What is the incidence and significance of "dry-lungs" in bodies found in water?
BACKGROUND
Drowning without aspiration of liquid, generally attributed to death from asphyxia while submerged and in laryngospasm, has been reported to occur in approximately 10% to 15% of drowning victims.


OBJECTIVE
The occurrence of "dry-drowning" recently has been questioned and the hypothesis developed that "dry-lungs" in bodies found dead in the water could conceal more natural deaths than previously recognized.


METHODS
Based on 578 selected adult victims who presumably drowned, we analyzed the correlation between the cases with a low combined lung/pleura liquid weight (< 1000 g and < 750 g) and a wide set of individual, circumstantial, and postmortem (PM) variables, using multivariate logistic regression analysis. Victims with lung weight < 1000 g were screened for long-QT syndrome (LQTS) founder mutations in KCNQ1 and KCNH2 genes.


RESULTS
Of the 578 victims, 120 (20.7%) had a lung weight of < 1000 g, and 22 of these (3.8%) of < 750 g. Multivariate analysis showed a significant correlation for women (P < 0.001), for women aged 65 years or older (P < 0.001), and for men with prolonged PM submersion time (P < 0.001). "Normal" lungs were found in only 8 (1.4%) victims. Low-weight (< 1000 g), overdistended lungs with no sign of liquid penetration were seen in 11 (1.9%). No LQTS founder mutations were detected.


CONCLUSIONS
The actual incidence of death of persons found in water who have normal lungs or do not have penetration of liquid into their airways, based on our study, is much lower (below 2%) than currently assumed.
Lunetta
Philippe
P
Department of Forensic Medicine, University of Helsinki, Helsinki, Finland. philippe.lunetta@helsinki.fi
Modell
Jerome H
JH
Sajantila
Antti
A
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D001344:Autopsy; D016208:Databases, Factual; D004332:Drowning / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology*; D005260:Female; D005387:Finland / Q000453:epidemiology; D049429:Forensic Pathology; D006801:Humans; D015994:Incidence; D008168:Lung / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D017678:Sex Distribution