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2017 ; 4
(3
): 160711
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Suicides on the Austrian railway network: hotspot analysis and effect of
proximity to psychiatric institutions
#MMPMID28405359
Strauss MJ
; Klimek P
; Sonneck G
; Niederkrotenthaler T
R Soc Open Sci
2017[Mar]; 4
(3
): 160711
PMID28405359
show ga
Railway suicide is a significant public health problem. In addition to the loss
of lives, these suicides occur in public space, causing traumatization among
train drivers and passengers, and significant public transport delays. Prevention
efforts depend upon accurate knowledge of clustering phenomena across the railway
network, and spatial risk factors. Factors such as proximity to psychiatric
institutions have been discussed to impact on railway suicides, but analytic
evaluations are scarce and limited. We identify 15 hotspots on the Austrian
railway system while taking case location uncertainties into account. These
hotspots represent 0.9% of the total track length (5916?km/3676 miles) that
account for up to 17% of all railway suicides (N=1130). We model suicide
locations on the network using a smoothed inhomogeneous Poisson process and
validate it using randomization tests. We find that the density of psychiatric
beds is a significant predictor of railway suicide. Further predictors are
population density, multitrack structure and-less consistently-spatial
socio-economic factors including total suicide rates. We evaluate the model for
the identified hotspots and show that the actual influence of these variables
differs across individual hotspots. This analysis provides important information
for suicide prevention research and practice. We recommend structural separation
of railway tracks from nearby psychiatric institutions to prevent railway
suicide.
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