Yau Rebecca K, Paschall Mallie J
Prevention Research Center, Pacific Institute for Research and Evaluation, 180 Grand Avenue, Suite 1200, Oakland, CA, 94612, USA.
School of Public Health, University of California, Berkeley, 50 University Avenue, Berkeley, CA, 94720, USA.
Inj Epidemiol. 2018 Jan 8;5(1):1. doi: 10.1186/s40621-017-0131-x.
From 2005 to 2014, the asphyxiation suicide rate in the United States (U.S.) increased by 45.7% from 2.45 to 3.57 per 100,000 population. The primary purpose of this cross-sectional study was to describe decedent and incident characteristics of asphyxiation suicides in the U.S. from 2005 to 2014. The secondary purpose of this study was to explore whether any demographic characteristics of asphyxia suicide decedents were associated with type of suicide incident.
Data from the National Violent Death Reporting System (NVDRS) were used to describe asphyxiation suicide mechanisms and means in 16 states. Anchor points of hanging suicides were also described. Mechanisms, means, and anchor points were determined through a text search of cause of death, coroner/medical examiner narrative, and law enforcement narrative. Multivariable logistic regression was conducted separately for females and males to estimate beta coefficients to obtain adjusted odds ratios (AORs) and 95% confidence intervals (CIs) to compare hanging-related asphyxiation and other types of asphyxiation.
From 2005 to 2014, there were 25,270 asphyxiation suicides. Most decedents were male (79.9%) and white, non-Hispanic (76.8%). Most asphyxiation suicides involved hanging (90.7%, N = 22,931); 1717 (6.8%) involved smothering; 968 (3.8%) involved chemicals or gasses; and 145 (0.6%) involved strangulation. For hanging suicides, the three most commonly used means were power or extension cords (N = 1834), bedding (N = 873), and animal ropes (N = 578). The three most common anchor points for hanging suicides were trees (N = 2215), beams (N = 2014), and closets (N = 2009). Among females and males, odds of asphyxiation suicide were highest among those of Other, non-Hispanic race and black, non-Hispanic race, respectively [AOR (95% CI) = 3.73 (1.59, 8.79) and 2.72 (1.34, 5.50), respectively].
Commonly available objects are used in asphyxiation suicides. Modification of anchor points represents a potential solution for reducing hanging suicides. Changes in design and availability of grocery bags could help reduce smothering suicides. Strategies to reduce asphyxiation suicides need to be identified. Improving access to and utilization of mental health services can also reduce asphyxiation suicides. Future research should be conducted to better describe characteristics of asphyxiation suicide so that prevention efforts targeted by demographic subgroups can be implemented.
2005年至2014年期间，美国的窒息自杀率从每10万人2.45例上升至3.57例，增幅达45.7%。这项横断面研究的主要目的是描述2005年至2014年美国窒息自杀者的特征及自杀事件的特点。本研究的次要目的是探讨窒息自杀者的任何人口统计学特征是否与自杀事件类型相关。
利用国家暴力死亡报告系统（NVDRS）的数据描述16个州的窒息自杀机制和手段。还描述了缢死自杀的固定点。通过对死亡原因、验尸官/法医叙述及执法人员叙述进行文本搜索来确定机制、手段和固定点。分别对女性和男性进行多变量逻辑回归，以估计β系数，从而获得调整后的优势比（AOR）和95%置信区间（CI），以比较与缢死相关的窒息和其他类型的窒息。
2005年至2014年期间，共有25270例窒息自杀事件。大多数死者为男性（79.9%），且为非西班牙裔白人（76.8%）。大多数窒息自杀事件涉及缢死（90.7%，N = 22931）；1717例（6.8%）涉及闷死；968例（3.8%）涉及化学品或气体；145例（0.6%）涉及勒死。对于缢死自杀，最常用的三种手段是电源线或延长线（N = 1834）、床上用品（N = 873）和动物绳索（N = 578）。缢死自杀最常见的三个固定点是树木（N = 2215）、横梁（N = 2014）和壁橱（N = 2009）。在女性和男性中，窒息自杀的几率分别在其他非西班牙裔种族和黑人非西班牙裔种族中最高[AOR（95%CI）分别为= 3.73（1.59，8.79）和2.72（1.34，5.50）]。
窒息自杀中使用的是常见物品。改变固定点是减少缢死自杀的一个潜在解决方案。食品杂货袋设计和可用性的改变有助于减少闷死自杀。需要确定减少窒息自杀的策略。改善心理健康服务的可及性和利用率也可减少窒息自杀。未来应开展研究，以更好地描述窒息自杀的特征，以便针对不同人口亚组实施预防措施。
