Abstract 198: Sudden Death While Bathing in Japan
BACKGROUND: Japanese people have a unique bathing custom, wherein they immerse themselves in hot water. Many elderly subjects die while bathing, which accounts for an estimated 17,000 deaths annually. The reason for this phenomenon still remains to be elucidated.
OBJECTVE: The aim of this study was to clarify the recent actual situation of death while bathing.
METHODS: We investigated the data of all victims for whom the emergency medical system needed to be activated because of accident and/or acute illness in relation to bathing in Tokyo between October 2012 and January 2013. Reports describing each event were obtained from emergency personnel and emergency physicians.
Results: During the study period, there were 2,630 events in relation to bathing. The number of such events increased as the atmospheric temperature decreased (number of events/mean temperature: October: 383/19.4 Celsius degree; November: 580/12.7; December: 871/ 7.3; January: 796/5.5). Of the 2,630 events, cardiac arrests accounted for 889 events (34%). Of the 889 cardiac arrests, 818 (92%) occurred while the patients bathed in a bathtub filled with hot water. Of the total of 2,630 events, 1,600 (61%) events occurred while the patients were immersed in hot water in their bathtubs (cardiac arrest: 818, trauma: 30, acute illness: 752). Of the 752 patients who became acutely ill while immersed in hot water, 546 needed to be rescued out of the bathtub as they could not get out of the tub by themselves. The major symptoms were lethargy and/or consciousness disturbance. There were a few cases with organic diseases, including cerebrovascular events. Many got better by themselves, without intervention, and did not require in-hospital care.
Discussion: It was considered that hot water immersion plays a key role in events related to bathing. Many events occurring during bathing, other than cardiac arrest, appeared to be self-limiting conditions. Because hot water immersion easily causes the body temperature to increase, it is possible that events including sudden death, may be related to hyperthermia occurring during hot water immersion.
Acknowledgement: This study was supported by a Health Labour Sciences Research Grant.
- © 2013 by American Heart Association, Inc.