Department of Forensic Medicine, Ibn El Jazzar University Hospital, Kairouan, Tunisia.
Emergency Department, Ibn El Jazzar University Hospital, Kairouan, Tunisia.
J Forensic Sci. 2021 May;66(3):934-939. doi: 10.1111/1556-4029.14644. Epub 2020 Dec 7.
Falls are a traumatic event that represents a major public health problem worldwide. The literature is rich in published studies of falls from heights, but only a few articles have focused on falls into wells. The region of Kairouan, in central Tunisia, is characterized by an arid climate, hence the abundance of wells for watering crops. In this study, 72 cases of deadly falls into wells were retrospectively investigated at the Department of Forensic Medicine in Kairouan over eight years (01/01/2008 to 31/12/2015). A male predominance was found (sex ratio of 2.42), with a mean age of 29 ± 16.1 years. Sixty-five cases (90.3%) were from rural areas, 62.5% had a low level of education, and 50% were unemployed. In our series, the deceased fell from a distance between 3 and 70 meters with an average of 28.3 m. The falls occurred into functional wells in 61.1%, which were filled with water in 51.4%, and were unprotected in 88.9%. Autopsy findings showed bone fractures in 51.4% of cases of which 44.4% were rib fractures. Visceral injuries were identified in 55.6% of cases. The predominant manner of death was suicide (73.2%), and severe polytrauma was the most frequent cause of death (52.8%). This study highlights the need for increased safety measures to keep wells covered and protected in order to prevent these falls.
跌倒事件是一种创伤性事件，是全球范围内一个主要的公共卫生问题。文献中已有大量关于高处坠落的研究，但仅有少数文章专门研究过掉入井中的情况。突尼斯中部的凯鲁万地区气候干燥，因此有大量的水井用于灌溉农作物。在这项研究中，法医系回顾性调查了八年来（2008 年 1 月 1 日至 2015 年 12 月 31 日）在凯鲁万发生的 72 例致命性掉入井中的案例。研究发现男性居多（男女比例为 2.42），平均年龄为 29±16.1 岁。65 例（90.3%）来自农村地区，62.5%的人受教育程度较低，50%的人失业。在我们的研究中，死者从 3 米到 70 米的高度坠落，平均为 28.3 米。61.1%的坠落事件发生在功能正常的水井中，其中 51.4%的水井中装满了水，88.9%的水井没有任何防护措施。尸检结果显示，51.4%的案例存在骨折，其中 44.4%为肋骨骨折。55.6%的案例存在内脏损伤。主要的死亡方式是自杀（73.2%），严重的多发伤是最常见的死亡原因（52.8%）。这项研究强调了需要采取更多的安全措施来保护水井，防止此类坠落事件的发生。
