The role of alcohol in accident and violent deaths in Finland.
BACKGROUND
In Finland, the high rates of forensic autopsy and postmortem toxicology furnish a reliable base for nation-wide studies on alcohol-related violent deaths.


METHODS
National mortality and population data within Finland, from 1987 to 1996, were used to analyze sex- and age-specific rates, proportions, and trends of violent deaths associated with alcohol. Deaths were defined as alcohol-related when alcohol was certified as a contributing factor to death.


RESULTS
During the study period, 10,360 (23.3%) of the 45,544 violent deaths that occurred were alcohol-related. Among 15- to 64-year-olds, 28.6% of accidents, 30.5% of suicides, and 55.3% of homicides were associated with alcohol (alcohol-positive). Differences in epidemiologic patterns and trends for different types of violent death were observed between sexes and age groups. For instance, alcohol-positive accidents significantly decreased in males (-2.3%/year; CL95: -3.3, -1.2; p < 0.001), but not in females (+0.5%/year; CL95: -2.7, +3.7; p = 0.772), and alcohol-positive suicides increased slightly in females (+3.9%/year; CL95: +0.0, +7.9; p = 0.047), but not in males (-0.2%/year, CL95: -1.4, +1.0; p = 0.704).


CONCLUSIONS
The victims of violent deaths have often consumed or abused alcohol before the fatal events. Especially in young adults, consumption of alcohol is likely one of the most serious risk factors in accidents and may decrease the threshold for suicide ideation and impulsive behaviors. Studies that explore the effects of sociodemographic and health factors on random populations with relevant control data will increase the understanding of the causal connection between alcohol and violent deaths.
Lunetta
P
P
Department of Forensic Medicine, University of Helsinki, Finland. philippe.lunetta@helsinki.fi
Penttilä
A
A
Sarna
S
S
D000059:Accidents / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D002423:Cause of Death; D000431:Ethanol / Q000009:adverse effects* / Q000097:blood; D005260:Female; D005387:Finland / Q000453:epidemiology; D006708:Homicide / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D016012:Poisson Distribution; D012737:Sex Factors; D013405:Suicide / Q000706:statistics & numerical data; D014754:Violence / Q000706:statistics & numerical data*
D000431:Ethanol