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In Japan, sudden death in the bath (what is called 'bath-related death') has been reported to occur particularly in theelderly population in the winter. Our continuous investigations into bath-related death in Kagoshima Prefecture from 2006to 2009 have shown that the death in Kagoshima occur at similar frequency as other prefectures in Japan. In this study,retrospective investigation of the inquest records in Kagoshima Prefecture in 2010 was performed in order to obtain theepidemiological data associated with bath-related death, especially, the relationship between the occurrence of the deathsand ambient temperature, air temperature differences within a day and those from previous day. The total number of thecase was 199 (98 males and 101 females), which corresponds to a crude mortality rate of 11.7 per 100,000 person-year.The rate was the highest of the past 5 years. As previously reported, most deaths occurred during winter season (45.7%),particularly on cold days. There was a significant negative correlation between the occurrence rate of the deaths (thevalue indicates that the number of bath-related death is divided by the total number of the day at each temperature onweather observation spots) and ambient temperature including maximum, minimum and mean air temperature of the day. Particularly, deaths occurred frequently on the days when the maximum, minimum and mean air temperature was<18°C, <7°C, <13°C, respectively. Moreover, the occurrence rate of the deaths showed a significant positive correlation withair temperature difference within a day, and significantly increased on the days when the difference was more than 15°C.Further, the occurrence rate of the deaths showed a significant negative correlation with mean air temperature differencefrom the previous day when the temperature of the day was lower than that of the previous day, and significantly increasedwhen the temperature dropped more than 3°C. In addition, the occurrence rate of the death in 2010 did not increasein the winter, but in the spring compared with those in 2009. In 2010, the average of the maximum temperature in the spring (21.3°C) was lower than that in 2009 (22.1°C). Since, out of the ambient temperature, the maximum temperaturecorrelated most strongly with the occurrence rate of the death, low maximum temperature in spring might contribute tothe increase of the death in 2010. Accordingly, it is necessary to warn the society to take precautions against bath-relateddeath in spring as well as in winter. In addition, other epidemiologic factors associated with the death such as the locationdiscovered, the time when the victims took a bath, and past history of illness were similar to those of our previous reports,which confirmed again that bath-related death occurs most often during the normal daily life of the elderly. Incidentally,the number of drowning case increased in the cause of death described in the death certificate, since cases that werediagnosed as drowning based on the findings by CT imaging may increase with the spread of postmortem CT scanning inrecent years. However, in order to reduce the number of bath-related death, it is necessary to elucidate the accurate causeof death and pathological mechanisms of the death by accumulating evidences from autopsy. Therefore, it is necessary forforensic pathologists to prompt investigation authorities to increase the rate of autopsies in bath-related death.
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