Abstract
Introduction
A cadaver in water sets a relevant issue for the forensic pathologist, concerning the differential diagnosis between homicide, suicide, accidental event, and natural death in water. In the present study, the drowning suicides in a non-coastal territory are analyzed, discussing the main diagnostic difficulties, the preventive intervention, and the strategies for outlining the profile of a “mean victim” that is at risk of committing suicide by drowning.
Methods
The cases of drowning suicide were extrapolated by the database of the 21,472 autopsies performed at the Civic Morgue of Milan, in the period between 1993 and 2013.
Results
Drowning represents the fifth cause of suicide registered in Milan for the study period, with 139 cases (3.8 % of all suicides). Victims were mainly elderly males (61–80 years old) with a history of psychiatric diseases in pharmacological therapy; they committed suicide mainly during summer, in the rivers. The diatoms test was positive in 82 cases (59 %) and highlighted typical taxa of fresh water. Alcohol and illicit drugs were not noticed, at high levels.
Conclusion
Drowning suicide occurs even in a non-coastal territory, far from the sea, if there is an easy access to the water: specifically, many natural and artificial waterways in the Milan district represent a high-risk factor predisposing the drowning suicide.
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References
ISTAT (2013) Available at http://www.istat.it-Censimento Popolazione residente al 30 settembre 2013
WIKIPEDIA (2013). Lista di aree metropolitane del mondo per popolazione
Colussi P, Tolfo MG (2013) Available at http://it.wikipedia.org/wiki/Idrografia_milanese
Colussi P, Tolfo MG Available at http://www.storiadimilano.it/Miti_e_leggende/acque.htm
Avis SP (1993) Suicidal drowning. J Forensic Sci 38(6):1422–1426
Wirthwein DP, Barnard JJ, Prahlow JA (2002) Suicide by drowning: a 20-year review. J Forensic Sci 47(1):131–136
Lunetta P, Modell JH (2005) Macroscopical, microscopical and laboratory findings in drowning victims. In: Tsokos M (ed) Forensic pathology reviews. Humana Press, Totowa, pp 3–77
Auer A (1990) Suicide by drowning in Uusimaa Province in Southern Finland. Med Sci Law 30(2):175–179
Lester D (1989) The suicide rate by drowning and the presence of oceans. Percept Mot Skills 69(1):338
Salib E (2005) Trends in suicide by drowning in the elderly in England and Wales 1979–2001. Int J Geriatr Psychiatry 20(2):175–181
Ohberg A, Lonnqvist J (1998) Suicides hidden among undetermined deaths. Acta Psychiatr Scand 98(3):214–218
Lunetta P, Smith G, Pentilla A, Sajanntila A (2003) Undetermined drowning. Med Sci Law 43(3):207–214
Papadodima SA, Athanaselis SA, Skliros E, Spiliopoulou CA (2010) Forensic investigation of submersion deaths. Int J Clin Pract 64(1):75–83
Stemberga V, Bralic M, Coklo M, Cuculic D, Bosnar A (2010) Suicidal drowning in Southwestern Croatia: a 25-year review. Am J Forensic Med Pathol 31(1):52–54
McCleary R, Chew KS, Hellsten JJ, Flynn-Bransford M (1991) Age- and sex-specific cycles in United States suicides, 1973 to 1985. Am J Public Health 81(11):1494–1497
Byard RW, Houldsworth G, James RA, Gilbert JD (2001) Characteristic features of suicidal drownings: a 20-year study. Am J Forensic Med Pathol 22(2):134–138
Zoja R (2006) Le asfissie meccaniche. In: Cazzaniga A, Cattabeni CM, Luvoni R, Zoja R (eds) Compendio di Medicina Legale e delle Assicurazioni, 12th edn. UTET, Torino, pp 149–160
Lorin de la Grandmaison G, Paraire F (2003) Place of pathology in the forensic diagnosis of drowning. Ann Pathol 23(5):400–407
Li Q, Ma KJ, Zhang XD, Yu YA, Xu SG, Zhao H, Chen X, Yan JJ (2011) Diatom test in lung tissue of corpses in water and causes of death. Fa Yi Xue Za Zhi 27(5):324–326, 333
Piette MH, De Letter EA (2006) Drowning: still a difficult autopsy diagnosis. Forensic Sci Int 163(1–2):1–9
Ludes B, Quantin S, Coste M, Mangin P (1994) Application of a simple enzymatic digestion method for diatom detection in the diagnosis of drowning in putrified corpses by diatom analysis. Int J Leg Med 107:37–41
Streble H, Krauter D (2002) Diatomee. In: Streble H, Krauter D (eds) Atlante dei microrganismi acquatici-La vita in una goccia d’acqua. F. Muzzio & C. Editore, Padova, pp 132–143
Devos C, Timperman J, Piette M (1985) Death in the bath. Med Sci Law 25:189–200
Funayama M, Mimasaka S, Nata M, Hashiyada M, Yajima Y (2001) Diatom numbers arounf the continental shelf break. Am J of Forensic Med Pathol 22:236–238
Ago K, Hayashi T, Ago M, Ogata M (2011) Tehe number of diatoms recoverd from the lungs and orther organs in drowning deaths in bathwater. Leg Med (Tokyo) 13(4):186–190
Umani Ronchi G, Bolino G (2006) Annegamento (e morte in acqua). In: Umani Ronchi G, Bolino G (eds) Asfissie meccaniche violente. Giuffrè Editore S.p.A, Milano, pp 181–279
Copeland AR (1987) Suicide by drowning. Am J Forensic Med Pathol 8(1):18–22
Gorniak JM, Jenkins AJ, Felo JA, Balraj E (2005) Drug prevalence in drowning deaths in Cuyahoga County, Ohio: a ten-year retrospective study. Am J of Forensic Med Pathol 26(3):240–243
Davis LG (1999) Suicidal drowning in south Florida. J Forensic Sci 44(5):902–905
Saberi Anary SH, Sheikhazadi A, Ghadyani MH (2010) Epidemiology of drowning in Mazandaran province, north of Iran. Am J Forensic Med Pathol 31(3):236–242
Van Beeck EF, Branche CM, Szpilman D, Model JH, Bierens JJ (2005) A new definition of drowning: towards documentation and prevention of a global public health problem. World Health Organization. Bulettin of the World Health Organization 83:853–856
Ahlm K, Saveman BI, Björnstig U (2013) Drowning deaths in Sweden with emphasis on the presence of alcohol and drugs—a retrospective study, 1992–2009. BMC Public Health 13:216
Knight B (1996) Immersion deaths. In: Saukko P, Knight B (eds) Forensic Pathology, 2nd edn. Edward Arnold, London, pp 395–411
Di Maio DJ, Di Maio VJM (2001) Death by drowning. In: Di Maio DJ, Di Maio VJM (eds) Forensic Pathology, 2nd edn. CRC Press, NY, Boca Raton, pp 399–407
Lunetta P, Penttilä A, Hällfors G (1998) Scanning and transmission electron microscopical evidence of the capacity of diatoms to penetrate the alveolo-capillary barrier in drowning. Int J Legal Med 111(5):229–237
Krstic S, Duma A, Janevska B, Levkov Z, Nikolova K, Noveska M (2002) Diatoms in forensic expertise of drowning— a Macedonia experience. Forensic Sci Int 127(3):198–203
Wintemute GJ, Kraus JF, Teret SP, Wright MA (1988) The epidemiology of drowning in adulthood: implications for prevention. Am J Prev Med 4:343–348
Ludes B, Coste M, North N, Doray S, Tracqui A, Kintz P (1999) Diatom analysis in victim's tissues as an indicator of the site of drowning. Int J Legal Med 112(3):163–166
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Muccino, E., Crudele, G.D.L., Gentile, G. et al. Suicide drowning in the non-coastal territory of Milan. Int J Legal Med 129, 777–784 (2015). https://doi.org/10.1007/s00414-014-1115-9
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DOI: https://doi.org/10.1007/s00414-014-1115-9