Contribution Of Postmortem Computed Tomography in evaluation of fatal work accidents: A Case Study During The Covid-19 Pandemic State.

Introduction: Workplace safety is continually improving in many developed countries, but, despite this, work-related injuries, including fatal ones, are on the rise. Furthermore, in all cases of serious non-fatal accidents, a high morbidity rate for workers has been documented, burdened by an equally large expense that the State will have to sustain as damage compensation. Often, in case of fatal accidents, it is necessary to reconstruct the dynamics that caused the death, which makes it necessary to analyze all the lesions detectable on corpses. In this perspective, postmortem computed tomography (PMCT) has become essential to increase the speed and diagnostic accuracy, especially in case of lesions affecting the bone structures.

Methods: A retrospective analysis aimed at evaluating the data collected from judicial autopsies performed between January 2019 and the recent month of March 2023 was carried out, focusing on those related to fatal accidents occurred at work.

Results: According to the inclusion criteria, 18 out of the 204 autopsies carried out during the pre-established time frame were included, as certainly classifiable as "occupational deaths". Among the 18 enrolled corpses, 16 were male and 2 female subjects. The traumatic events responsible of the death were analysed: 40% were related to falls from heights greater than 2 meters, 28% to explosion, 22% to accidental crush, 5% to electrocution and 5% to semi-truncation.

Discussion and conclusions: Among fatal accidents, those related to falls from great heights and crushing are described as the most common, while among the least common are deaths due to electrocution. With reference to the location of injuries, those involving the head are considered the most fatal, while rib fractures are considered as the most common. In this context, postmortem computed tomography can be very helpful, not only for the two- and three-dimensional reconstruction of fractures, but also for understanding the dynamics with which fatal accidents develop in the workplace. This can both ensure a better assessment of the responsibilities of workers and/or the employer, and lead to the evaluation of the suitability of protective devices, also allowing to make them safer.