Abstract
Abstract. In many motorized countries, inhalation of carbon monoxide from motor vehicle exhaust gas (MVEG) has been one of the leading methods of suicide. In some countries it remains so (e.g., Australia 16.0% of suicides in 2005). Relative to other methods it is a planned method and one often used by middle-aged males. The study provides a review of countermeasures aimed at restricting this method of suicide. The prevention measures identified were catalytic converters (introduced to reduce carbon monoxide for environmental reasons); in-cabin sensors; exhaust pipe modification; automatic idling stops; and helpline signage at suicide “hotspots.” Catalytic converters are now in 90% of new vehicles worldwide and literature supports them being associated with a reduction in exhaust-gassing suicides. There remain, however, accounts of exhaust-gas fatalities in modern vehicles, whether accidentally or by suicide. These deaths and also crashes from fatigue could potentially be prevented by in-cabin multi-gas sensors, these having been developed to the prototype stage. Helpline signage at an exhaust-gassing suicide “hotspot” had some success in reducing suicides. The evidence on method substitution and whether a reduction in MVEG suicides causes a reduction in total suicides is inconsistent.
References
(2001). Changes in rates of suicide by car exhaust asphyxiation in England and Wales. Psychological Medicine, 31, 935–939
(2006). Vehicle emissions reductions - Actual experiences with gasoline fueled vehicles. Retrieved on 3/9/06 from www.adb.org/vehicle-emissions/General/inuse-retrofits-1.asp
(2007). Suicides 2005. Cat. 3309.0. Retrieved on 13/7/07 from www.abs.gov.au/AUSSTATS/[email protected]/DetailsPage/3309.02005?Open Document
(2005). Motor vehicle census. Cat. 9309.0. Retrieved September 2006 from www.abs.gov.au
(2000). Restricting access to means of suicide in New Zealand. Wellington: Ministry of Health, New Zealand
(2001). Effectiveness of barriers at suicide jumping sites: A case study. Australian and New Zealand Journal of Psychiatry, 35, 557–562
(2003). Subsequent mortality in medically serious suicide attempts: A 5-year follow-up. Australian and New Zealand Journal of Psychiatry, 37, 595–599
(2006). Motor vehicle exhaust gas suicide (MVEGS) in Victoria, Australia 1998-2002. Crisis, 27, 119–124
(1989). The changing pattern of suicide by gassing in Australia, 1910-1987: The role of natural gas and motor vehicles. Acta Psychiatrica Scandinavica, 81, 178–184
(1990). Suicide from river bridges. Australian and New Zealand Journal of Psychiatry, 24, 377–380
(2004). Injury mortality reports 1999 to 2003. Retrieved 9 Sept 2006 from www.cdc.gov/ncipc/wisqars/default.htm
(1990). Childhood injuries in the United States. American Journal of Diseases of Children, 144, 627–46
(1989). Suicide: Closing the exits. New York: Springer-Verlag
(2000). Technology and testing: Working-group report. London: Department of Trade and Industry Automotive Directorate
(1997). Title 40; Protection of environment. Part 86 - Control of air pollution from new and used in-use motor vehicle engines: certification and test procedures. Washington, DC: Office of the Federal Register National Archives and Records Administration
(2005). Suicide prevention through means restriction: Assessing the risk of substitution. A critical review and synthesis. Accident Analysis and Prevention, 37, 625–632
(2002). Hanging, firearm, and nondomestic gas suicides among males: A comparative study. Australian and New Zealand Journal of Psychiatry, 36, 183–189
(1988). Aviation medicine (2nd ed.). London: Butterworths
(2002). TERM 2002 33 AC - Average age of the vehicle fleet. Retrieved on 20/8/06 from themes.eea.europa.eu/Sectors_and_activities/transport/indicators/technology/TERM33,2002/TERM_2002_33_AC_Average_age_of_the_vehicle_fleet.pdf
(2003a, 1-5-2003). TERM 2002 33 EU - Average age of the vehicle fleet. Retrieved on 23/8/06 from themes.eea.europa.eu/Sectors_and_activities/transport/indicators/technology/TERM33,2002/TERM_2002_33_EU_Average_age_of_the_vehicle_fleet.pdf
(2003b). TERM 2002 34 EU - Proportion of vehicle fleet meeting certain emission standards (by mode). Retrieved on 12/7/07 from themes.eea.europa.eu/Sectors_and_activities/transport/indicators/technology/TER M34%2C2003.09/TERM2003_34_EEA31_Proportion_of_vehicle_fleet_meeting_certain_e mission_standardsfinal.pdf
(2000). Vehicle cabin air quality detector for fatigue and suicide prevention (Technical Paper series, 2000-01-084). Warrendale, PA: Society of Automotive Engineers
(1991). Carbon monoxide detector for automobile passenger compartment (No. DOT HS 807 761). Washington DC: US Department of Transportation, National Highway Traffic Safety Administration
(1978).
(1998). Catalytic converters and prevention of suicides. The Lancet, 352(Nov. 7), 1525–
(2005). The New Forest suicide prevention initiative (NFSPI). Crisis, 26, 25–33
(2007). . Director, Suicide Prevention Section, Mental Health & Suicide Prevention Branch, Department Health & Ageing (Personal communication)
(1976). The coal gas story. British Journal of Preventive and Social Medicine, 30, 86–93
(1989). Changing rates of suicide by car exhaust in men and women in the US after car exhaust was detoxified. Crisis, 10, 164–68
(1990). The effects of detoxification of domestic gas on suicide in the United States. American Journal of Public Health, 80, 80–
(1991). Effects of detoxification of domestic gas on suicide in the Netherlands. Psychological Reports, 68, 202–
(1998). Preventing suicide by restricting access to methods for suicide. Archives of Suicide Research, 4, 7–24
(1989). Car availability, exhaust toxicity and suicide. Annals of Clinical Psychiatry, 1, 247–250
(1988). Effects of reduced toxicity of car exhaust. American Journal of Public Health, 78, 594–
(2005). Suicide prevention strategies. Journal of the American Medical Association, 294, 2064–2074
(2000). Changes in suicide in England and Wales. British Journal of Psychiatry, 176, 64–67
(2003). Vehicle exhaust emissions Rule 2003 Q&A. Retrieved 13 September 2006 from www.transport.govt.nz/vehicle-exhaust-emissions-rule-2003-q-a/
(1999). Toward reducing motor vehicle exhaust gas suicide. Hazard, 41, 13–
(1988). Automobile exhaust as a suicidal means: An experimental study with a proposed model. Journal of Forensic Science, 43, 827–836
(2007). The decline in Australian young male suicide. Social Science & Medicine, 64, 747–754
(2002). National vehicle emissions policies and practices and declining US carbon monoxide-related mortality. Journal of the American Medical Association, 288, 988–995
(2006). National Suicide Prevention Strategy for England. Leeds: Author
(2005). Mortality and demographic data. Ministry of Health. Retrieved on 15/6/07 from www.moh.govt.nz/statistics
(1996). Suicide from the Clifton Suspension Bridge in England. Journal of Epidemiology and Community Health, 50, 30–32
(2005). National statistics online. Retrieved on 14/6/07 from www.statistics.gov.uk/downloads/theme_health/Dh2_31/Table2.19.xls
(1996). Carbon monoxide suicide from car exhausts. Social Sciences and Medicine, 42, 447–451
(1998). Trends in personal motor vehicle ownership and use: Evidence from the nationwide personal transportation survey. Cambridge, MA: US DOT Volpe Center
(2003). Does means Matter? Differences in characteristics of Finnish suicide completers using different methods. The Journal of Nervous and Mental Disease, 191, 745–750
(1998). Motor vehicle exhaust gassing suicides in Australia: Epidemiology and prevention (No. 139). Melbourne: Monash University
(1998). The impact of catalytic converters on motor vehicle exhaust gas suicides. Medical Journal of Australia, 168, 65–67
(2006, August 31). A tough ride for Japan car makers. Businessweek online,
(2002). Asphyxial deaths caused by automobile exhaust inhalation not attributable to carbon monoxide toxicity: Study of two cases. The American Journal of Forensic Medicine and Pathology, 23, 123–126
(1994). Unanticipated benefits of automotive emission control: Reduction in fatalities by motor vehicle exhaust. Science of the Total Environment, 146/147, 93–101
(1998). Deliberate exposure to motor vehicle exhaust gas: The psychosocial profile of attempted suicide. Australian and New Zealand Journal of Psychiatry, 32, 830–838
(2005). Retrieved from www.statcan/english/freepub/84-208-XIE/2005002/ch20.pdf
(2004). To make further progress against carbon monoxide poisoning, focus on motor vehicles. Injury Prevention, 10, 74–75
(1990). Carbon monoxide poisoning. Five years experience in a defined population. The American Journal of Forensic Medicine and Pathology, 11, 219–225
(1999). Catalytic converters and prevention of suicides. The Lancet, 353, 244–
(2006, June 8). Summary of emission requirements for new petrol passenger cars in Australia 1972-2010. Retrieved September 8 2006 from www.dotars.gov.au/roads/environment/impact/emission.aspx
(1999). The role of catalytic converters in automobile carbon monoxide poisoning. Chest, 115, 580–581
(2005). Sustainable transportation. The lessons of the past 50 years. Retrieved on 7/8/06 from www.walshcarlines.com/pdf/Lessons%20Of%2050%20Years%20Abu%20Dhabi.pdf
(2002). Analysis of carbon monoxide. Annals of Clinical Biochemistry, 39, 378–391
(2007). Retrieved on 19/6/07 from en.wikipedia.org/wiki/Retrofit
(2000). The impact of legislation and changing vehicle propulsion methods on suicides using motor vehicle exhaust gases across the UK. Journal of Epidemiology and Community Health, 54, 797–
(2001). Drug and chemical blood level data 2001. Forensic Science International, 122, 107–123
(1992). International Classification of diseases and related health problems (Vol. ICD-10). Geneva: Author