| 1. |
- Björnstig, Ulf, et al.
(författare)
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Violent deaths in small children in northern Sweden.
- 2006
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Ingår i: International journal of circumpolar health. - 1239-9736. ; 65:1, s. 28-34
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Tidskriftsartikel (refereegranskat)abstract
- 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.
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| 2. |
- Sjögren, Harmeet, et al.
(författare)
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Alcohol and unnatural deaths in Sweden: a medico-legal autopsy study.
- 1999
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Ingår i: 15th Triennial Meeting International Association of Forensic Sciences. ; , s. 38-
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Konferensbidrag (populärvet., debatt m.m.)abstract
- 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.
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| 3. |
- Sjögren, Harmeet, et al.
(författare)
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Alcohol and unnatural deaths in Sweden: a medico-legal autopsy study.
- 2000
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Ingår i: Journal of Studies on Alcohol. - 0096-882X. ; 61:4, s. 507-14
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- 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.
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| 4. |
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| 5. |
- Sjögren, Harmeet, et al.
(författare)
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Gender differences in role of alcohol in fatal injury events.
- 2006
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Ingår i: European journal of public health. - 1101-1262. ; 16:3, s. 267-71
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The aim was to investigate the differences in alcohol involvement in fatal injury events between females and males. METHODS: Information was obtained from the Forensic Medicine Database and the Forensic Toxicology Database of the National Board of Forensic Medicine, and from the inpatient register of the National Board of Health and Welfare. Alcohol was regarded to be involved in the injury event: if there was any indication that the deceased was a 'known alcoholic'; if the underlying or contributing causes of death were alcohol-related; if the deceased had alcohol-related inpatient diagnosis during a 3-year period prior to death; or if the deceased tested positive for blood alcohol at autopsy. All injured cases who underwent medico-legal autopsies (1992-1996) in Sweden were analysed (4471 females and 11 156 males). RESULTS: Compared to males, females died more often (P < 0.05) in intentional injury events (48.0% females, 44.2% males), were less often (P < 0.001) blood alcohol-positive (29% females, 43% males), had lower (P < 0.05) blood alcohol concentrations (0.17% in females, 0.18% in males), and were less likely (P < 0.001) to have an alcohol-related history (18.4% females, 24.4% males). For females, intentional deaths (31.4%) were significantly (P < 0.001) more often alcohol-related than unintentional deaths (22.9%). A significantly (P < 0.001) higher proportion of deaths in males (48.4%) were alcohol-related compared to females (32.9%). CONCLUSIONS: Almost every third injury event in females and in almost every other event in males is alcohol-related, showing that alcohol plays an important part in fatal injuries in females even though it is mostly a male problem.
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| 6. |
- Sjögren, Harmeet, 1954-
(författare)
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Injuries among the elderly : study of fatal and non-fatal injury events
- 1994
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- In view of the expected increase in the proportion of elderly in the population in most western countries, we studied injuries among the elderly (>60 years) by investigating hospital-treated injuries in inpatients and outpatients, and fatal injuries.One-year Hospital Injury Data - Even though the elderly made up only 15% of the injured in one year, they accounted for 42% of the total cost of trauma medical care, showing that injuries among the elderly place a disproportional burden on the health care system. The mean medical care cost increased significantly from the age of 60 years. Serious injuries (MAIS>3) in the elderly cost almost 2.5 times more than those in the younger group (<60 years).Study of 1,313 injury events in 1,268 elderly showed annual injury, fracture, and mortality rates per 1,000 elderly population of 57, 31, and 0.6, respectively. Almost half were injured in the home environment, and 23% in the traffic environment. Most of the severe and critical injuries (MAIS>4) occurred in the traffic environment. Injury rate, severity of injuries, fractures, and the duration of hospitalization increased with age. Almost half of the injuries were fractures; most common were wrist and hip fractures. Women had a higher injury rate, more severe injuries, and longer duration in hospitalization than men had.Study of 621 injury events in 600 elderly injured in the home environment, showed annual injury and fracture rates of 30 and 15 per 1,000 elderly home population, respectively. Injuries were grouped into fall injuries (76%) and non-fall injuries (24%). The fall injury incidence was higher in women than in men. Most falls occurred indoors. Environmental factors played a role in half of the fall injuries, and intrinsic factors in at least one fifth. Intrinsic factors in falls became increasingly important with advancing age. Non-fall injuries were mostly sustained in woodworking. Fall injuries were of a greater severity and accounted for 80% of the cost of medical care of elderly in the home environment.Study of 298 injury events in 297 elderly injured in the traffic environment, showed that pedestrian falls accounted for 52% of the injuries, and vehicle-related events for 44%. The main groups in the vehicle-related injury category were bicyclists (48%), car occupants (34%), and pedestrians (4%). Two thirds of the pedestrian falls involved slipping on ice/snow. Ice/snow-related injuries (all categories) accounted for 37% of the total cost of all injuries in the elderly in the traffic environment. Vehicle-related crashes resulted in the most severe and critical injuries and the most fatalities, and cost (total and mean) more than pedestrian falls.Fatal Injury Data from Northern Sweden - Study of 379 elderly injured in the traffic environment in a ten-year period, showed that the car occupants (43%) made up the largest category followed by pedestrians (28%), bicyclists (15%), and two-wheel-motor-vehicle riders (8%), but the risk of fatal injury per unit distance travelled was highest for pedestrians and bicyclists. Males had double the death rate as females. Most car occupants were killed in multivehicle crashes, mostly in the daylight, and at intersections. Ice/snow was the major (31%) precrash factor. One quarter of pedestrians were injured at pedestrian crossings, and half of them during darkness. One in six pedestrians was under the influence of alcohol. All pedestrians and bicyclists were injured in collisions with motor vehicles and most were injured at intersections. Pedestrians and bicyclists had more serious head injuries than chest injuries.Study of 514 car drivers (>18 years) injured in a 13-year-period, showed that fatalities per unit distance, and per licensed driver were highest for the >70-year-old and 18-19-year-old drivers. Elderly (>60 year old) and <25 year old drivers had similar fatality frequencies. The older drivers (>60 years) initiated the crash more often than younger (<60 years) ones. Fatal head injuries decreased whilst chest injuries increased with age. The older drivers were more likely to die from post-trauma complications than younger ones.In a study of role of disease in 480 fatally injured drivers (>18 years) who died within three days of the crash, a grading system was developed to assess the probability of contribution of medical intrinsic factors (MIF) to the crash. Almost one quarter of the drivers were found to have MIF. Drivers with MIF were more often at fault than those without. Medical intrinsic factors were probably an underlying cause in 1 of 17 fatal crashes in all ages, and 1 of 5 fatal crashes in the elderly; in 4% of the elderly the probability was strong.A "passive automatic" approach which does not require any action on the part of the elderly, is to be recommended when improving safety in the home and in the traffic environments. The elderly drivers can be regarded as the "miner's canary" to indicate which passive safety improvements are needed in the traffic environment. In view of the expected population trends, it is important that authorities and public health workers accept the challenge to continue and intensify the injury preventive work for the elderly.
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| 7. |
- Sjögren, Harmeet, et al.
(författare)
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Role of alcohol in unnatural deaths: a study of all deaths in Sweden.
- 2000
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Ingår i: Alcoholism, clinical and experimental research. - 0145-6008. ; 24:7, s. 1050-6
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Tidskriftsartikel (refereegranskat)abstract
- 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.
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