Sudden Death in the Japanese Hot Bath in the Senior Population
10.11390/onki.72.31
- VernacularTitle:秋田県における入浴中突然死の現状
- Author:
Naofumi YOSHIOKA
- Publication Type:Journal Article
- Keywords:
Sudden death;
Hot bath;
CPA;
Elderly
- From:The Journal of The Japanese Society of Balneology, Climatology and Physical Medicine
2008;72(1):31-35
- CountryJapan
- Language:Japanese
-
Abstract:
According to the annual report of the Japanese National Police Agency, about 100,000 cases of unnatural death are reported every year. More than 10,0000 of these cases occurred during bathing. In Akita Prefecture, more than 150 cases are reported every year which is represents about 10% of the total unexpected death. According to the epidemiological statistics by our department, sudden death or sudden cardio pulmonary arrest in the hot bath occurs mostly in winter time, from late October to early March, and more than 90% of the decedents are senior population. Although some cardiac or cerebral events might occur during bathing, few cases of those died in the bath tub are autopsied by forensic pathologists. In most cases, the cause of death is suspected by postmortem examination by police surgeon, and the cause of death are generally assigned to ischemic heart attack, cerebral stroke, or unclear cause of drowning. It is often difficult to determine the pathogenesis related to the cause of death in the bathtub even by full autopsy. It is reported that the past and/or present medical history of the deceased persons in the bath tub is reported as hypertension, arrhythmia, ischemic heart disease, or diabetes, it is still unclear what actually triggers a lapse in consciousness in the elderly during bathing. We examined the biodynamic change of elderly volunteers while bathing under actual bathing situations occurring in both the winter and summer seasons. Most subjects decreased the level of blood pressure gradually by bathing regardless the season, and some subjects in the elderly developed ECG changes while bathing such as supraventricular extrasystole or ventricular tachycardia. The body temperature increase to 38°C or more in both the elderly and young groups while bathing. By our observations, lower room temperature in the winter time, hot water immersion may result in risky changes in the above parameters which may partially explain some of the causes of the cases of lapse of consciousness and sudden cardiac arrest in the elderly while bathing.