]
Ventricular fibrillation
A domestic power supply voltage (110 or 230 V), 50 or 60 Hz alternating current (AC) through the chest for a duration longer than one second may induce ventricular fibrillation at currents as low as 30 milliamperes (mA).[10] With direct current (DC), 300 to 500 mA are required to cause cardiac arrest.[11] 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, ventricular fibrillation is usually lethal, causing cardiac arrest, because all of the heart muscle fibres move independently instead of in the coordinated action needed for successful cardiac cycle to pump blood and maintain circulation. Short single DC pulses induce ventricular fibrillation dependent on the amount of charge (in mC) transferred to the body, which makes the amplitude of the electrical stimulus independent of the exact amount of current flowing through the body for very short pulse durations. DC shocks of short duration are usually better tolerated by the heart even at high currents and rarely induce ventricular fibrillation compared to lower currents with longer duration with both DC or AC. The amount of current can easily reach very high values as amperage is only of second order importance to fibrillation risk in the case of ultra short contact times with direct currents. But even if the charge itself is harmless, the amount of energy being discharged still can lead to thermal and chemical hazards if its value is high enough. One example of high current electric shock which may be usually harmless is an electrostatic discharge as experienced in everyday life on door handles, car doors etc. These currents can reach values up to 60 A without harmful effects on the heart as the duration is in the order of only several ns. Another example for dangerous electrostatic discharges even without flowing directly through the body are lightning strikes and high voltage arcs.[citation needed]
Mechanism
Mechanism of cardiac arrhythmias induced by electricity is not fully understood, but various biopsies have shown arrhythmogenic foci in patchy myocardial fibrosis which contained increased amount of Na+ and K+ pumps, possibly associated with transient and localized changes in sodium- potassium transport as well as their concentrations, resulting in changes in membrane potential.[10][12]
Neurological effects
Electric shock which does not lead to death has been shown to cause neuropathy in some cases at the site where the current entered the body.[8] The neurologic symptoms of electrical injury may occur immediately, which traditionally have a higher likelihood for healing, though they may also be delayed by days to years.[8] The delayed neurologic consequences of electrical injury have a worse prognosis.[8]
When the path of electric current proceeds through the head, it appears that, with sufficient current applied, loss of consciousness almost always occurs swiftly. This is borne out by research from the field of animal husbandry, where electric stunning has been extensively studied.[13]
If ventricular fibrillation occurs (as above), the blood supply to the brain is diminished, which may cause cerebral hypoxia (and its associated neurologic consequences).[citation needed]
Mental health
There are a variety of psychiatric effects that may occur as a result of electrical injuries. Behavioral changes can occur as well, even if the path of electric current did not proceed through the head.</ref> Symptoms may include:[8] Symptoms may include:[8]
- Depression, including feelings of low self-esteem and guilt
- Anxiety spectrum disorders, including posttraumatic stress disorder and fear of electricity
- Moodiness, including a lower threshold for frustration and "losing one's temper"
- Memory loss, decreased attention span, and difficulty learning
Arc-flash hazards
In cases of exposure to high voltages, such as on a power transmission tower, direct contact may not be necessary as the voltage may "jump" the air gap to the electrical device.[14] OSHA found that up to 80 percent of its electrical injuries involve thermal burns due to arcing faults.[15] 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.[16] The heat produced may cause severe burns, especially on unprotected flesh. The arc blast produced by vaporizing metallic components can break bones and 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.[citation needed]
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Pathophysiology
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The minimum current a human can feel depends on the current type (AC or DC) as well as frequency for AC. A person can sense electric current as low as 1 mA (rms) for 60 Hz AC and as low as 5 mA for DC. At around 10 mA, AC current passing through the arm of a 68-kilogram (150 lb) human can cause powerful muscle contractions; the victim is unable to voluntarily control muscles and cannot release an electrified object.[17] This is known as the "let go threshold" and is a criterion for shock hazard in electrical regulations.
The current may, if it is high enough, cause tissue damage or fibrillation which can cause cardiac arrest; more than 30 mA[18] of AC (rms, 60 Hz) or 300–500 mA of DC at high voltage can cause fibrillation.[19][20] A sustained electric shock from AC at 120 V, 60 Hz is an especially dangerous source of ventricular fibrillation because it usually exceeds the let-go threshold, while not delivering enough initial energy to propel the person away from the source. However, the potential seriousness of the shock depends on paths through the body that the currents take.[19] 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.[21] The protection offered by the skin is lowered by perspiration, and this is accelerated if electricity causes muscles to contract above the let-go threshold for a sustained period of time.[19]
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 through the heart is established. This is known as a microshock. Currents of only 10 μA can be sufficient to cause fibrillation in this case with a probability of 0.2%.[22]
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".[23]
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):[24]
Skin
The voltage-current characteristic of human skin is non-linear and depends on many factors such as intensity, duration, history, and frequency of the electrical stimulus. Sweat gland activity, temperature, and individual variation also influence the voltage-current characteristic of skin. In addition to non-linearity, skin impedance exhibits asymmetric and time varying properties. These properties can be modeled with reasonable accuracy.[25] Resistance measurements made at low voltage using a standard ohmmeter do not accurately represent the impedance of human skin over a significant range of conditions.
For sinusoidal electrical stimulation less than 10 volts, the skin voltage-current characteristic is quasilinear. Over time, electrical characteristics can become non-linear. The time required varies from seconds to minutes, depending on stimulus, electrode placement, and individual characteristics.[citation needed]
Between 10 volts and about 30 volts, skin exhibits non-linear but symmetric electrical characteristics. Above 20 volts, electrical characteristics are both non-linear and symmetric. Skin conductance can increase by several orders of magnitude in milliseconds. This should not be confused with dielectric breakdown, which occurs at hundreds of volts. For these reasons, current flow cannot be accurately calculated by simply applying Ohm's law using a fixed resistance model.[citation needed]
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.[26]
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.[22]
Lethality
Electrocution
The earliest usage of the term "electrocution" cited by the Oxford English Dictionary was an 1889 newspaper reference to the method of execution then being considered.[27] Shortly thereafter, in 1892, the term was used in Science to refer generically to death or injury caused by electricity.[27]
Factors in lethality of electric shock
AC-1: imperceptible
AC-2: perceptible but no muscle reaction
AC-3: muscle contraction with reversible effects
AC-4: possible irreversible effects
AC-4.1: up to 5% probability of ventricular fibrillation
AC-4.2: 5–50% probability of fibrillation
AC-4.3: over 50% probability of fibrillation
The lethality of an electric shock is dependent on several variables:
Current: The higher the current, the more likely it is lethal. Since current is proportional to voltage when resistance is fixed (Ohm's law), high voltage is an indirect risk for producing higher currents.
Duration: The longer the shock duration, the more likely it is lethal—safety switches may limit time of current flow.
Pathway: If current flows through vital organs, like the heart muscle, it is more likely to be lethal.
High voltage (over about 600 volts). In addition to greater current flow, high voltage may cause dielectric breakdown at the skin, thus lowering skin resistance and allowing further increased current flow.
Medical implants: Artificial cardiac pacemakers or implantable cardioverter-defibrillators (ICD) are sensitive to very small currents.[29]
Pre-existing medical condition[30]
Age, body mass, and health status[31]
Sex: Women are more vulnerable to electric shock than men.[32]
Other issues affecting lethality are frequency, which is an issue in causing cardiac arrest or muscular spasms. Very high frequency electric current causes tissue burning but does not stimulate the nerves strongly enough to cause cardiac arrest (see electrosurgery). Also important is the pathway: if the current passes through the chest or head, there is an increased chance of death.
The comparison between the dangers of alternating current (AC) at typical power transmission frequencies (i.e., 50 or 60 Hz), and direct current (DC) has been a subject of debate ever since the war of the currents in the 1880s. While both can be fatal, low-frequency AC is generally considered three to five times more dangerous than DC of the same nominal voltage.[11]
It is sometimes suggested that human lethality is most common with AC at 100–250 volts; however, death has occurred below this range, with supplies as low as 42 volts DC.[33] Assuming a steady current flow (as opposed to a shock from a capacitor or from static electricity), shocks above 2,700 volts are often fatal, with those above 11,000 volts being usually fatal, though exceptional cases have been noted. According to the Guinness Book of World Records, seventeen-year-old Brian Latasa survived a 230,000 volt shock on the tower of an ultra-high voltage line in Griffith Park, Los Angeles on November 9, 1967.[34]
Treatment
Following an electrical injury from household current, if a person has no symptoms, no underlying heart problems, and is not pregnant, further testing is not required.[35] Otherwise an electrocardiogram, blood work to check the heart, and urine testing for signs of muscle breakdown may be performed.[35]
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Prevention
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Preventing electrical injuries is a fundamental objective of national electrical codes and occupational safety standards. Key strategies focus on engineering controls, administrative procedures, and personal protective equipment.
Engineering Controls: These are designed to isolate workers from hazards.
Insulation: Electrical devices have non-conductive insulation to prevent contact with energized parts. Double insulated devices provide a secondary layer of protection.[11]
Grounding and Bonding: Conductive metal enclosures of equipment are connected to the earth ground to provide a safe path for fault currents to flow, preventing the enclosure from becoming energized.[11]
Circuit Protection: Devices like residual-current devices (RCDs), also known as Ground Fault Circuit Interrupters (GFCIs), are designed to quickly interrupt a circuit when they detect a dangerous current leakage to ground, preventing serious shocks.[36]
Guarding: Live parts of electrical equipment are placed in enclosures, cabinets, or behind barriers to prevent accidental contact.[11]
Administrative Procedures and Safe Work Practices:
Lockout–tagout (LOTO): This is a critical safety procedure used to ensure that dangerous equipment is properly shut off and not re-energized prior to the completion of maintenance or repair work.[37][failed verification]
Training: Workers who may be exposed to electrical hazards must be trained to understand the specific risks and the safety-related work practices necessary to protect themselves.[37][failed verification]
Personal Protective Equipment (PPE):
When engineering and administrative controls are not sufficient, workers must use PPE, such as insulated gloves, face shields, and non-conductive boots, to provide a final layer of protection against electrical shock and arc flash.[37][failed verification]
Epidemiology
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There were 550 reported electrocution deaths in the US in 1993, 2.1 deaths per million inhabitants. At that time, the incidence of electrocutions was decreasing.[38] Electrocutions in the workplace make up the majority of these fatalities. From 1980 to 1992, an average of 411 workers were killed each year by electrocution.[23] Workplace deaths caused by exposure to electricity in the U.S. increased by nearly 24% between 2015 and 2019, from 134 to 166. However, workplace electrical injuries dropped 23% between 2015 and 2019 from 2,480 to 1,900.[39] In 2019, the top 5 states with the most workplace electrical fatalities were: (1) Texas (608); (2) California (451); (3) Florida (306); (4) New York (273); and (5) Georgia (207).[40]
A study conducted by the National Coroners Information System (NCIS) in Australia has revealed 321 closed case fatalities (and at least 39 case fatalities still under coronial investigation) that had been reported to Australian coroners where a person died from electrocution between July 2000 and October 2011.[41]
In Sweden, Denmark, Finland and Norway the number of electric deaths per million inhabitants was 0.6, 0.3, 0.3 and 0.2, respectively, in the years 2007–2011.[42]
In Nigeria, analysis of Nigerian Electricity Regulatory Commission data found 126 recorded electrocution deaths and 68 serious injuries in 2020 and the first half of 2021.[43]
People who survive electrical trauma may develop a host of injuries including loss of consciousness, seizures, aphasia, visual disturbances, headaches, tinnitus, paresis, and memory disturbances.[44] Even without visible burns, electric shock survivors may be faced with long-term muscular pain and discomfort, exhaustion, headache, problems with peripheral nerve conduction and sensation, inadequate balance and coordination, among other symptoms. Electrical injury can lead to problems with neurocognitive function, affecting speed of mental processing, attention, concentration, and memory. The high frequency of psychological problems is well established and may be multifactorial.[44] As with any traumatic and life-threatening experience, electrical injury may result in post traumatic psychiatric disorders.[45] There exist several non-profit research institutes that coordinate rehabilitation strategies for electrical injury survivors by connecting them with clinicians that specialize in diagnosis and treatment of various traumas that arise as a result of electrical injury.[46][full citation needed][47][full citation needed]
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Deliberate uses
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Medical uses
Electric shock is also used as a medical therapy, under carefully controlled conditions:
Electroconvulsive therapy or ECT, a controversial psychiatric therapy for mental disorders. While used as a treatment, some patient advocates and researchers argue that it constitutes a form of repetitive electrical injury with risks of delayed and progressive neurological damage.[48][49] Proponents of this view cite studies linking ECT to an increased risk of developing Amyotrophic Lateral Sclerosis (ALS) and point to a lack of long-term human safety testing for the devices, noting that one popular device was reportedly safety tested on only two dogs.[50]
As a surgical tool for cutting or coagulation in electrosurgery. An electrosurgical unit (ESU) uses high currents (e.g. 10 amperes) at high frequency (e.g. 500 kHz) with various schemes of amplitude modulation to cut or coagulate
As a treatment for fibrillation or irregular heart rhythms: see Defibrillation and Cardioversion
As a method of pain relief: see Transcutaneous electrical nerve stimulation (TENS)
As a treatment for excessive sweating with a process called iontophoresis
Electrodiagnosis, for example nerve conduction studies and electromyography
Electroporation for gene delivery
Entertainment
Mild electric shocks are also used for entertainment, especially as a practical joke for example in such devices as a shocking pen or a shocking gum. However devices such as a joy buzzer and most other machines in amusement parks today only use vibration that feels somewhat like an electric shock to someone not expecting it.[citation needed]
Policing and personal defense
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.[52] Other electroshock weapons such as stun guns, stun batons ("cattle prods"), and electroshock belts administer an electric shock by direct contact.
Electric fences are barriers that use electric shocks to deter animals or people from crossing a boundary. The voltage of the shock may have effects ranging from uncomfortable, to painful or even lethal. Most electric fencing is used today for agricultural fencing and other forms of animal control purposes, though it is frequently used to enhance security of restricted areas, and there exist places where lethal voltages are used.[citation needed]
Torture
Electric shocks are used as a method of torture, for example in the Tucker Telephone. since the received voltage and current can be controlled with precision and used to cause pain and fear while avoiding visible damage to the victim's body.
Electrical torture has been used in war and by repressive regimes since the 1930s.[53] During the Algerian War electrical torture was used by French military forces.[54] Amnesty International published a statement that Russian military forces in Chechnya tortured local women with electric shocks by attaching wires onto their breasts.[55]
The use of electric shocks to torture political prisoners of the military dictatorship in Brazil (1964–1985) is detailed in the final report of the National Truth Commission, published December 10, 2014.[56]
The parrilla (Spanish for 'grill') is a method of torture whereby the victim is strapped to a metal frame and subjected to electric shock.[57] It has been used in a number of contexts in South America. The parrilla was commonly used at Villa Grimaldi, a prison complex maintained by Dirección de Inteligencia Nacional, a part of the Pinochet regime.[58] In the 1970s, during the Dirty War, the parrilla was used in Argentina.[59] Francisco Tenório Júnior (known as Tenorinho), a Brazilian piano player, was subjected to the parrilla during the military dictatorship in Brazil.[60]
The Islamic State has used electric shocks to torture and kill captives.[61][62][63]
Advocates for the mentally ill and some psychiatrists such as Thomas Szasz have asserted that electroconvulsive therapy (ECT) is torture when used without a bona fide medical benefit against recalcitrant or non-responsive patients.[64][65][66]
The Judge Rotenberg Center in Canton, Massachusetts has been condemned for torture by the United Nations special rapporteur on torture for its use of electric shocks as punishment as part of its behavior modification program.[67][68]
Japanese serial killer Futoshi Matsunaga used electric shocks to control his victims.[69]
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 from the 1990s onward due to the adoption of lethal injection. Although some original proponents of the electric chair considered it to be a more humane execution method than hanging, shooting, poison gassing, etc., it has now generally been replaced by lethal injections in states 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 death.[citation needed]
Other than in parts of the United States, only the Philippines reportedly has used this method, from 1926 to 1976. It was intermittently replaced by the firing squad, until the death penalty was abolished in that country.[citation needed] Electrocution remains legal in 9 states (primary method in South Carolina, optional in Alabama and Florida, optional if sentenced before a certain date in Arkansas, Kentucky and Tennessee, can only be used if other methods are found to be unconstitutional in Louisiana, Mississippi and Oklahoma) of the United States.[when?][70][failed verification]
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Medical-legal challenges
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Diagnosing and assessing the long-term impact of electrical injuries often presents a challenge in legal and workers' compensation contexts due to the often delayed and subjective nature of the symptoms.[8] A 2019 decision from the Workers' Compensation Board of Alberta's Appeals Commission highlighted this issue, noting a direct contradiction between the female medical consultant Marni Wesner's opinion for the WCB and a peer-reviewed article the same expert had co-authored regarding the delayed onset of symptoms. The Commission consequently placed "less weight" on the consultant's opinion for the claim.[71]
Case study: O'Leary v S&A Elec. Contr. Corp.
The 2017 New York appellate decision in O'Leary v S&A Elec. Contr. Corp. illustrates the legal complexities of electrical injury cases, particularly those involving cross-border jurisdictions. The plaintiff, Dr. Patrick O'Leary, a Canadian citizen from Manitoba, was injured by temporary wiring while working as a supervisor for Nygard International Partnership in New York City. The court granted him partial summary judgment on liability under New York Labor Law § 241(6), finding a clear violation of Industrial Code 12 NYCRR 23-1.13(b)(4), which requires electrical circuits to be de-energized or properly guarded.[72]
The case is notable for its jurisdictional interplay. Despite being covered by Manitoba's no-fault Workers' Compensation Board (WCB) system, the plaintiff was able to pursue a third-party lawsuit in New York. This was possible because the Manitoba WCB assigned him the right to pursue claims against negligent third parties not covered by the provincial compensation scheme, such as the New York-based electrical contractor and building owner. The case highlights how a claimant from a no-fault jurisdiction can leverage specific provisions to seek legal recourse in a different legal system where the injury occurred.[72]
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Advocacy and Research
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The understanding of electrical injury has been significantly advanced by patient advocates and researchers, particularly in Canada.
Patient and Industry Advocacy
Advocacy from patients and industry professionals has been crucial in raising awareness about the long-term, "invisible" consequences of electrical injury. Patient safety advocate Sarah Price Hancock, co-founder of the Ionic Injury Foundation, focuses on the neurological effects of repetitive electrical trauma, such as from electroconvulsive therapy (ECT). Having received 116 ECT treatments herself for what was later identified as a misdiagnosed medical condition, Hancock reframes ECT as an electrical injury with the potential for delayed and progressive neurological damage. Her research and advocacy highlight the link between electrical trauma and an increased risk of developing neurodegenerative diseases like Amyotrophic Lateral Sclerosis (ALS), citing a 2022 study of Medicare data to support this claim.[50] From an industry perspective, former Master Electrician John Knoll has become an advocate for worker safety after sustaining a career-ending disability he attributes to repeated low-voltage shocks. His work highlights a systemic issue within the electrical trade: the normalization of minor shocks as "part of the job." He advocates for stricter adherence to safety protocols like "Test-Before-Touch" and "Lock Out Tag Out" (LOTO) to prevent the cumulative damage that can result from seemingly minor incidents.[73][failed verification] In Canada, advocacy organizations like the Electrical Injury Network of Canada (einCanada) work to support survivors and promote education on the complex, long-term consequences of electrical injuries.[74]
Key Research and Contributors
Canada
Canadian researchers have been instrumental in shifting the focus from the acute burn to the chronic, long-term sequelae of electrical injury. The work of Dr. Marc Jeschke (Sunnybrook Health Sciences Centre) has shown that debilitating long-term neuropsychological effects occur at similar rates regardless of the initial injury voltage.[75] The research of Dr. Joel Fish (Hospital for Sick Children) challenged the conventional wisdom that low-voltage injuries have minimal long-term consequences, showing they can cause severe, delayed symptoms.[76]
United States
Research in the United States has been foundational in understanding the biophysics and neuropsychological outcomes of electrical trauma. Dr. Raphael C. Lee (University of Chicago), a co-founder of the Chicago Electrical Trauma Rehabilitation Institute (CETRI), has been a key figure in characterizing the non-thermal mechanism of electroporation, where electric fields damage cell membranes directly.[7] The work of Dr. Neil H. Pliskin (University of Illinois College of Medicine) has provided objective evidence for the cognitive deficits experienced by survivors, whose performance is often significantly worse on measures of attention, mental speed, and motor skills compared to control groups.[77]
Other International Centers
Globally, numerous centers contribute to the understanding of electrical injury. Research from German burn centers, such as BG Trauma Center Ludwigshafen, has provided detailed clinical data comparing high- and low-voltage injuries.[78] In India, researchers at the Post Graduate Institute of Medical Education and Research have highlighted the severe impact of electrical burns on quality of life in developing nations, where the injuries are often occupation-related and lead to poor long-term outcomes.[79]
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See also
References
External links
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