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  • 1.
    Ahlm, Kristin
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rättsmedicin.
    Traffic and drowning incidents with emphasis on the presence of alcohol and drugs2014Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    Worldwide, fatal traffic injuries and drowning deaths are important problems. The aim of this thesis was to investigate the cirumstances of fatal and non-fatal traffic injuries and drowning deaths in Sweden including analysis of the presence of alcohol and drugs, which are considered to be major risk factors for these events. Data where obtained from the database of National Board of Forensic Medicine.

    In the first study, we investigated 420 passenger deaths from 372 crashes during 1993-1996. There were 594 drivers involved. In total, 21% of the drivers at fault were alcohol positive compared to 2% of drivers not at fault (p<0.001) (Paper I). During 2004-2007, crashes involving 56 fatally and 144 non-fatally injured drivers were investigated in a prospective study from Northern Sweden (Paper II). The drivers were alcohol positive in 38% and 21%, respectively. Psychoactive drugs were found in 7% and 13%, respectively. Benzodiazepines, opiates and antidepressants were the most frequent drugs found in drivers. Illict drugs were found 9% and 4% respectively, with tetrahydrocannabinol being the most frequent of these drugs (Paper II).

    We investigated 5,125 drowning deaths in Sweden during 1992-2009 (Paper III). The incidence decreased on average by about 2% each year (p<0.001). Unintentional drowning was most common (50%). Alcohol was found in 44% of unintentional, 24% of intentional, and 45% of undetermined drowning deaths. Psychoactive substances were detected in 40% and benzodiazepines were the most common substance. Illicit drugs were detected in 10%. Of all drowning deaths, a significantly higher proportion females commited suicide compared with males (55% vs. 21%, p<0.001). Suicidal drowning deaths (n=129) in Northern Sweden were studied further in detail (Paper IV). of these, 53% had been hospitalized due to a psychiatric diagnosis within five years prior to the suicide. Affective and psychotic disorders were the most common psychiatric diagnoses. Almost one third had performed a previous suicide attempt. One fourth had committed suicide after less than one week of discharge from hospital. Alochol was found in 16% and psychoactive drugs in 62% of these cases, respectively. 

    In conclusion, alcohol and psychoactive drugs are commonly detected among injured drivers and drowning victims, and probably play a role in these events. Most of the individuals that tested positive for alcohol and high blood concentrations, indicating alochol dependence or abuse. This association warrants futher attention when planning future prevention. 

  • 2.
    Ahlm, Kristin
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rättsmedicin.
    Björnstig, Ulf
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Kirurgi.
    Öström, Mats
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Kirurgi.
    Alcohol and drugs in fatally and non-fatally injured motor vehicle drivers in northern Sweden2009Inngår i: Accident Analysis and Prevention, ISSN 0001-4575, E-ISSN 1879-2057, Vol. 41, nr 1, s. 129-136Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Alcohol and drugs are important risk factors for traffic injuries, a major health problem worldwide. This prospective study investigated the epidemiology and the presence of alcohol and drugs in fatally and hospitalized non-fatally injured drivers of motor vehicles in northern Sweden. During a 2-year study period, blood from fatally and hospitalized non-fatally injured drivers was tested for alcohol and drugs. The study subjects were recruited from well-defined geographical areas with known demographics. Autopsy reports, medical journals, police reports, and toxicological analyses were evaluated. Of the fatally injured, 38% tested positive for alcohol and of the non-fatally 21% tested positive; 7% and 13%, respectively, tested positive for pharmaceuticals with a warning for impaired driving; 9% and 4%, respectively, tested positive for illicit drugs. The most frequently detected pharmaceuticals were benzodiazepines, opiates, and antidepressants. Tetrahydrocannabinol was the most frequently detected illicit substance. No fatally injured women had illegal blood alcohol concentration. The relative proportion of positively tested drivers has increased and was higher than in a similar study 14 years earlier. This finding indicates that alcohol and drugs merit more attention in future traffic safety work.

  • 3.
    Ahlm, Kristin
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rättsmedicin.
    Eriksson, Anders
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rättsmedicin.
    Blood loss in exsanguination deaths2011Inngår i: Indian Journal of Forensic Medicine & Toxicology, ISSN 0973-9122, Vol. 5, nr 2, s. 5-8Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Deaths by exsanguination among various underlying causes of death were analyzed in order to expand the knowledge on the relation of extravasated blood volume to other documented parameters.

    A consecutive series of 193 cases of ruptured thoracic aortic aneurysm (n=13), gunshot wounds (n=63), stab wounds (n=28), rib fractures (n=5), and blunt injury to thoracic aorta (n=84) were investigated.

    The amount of internal bleeding into pleural cavities only varied greatly (200-3,400 ml) with a mean value of 1,174 ml, slightly higher among males. Age, body weight, cause and manner of death, external bleeding, alcohol inebriation, multiplicity of injuries, and degree of coronary heart disease did not significantly affect the amount of internal (pleural) bleeding. Also, post-mortem delay to autopsy did not correlated to the amount of extravasated blood, indicating that post-mortem bleeding is of no importance in these days.

     

  • 4.
    Ahlm, Kristin
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rättsmedicin.
    Eriksson, Anders
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rättsmedicin.
    Driver's alcohol and passenger's death in motor vehicle crashes2006Inngår i: Traffic Injury Prevention, ISSN 1538-9588, E-ISSN 1538-957X, Vol. 7, nr 3, s. 219-223Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: Previous studies on alcohol involvement associated with fatal injury in traffic crashes have focused on the drivers, but the passenger's view is not well known. This study (1) analyzes the relationship between passenger's death and alcohol inebriation of the driver and (2) estimates the role of alcohol as the cause of a crash by examining who was at fault, sober, or inebriated.

    METHOD: The study includes all motor vehicle passengers (n = 420) who died in crashes in Sweden 1993 through 1996 and were medicolegally autopsied. Autopsy reports from the Departments of Forensic Medicine, including toxicological analyses, and police reports were studied. Presence of alcohol among drivers was based on blood and breath tests.

    RESULTS: One-fifth of the fatally injured passengers and one-fifth of the tested drivers were under the influence of alcohol. The youngest drivers had the highest prevalence of drunken driving. Drivers at fault were alcohol positive in 21% of these crashes and drivers were not at fault in 2% of these crashes. In 53% of the crashes where both the passenger and driver were alcohol positive, the passenger had a lower alcohol concentration than the driver. Children (<16 years) comprised 15% of the killed passengers. Notably, the children were riding with a driver who was under influence of alcohol in 13% of these crashes. Alcohol involvement was not tested in half of the surviving drivers.

    CONCLUSIONS: The data show that 20% of both passengers and drivers were under the influence of alcohol. Increased testing of surviving drivers regarding alcohol and other drugs is recommended.

  • 5.
    Ahlm, Kristin
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rättsmedicin.
    Hassler, Sven
    Sjölander, Per
    Eriksson, Anders
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rättsmedicin.
    Unnatural deaths in reindeer-herding Sami families in Sweden, 1961-20012010Inngår i: International Journal of Circumpolar Health, ISSN 1239-9736, E-ISSN 2242-3982, Vol. 69, nr 2, s. 129-137Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVES: Unnatural deaths among Indigenous populations, including the Swedish Sami, occur more often than among the general population. To find prevention strategies, we explored the circumstances of the unnatural deaths of members of reindeer-herding Sami families.

    STUDY DESIGN: The number of deaths from among a cohort of 7,482 members of reindeer-herding Sami families were retrieved from the National Board of Health and Welfare for the years 1961- 2001.

    METHODS: An evaluation of the information from autopsy records at the National Board of Forensic Medicine, police reports, and available medical records identified 158 unnatural deaths. These were then analysed in detail.

    RESULTS: Transport-related deaths and suicides were the most common unnatural deaths among Swedish reindeer-herding Sami family members. Suicides contributed to 23% of all deaths, road traffic accidents to 16%, and snowmobile fatalities to 11%. The accidents generally reflected an "outdoor lifestyle" and the working conditions were characterized by the use of off-road vehicles such as snowmobiles. Half of the number of victims tested positive for alcohol and alcohol abuse was documented in 15% of all victims.

    CONCLUSIONS: The results indicate that alcohol is an important factor in preventing unnatural deaths among reindeer-herding Sami, together with increased safety of both on-road and off-road transportation.

  • 6.
    Ahlm, Kristin
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rättsmedicin.
    Lindqvist, Per
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Klinisk fysiologi. Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Medicin.
    Saveman, Britt-inger
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Kirurgi.
    Björnstig, Ulf
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Kirurgi.
    Suicidal drowning deaths in Northern Sweden 1992-2009Manuskript (preprint) (Annet vitenskapelig)
  • 7.
    Ahlm, Kristin
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rättsmedicin.
    Lindqvist, Per
    Division of Social and Forensic Psychiatry, Karolinska Institutet, Stockholm, Sweden; Dalarna University, Falun, Sweden.
    Saveman, Britt-inger
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Björnstig, Ulf
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Kirurgi.
    Suicidal drowning deaths in northern Sweden 1992-2009: the role of mental disorder and intoxication2015Inngår i: Journal of Forensic and Legal Medicine, ISSN 1752-928X, E-ISSN 1878-7487, Vol. 34, s. 168-172Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Suicides by drowning have received limited attention by researchers. A recent finding that almost onethird of all drowning deaths in Sweden were classified as suicide instigated this study. We identified 129 cases of suicide by drowning in Northern Sweden and analyzed the circumstances and the psychiatric history prior to the suicide. Information was obtained from autopsy, police and medical records, as well as from the National Inpatient Register. One-third of the suicide victims had previously attempted suicide and half of the victims had been hospitalized due to mental health problems. One-third of these had left the hospital less than one week before the suicide. Alcohol and psychoactive drugs were present in 16% and 62% of the cases, respectively. A history of mental disorder and previous suicide attempt (s), especially by drowning, is an ominous combination necessitating efficient clinical identification, treatment and follow-up if a complete suicide is to be prevented.

  • 8.
    Ahlm, Kristin
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rättsmedicin.
    Saveman, Britt-Inger
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Björnstig, Ulf
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Kirurgi.
    Drowning deaths in Sweden with emphasis on the presence of alcohol and drugs: a retrospective study, 1992-20092013Inngår i: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 13, s. 216-Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Drowning deaths constitute a significant proportion of unnatural deaths globally. In Sweden and other high-income countries, drowning deaths have decreased. This study investigates the epidemiology and current trends of unintentional, intentional, and undetermined drowning deaths with emphasis on the presence of alcohol and other drugs.

    Methods: During an 18-years period, 5,125 drowning deaths were autopsied in Sweden. Data on cases including toxicological analysis on alcohol, pharmaceutical drugs, and illicit drugs were obtained from the National Board of Forensic Medicine.

    Results: During the study period, the annual incidence of drowning deaths in Sweden was 3.1/100,000 inhabitants and decreased on average by about 2% each year (p<0.001). The highest incidence was found among males and in middle/older age groups. The incidence increased 3% for each year of age. Children/adolescents (<= 18 years) constituted 5% of all drowning deaths. Of all drowned females in the study, 55% (847/1,547) committed suicide, which was a significantly higher proportion compared with males (21%, 763/3,578) (p<0.001). In total, 38% (1,656/4,377) of tested drowned persons had alcohol in their blood and the mean concentration was 1.8 g/l. In the unintentional drowning group, intentional drowning group, and the undetermined group, the proportion of alcohol positive was 44%, 24%, and 45%, respectively. One or several psychoactive drugs were present in the blood in 40% (1,688/4,181) of all tested persons and in 69% (965/1,394) of tested persons who died from suicidal drowning. The most common drug was benzodiazepines (21%, 891/4,181). Illicit drugs were detected in 10% (82/854) of tested persons.

    Conclusion: Presence of alcohol and drugs were frequent and may have contributed to the drowning deaths. The incidence of drowning deaths significantly decreased during the study period. Males and the middle/older age groups had a higher incidence compared to females and children. Suicidal drowning was common especially among women. Alcohol and drugs are significant contributors in drowning deaths in Sweden and should be considered as part of a comprehensive prevention program.

  • 9.
    Björnstig, Ulf
    et al.
    Umeå universitet, Medicinsk fakultet, Kirurgisk och perioperativ vetenskap, Kirurgi.
    Björnstig, Johanna
    Umeå universitet, Medicinsk fakultet, Kirurgisk och perioperativ vetenskap, Kirurgi.
    Ahlm, Kristin
    Umeå universitet, Medicinsk fakultet, Samhällsmedicin och rehabilitering.
    Sjögren, Harmeet
    Eriksson, Anders
    Umeå universitet, Medicinsk fakultet, Samhällsmedicin och rehabilitering.
    Violent deaths in small children in northern Sweden.2006Inngår i: International journal of circumpolar health, ISSN 1239-9736, Vol. 65, nr 1, s. 28-34Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVES: To identify causes and trends of violent deaths among children younger than 4 years in a northern region. STUDY DESIGN: Retrospective analysis of medico-legal autopsy and police data. METHODS: Data from all 72 deaths from "external causes" 1977-2004, in children < 4 years from the northern half of Sweden were analysed. RESULTS: The death rate was 7.1 per 100,000 children and year during the first half of the study period, and 5.2 during the second half. Vehicle- and drowning-related deaths were halved. Fifteen were struck by motor vehicles (in 8 cases by heavy vehicles), 14 car occupants were killed in car crashes, 12 were killed by intentional violence inflicted by an adult, and 9 each were killed by (i) carbon monoxide/smoke inhalation, (ii) asphyxiation, or (iii) drowning. The boy:girl ratio was 1:1 in all groups, except in the groups "drowning" and "run over by motor vehicle", where boys dominated. CONCLUSIONS: Medical professionals have a difficult but important task in identifying and taking action against child abuse and in promoting child safety especially in the traffic and home environments.

  • 10.
    Connolly-Andersson, Anne-Marie
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk mikrobiologi, Infektionssjukdomar.
    Ahlm, Kristin
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rättsmedicin.
    Ahlm, Clas
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk mikrobiologi, Infektionssjukdomar.
    Klingström, Jonas
    Puumala virus infections associated with cardiovascular causes of death2013Inngår i: Emerging Infectious Diseases, ISSN 1080-6040, E-ISSN 1080-6059, Vol. 19, nr 1, s. 126-128Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    We studied the causes of death of patients in Sweden with diagnoses of hemorrhagic fever with renal syndrome (HFRS) during 1997–2009. Cardiovascular disorders were a common cause of death during acute-phase HFRS and were the cause of death for >50% of those who died during the first year after HFRS.

  • 11.
    Eriksson, Anders
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rättsmedicin.
    Stenlund, Hans
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Ahlm, Kristin
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rättsmedicin.
    Boman, Kurt
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Medicin.
    Bygren, Lars Olov
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Johansson, Lars Age
    Swedish National Board of Health and Welfare.
    Olofsson, Bert-Ove
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Medicin.
    Wall, Stig
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Weinehall, Lars
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Accuracy of death certificates of cardiovascular disease in a community intervention in Sweden.2013Inngår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 41, nr 8, s. 883-889Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim: The aim was to investigate the possibility to evaluate the mortality pattern in a community intervention programme against cardiovascular disease by official death certificates.

    Methods: For all deceased in the intervention area (Norsjö), the accuracy of the official death certificates were compared with matched controls in the rest of Västerbotten. The official causes of death were compared with new certificates, based on the last clinical record, issued by three of the authors, and coded by one of the authors, all four accordingly blinded.

    Results: The degree of agreement between the official underlying causes of death in "cardiovascular disease" (CVD) and the re-evaluated certificates was not found to differ between Norsjö and the rest of Västerbotten. The agreement was 87% and 88% at chapter level, respectively, but only 55% and 55% at 4-digit level, respectively. The reclassification resulted in a 1% decrease of "cardiovascular deaths" in both Norsjö and the rest of Västerbotten.

    Conclusions: The disagreements in the reclassification of cause of death were equal but large in both directions. The official death certificates should be used with caution to evaluate CVD in small community intervention programmes, and restricted to the chapter level and total populations.

  • 12.
    Palmcrantz, Johan
    et al.
    Umeå universitet, Medicinska fakulteten.
    Hardcastle, Timothy C
    Naidoo, Steven R
    Muckart, David J
    Ahlm, Kristin
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rättsmedicin.
    Eriksson, Anders
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rättsmedicin.
    Pelvic fractures at a new level 1 trauma centre: who dies from pelvic trauma?: The Inkosi Albert Luthuli Central Hospital Experience2012Inngår i: Orthopaedic surgery, ISSN 1757-7861, Vol. 4, nr 4, s. 216-221Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: To identify the incidence of pelvic trauma, causes of death and factors predicting death with pelvic fractures.

    Methods: All pelvic fractures were retrospectively identified from a registry spanning from March 2007 to August 2009. Data was captured on a proforma. Data for survivors, non-survivors and a subgroup with pelvic injury as the underlying cause of death were compared.

    Results: Pelvic fracture incidence was 16% of major trauma cases. Patient with pelvic fractures had 31% mortality and 9% pelvic fracture-induced mortality. Motor vehicle collisions were the commonest external cause of pelvic fractures (59%); however, the highest mortality was from falls >6 m. The Injury Severity Score (ISS) was 29 in survivors, 36 in non-survivors, and 54 in the pelvic death subgroup. Type C fracture was a predictor of mortality (P = 0.135). 53% of the cases required transfusion in the first 24 hours. The pelvic death subgroup received a mean of 10.7 units of blood, versus 4 units for survivors and 3.7 units for non-survivors (P = 0.259).

    Conclusion: The overall incidence of pelvic fracture and associated mortality were higher than previously reported. Fracture severity and falls from heights are associated with additional injuries (higher ISS) and mortality. More severe fractures cause deaths directly attributable to the pelvic injury. The requirement for major blood transfusions for pelvic fracture hemorrhage was related to mortality. Female patients appeared to fare worse than males.

  • 13.
    Sjögren, Harmeet
    et al.
    Umeå universitet, Medicinsk fakultet, Samhällsmedicin och rehabilitering, Rättsmedicin.
    Eriksson, Anders
    Umeå universitet, Medicinsk fakultet, Samhällsmedicin och rehabilitering, Rättsmedicin.
    Ahlm, Kristin
    Umeå universitet, Medicinsk fakultet, Samhällsmedicin och rehabilitering, Rättsmedicin.
    Alcohol and unnatural deaths in Sweden: a medico-legal autopsy study.1999Inngår i: 15th Triennial Meeting International Association of Forensic Sciences, 1999, s. 38-Konferansepaper (Annet (populærvitenskap, debatt, mm))
    Abstract [sv]

    The aim was to inverstigate role of alcohol in all types of unnatural deaths in Sweden. It was found that two of five unnatural deaths are associated with alcohol. Alcohol-associated mortality varies between different groups of external causes of death, between males and females, and with age.

  • 14. Sjögren, Harmeet
    et al.
    Eriksson, Anders
    Umeå universitet, Medicinsk fakultet, Samhällsmedicin och rehabilitering, Rättsmedicin.
    Ahlm, Kristin
    Alcohol and unnatural deaths in Sweden: a medico-legal autopsy study.2000Inngår i: Journal of Studies on Alcohol, ISSN 0096-882X, Vol. 61, nr 4, s. 507-14Artikkel i tidsskrift (Annet vitenskapelig)
    Abstract [en]

    OBJECTIVE: To investigate alcohol involvement in all types of unnatural deaths in Sweden. METHOD: All cases of unnatural death that underwent medico-legal autopsies (1992-1996) in Sweden were analyzed (N = 15,630; i.e., 68% of all unnatural deaths). Alcohol was regarded as contributing to the death if: (1) there was any indication that the deceased was a "known alcoholic"; (2) the underlying or contributing causes of death were alcohol-related; (3) the deceased had alcohol-related inpatient diagnosis during a period of 3 years prior to death; or (4) the case tested positive for blood alcohol. RESULTS: Thirty-nine percent of the blood-tested cases (n = 13,099) were positive for alcohol. Almost 40% of the unnatural deaths were associated with alcohol. Alcohol involvement was most common in the intoxication group (84%), followed by the "undetermined" (65%), homicide (55%), fall (48%), fire (44%), asphyxia (41%), suicide (35%) and traffic (22%) groups. More than half (52%) of the deaths in the age group 30-60 years, 35% of those aged 0-29 years and 25% of those aged 60 and over were associated with alcohol. CONCLUSIONS: In Sweden, two of five unnatural deaths are associated with alcohol; this is a conservative estimate. Alcohol-associated mortality varies considerably between different groups of external causes of death, between men and women, and with age.

  • 15. Sjögren, Harmeet
    et al.
    Eriksson, Anders
    Umeå universitet, Medicinsk fakultet, Samhällsmedicin och rehabilitering, Rättsmedicin.
    Ahlm, Kristin
    Umeå universitet, Medicinsk fakultet, Samhällsmedicin och rehabilitering, Rättsmedicin.
    Role of alcohol in unnatural deaths: a study of all deaths in Sweden.2000Inngår i: Alcoholism, clinical and experimental research, ISSN 0145-6008, Vol. 24, nr 7, s. 1050-6Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: Most previous research has concentrated on the role of alcohol in one type of unnatural death in a selected population, but the present objective was to investigate the role of alcohol in all unnatural deaths (autopsied and not autopsied). METHODS: All cases of unnatural death from 1992 through 1996 in Sweden were analyzed (n = 23,132). Death was attributed at least in part to alcohol if the deceased was a "known alcoholic"; if the underlying or contributing cause of death was alcohol-related; if the deceased had an alcohol-related inpatient diagnosis during the 3-year period prior to death; or if the deceased tested positive for blood alcohol. RESULTS: Just over 28% of the unnatural deaths could be associated with alcohol; the association with alcohol was more than twice as common in deaths of males (35%) as in females (16%). When only autopsied cases or only blood-tested cases were taken as the denominators, 38% and 44%, respectively, of the deaths were associated with alcohol. Alcohol involvement also was twice as common in intentional deaths (36%) as in unintentional deaths (18%). The intoxication group (78%) had the highest fraction of deaths that could be associated with alcohol, followed by the undetermined group (62%), homicide (49%), fire (41%), suicide (35%), asphyxia (29%), traffic (18%) and fall (9%) groups. In the 20- to 59-year age group, alcohol involvement was found in 51% of the males and 35% of the females (47% for males and females combined). CONCLUSIONS: The present estimates are conservative; alcohol involvement in unnatural deaths probably is even higher, up to 44% of the total. The present estimation is an important step in policy-making to lower the number of alcohol-related deaths in Sweden.

  • 16.
    Öström, Mats
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rättsmedicin.
    Ahlm, Kristin
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rättsmedicin.
    Eriksson, Anders
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rättsmedicin.
    Brister i handläggningen av onaturliga dödsfall1999Inngår i: Svenska Läkaresällskapets Handlingar Hygiea, 1999Konferansepaper (Annet (populærvitenskap, debatt, mm))
    Abstract [sv]

    Enligt gällande svenska rättsregler förutsätts att i princip samtliga onaturliga dödsfall, inkluderande samtliga fall där misstanke finns om yttre våld, förgiftning, missbruk eller om fel eller försummelse inom sjukvården, ska anmälas till polis och genomgå rättsmedicinsk undersökning. Syftet med den föreliggande undersökningen var att närmare studera de dödsfall som inte genomgått rättsmedicinsk undersökning trots att så borde ha skett enligt gällande regelverk, och att belysa varför så inte blivit fallet.

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