Abstract
Background: Belgium is a country with a high suicide rate (19.1/100,000 in 2004), and railway suicide poses a substantial safety and public health problem. This problem was addressed by the Suicide Prevention Unit of Infrabel (Manager of the Belgian Railway Infrastructure), which collects relevant data and implements a prevention program. Aims: To present data on fatal and nonfatal suicidal behavior on the Belgian railway network, including monthly and regional distribution and identification of hotspots; and to present the Infrabel suicide prevention program. Methods: Analysis of Infrabel data on railway suicide (1998–2009) and comparison with data on suicide in Belgium. Results: A total of 1,092 railway suicides (1998–2009) and 557 suicide attempts (2003–2009) in Belgium (fatality rate of 54%) were studied. Monthly fluctuations were observed, with the majority of suicides occurring in Flanders, followed by Wallonia and Brussels. We identified 34 hotspots accounting for 35% of cases, mostly in Flanders. Conclusions: In 2004 railway suicide accounted for 5.3% of all suicides in Belgium (railway suicide rate of 1.03/100,000). Such a major human and economic loss warrants implementation of prevention measures. Infrabel has initiated a comprehensive suicide prevention program which focuses mainly on safeguarding the suicide hotspots.
References
2003). Railway suicide: An investigation of individual and organizational consequences. Doncaster: Doncaster and South Humber Healthcare NHS Trust.
(2005). Ten-year incidence and time trends of railway suicides in Germany from 1991 to 2000. European Journal of Public Health, 16, 173–178.
(2004). Professional and medical outcomes for French train drivers after “person under train” accidents: Three-year follow-up study. Occupational and Environment Medicine, 61, 488–494.
(2008). Suicidal behavior by train collision in Queensland, 1990–2004. Australian and New Zealand Journal of Psychiatry, 42, 772–779.
(2010). Jumping, lying, wandering: Analysis of suicidal behavior patterns in 1,004 suicidal acts on the German railway net. Psychiatric Research, 45, 121–125.
(2004). Sex-specific time patterns of suicidal acts on German Railway system. An analysis of 4003 cases. Journal of Affective Disorders, 83, 1–9.
(2009). The railway safety performance in the European Union, 2009. Valenciennes: Author.
(2009). Psychopathology and suicide method in mental health care. Journal of Affective Disorders, 121, 94–99.
(2008). Actieplan ter Voorkoming van Zelfdodingen op het Spoor [
(Action plan to prevent suicides on the railway ]. Brussels: Author.2009). Rapportering Actieplan ter Voorkoming van Zelfdodingen op het Spoor [
(Report of the action plan to prevent suicides on the railway ]. Brussels: Author.2003). Railway suicide: Who is responsible? Crisis, 24, 47–48.
(2008). Suicide on railway networks: Epidemiology, risk factors, and prevention. Australian and New Zealand Journal of Psychiatry, 42, 763–771.
(2009). Prevention of metropolitan and railway suicide. In , Oxford textbook of suicidology and suicide prevention (pp. 589–594). Oxford: Oxford University Press.
(2009). Evaluating the effectiveness of barrier installation for preventing railway suicides in Hong Kong. Journal of Affective Disorders, 114, 254–262.
(2005). A prospective study of the psychological effects of “person under train” incidents on drivers. Journal of Psychiatric Research, 40, 755–761.
(2009). Subway train-related fatalities in New York City: Accident versus suicide. Journal of Forensic Sciences, 54, 1414–1418.
(1985). Train suicide in the Country of Fyn 1979–82. Acta Psychiatrica Scandinavica, 72, 150–154.
(2005). Suicide prevention strategies: A systematic review. Journal of American Medical Association, 294, 2064–2074.
(2007). Railway and metro suicides: Understanding the problem and prevention potential. Crisis, 28, 36–43.
(2006). Guidance on action to be taken at suicide hotspots. Retrieved from www.nmhdu.org.uk/silo/files/guidance-on-action-to-be-taken-at-suicide-hotspots.pdf.
(1992). Suicidal acts on metro systems: An international perspective. Acta Psychiatrica Scandinavica, 86, 60–63.
(2006). The epidemiology of the railway related causalities. Turkish Journal of Trauma and Emergency Surgery, 12, 235–241.
(1999). An unusual case of railway suicide. Journal of Forensic Sciences, 44, 444–446.
(2005). Suicides and other fatalities from train-person collisions on Swedish railroads: A description epidemiology analysis as a basis for systems-oriented prevention. Journal of Safety Research, 36, 423–428.
(2002). Seasonal variation in specific methods of suicide: A national register study of 20,234 Finnish people. Journal of Affective Disorders, 71, 51–59.
(2010). The reliability of suicide rates: An analysis of railway suicides from two sources in fifteen European countries. Journal of Affective Disorders. doi: 10.1016/j.jad.2010.11.003 [Epub ahead of print].
(1994). Suicidal behavior on railways in the FRG. Social Science and Medicine, 38, 419–426.
(1994). Imitative suicide on the Viennese Subway. Social Science and Medicine, 38, 453–457.
(2010). Bevolking, doodsoorzaken [
(Population, causes of death ]. Retrieved from statbel.fgov.be/.1985). Psychiatric aspects of railway fatalities. Psychological Medicine, 15, 609–621.
(1994). Psychiatric and preventative aspects of railway fatalities. Social Science and Medicine, 38, 431–435.
(2009). NMBS – Zelfmoord en zelfmoordpogingen – Aantallen – Kosten. Belgische Parlement Vraag nr. 4–2422 d. d. 12 Januari 2009 [
(Railways – Suicide and attempted suicide – Numbers – Costs. Belgian Parliament Question nr 4–2422 dated 12 January 2009 ]. Retrieved from www.senate.be/www/?MIval=/Vragen/SchriftelijkeVraag&LEG=4&NR=2422&LANG=nl.2001). Seasonal changes in 24-h patterns of suicide rates: A study on train suicides in The Netherlands. Journal of Affective Disorders, 66, 215–223.
(2008). Mental healthcare status and psychiatric diagnoses of train suicides. Journal of Affective Disorders, 107, 281–284.
(2010). Train suicides in The Netherlands. Journal of Affective Disorders, 127, 281–286.
(