Electrical injuries and deaths

DEFINITION: Injuries or death caused by electricity passing through the body.

SIGNIFICANCE: Death from electrocution often leaves no external signs, and investigators must determine the cause of death from the circumstances. Sometimes, however, forensic pathologists are able to detect marks on the body of a person killed by electricity that show the entry or exit of the electrical current; in other cases, internal injuries may indicate electrocution.

Most injuries and deaths resulting from contact with electricity are accidental. The human body is very susceptible to injuries and death from electricity because the body is made up mostly of water and other types of fluids, and electricity passes through water with low resistance. When electricity passes through a body, it causes damage, sometimes massive damage, to tissues. If the body is wet, it has even less resistance, causing higher currents to pass through and thus more tissue damage. Many electrocutions occur in bathrooms, where wet skin and electrical appliances make a deadly combination, or in bodies of water, such as lakes. Electrical injuries are more common in men than in women, but women do experience such injuries. In pregnant women, electric shock may cause miscarriage.

How Electricity Causes Death

The amount of tissue damage and whether death occurs from electric shock depends on how large the electrical current is and how long it continues to run through the body. Generally, when a person touches something emitting an electrical current, the resulting pain causes the person to release the object before any tissue damage occurs. If the electrical current is strong enough, however, it causes the muscles to contract in a spasm, and the person is unable to let go of the object emitting the current. The longer the body stays in contact with this object, the more electrical current flows through the body and the more damage is done to tissues and internal organs. Long contact with a high current of electricity can cause the heart to begin to beat irregularly, leading to cardiac arrest.

Contact with high-voltage power cables generally does not initially cause cardiac arrest. This kind of electrical contact is more likely to first cause serious internal burns and damage to organs and tissues, which can cause death. If the current passes through the brain stem, where breathing is controlled, the result can be respiratory failure.

The possibility of death from contact with electricity is increased when the electric current passes through the chest or head. Contact with an electrical current of more than 250 volts generally causes death, but death may also result from a current as low as 32 volts. Lethality from contact with electric current depends on many factors, not just voltage: the extent of the body’s resistance at the point of exposure, the nature of the current, the duration of the person’s exposure to current, and the pathway of the current within the body

Signs of Electrocution

External signs of electrocution may be minimal and hardly noticeable, or they may be obvious, such as severe burns. If the circumstances surrounding a death point to electrocution and no obvious signs are visible, the forensic pathologist will often examine the victim’s hands for small burn marks or marks that look like blisters with white rims and dark centers. Such marks, which are characteristic of the entry and exit points of electrical current, are also sometimes found on body parts other than the hands, such as the feet.

Forensic pathologists emphasize that the best tissue sampling is from predictable current pathways in cases without obvious entry/exit marks, which happens in about two-thirds of electrocutions. The anterior wrist (for hand-to-hand/shoulder paths) and medial malleolus (for hand-to-foot paths) are suggested locations because they are the most reliable places to find microscopic alterations like vacuolization and nuclear pyknosis, even in the absence of macroscopic burns.

Bibliography

Alqassim, Mohammad, et al. “The Role of Forensic Engineering in the Diagnosis of Electrocution Fatalities: Two Case Reports.” Safety and Health at Work, vol. 14, no. 1, Mar. 2023, pp. 124–30, doi:10.1016/j.shaw.2022.11.002. Accessed 31 Dec. 2025.

Arnoldo, Beniamino, et al. “Electrical Injuries.” StatPearls, 5 July 2025, www.ncbi.nlm.nih.gov/books/NBK448087/. Accessed 31 Dec. 2025.

Bazelyan, Eduard M., and Yuri P. Raizer. Lightning Physics and Lightning Protection. CRC Press, 2000.

Electrical Safety Foundation International. “Workplace Injury & Fatality Statistics.” ESFI.org, 17 Nov. 2025, www.esfi.org/workplace-safety/workplace-injury-fatality-statistics/. Accessed 31 Dec. 2025.

Fish, Raymond M., and Leslie A. Geddes. Medical and Bioengineering Aspects of Electrical Injuries. Lawyers & Judges Publishing, 2003.

Geddes, Leslie A., and Rebecca A. Roeder. Handbook of Electrical Hazards and Accidents. Lawyers & Judges Publishing, 2006.

Jin, Xin, et al. “Advances in Forensic Diagnosis of Electric Shock Death in the Absence of Typical Electrical Marks.” International Journal of Legal Medicine, vol. 135, no. 6, Nov. 2021, pp. 2469–78, doi:10.1007/s00414-021-02658-0. Accessed 31 Dec. 2025.

Nabours, Robert E., et al. Electrical Injuries: Engineering, Medical, and Legal Aspects. 2nd ed., Lawyers & Judges Publishing, 2004.

Rakov, Vladimir A., and Martin A. Uman. Lightning: Physics and Effects. Cambridge University Press, 2003.