Occupational mortality in older workers: A forensic autopsy-based evaluation

Abstract

The aging of the global workforce has led to an increasing number of individuals remaining occupationally active at older ages. However, forensic autopsy-based data on workplace deaths in this population remain limited. This study aimed to evaluate the causes and manners of workplace-related deaths among individuals aged 65 years and older based on forensic autopsy findings. This retrospective study included individuals aged ≥65 years who died at the workplace and underwent forensic autopsy between 2020 and 2024. Demographic characteristics, manner and cause of death, comorbidities, autopsy findings, and toxicological results were analyzed. A total of 126 cases were evaluated. Natural deaths accounted for 67.5% (n = 85) of cases and were primarily attributed to cardiovascular diseases, most commonly ischemic heart disease and severe coronary atherosclerosis (60.3%, n = 76). Non-natural deaths comprised 32.5% (n = 41) and included both accidental and suicidal deaths. Accidental deaths were most frequently associated with blunt force trauma (19.8%, n = 25), while suicidal deaths were mainly related to hanging (4.8%, n = 6) and drug intoxication (4.0%, n = 5). Toxicological analyses were negative in the majority of cases (91.3%, n = 115), and no substances were identified as contributory to death. Workplace-related deaths among older workers reflect a combination of natural disease processes and external causes. Forensic autopsy provides essential information for accurate determination of cause and manner of death and for distinguishing accidental occupational fatalities from intentional self-harm.