Identifying and Tracking Gas Suicides in the U.S. Using the National Violent Death Reporting System, 2005-2012

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• 作者：Deborah Azrael ; PhD¹ ; ³ ; ^{azrael@hsph.harvard.edu" class="auth_mail" title="E-mail the corresponding author} ; Alexander Mukamal¹ ; ² ; Amy P. Cohen ; EdM¹ ; David Gunnell ; DSc³ ; Catherine Barber ; MPA¹ ; Matthew Miller ; MD¹ ; ⁴
• 刊名：American Journal of Preventive Medicine
• 出版年：2016
• 出版时间：November 2016
• 年：2016
• 卷：51
• 期：5_supp_S3
• 页码：S219-S225
• 全文大小：283 K

文摘

Identifying the source and specific type of gas used in suicides is difficult using most data systems owing to limitations in ICD-10 coding. The National Violent Death Reporting System (NVDRS), with its rich collection of both coded and free-text variables, has the potential to overcome these limitations. This study used a multipronged approach to identify gas-specific suicides in NVDRS and to track the incidence of these suicides over time.

Methods

Using suicide cases from the 16 NVDRS states that participated throughout 2005–2012, free-text and code searches were conducted for four types of variables—incident narratives, coroner/medical examiner cause-of-death statements, cause-of-death codes, and substance names—to identify suicides by carbon monoxide, helium, hydrogen sulfide, and four other gases. All analyses were conducted in 2015.

Results

Approximately 4% (3,242 of 80,715) of suicides recorded in NVDRS over the study period were the result of gas inhalation. Of these, the majority (73%) were carbon monoxide suicides (almost exclusively from motor vehicle exhaust and charcoal burning). Other types of gas (most notably helium), once rare, are now more common: At the start of the study period non–carbon monoxide gas suicides represented 15% of all gas suicides; at the end of the study period, they represented 40%.

Conclusions

Public health policies to reduce a suicidal person’s access to more lethal suicide methods require a reliable source of surveillance data on specific methods used in suicide. Small changes to NVDRS could make it an efficient and nimble surveillance system for tracking these deaths.