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Bierens J, Hoogenboezem J. Fatal drowning statistics from the Netherlands - an example of an aggregated demographic profile. BMC Public Health 2022; 22:339. [PMID: 35177025 PMCID: PMC8851711 DOI: 10.1186/s12889-022-12620-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 01/14/2022] [Indexed: 11/29/2022] Open
Abstract
Introduction Incompleteness of fatal drowning statistics is a familiar problem impeding public health measures. Part of the problem may be that only data on accidental drowning are used and not the full potential of accessible data. Methods This study combines cause-of-death certificates and public prosecutor’s court documents between 1998 and 2017 to obtain an aggregated profile. Data are also used as a basis for a trend analysis. Results The dataset includes 5571 drowned persons (1.69 per 100,000). The highest risk group are persons above the age of 50. Demographic differences are observed between suicide by drowning, accidental drowning, and drowning due to transportation (0.72, 0.64, 0.28 per 100.000) and between native Dutch, and Dutch with western and non-western background (1.46, 1.43, 1.76 per 100.000). Non-residents account for another 12.2%. When comparing the periods 1998–2007 with 2008–2017, the Standard Mortality declines for suicide drowning and accidental drowning among persons with a native Dutch and non-western background. Single regression analysis confirms a decrease of drowning over the full period, breakpoint analysis shows an increase in the incidence of the total number of drowning, suicide by drowning and accidental drowning starting in 2007, 2008 resp. 2012. Discussion Compared to the formal number of fatal accidental drowning in the Netherlands (n = 1718; incidence 0.52 per 100,000), the study identifies 350% more drowning. Differences in demographic data and the recent increase needs to be explored for public health interventions. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-12620-3.
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Affiliation(s)
- Joost Bierens
- Research Group Emergency and Disaster Medicine, Vrije Universiteit Brussels, Laarbeeklaan 103, 1090, Brussels, Belgium.
| | - Jan Hoogenboezem
- Centraal Bureau voor de Statistiek (Statistics Netherlands), Department of Causes of Death Statistics, Henri Faasdreef 312, 2492, JP, Den Haag, the Netherlands
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Paraschakis A, Michopoulos I, Efstathiou V, Christodoulou C, Boyokas I, Douzenis A. Suicides by drowning in Greece: Findings from a 10-year sample (2006-2015). Med Leg J 2018; 86:45-48. [PMID: 28832253 DOI: 10.1177/0025817217727648] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
We studied a sample of suicide victims from Greece's main port of Piraeus area (population: approx. 700,000 individuals) and investigated all suicides for the 10-year period 2006-2015, collecting data from the victims' forensic records at the Piraeus Department of Forensic Medicine. Sixty-nine (15.9%) out of 435 suicides were due to drowning, 51 (73.9%) males and 18 (26.1%) females. Drowning was the third most common suicide method with most in the sea (92.8%), fewer in wells (7.2%). Median age: males 52.2 years (standard deviation (SD): 20.3, range: 27-89) and females 58.8 years (SD: 15.2, range: 32-84). Psychiatric medications: antidepressants (6 cases, 8.9%), benzodiazepines (6 cases, 8.9%) and antipsychotics (1 case, 1.5%). Other substances: alcohol (14 cases, 20.9%), cocaine (1 case, 1.5%) and opioids (1 case, 1.5%). No seasonal effect was observed for suicides by drowning. Greece, being a country with an embracing coastline, could provide a field of study for suicide by drowning.
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Affiliation(s)
| | - Ioannis Michopoulos
- 2 2nd Department of Psychiatry, Athens University Medical School, "Attikon" General Hospital, Athens, Greece
| | - Vasiliki Efstathiou
- 2 2nd Department of Psychiatry, Athens University Medical School, "Attikon" General Hospital, Athens, Greece
| | - Christos Christodoulou
- 2 2nd Department of Psychiatry, Athens University Medical School, "Attikon" General Hospital, Athens, Greece
| | - Ilias Boyokas
- 3 Piraeus Department of Forensic Medicine, Athens, Greece
| | - Athanassios Douzenis
- 2 2nd Department of Psychiatry, Athens University Medical School, "Attikon" General Hospital, Athens, Greece
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Abstract
The World Health Organization estimates that in the year 2000, approximately one million people died from suicide worldwide. Over the last 45 years, suicide rates have increased by 60%, with a particularly precipitous rise among young people. The underlying psychology of suicide is complex and individual. However, certain themes emerge from studying individuals who have attempted or completed suicides. This paper will provide an overview of suicide and suicidal behaviour as it relates to trauma practitioners, detailing risk factors, biologic and genetic interactions, and opportunities for prevention and treatment.
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Affiliation(s)
- Marie Crandall
- Department of Surgery, Northwestern University, Chicago, IL 60611, USA,
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Abstract
The objectives of this study were to carry out a comprehensive review of the worldwide literature on suicidal behaviour by drowning. Systematic electronic searches of databases using various search terms were carried out. Recent trends in suicide and undetermined deaths due to drowning in England and Wales are described. The characteristics of patients presenting to the general hospital in Oxford, UK following attempted drowning are compared with self-poisoning patients. A total of 20 studies containing empirical data about suicide by drowning were identified, mainly concerning Western countries. Drowning suicides have declined in most countries in recent years. The proportion of undetermined deaths remains high. Drowning suicides and self-harm patients tend to be older, with only a small excess of males compared to those using other methods. This is an under-researched area that deserves good quality studies focusing upon prevention.
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Ahlm K, Lindqvist P, Saveman BI, Björnstig U. Suicidal drowning deaths in northern Sweden 1992-2009 - The role of mental disorder and intoxication. J Forensic Leg Med 2015; 34:168-72. [PMID: 26165679 DOI: 10.1016/j.jflm.2015.06.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2015] [Revised: 06/01/2015] [Accepted: 06/03/2015] [Indexed: 11/18/2022]
Abstract
Suicides by drowning have received limited attention by researchers. A recent finding that almost one-third of all drowning deaths in Sweden were classified as suicide instigated this study. We identified 129 cases of suicide by drowning in Northern Sweden and analyzed the circumstances and the psychiatric history prior to the suicide. Information was obtained from autopsy, police and medical records, as well as from the National Inpatient Register. One-third of the suicide victims had previously attempted suicide and half of the victims had been hospitalized due to mental health problems. One-third of these had left the hospital less than one week before the suicide. Alcohol and psychoactive drugs were present in 16% and 62% of the cases, respectively. A history of mental disorder and previous suicide attempt (s), especially by drowning, is an ominous combination necessitating efficient clinical identification, treatment and follow-up if a complete suicide is to be prevented.
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Affiliation(s)
- Kristin Ahlm
- Section of Forensic Medicine, Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden.
| | - Per Lindqvist
- Division of Social and Forensic Psychiatry, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Department of Medical Science, School of Health and Social Studies, Dalarna University, Falun, Sweden.
| | | | - Ulf Björnstig
- Division of Surgery, Department of Surgical and Perioperative Sciences, Umeå University, Umeå, Sweden.
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Rácz E, Könczöl F, Mészáros H, Kozma Z, Mayer M, Porpáczy Z, Poór VS, Sipos K. Drowning-related fatalities during a 5-year period (2008–2012) in South-West Hungary – A retrospective study. J Forensic Leg Med 2015; 31:7-11. [DOI: 10.1016/j.jflm.2015.01.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Revised: 01/06/2015] [Accepted: 01/08/2015] [Indexed: 10/24/2022]
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Muccino E, Crudele GDL, Gentile G, Marchesi M, Rancati A, Zoja R. Suicide drowning in the non-coastal territory of Milan. Int J Legal Med 2014; 129:777-84. [PMID: 25398634 DOI: 10.1007/s00414-014-1115-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Accepted: 11/05/2014] [Indexed: 10/24/2022]
Abstract
INTRODUCTION A cadaver in water sets a relevant issue for the forensic pathologist, concerning the differential diagnosis between homicide, suicide, accidental event, and natural death in water. In the present study, the drowning suicides in a non-coastal territory are analyzed, discussing the main diagnostic difficulties, the preventive intervention, and the strategies for outlining the profile of a "mean victim" that is at risk of committing suicide by drowning. METHODS The cases of drowning suicide were extrapolated by the database of the 21,472 autopsies performed at the Civic Morgue of Milan, in the period between 1993 and 2013. RESULTS Drowning represents the fifth cause of suicide registered in Milan for the study period, with 139 cases (3.8% of all suicides). Victims were mainly elderly males (61-80 years old) with a history of psychiatric diseases in pharmacological therapy; they committed suicide mainly during summer, in the rivers. The diatoms test was positive in 82 cases (59%) and highlighted typical taxa of fresh water. Alcohol and illicit drugs were not noticed, at high levels. CONCLUSION Drowning suicide occurs even in a non-coastal territory, far from the sea, if there is an easy access to the water: specifically, many natural and artificial waterways in the Milan district represent a high-risk factor predisposing the drowning suicide.
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Affiliation(s)
- Enrico Muccino
- Sezione di Medicina Legale e delle Assicurazioni - Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Luigi Mangiagalli 37, 20133, Milano, Italy
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Ahlm K, Saveman BI, Björnstig U. Drowning deaths in Sweden with emphasis on the presence of alcohol and drugs - a retrospective study, 1992-2009. BMC Public Health 2013; 13:216. [PMID: 23497055 PMCID: PMC3610133 DOI: 10.1186/1471-2458-13-216] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2012] [Accepted: 03/05/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Drowning deaths constitute a significant proportion of unnatural deaths globally. In Sweden and other high-income countries, drowning deaths have decreased. This study investigates the epidemiology and current trends of unintentional, intentional, and undetermined drowning deaths with emphasis on the presence of alcohol and other drugs. METHODS During an 18-years period, 5,125 drowning deaths were autopsied in Sweden. Data on cases including toxicological analysis on alcohol, pharmaceutical drugs, and illicit drugs were obtained from the National Board of Forensic Medicine. RESULTS During the study period, the annual incidence of drowning deaths in Sweden was 3.1/100,000 inhabitants and decreased on average by about 2% each year (p<0.001). The highest incidence was found among males and in middle/older age groups. The incidence increased 3% for each year of age. Children/adolescents (≤18 years) constituted 5% of all drowning deaths. Of all drowned females in the study, 55% (847/1,547) committed suicide, which was a significantly higher proportion compared with males (21%, 763/3,578) (p<0.001). In total, 38% (1,656/4,377) of tested drowned persons had alcohol in their blood and the mean concentration was 1.8 g/l. In the unintentional drowning group, intentional drowning group, and the undetermined group, the proportion of alcohol positive was 44%, 24%, and 45%, respectively. One or several psychoactive drugs were present in the blood in 40% (1,688 /4,181) of all tested persons and in 69% (965/1,394) of tested persons who died from suicidal drowning. The most common drug was benzodiazepines (21%, 891/4,181). Illicit drugs were detected in 10% (82/854) of tested persons. CONCLUSION Presence of alcohol and drugs were frequent and may have contributed to the drowning deaths. The incidence of drowning deaths significantly decreased during the study period. Males and the middle/older age groups had a higher incidence compared to females and children. Suicidal drowning was common especially among women. Alcohol and drugs are significant contributors in drowning deaths in Sweden and should be considered as part of a comprehensive prevention program.
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Affiliation(s)
- Kristin Ahlm
- Section of Forensic Medicine, Department of Community Medicine and Rehabilitation, Umeå University, POB 7616, Umeå, SE 907 12, Sweden.
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Värnik P, Sisask M, Värnik A, Laido Z, Meise U, Ibelshäuser A, Van Audenhove C, Reynders A, Kocalevent RD, Kopp M, Dosa A, Arensman E, Coffey C, van der Feltz-Cornelis CM, Gusmão R, Hegerl U. Suicide registration in eight European countries: A qualitative analysis of procedures and practices. Forensic Sci Int 2010; 202:86-92. [DOI: 10.1016/j.forsciint.2010.04.032] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2010] [Revised: 04/12/2010] [Accepted: 04/20/2010] [Indexed: 10/19/2022]
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Abstract
SummarySuicide is accepted as a major health problem worldwide, especially in the young and middle aged. It is, however, a significant health problem in older people as well, and those aged 65 years and over generally have the highest suicide rates compared with all other age groups. In research literature from the last decade, there has been an increased interest in disentangling the phenomenon of suicide in later life. This paper aims to critically review the literature on suicide and suicidality in later life published from 2000 to 2009. Prevalence rates as well as risk and protective factors are mapped and correlates reviewed. The association between suicidality and help-seeking behaviour is considered. Finally, potential prevention strategies are reviewed.
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Burns A, Goodall E, Moore T. A study of suicides in Londonderry, Northern Ireland, for the year period spanning 2000–2005. J Forensic Leg Med 2008; 15:148-57. [DOI: 10.1016/j.jflm.2007.08.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2007] [Accepted: 08/02/2007] [Indexed: 11/25/2022]
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