I know I was once shocked by 120v AC while working; I was reaching around a metal PDU with 15-15R plugs to plug something in. As I couldn't see, I was guiding the prongs in with my fingers, and I didn't get my fingers out of the way before it made contact. ouch. (let us just say that I was younger and... a lot less careful than a sysadmin ought to be.) Fortunately, the case of the PDU was grounded (I think it was a baytech RPC) and the case of the server above it was grounded, and everything was screwed in well, so the circut went through my fingers and arm and into a chassis. my impression was that my arm bounced between the PDU and the next server up for a while before I managed to jerk my shoulder back and pull my whole arm out of the rack.
Apparently I'm not a very good conductor, or there was something up with the breaker, 'cause it didn't blow the circuit. I wasn't hurt, save for maybe some light bruising, and no downtime resulted, so it turned out okay, but I'm much more careful now (and my PDUs use C14 receptacles, making this problem impossible, at least without a knife.)
From what I've seen, 48vdc is usually just two leads sticking out from the equipment in question.. you just strip the ends of the wires and screw 'em in. I don't think I'd be comfortable doing that with 240v. I guess that's just a simple matter of standardization.