Başar Çolak

Fatal Occupational Injuries among Workers in Kocaeli, Turkey, 1990–1999

Abstract The authors evaluated occupational accidents in Kocaeli, Turkey, using epidemiologic criteria. Data were derived from the registries of the service on Occupational Injuries and Diseases of the Social Insurance Institutions District Authority in Kocaeli. The analysis was based on data from 387 deaths. The rates of occupational injuries and mortality and fatalities from them were 5.1 %, 30.6 per 100,000 workers, and 6.0%, respectively, compared with 2.8%, 35.2 per 100.000 workers, and 12.7% in Turkey. Sectors with the highest rates of fatal occupational injuries were construction (30.2%), transportation (13.2%), basic metal industry (9.0%), manufacturing of metal products (5.9%), and heating with electricity, gas, and steam (5.9%). 38.2% of these workers were 25–34 years old. Nearly all were male, most were married, and three fourths had children. Of all deaths due to occupational injuries, 121 (31.3%) were caused by traffic injuries, 93 (24.1 %) by falling from high places, and 43 (11.1%) by electrocution; 89% occurred at workplaces, 42% of the workplaces were small, and 45.9% of the deceased workers had been working there for less than three months. Although the situation was better than that in the rest of Turkey in terms of epidemiologic criteria, the death rates, as in other developing countries, are higher than those in the world in general.

Consistency of postmortem interval estimations of physicians using only postmortem changes of putrefied dead bodies.

The postmortem interval is estimated based on physical, biochemical, and morphologic changes in dead bodies, scene investigation findings, and judicial investigation findings. Many factors affect the onset and the course of the postmortem changes. There is no established method for accurate estimation of the postmortem interval, especially with regard to putrefied dead bodies. Aiming to determine the consistency and the variation of postmortem interval estimations in cases with various putrefaction degrees by forensic medicine assistants and specialists from different centers, a prospective study was undertaken. A form containing data about the time, environment, and geographical location where the cases were found, along with their postmortem changes was mailed to 110 forensic medicine assistants and specialists from different centers, who were also asked to note their postmortem interval estimations. About half of the forms were returned. Those postmortem interval estimations made based on the information included in the forms, showed great variability between the participants, and in only 6 cases a consistency exceeding 50% was found between the participants and the autopsy teams. It is not possible to estimate the postmortem interval in a standard way by using only the postmortem changes of putrefied bodies. Therefore, especially in the cases involving putrefied bodies, in addition to the postmortem changes, factors such as environmental conditions, the scene, and judicial investigation findings should be taken into consideration.

Infection control implementations at forensic medicine practice: a national survey in Turkey.

Because forensic medicine workers have a greater occupational risk for infectious diseases, strict rules and measures against infections must be implemented at every stage of forensic medicine practices. In this study, we aim to evaluate the infection control implementations in forensic medicine practices in Turkey. A questionnaire survey was mailed to forensic medicine specialists and residents between April and June 2005. The questionnaire consisted of 36 questions whose designed was based on standard precautions and protective barriers against infectious risks. In all, 111 doctors from 27 different cities responded to the questionnaire. Of those doctors who responded, 43.2% reported performing external examination anywhere. The percentage of doctors performing external examinations who regularly wore gloves, masks, and gowns, and washed hands with a disinfectant were 81.5%, 24.7%, 30.9%, and 81.5%, respectively. The percentage of doctors performing autopsies who regularly wore masks, protective eye-wear, gloves, special gloves, and special boots were 59.6%, 10.6%, 98.9%, 71.3%, and 36.2%, respectively. Only 2 negative pressure rooms were reported. According to these results, precautionary measures against infectious risks in forensic medicine practice in our country are insufficient. Conditions to facilitate and to improve the compliance with infection control procedures must be prepared.

Deaths from drug overdose and toxicity in Turkey: 1997-2001

Turkey is located on the main overland connection between Asia and Europe, making the country potentially vulnerable to drug trafficking and its associated harms. The aim of the present study is to explore the frequency of all deaths from drug overdose and toxicity in Turkey and to describe some of the characteristics of these deaths. We collected data on all deaths from drugs in Turkey between 1997 and 2001 using records from the Council of Forensic Medicine. Data obtained from autopsy reports were retrospectively analyzed. In the present study, 374 deaths from drugs were reported in Turkey, with a mortality rate of 0.17 per 100,000 population. Highest mortality rates were found in Istanbul (0.83) and Gaziantep (0.71). The mean age was 34.0, and most cases (71.7%) were below the age of 40. The proportion of female cases was 13.6%. Opiates were implicated in 91.5% of deaths and benzodiazepines in 25.9%. Two fifths (38.8%) of the cases involved use of more than 1 drug. In 36.6% of cases, the route of final drug administration was by injection. The most common location of death was at a home (33.7%). Interventions to reduce drug use nationally are urgently required. International cooperation in social-educational activities, scientific research, and security measures is essential for this war.

Kocaeli Üniversitesi Tıp Fakültesi Adli Tıp Anabilim Daltna Başvuran Çocuklara Yönelik Cinsel İstismar Olguları 1998-2006

Child sexual abuse is the abuse of the child, who has not yet completed his/her sexual development, by an adult for sexual arousal. Misdiagnosed sexual abuse is the cause of either suspect’s being punished or harming of unguilt as well as preventing children’s protection. In this study, it was aimed to evaluate child sexual abuse cases with their characteristics and examination periods which are informed to Kocaeli University School of Medicine, Department of Forensic Medicine. Between 1998-2006, the reports and files of cases at the registers of Kocaeli University School of Medicine, Department of Forensic Medicine, examined retrospectively. Fifty cases (3,1%)under the heading of sexual abuse are included in the study. It is determined that 62% of cases are females, 38% of them are males and 60 % of the cases are under the age of 12. It is also determined that suspects are mostly the cases’ acquaintances (70%) and all of suspects are males. In the 36% (n= 18) of the cases, the questions are asked towards physical diagnosis, in 50% (n = 25) of the cases, the questions were oriented towards mental health, while 14% (n=7) of the cases are examined through both physical and mental evaluations. Impairment of mental health which can be considered as the result of sexual abuse are determined in the 60,5% (n=23) of 38 mental-oriented cases. After recent legal arrangement, a significant increase in sexual abuses is observed and recorded in Department of Forensic Medicine. The organisation and functioning of the units connected to the Ministry of Health and Ministry of Justice are considered unsuitable for the evaluation of sexual abuse. Foundation of Center of Sexual Abuse Evaluation would provide early treatment of present or probable pathologies as well as precise diagnosis.Key words: Child, sexual abuse, mental evaluation, child psychiatry