Firearm suicides in Sweden.

In a setting with restrictive firearm laws, prevention of firearm deaths is challenging. Around 100 firearm suicides occur annually in Sweden, representing the most common manner of death from firearm use. In order to explore a possible correlation between firearm suicides and firearm availability, legality of firearm possession, and demographic and geographical factors, all firearm suicides in Sweden among adults during the years 2016-2017 were studied. Data were collected from the National Board of Forensic Medicine and the Swedish Police. In total, 221 firearm suicides were found. Most victims were male (99%) and half (49%) were ≥65 years old. Firearm suicide rates were positively correlated with firearm ownership rates in Swedish counties. Legal firearms (80%) and long-barreled firearms (76%) predominated in the overall material, but illegal firearms were common among young suicide victims (18-29 years) and in urban areas. Prevention work needs to emphasize strategies to reach firearm owners at risk of suicide. Local health and healthcare-related factors, as well as geographic and demographic factors, should be considered in tailoring such strategies.

Explosion fatalities in Sweden, 2000-2018.

Epidemiological aspects of explosion-related deaths in a civilian setting may bring comprehensive knowledge that is important for prevention efforts. This Swedish national study aimed to describe the extent of such deaths, circumstances and fatal injuries. Data, including all explosion-related deaths in Sweden from 2000 through 2018, were retrieved from the register of the National Board of Forensic Medicine. Among all 87 cases found, accidental deaths accounted for 62%, suicides for 21%, homicides for 7% and undetermined manner of death for the remaining 10% of cases. Most victims died on site. Adult males dominated in the study material, but explosions also killed four children. Explosives were most commonly involved in occupational blast deaths, suicides and homicides, followed by flammable gases and fluids. The incidence showed a significant decrease since the 1980s, based on the incidence rate from this study and a previous Swedish study (1979-1984). As already rare occurrences, blast-related deaths are challenging to prevent. Prevention efforts are needed to restrict the availability of explosives and focus on lowering the occupational risk for injury. In addition, child deaths must not be neglected. A vision of no fatalities is an appropriate goal for acting against explosion-related deaths in a civilian setting.

Child suicides in Sweden, 2000-2018.

Although child mortality is decreasing in Sweden, an increase in suicide rates has been previously observed among children and adolescents collectively. To increase knowledge about trends, demographics, and means in child suicides, data including all child (< 18 years) suicides in Sweden in 2000 through 2018 were retrieved from the Swedish National Board of Forensic Medicine. In all, a total of 416 child suicides were found in a 19-year period, accounting for an annual suicide rate of 1.1/100,000 child population. The number of suicides increased with 2.2% by each successive year during the study period (p < 0.001). The mean age in both sexes was 16 years; boys accounted for 55% and girls for 45% of all study cases. The majority of the children who died by suicide (96%) were teenagers (13-17 years old) and suicides in children younger than 10 years were uncommon. Suicide methods were 59% hanging, 20% lying/jumping in front of a moving object, 8% jumping from a height, 7% firearm injury, 4% poisoning, and 2% other methods. Sex differences were significant (p < 0.001) only for firearms being preferably used by boys. The vast majority of firearms used were licensed long-barreled weapons.Conclusion: The number of child suicides in Sweden is relatively low but increasing. Most of the children used a violent and highly lethal method. Prevention of premature mortality is an urgent concern with an emphasis on resolutely reducing the availability of suicide means. What is Known: • Suicide is a significant cause of death globally among children, bringing tragic consequences for young individuals, their family, and the entire society. • Suicide rates and distribution of suicide methods in children differ between countries and settings, but studies of time trends are scarce. What is New: • Increasing number of minors' suicides and the predominance of violent methods emphasize the importance of prevention strategies tailored for a child population. • Even in a setting of very restrictive firearm laws, firearm suicides in children must not be overlooked.

Unintentional Nonhunting Firearm Deaths in Sweden, 1983-2012.

We examined the association between unintentional nonhunting firearm deaths and changes in firearm legislation in Sweden. There were 43 fatalities during the study time frame 1983-2012, representing 46% of all unintentional firearm deaths during the same period. The victims were predominantly young males (mean age 25 years). Slightly more than half of the deaths were caused by another person and were inflicted at close range. The main cause of the incidents was human error. The majority of the involved firearms were legal; however, most victims killed with illegal firearms were under the influence of alcohol and/or drugs at the time. The death rate decreased significantly following the introduction of the hunter's examination in 1985. Education and training associated with the hunter's examination was at least partially responsible for the decline in fatalities after 1985. Future prevention should target the availability of illegal firearms.

Swedish hunters' safety behaviour and experience of firearm incidents.

Since any firearm injury is potentially lethal, it is of great interest to prevent firearm incidents. This study investigated such incidents during hunting and Swedish hunters' safety behaviour. A 48-item questionnaire was posted to a random sample of 1000 members of the Swedish Association for Hunting and Wildlife Management. The questions considered demographics, hunting experience/hunting habits/safety behaviour/attitudes and experience of careless weapon handling, hunters' weapons and safety behaviour relating to weapons, health status, firearm incidents and their preventability, and personal comments on the questionnaire. The response rate was almost 50%. The mean age of the responders was 54 years; 5% were females. Almost none (1%) reported hunting under the influence of alcohol. Young age and male sex were positively associated with risk behaviour, although the presence of multiple risk behaviours in the same responder was not common. A very high degree of compliance with Swedish laws regarding weapon storage was reported. One-quarter of the responders had witnessed a firearm incident caused by another hunter, which in most situations did not result in human injury or death. An unsafetied weapon was the most common reported "cause" of these incidents. Experience of a firearm incident was not uncommon and the majority of the responders considered the incident in question to be preventable. This study provides a picture of the possible risk behaviour among hunters and the results suggest that future prevention work should target safer weapon handling.

Homicide by poisoning.

By studying the number and method of homicidal poisoning in Miami-Dade County, Florida; New York City, NY; Oakland County, Michigan; and Sweden, we have confirmed that this is an infrequently established crime.Several difficulties come with the detection of homicidal poisonings. Presenting symptoms and signs are often misdiagnosed as natural disease, especially if the crime is committed in a hospital environment, suggesting that an unknown number of homicides go undetected.In the reported cases analyzed, the lethal agent of choice has changed over the years. In earlier years, traditional poisons such as arsenic, cyanide, and parathion were frequently used. Such poisonings are nowadays rare, and instead, narcotics are more commonly detected in victims of this crime.

Unintentional firearm hunting deaths in Sweden.

This study examined all unintentional firearm fatalities while hunting that occurred in Sweden between 1983 through 2008. The circumstances as well as the impact of the hunter's exam on fatality frequency were analysed. During these 26 years, there were 48 such fatalities, representing 53% of all (n=90) unintentional firearm deaths during the same period. The average annual number of fatalities decreased over the last few decades. Very restrictive firearm legislation in Sweden combined with the introduction of a mandatory hunter's exam since 1985 accounted, at least partly, for this finding. Moose hunting accounted for 46% of the fatalities and small game hunting for the remaining cases. The mean age of the victims was 50 years and 96% of them were males; all shooters were males. During moose hunting, most of the victims were mistaken for game, whereas in small game hunting most of the fatalities were related to falls and improper handling of the weapon. Human error was thus the main cause of these fatalities.