A retrospective review of railway-associated deaths in the Cape Town Metro East region over a two-year period.

dc.contributor.advisorAfonso, Estevaoen_ZA
dc.contributor.authorOkkers, Heidi Leeen_ZA
dc.contributor.otherStellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Pathology: Forensic Medicine.en_ZA
dc.date.accessioned2021-12-06T06:49:57Z
dc.date.accessioned2021-12-22T14:28:38Z
dc.date.available2021-12-06T06:49:57Z
dc.date.available2021-12-22T14:28:38Z
dc.date.issued2021-03
dc.descriptionThesis (MMed)--Stellenbosch University, 2021.en_ZA
dc.description.abstractBackground: Railway travel is an integral part of the daily transport of people and cargo worldwide, and no less so in South Africa. Generally considered safer than road transport, rail travel is still associated with risk and railway-related deaths attract significant media attention. There is limited local research into the epidemiology and pathology of these deaths. An improved understanding of these cases will assist in preventative strategies to minimise fatalities. Objectives: The aim of this study was to investigate railway-associated fatalities in the Cape Town Metro East region over two years, from 2016 to 2017. The objectives were to obtain a demographic profile of victims, characterise injury patterns, identify the temporal and geographical distribution of deaths and, where possible, the causes of death. Methods: A retrospective descriptive review of all railway-associated fatalities admitted to the Tygerberg Forensic Pathology Laboratory between 1 January 2016 and 31 December 2017 was performed. Data were collected from autopsy reports and available contemporaneous notes for each case, including South African Police documents and hospital notes, where relevant. Results: There were 104 cases of railway-associated deaths during the two-year period under study. Males accounted for 87 cases, while there were only 17 female victims. The mean age of all cases was 34.8 years. Most incidents occurred between the morning hours of 8 am and 10 am and in the evening from 7 pm to 10 pm, and a midweek peak of 62.5% of cases were reported as pedestrians who were struck whilst crossing the railway tracks. Khayelitsha was the suburb where the highest number of cases were recorded. Multiple blunt force injuries as the terminal cause of death accounted for 81.7% of cases. One case of electrocution and one of downing were reported. Two cases of alleged assault were recorded. Head injuries accounted for 91 cases with only five decapitations. Transection of the thorax occurred in eight cases and multiple rib fractures were also recorded. Multiple organs were disrupted and the upper limbs on the right were predominantly injured. 17 victims had blood alcohol levels above the legal limit of 0.05 g/100ml. Conclusion: More than half of the cases died as a result of multiple traumatic injuries after crossing the railway tracks as pedestrians. This study emphasizes the importance of adequate contemporaneous documentation of the cases. The background information and scene investigation play a significant role in determining factors assisting in the determination of the cause and manner of death. Optimal security can aid in the decline of unnecessary railway incidents and death. It is recommended that the investigation of railway-associated fatalities become a priority to prevent circumstances in which these cases occur.en_ZA
dc.description.abstractAgtergrond: Spoorwegreise is ʼn intergrale deel van die daaglikse vervoer van passasiers en vrag wêreldwyd, en ook grotendeels in Suid-Afrika. Oor die algemeen word dit veiliger beskou as padvervoer, inteendeel is dit nogsteeds geassosieer met ʼn risiko’s. Spoorwegverwante sterftes trek groot aandag in die media. Daar is ʼn beperkte plaaslike navorsing oor die epidemiologie en patologie van hierdie sterftes. ʼn Deeglike begrip van hierdie gevalle sal van hulp wees met voorkomende strategieë om sterftes te minimaliseer. Doelwit: Die hoofdoel van hierdie studie was om ondersoek in te stel in verband met spoorweg verwante sterftes in die Kaapstad- oostelike streek oor ʼn tydperk van twee jaar vanaf 2016 tot 2017. Die doelwitte was om ʼn demografiese profiel van slagoffers te verkry, beseringspatrone te karakteriseer, die daaglikse temporale en geografiese verspreiding van die sterftes vas te stel en waar moontlik die oorsake van die dood. Metodes: ʼn Terugskouende beskrywende oorsig van alle sterftes wat veband hou met spoorweë wat tussen 1 Januarie 2016 en 31 Desember 2017 in die Tygerberg Forensiese Patologie lykshuis opgeneem is, is uitgevoer. Data is versamel uit lykhouingsverslae en beskikbare eietydse aantekeninge vir elke geval, insluitend die Suid-Afrikaanse Polisie dokumente en hsopitaal notas, waar van toepassing. Bevindinge: Oor die twee jaar tydperk is 104 spoorwegverwante sterfgevalle geindentifiseer. 87 van die gevalle was mans, terwyl daar net 17 vroue slagoffers was. Die gemiddelde ouderdom van alle gevalle was 34.8 jaar oud. Meeste van die voorvalle het tussen die oggendure van 8:00 tot 10:00 en saans van 19:00 tot 22:00 plaasgevind. Daar was n piek van 62.5% gevalle in die middel van die week geraporteer as voetgangers wat getref was toe hulle die trienspoor gekruis het. Khayelitsha was die voorstad waar ʼn beduidende aantal gevalle aangeteken is. Verskeie stomp kragbeserings het 81.7% uitgemaak as die terminal oorsaak van dood. Een geval van dood was deur middel van elektriese skok en n ander deur verdrinking geidentifiseer. Daar was twee beweerde aanrandings. Met betrekking tot die beseringspatrone, is 91 gevalle hoofbeserings en slegs vyf onthoofdings. Transeksie van die toraks het in ag gevalle plaasgevind en veelvuldige rib frakture is aangeteken. Verskeie organe is ontwrig en die boonste ledemate aan die regterkant is hoofsaaklik beseer. Bloed alkohol vlakke van 17 slagoffers was bo die wettige limiet van 0.05 g/100ml. Afleidings: ʼn Groot hoeveelheid van die slagoffers het gesterf a.g.v. veelvuldige traumatiese beserings nadat hulle as voetgangers die spoorwegoorgesteek het. Hierdie studie beklemtoon die belangrikheid van doelgerigte eietydse dokumentasie van die gevalle. Die agtergrond inligting en toneelondersoek speel ʼn belangrike rol in die bepaling van faktore wat help om die oorsaak en manier van dood te bepaal. Optimale veiligheid kan help met die afname van onnodige spoorwegvoorvalle en dood. Dit word aanbeveel dat die ondersoek van sterftes wat verband hou met spoorweë geprioritseer prioriteit word om gevalle soos hierdie te voorkom.af_ZA
dc.description.versionMastersen_ZA
dc.format.extent57 pagesen_ZA
dc.identifier.urihttp://hdl.handle.net/10019.1/123911
dc.language.isoen_ZAen_ZA
dc.publisherStellenbosch : Stellenbosch Universityen_ZA
dc.rights.holderStellenbosch Universityen_ZA
dc.subjectUCTDen_ZA
dc.subjectRailroad passengers -- Deathsen_ZA
dc.subjectRailroad accidentsen_ZA
dc.subjectRailway-associated death -- Cape Townen_ZA
dc.titleA retrospective review of railway-associated deaths in the Cape Town Metro East region over a two-year period.en_ZA
dc.typeThesisen_ZA
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