title: Suicide by asphyxiation with or without helium inhalation in the region of Amsterdam (2005-2014).
abstract: BACKGROUND
  Annually about 28% of the 5800 death of unnatural cause in the Netherlands are a result of suicide. In 2012 and 2013 a movie and a book were published about a "dignified end of life" which also described the suicide using the exit bag to establish asphyxia using helium. The purpose of this study is to investigate if the suicide methods changed since the publicity in 2013 about suicidal asphyxiation by using helium gas. This study especially focuses on suicide using the 'exit bag' with or without helium gas.
  
  
  METHODS
  In the period 2005 to 2014 all suicides in the region of Amsterdam-Amstelland and Zaanstreek-Waterland were analyzed and from these suicides cases using the exit bag were selected.
  
  
  RESULTS
  The study shows a rising trend with the use of the helium (P > 0.01) and a decreasing trend for suicide by asphyxia using an exit bag (P < 0.05). The data does not show a sudden difference, but there seems to be a gradually change.
  
  
  CONCLUSIONS
  The number of suicides using the helium method is rising in Amsterdam-Amstelland and Zaanstreek-Waterland, while suicides by asphyxiation without helium are decreasing. The specific publicity of books about suicides using helium may have influenced this transition.
authors: Forensic Physicians Rotterdam Rijnmond (FARR), Rotterdam, The Netherlands. Electronic address: vdhondel@farr.nl.
authors: Karen E
authors: KE
authors: van den Hondel
authors: Public Health Service, Department of Epidemiology & Health Promotion/Forensic Medicine, Amsterdam, The Netherlands.
authors: Marcel
authors: M
authors: Buster
authors: Public Health Service, Department of Forensic Medicine, Amsterdam, The Netherlands.
authors: Udo J L
authors: UJ
authors: Reijnders
mesh_terms: D000280:Administration, Inhalation; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001237:Asphyxia / Q000209:etiology / Q000401:mortality*; D001877:Books; D005260:Female; D006371:Helium / Q000633:toxicity*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D013405:Suicide / Q000706:statistics & numerical data / Q000639:trends*; D055815:Young Adult
chemical_list: D006371:Helium
keywords: Asphyxial suicide; Documentation about suicide; Exit bag; Forensic physician; Helium; Plastic bag; Suicide