Oulu University Hospital, Department of Anesthesiology, Division of Intensive Care Medicine, P.O.BOX 21, 90029 OYS, Oulu, Finland.
Oulu University, Medical Research Center, Study Group of Surgery, Anesthesiology and Intensive Care, Oulu, Finland.
Scand J Trauma Resusc Emerg Med. 2017 Sep 8;25(1):90. doi: 10.1186/s13049-017-0431-8.
In this study we evaluate differences between rural and urban areas in the causes and incidence of fatal poisonings.
Data from all fatal poisonings that occurred in Northern Finland from 2007 to 2011 were retrieved from Cause of Death Registry death certificates provided by Statistics Finland. The demographics and causes of fatalities were compared between rural and urban areas. Incidences were calculated based on the population data.
There were a total of 684 fatal poisonings during the study period and 57.9% (n = 396) occurred in the urban population. Ethanol was the most common primary poisoning agent in cases of fatal poisoning, accounting for 47.5% of cases in urban areas and 68.1% in rural areas (P < 0.001). Fatal poisonings caused by psychoactive pharmaceutical products and opioids were more common in urban areas (28.3% compared to 18.0%, P < 0.001). The crude incidence of fatal poisonings in the study area was 18.8 (17.4-20.2) per 100,000 inhabitants per year and there was no difference in incidence between urban and rural areas. In the youngest age group (15 to 24 years), the incidence of fatal poisonings observed in urban areas was two times higher than that in rural areas.
Higher rate of fatal ethanol poisonings in rural areas could be linked to higher alcohol consumption in rural areas and also differences in drinking behaviour. Higher incidence of poisoning suicides in urban areas could be due to availability of different toxic agents as a suicidal method. Preventive measures could be key in reducing the number of fatal poisonings in both areas, as most of the fatal poisonings still occur outside hospital.
There was a higher rate of fatal ethanol poisoning in rural areas and higher rate of fatal poisoning related to psychoactive pharmaceutical products and opioids in urban areas. There were twice as many fatal poisonings in the youngest age group (15-24 years) in urban areas compared to rural areas, and suicide was more common in urban areas.
本研究旨在评估农村和城市地区在致命性中毒的原因和发生率方面的差异。
本研究从芬兰统计局提供的死因登记处死亡证明中检索了 2007 年至 2011 年期间在芬兰北部发生的所有致命性中毒事件的数据。比较了农村和城市地区的人口统计学和死亡原因。根据人口数据计算了发病率。
研究期间共发生 684 例致命性中毒，其中 57.9%（n=396）发生在城市人口中。乙醇是致命性中毒中最常见的原发性中毒药物，在城市地区占 47.5%，在农村地区占 68.1%（P<0.001）。城市地区致命性中毒由精神活性药物和阿片类药物引起的情况更为常见（28.3%比 18.0%，P<0.001）。研究区域致命性中毒的粗发病率为每 10 万人每年 18.8（17.4-20.2），城乡地区发病率无差异。在最年轻的年龄组（15 至 24 岁），城市地区致命性中毒的发生率是农村地区的两倍。
农村地区致命性乙醇中毒发生率较高可能与农村地区较高的酒精消费水平以及饮酒行为的差异有关。城市地区中毒自杀发生率较高可能是由于不同的有毒物质作为自杀手段更容易获得。预防措施可能是减少两个地区致命性中毒数量的关键，因为大多数致命性中毒仍发生在医院之外。
农村地区致命性乙醇中毒发生率较高，城市地区致命性中毒与精神活性药物和阿片类药物有关的发生率较高。城市地区最年轻年龄组（15-24 岁）的致命性中毒人数是农村地区的两倍，城市地区自杀更为常见。
