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Accidental poisoning, intentional self-harm and event of undetermined intent mortality over 20 years in Iceland: a population-based cohort study.

ABSTRACT: OBJECTIVES:The aim was to study mortality due to suicide, accidental poisoning, event of undetermined intent and drug-related deaths through 20 years in Iceland. DESIGN:A population-based register study. PARTICIPANTS:Individuals who died due to road traffic injury, suicide, accidental poisoning, event of undetermined intent and drug-related deaths in the population of Iceland during the years 1996-2015. Annual age-standardised rates were calculated, and the trend analysed by Pearson correlation and joinpoint regression. SETTING:The population of Iceland framed the study material, and the data were obtained from nationwide registries for information on number of deaths and age-specific mean population in each year by gender. RESULTS:The crude overall suicide rate during the last 10 years was 12.2 per 100?000 persons per year (95%?CI 7.4 to 18.1), while the crude overall rate due to road traffic injuries was 4.6 per 100?000 persons per year (95%?CI 2.0 to 8.3). Among men, suicide rates decreased, however not significantly (r(19)=-0.22, p=0.36), and for overdose by narcotics the rates increased significantly (r(19)=0.72, p<0.001) during the study period. Among women, the suicide rates increased, however not significantly (r(19)=0.35, p=0.13), for accidental poisoning, suicide and event of undetermined intent combined the rates increased significantly (r(19)=0.60, p=0.006); and the rates for overdose by sedative and overdose by narcotics both increased significantly r(19)=0.49, p=0.03, and r(19)=0.67, p=0.001, respectively. CONCLUSION:The suicide rates have not changed during 1996 to 2015; however, the rates for the combined accidental poisoning, suicide and event of undetermined intent increased significantly for women. The rise of the overdose rates for sedative among women and for narcotics among both genders are consistent with reports elsewhere.

SUBMITTER: Gunnarsdottir OS

PROVIDER: S-EPMC7247372 | biostudies-literature | 2020 May

REPOSITORIES: biostudies-literature

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Accidental poisoning, intentional self-harm and event of undetermined intent mortality over 20 years in Iceland: a population-based cohort study.

Gunnarsdottir Oddny Sigurborg OS Rafnsson Vilhjálmur V

BMJ open 20200520 5

<h4>Objectives</h4>The aim was to study mortality due to suicide, accidental poisoning, event of undetermined intent and drug-related deaths through 20 years in Iceland.<h4>Design</h4>A population-based register study.<h4>Participants</h4>Individuals who died due to road traffic injury, suicide, accidental poisoning, event of undetermined intent and drug-related deaths in the population of Iceland during the years 1996-2015. Annual age-standardised rates were calculated, and the trend analysed b ...[more]

PMID: 32439692

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Project description:ObjectiveTo analyze data for death of veterinary professionals and veterinary students, with manner of death characterized as suicide or undetermined intent from 2003 through 2014.SampleDeath records for 202 veterinary professionals and veterinary students.ProceduresDecedents employed as veterinarians, veterinary technicians or technologists, or veterinary assistants or laboratory animal caretakers and veterinary students who died by suicide or of undetermined intent were identified through retrospective review of National Violent Death Reporting System records. Standardized mortality ratios (SMRs) and 95% confidence intervals were calculated, and mechanisms and circumstances of death were compared among veterinary occupational groups.Results197 veterinary professionals and 5 veterinary students had deaths by suicide or of undetermined intent. Among decedents employed at the time of death, SMRs for suicide of male and female veterinarians (1.6 and 2.4, respectively) and male and female veterinary technicians or technologists (5.0 and 2.3, respectively) were significantly greater than those for the general US population, whereas SMRs for suicide of male and female veterinary assistants or laboratory animal caretakers were not. Poisoning was the most common mechanism of death among veterinarians; the drug most commonly used was pentobarbital. For most (13/18) veterinarians who died of pentobarbital poisoning, the death-related injury occurred at home. When decedents with pentobarbital poisoning were excluded from analyses, SMRs for suicide of male and female veterinarians, but not veterinary technicians or technologists, did not differ significantly from results for the general population.Conclusions and clinical relevanceResults suggested higher SMRs for suicide among veterinarians might be attributable to pentobarbital access. Improving administrative controls for pentobarbital might be a promising suicide prevention strategy among veterinarians; however, different strategies are likely needed for veterinary technicians or technologists.

Project description:INTRODUCTION: In this study, we investigated the outcomes for patients with intentional organophosphate poisoning. Previous reports indicate that in contrast to normal heart rate-corrected QT intervals (QTc), QTc prolongation might be indicative of a poor prognosis for patients exposed to organophosphates. METHODS: We analyzed the records of 118 patients who were referred to Chang Gung Memorial Hospital for management of organophosphate poisoning between 2000 and 2011. Patients were grouped according to their initial QTc interval, i.e., normal (<0.44 s) or prolonged (>0.44 s). Demographic, clinical, laboratory, and mortality data were obtained for analysis. RESULTS: The incidence of hypotension in patients with prolonged QTc intervals was higher than that in the patients with normal QTc intervals (P?=?0.019). By the end of the study, 18 of 118 (15.2%) patients had died, including 3 of 75 (4.0%) patients with normal QTc intervals and 15 of 43 (34.9%) patients with prolonged QTc intervals. Using multivariate-Cox-regression analysis, we found that hypotension (OR?=?10.930, 95% CI?=?2.961-40.345, P?=?0.000), respiratory failure (OR?=?4.867, 95% CI?=?1.062-22.301, P?=?0.042), coma (OR?=?3.482, 95% CI?=?1.184-10.238, P?=?0.023), and QTc prolongation (OR?=?7.459, 95% CI?=?2.053-27.099, P?=?0.002) were significant risk factors for mortality. Furthermore, it was revealed that non-survivors not only had longer QTc interval (503.00±41.56 versus 432.71±51.21 ms, P?=?0.002), but also suffered higher incidences of hypotension (83.3 versus 12.0%, P?=?0.000), shortness of breath (64 versus 94.4%, P?=?0.010), bronchorrhea (55 versus 94.4%, P?=?0.002), bronchospasm (50.0 versus 94.4%, P?=?0.000), respiratory failure (94.4 versus 43.0%, P?=?0.000) and coma (66.7 versus 11.0%, P?=?0.000) than survivors. Finally, Kaplan-Meier analysis demonstrated that cumulative mortality was higher among patients with prolonged QTc intervals than among those with normal QTc intervals (Log-rank test, Chi-square test?=?20.36, P<0.001). CONCLUSIONS: QTc interval helps predict mortality after intentional organophosphate poisoning.

Dataset Information

Accidental poisoning, intentional self-harm and event of undetermined intent mortality over 20 years in Iceland: a population-based cohort study.

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Accidental poisoning, intentional self-harm and event of undetermined intent mortality over 20 years in Iceland: a population-based cohort study.

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