CARBON-MONOXIDE SUICIDE FROM CAR EXHAUSTS

Study objective: the aim of the study was to analyse the victims and c ircumstances 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 comm itted suicide by carbon monoxide poisoning from car exhausts during a four-year period in Sweden. Setting and participants: the State Instit utes of Forensic Medicine in Umea and Stockholm. Results: a higher inc idence (24.2/million population) was seen in the rural region than in the urban region(14.9). Males dominated (88%), most of them middle age d. Most victims committed suicide in a car outdoors. A vacuum cleaner tube connected to the compartment was most commonly used. Severe disea se, mostly psychiatric, was seen in 61% of the victims. Drugs were det ected in 8% of the victims under psychiatric treatment. In 37%, earlie r suicide behaviour was documented. Suicide notes were found in 40%. B lood alcohol was detected in 51% of the victims and other drugs in 7%. Conclusions: environmental changes may reduce the number of carbon mo noxide suicides from car exhausts, e.g. introduction of a law requirin g catalyst exhaust, of automatic idling stop, and of exhaust pipes inc ompatible with vacuum cleaner tubes. The importance of accurate treatm ent of psychiatric patients is stressed.