Jan Thorson

Carbon monoxide suicide from car exhausts

STUDY OBJECTIVE the aim of the study was to analyse the victims and circumstances in carbon monoxide suicides from car exhausts in order to find strategies for mitigation of the suicide risk. DESIGN necropsy, police and hospital records were scrutinized for 194 victims who committed suicide by carbon monoxide poisoning from car exhausts during a four-year period in Sweden. SETTING AND PARTICIPANTS the State Institutes of Forensic Medicine in Umeå and Stockholm. RESULTS a higher incidence (24.2/million population) was seen in the rural region than in the urban region (14.9). Males dominated (88%), most of them middle aged. Most victims committed suicide in a car outdoors. A vacuum cleaner tube connected to the compartment was most commonly used. Severe disease, mostly psychiatric, was seen in 61% of the victims. Drugs were detected in 8% of the victims under psychiatric treatment. In 37%, earlier suicide behaviour was documented. Suicide notes were found in 40%. Blood alcohol was detected in 51% of the victims and other drugs in 7%. CONCLUSIONS environmental changes may reduce the number of carbon monoxide suicide from car exhausts, e.g. introduction of a law requiring catalyst exhaust, of automatic idling stop, and of exhaust pipes incompatible with vacuum cleaner tubes. The importance of accurate treatment of psychiatric patients is stressed.

Collisions with passenger cars and moose, Sweden.

The number of collisions between motor vehicles and moose is increasing in many countries. Collisions with large, high animals such as moose cause typical rear- and downward deformation of the windshield pillars and front roof, most pronounced for small passenger cars; the injury risk increases with the deformation of the car. A strengthening of the windshield pillars and front roof and the use of antilacerative windshields would reduce the injury risk to car occupants.

Sequelae of accidental near-drowning in childhood

Patients admitted to hospital because of near-drownings were followed-up 2–7 years after the admissions. The material comprises 36 children and 15 adults, which is the total number of patients cared for because of accidental near-drownings within the Uppsala Hospital Region 1964–1968. The region contains one-sixth of Swedens population. Hospital records were examined and parents of the children were interviewed by telephone. Two seriously disabled cases were found. The annual figure for severely and permanently disabled children, injured by near-drownings, is estimated at 2 or 3 for all Sweden. The corresponding point prevalence is estimated to be anything between 50 and 120 patients; this too concerns patients disabled as children. The incidence of children with non-fatal of permanent organic brain injuries due to accidental near-drowning is small compared with the corresponding mortality. Maybe the small probability of being saved within the short time required for this final result is a suitable explanation.

Industrial Accidents in the Construction Industry

In this investigation, accidents in the Swedish construction industry in 1967 leading to permanent disability or death were studied. The aims were to illustrate the magnitude of the problem and to create a basis of decision for the taking of preventive measures. The population consisted of nearly 400 cases. The whole population excluding a 5% non-response was studied. The course of events and causes of the accidents were analysed according to the statements of workers, employers and police. The injured workers were interviewed by telephone; otherwise information was acquired from police reports and injury reports of the National Social Insurance Board. Not only had the injured been subjected to physical suffering and financial problems as a result of the accidents, but the humanitarian losses, in terms of limitations to family life and leisure activities were striking. Accident prevention must not be restricted to mere technical and psychological measures. According to our results it would be more fruitful to attack juridical, organizational, professional-economical, political circumstances. It is particularly important that a practical plan be formulated and accepted by the responsible authorities.