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MethodsInternal communications include: flyers, posters, email announcements. The secondary purpose of this study was to explore whether any demographic characteristics of asphyxia suicide decedents were associated with type of suicide incident. The primary purpose of this cross-sectional study was to describe decedent and incident characteristics of asphyxiation suicides in the U.S.
Multivariable logistic regression was conducted separately for females and males to estimate beta coefficients to obtain adjusted odds ratios (AORs) and 95% confidence intervals (CIs) to compare hanging-related asphyxiation and other types of asphyxiation. Mechanisms, means, and anchor points were determined through a text search of cause of death, coroner/medical examiner narrative, and law enforcement narrative. Anchor points of hanging suicides were also described. Data from the National Violent Death Reporting System (NVDRS) were used to describe asphyxiation suicide mechanisms and means in 16 states. 125,126 This is different from humans, who die in less than a minute if the oxygen concentration is 2 to 3.
Among females and males, odds of asphyxiation suicide were highest among those of Other, non-Hispanic race and black, non-Hispanic race, respectively. The three most common anchor points for hanging suicides were trees ( N = 2215), beams ( N = 2014), and closets ( N = 2009). For hanging suicides, the three most commonly used means were power or extension cords ( N = 1834), bedding ( N = 873), and animal ropes ( N = 578). Most asphyxiation suicides involved hanging (90.7%, N = 22,931) 1717 (6.8%) involved smothering 968 (3.8%) involved chemicals or gasses and 145 (0.6%) involved strangulation. Most decedents were male (79.9%) and white, non-Hispanic (76.8%).
Among the 42,773 suicides in 2014, 11,407 (26.7%) were due to hanging, strangulation, or suffocation (collectively referred to as asphyxia for the remainder of this paper), the second leading cause of suicides behind firearms ( Centers for Disease Control and Prevention). Future research should be conducted to better describe characteristics of asphyxiation suicide so that prevention efforts targeted by demographic subgroups can be implemented.In 2014, suicides were the tenth leading cause of death in the United States (U.S.). Improving access to and utilization of mental health services can also reduce asphyxiation suicides. Strategies to reduce asphyxiation suicides need to be identified. Changes in design and availability of grocery bags could help reduce smothering suicides. Modification of anchor points represents a potential solution for reducing hanging suicides.
These suicides also leave an economic and emotional burden on surviving family members and friends (Cerel et al. Cost the economy $13.1 billion in medical and work loss costs, or $1.38 million per suicide ( Centers for Disease Control and Prevention). In 2010, asphyxiation suicides in the U.S.
2000, Prahlow 2010).Previous research has investigated overall (Nock et al. In asphyxiation involving chemicals or gasses, the chemical or gas prevents the oxygen from either being transported in the blood or being used by the cells (Dix et al. Neck compression occurs when a force is placed on the neck that compresses prominent blood vessels or airways and consists of two subtypes: 1) hanging, where a ligature places a force through the victim’s body weight and 2) strangulation, where a force other than body weight is exerted on the neck (Dix et al. Two subtypes of suffocation are 1) smothering, where the air supply is restricted by covering the nose or mouth and 2) choking, where the internal airway is blocked by foreign objects (Dix et al. During suffocation, the oxygen supply to the body is restricted by limiting the air supply in the environment (Dix et al.
Described the epidemiology of asphyxiation suicides, and noted that asphyxiation suicide rates increased from 2000 to 2010 the increase varied by age (Baker et al. One previous study in the U.S. 2016) suicides extensively, but limited research has been conducted on asphyxia suicides.
The secondary purpose of this study was to explore whether any demographic characteristics of asphyxia suicide decedents were associated with type of suicide incident. Therefore, the primary purpose of this study was to describe distribution and characteristics of asphyxia suicide decedents and incidents. Describing such characteristics may help to identify strategies to prevent asphyxia suicides. Doing so will improve understanding of how and where asphyxiation suicides occur in the U.S., and population subgroups at risk for specific types of asphyxia suicide. However, no prior studies have examined the distribution of asphyxia suicide means and mechanisms, and how these are related to decedent demographic characteristics. One previous systematic review specifically investigated the epidemiology of hanging suicides (i.e., not all asphyxiation suicides), and concluded that reductions in suicide hangings could be achieved by focusing on reducing hanging suicides in institution settings (e.g., prisons, hospitals) and reducing the lethality of attempted suicides through enhanced emergency management procedures (Gunnell et al.
To identify potential miscodes, one author (RKY) reviewed CME and LE narratives for records where the cause of death mentioned car exhaust, CO, or fire. We also excluded any deaths where CO was not explicitly mentioned, but the decedent was in an automobile in an enclosed space and the car ignition was turned on when the decedent was found. Additionally, any deaths due to carbon monoxide (CO) were excluded, as these deaths should have been coded “poisoning”. Per NVDRS coding rules, deaths due to smoke inhalation were excluded, as these should have been coded “fire or burn”. The total number of decedents from other types of suicide was low ( N = 19).Potential asphyxiation suicides were identified by selecting incidents where manner of death was suicide and the primary method used to inflict the injury was coded “hanging, strangulation, or suffocation”.
Additionally, to code for potential chemicals used in chemical asphyxiation, we searched for terms identified by Azrael et al. In total, 2400 records were reviewed to identify asphyxiation means. Once we reached a group of 100 asphyxiations where no new means were identified, we ended record review. After all means mentioned were identified, we reviewed additional records in increments of 100 to identify additional means. First, 200 records were randomly selected for review to identify the means. There were sixty-five suicides that were identified where the primary method was not “hanging, strangulation, or suffocation” (35 where either CO poisoning was involved or the victim died in a car and it was specifically mentioned that the car ignition was on, 14 where the victim died in a fire, eight due to gunshot wounds, seven due to drowning and one due to other poisoning).We identified asphyxiation means (e.g., rope, plastic bag) through record review conducted by one author (RKY) on a subset of records.
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