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      Railway suicide in England and Wales 2000–2013: a time-trends analysis

      research-article
      , ,
      BMC Public Health
      BioMed Central
      Suicide, Railways, England and Wales, Epidemiology, Train

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          Abstract

          Background

          In 2010, the “Tackling Suicide on the Railways” programme was launched as a joint initiative among Network Rail, the Samaritans and other key organisations such as the British Transport Police and train operators to achieve a 20 % reduction in railway suicides from 2010 to 2015 in Great Britain. We report the most recent age and sex specific trends in railway suicide in England and Wales from 2000 to 2013 and examine whether the initiative’s target reduction in railway suicides is likely to be achieved.

          Methods

          Population data and suicide mortality data (all methods combined and railway) for England and Wales were obtained from the Office for National Statistics (ONS) and used to calculate age and gender specific rates for deaths registered from 2000 to 2013. Data on railway suicides were also obtained from the Rail Safety and Standards Board (RSSB) and compared with ONS data. We used joinpoint regression to identify changes in suicide trends across the study period.

          Results

          The railway was used in 4.1 % of all suicides in England and Wales (RSSB data were similar to ONS data for most years). Suicides in all persons from all causes decreased from 2000 to 2007, with small increases from 2008 until 2013; this rise was entirely due to an increase in male suicides. Railway suicide rates increased over the entire study period; the proportion of railway suicides in all persons increased from 3.5 to 4.9 % during the study period. This trend was also mainly driven by increases in male suicides as female railway suicide rates remained steady over time. The highest age specific railway suicide rates were observed in middle aged men and women. Although there was no conclusive evidence of an increase in ONS railway suicides, RSSB data showed a statistically significant increase in railway suicides in males from 2009 onwards.

          Conclusion

          The continued rise in male railway suicide in England and Wales is concerning, particularly due to the high economic costs and psychological trauma associated with these deaths. The initiative’s target of a 20 % reduction in railway suicide is unlikely to be achieved.

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          Most cited references19

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          Suicide on railway networks: epidemiology, risk factors and prevention.

          The aim of the present study was to review international literature on the incidence of suicide on railway networks, describe risk factors associated with it, and examine existing prevention practices. Searches on Medline and PsycINFO for the period 1966-2007 were performed. Thirty original studies published in English on epidemiology of rail suicide were included in the review along with peer-reviewed articles on risk factors and prevention of rail suicide. Internationally, suicide by collision with a train accounted for 1-12% of all suicides, with up to 94% of all attempts resulting in death. Suicide by train seriously affects not only survivors, but also train drivers and bystanders. Correlations between density of rail network, number of passengers and number of suicides by train have been found. Conflicting data exist on gender ratio of this type of suicide, but studies are homogenous in identifying young adults (20-40 year of age) as those most exposed to train suicide. Documented psychiatric diagnoses were found in up to 83% of cases. Mid-seasonal peaks were also identified, with events occurring mostly during late morning and early afternoon. Limited evidence exists for effective suicide prevention practices. Successful examples are represented by pits and sliding door systems (Singapore Mass Rapid Transit System) and responsible media reporting (Viennese Subway). Suicide by train involves emotional and financial costs to individuals and society as a whole. A combination of different strategies might significantly reduce its effect.
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            A systematic review of the literature on safety measures to prevent railway suicides and trespassing accidents.

            This review covers a central aspect in railway safety which is the prevention of suicides and trespassing accidents. The paper attempts to answer the following research question: 'What measures are available to reduce railway suicide and trespass, and what is the evidence for their effectiveness?' The review is based on 139 relevant publications, ranging from 1978 to 2014. The analysis aimed to identify the past and current trend in the prevention practice by looking both quantitatively and qualitatively at the recommended measures. According to the results, there has been a constant focus on suicide prevention, and only relatively recent interest in trespass countermeasures. The content analysis revealed 19 main preventative categories which include more than 100 specific measures. We identified 16 common categories against railway suicide and trespass, and 3 categories of specific measures to prevent suicide. There are only 22 studies which provide empirical support for the effectiveness of measures. Actual combinations of measures are barely evaluated, but several challenges emerge from the literature. The discussion focuses on the need for a unified approach to suicide and trespass prevention, and on the importance to consider the effect mechanism of the measures in order to design better interventions.
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              Train suicides in The Netherlands.

              Little is known about train suicide and factors influencing its prevalence. This study tests the hypotheses that railway density, railway transportation volume, familiarity with railway transportation and population density contribute to train suicide. It also tests the relationship between train suicide and general population suicide and examines the prevalence and the characteristics of high-risk locations and their contribution to the grand total of train suicides. Trends in train suicides were compared with trends in railway track length, train kilometres, passenger kilometres and national suicide figures over the period 1950-2007. The geographical distribution over the national network over the period 1980-2007 was studied. Data were obtained from The Netherlands Railways, Prorail and Statistics Netherlands. 1. The incidence of train suicides is unrelated to railway parameters. 2. Being familiar with railway transportation as a passenger is not a contributory factor. 3. Train suicide rates are unrelated to regional population density. 4. The incidence of train suicides parallels that of general population suicides. 5. Half of the train suicides took place at a limited number of locations, the most important of which were situated within a village or town and were close to a psychiatric hospital. Most conclusions are based on correlational relationships between variables. 1. Train suicide trends reflect trends in general population suicides. 2. Increased train transportation does not lead to more train suicides. 3. The prevention of train suicide at high-risk locations (HRLs) in built-up areas and near psychiatric hospitals deserves first priority. Copyright © 2010 Elsevier B.V. All rights reserved.
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                Author and article information

                Contributors
                at0012@my.bristol.ac.uk
                dee.knipe@bristol.ac.uk
                (+44) 0117 928 7200 , kyla.thomas@bristol.ac.uk
                Journal
                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central (London )
                1471-2458
                15 March 2016
                15 March 2016
                2016
                : 16
                : 270
                Affiliations
                School of Social and Community Medicine, University of Bristol, Address-School of Social and Community Medicine, 39 Whatley Road, Bristol, BS8 2PS UK
                Article
                2944
                10.1186/s12889-016-2944-x
                4791921
                26979534
                dce46fad-e5a6-47c3-bbf2-37836590406b
                © Taylor et al. 2016

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 28 September 2015
                : 9 March 2016
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2016

                Public health
                suicide,railways,england and wales,epidemiology,train
                Public health
                suicide, railways, england and wales, epidemiology, train

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