Gunshot fatalities in Stockholm, Sweden with special reference to the use of illegal weapons.

During the years 1980-1992 the Swedish legislation regarding possession and use of firearms has remained fairly unchanged. Simultaneously the reported incidence of both stolen firearms and confiscation of illegally possessed handguns has increased significantly. In order to determine the impact of this trend on gunshot mortality, all victims of firearm fatalities subjected to medicolegal autopsy in the Stockholm area 1980-81 and 1990-91 were studied. The overall two-year rate increased from 50 to 65, homicides and suicides contributing seven new cases each; accidents and "not determined" comprising only 0 to 2 cases in each period. Suicides were four times as common as homicides in the former period; ca. three times as common in the latter. Thus, a 70% increase in homicidal shooting has occurred (from 10 to 17), and the fatal use of illegal firearms increased from 50% to 93%. As expected, there was a definite male dominance (96%) among perpetrators as well as among victims (85%). Concerning suicides, the rate in the latter period was 18% above that in the former; illegal guns were used in 30% in 1990-91 as compared to 20% 1980-81. The pattern of wounding in suicides was similar to that reported in earlier studies; confirming that entrance wounds in the back, extremities and lower abdomen are indicative of homicide. Thus, common sense knowledge of firearm fatalities are confirmed: More widespread access to illegal weapons conveys a higher rate of gunshot fatalities. The perpetrator is likely to be male. Suicidal shots are usually aimed at the head (mouth, temple, forehead) or precordium. Most gunshot suicides are committed by means of legally possessed firearms.