ELECTRICAL INJURY FROM SUBWAY 3RD-RAILS - SERIOUS INJURY ASSOCIATED WITH INTERMEDIATE VOLTAGE CONTACT

Background. Railway and subway-associated electrical trauma is rare an d typically involves high voltage (>20000) are injuries. Not all mil s ystems utilize such high voltage. We report 16 cases of electrical tra uma due to 600 V direct contact with subway 'third' rails. Methods. A case series of injured patients presenting to Shriners Burns Institute , Boston or Massachusetts General Hospital between 1970 and 1995 was r etrospectively analyzed. Results. A total of 16 cases was identified. Among seven subway workers, the mechanism of rail contact was unintent ional by a tool, a hand or by falling; no deaths occurred. Among nine non-occupational falls victims, injuries involved suicide attempts, un intentional falls, or risk-faking behavior. This group suffered greate r burn severity, operative procedures, and complications; three deaths occurred. Conclusions. This is the largest report series of direct el ectrical trauma from a subway third rail. The high morbidity and morta lity from this 600 V contact suggests that the traditional classificat ion of low voltage (<1000 V) exposure can be subdivided to reflect the serious and lethal potential of intermediate range exposures compared to household range exposures (0-220 V). (C) 1997 Elsevier Science Ltd for ISBI.