Alcohol and unnatural deaths in Sweden: a medico-legal autopsy study.
OBJECTIVE
To investigate alcohol involvement in all types of unnatural deaths in Sweden.


METHODS
All cases of unnatural death that underwent medico-legal autopsies (1992-1996) in Sweden were analyzed (N = 15,630; i.e., 68% of all unnatural deaths). Alcohol was regarded as contributing to the death if: (1) there was any indication that the deceased was a "known alcoholic"; (2) the underlying or contributing causes of death were alcohol-related; (3) the deceased had alcohol-related inpatient diagnosis during a period of 3 years prior to death; or (4) the case tested positive for blood alcohol.


RESULTS
Thirty-nine percent of the blood-tested cases (n = 13,099) were positive for alcohol. Almost 40% of the unnatural deaths were associated with alcohol. Alcohol involvement was most common in the intoxication group (84%), followed by the "undetermined" (65%), homicide (55%), fall (48%), fire (44%), asphyxia (41%), suicide (35%) and traffic (22%) groups. More than half (52%) of the deaths in the age group 30-60 years, 35% of those aged 0-29 years and 25% of those aged 60 and over were associated with alcohol.


CONCLUSIONS
In Sweden, two of five unnatural deaths are associated with alcohol; this is a conservative estimate. Alcohol-associated mortality varies considerably between different groups of external causes of death, between men and women, and with age.
Department of Forensic Medicine, Umeå University, Sweden.
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Sjögren
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Eriksson
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Ahlm
D000059:Accidents / Q000401:mortality*; D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000097:blood / Q000401:mortality*; D000437:Alcoholism / Q000097:blood / Q000401:mortality*; D000704:Analysis of Variance; D001334:Automobile Driving / Q000706:statistics & numerical data; D002423:Cause of Death; D016009:Chi-Square Distribution; D003645:Death, Sudden / Q000453:epidemiology*; D005260:Female; D006708:Homicide / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D013405:Suicide / Q000706:statistics & numerical data; D013548:Sweden / Q000453:epidemiology