Epidemiology of subway-related fatalities in New York City, 1990-2003.
OBJECTIVE
Subway transit is a relatively safe mode of transportation, yet compared to all other forms of mass transit in the United States (U.S.), subways have the highest fatality rate. The aim of this paper is to characterize subway-related fatalities in order to identify opportunities for risk reduction.


METHODS
Medical examiner records for all New York City (NYC) subway-related deaths (1990-2003) were reviewed. Data were abstracted on decedents' demographics and autopsy findings, including laboratory findings.


RESULTS
There were 668 subway-related fatalities, of these, 10 (1.5%) were homicides, 343 (51.3%) were determined to be suicides, and 315 (47.2%) were accidental. Although decedent characteristics varied between fatality categories, they were not particularly informative with regard to prevention.


CONCLUSIONS
Prevention strategies that focus on structural controls are likely to be most efficacious in improving the overall safety of the NYC subway systems.


CONCLUSIONS
These findings suggest that structural rather than individual-level interventions would be most successful in preventing subway fatalities.
Gershon
Robyn R M
RR
Mailman School of Public Health, Columbia University, New York, NY 10032, USA. rg405@columbia.edu
Pearson
Julie M
JM
Nandi
Vijay
V
Vlahov
David
D
Bucciarelli-Prann
Angela
A
Tracy
Melissa
M
Tardiff
Kenneth
K
Galea
Sandro
S
D000063:Accidents, Traffic / Q000401:mortality / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D006293:Health Promotion / Q000706:statistics & numerical data; D006708:Homicide / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D011634:Public Health / Q000706:statistics & numerical data*; D011890:Railroads / Q000706:statistics & numerical data*; D012307:Risk Factors; D040242:Risk Reduction Behavior; D012449:Safety / Q000706:statistics & numerical data*; D040241:Social Marketing; D013405:Suicide / Q000706:statistics & numerical data; D055815:Young Adult