Train suicides in The Netherlands.
BACKGROUND
Little is known about train suicide and factors influencing its prevalence. This study tests the hypotheses that railway density, railway transportation volume, familiarity with railway transportation and population density contribute to train suicide. It also tests the relationship between train suicide and general population suicide and examines the prevalence and the characteristics of high-risk locations and their contribution to the grand total of train suicides.


METHODS
Trends in train suicides were compared with trends in railway track length, train kilometres, passenger kilometres and national suicide figures over the period 1950-2007. The geographical distribution over the national network over the period 1980-2007 was studied. Data were obtained from The Netherlands Railways, Prorail and Statistics Netherlands.


RESULTS
1. The incidence of train suicides is unrelated to railway parameters. 2. Being familiar with railway transportation as a passenger is not a contributory factor. 3. Train suicide rates are unrelated to regional population density. 4. The incidence of train suicides parallels that of general population suicides. 5. Half of the train suicides took place at a limited number of locations, the most important of which were situated within a village or town and were close to a psychiatric hospital.


CONCLUSIONS
Most conclusions are based on correlational relationships between variables.


CONCLUSIONS
1. Train suicide trends reflect trends in general population suicides. 2. Increased train transportation does not lead to more train suicides. 3. The prevention of train suicide at high-risk locations (HRLs) in built-up areas and near psychiatric hospitals deserves first priority.
van Houwelingen
Cornelis A J
CA
GGz Eindhoven, Eindhoven, The Netherlands. cajvhou@tiscali.nl
Kerkhof
Ad J F M
AJ
Beersma
Domien G M
DG
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D011156:Population Density; D011890:Railroads / Q000706:statistics & numerical data*; D012307:Risk Factors; D012744:Sex Ratio; D013405:Suicide / Q000706:statistics & numerical data* / Q000639:trends*; D055815:Young Adult