Abstract
BackgroundIn this study we evaluate differences between rural and urban areas in the causes and incidence of fatal poisonings.MethodsData 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.ResultsThere 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.DiscussionHigher 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.ConclusionThere 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.
Highlights
In this study we evaluate differences between rural and urban areas in the causes and incidence of fatal poisonings
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
Summary
In this study we evaluate differences between rural and urban areas in the causes and incidence of fatal poisonings. There is a higher rate of fatal poisoning due to pesticides in rural areas in South-East Asia and Africa, and reports of other differences in types of Koskela et al Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine (2017) 25:90 geographical differences in poisonings could be used to target preventative interventions to the at-risk population, as well as to organize education and access to emergency medical services. A recent study from Northern Finland indicated that there are regional differences between rural and urban areas in the use of health care services and in well-being [6]. The aim of this study is to investigate and compare the incidence and characteristics of fatal poisoning between urban and rural areas in northern Finland using autopsy reports that include full and detailed toxicological screening
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