Suicide in Newfoundland and Labrador: a linkage study using medical examiner and vital statistics data.

OBJECTIVE: To examine suicide epidemiology in Newfoundland and Labrador from 1997 to 2001. METHOD: Data from the Office of the Chief Medical Examiner (CME) were linked with data derived from the Canadian Vital Statistics Death Database. Ninety-five percent confidence intervals (CI) were calculated to assess variation of rates. We used the chi-square test to compare categorical data. RESULTS: The CME recorded 225 suicide deaths, compared with 187 in the Canadian Vital Statistics Death Database. Most deaths not coded as suicide in the national database were coded as accidental. Using the CME data, the overall suicide rate was 9.5/100000, aged 10 years and older. The rate among males (15.8/100 000, 95% CI, 10.7 to 20.8) was almost 5 times that of females (3.3/100000; 95% CI, 1.0 to 5.5). Age-standardized rates decreased over the study period, from 10.9 to 8.0/100000; however, the difference was not significant. The proportionate mortality ratio for suicide deaths was highest among those aged 10 to 19 years (20.0%) and decreased with age. The suicide rate was highest among those aged 50 to 59 years. The rate for unpartnered individuals (17.0/100000, 95% CI, 10.7 to 23.0) was significantly higher, compared with partnered individuals (5.1/100000; 95%CI, 2.5 to 7.8). Males used more violent methods than females. Suicide was significantly higher in Labrador (27.7/100000, 95% CI, 18.4 to 37.0), an area with a higher Aboriginal population, compared with the island of Newfoundland (8.5/100000, 95% CI, 7.3 to 9.7). Psychiatric illness was the most common predisposing factor. CONCLUSIONS: Suicide deaths are highest among males, unpartnered individuals, and individuals with psychiatric disorders.

A case of fatal aconitine poisoning by Monkshood ingestion.

Accidental aconitine poisoning is extremely rare in North America. This report describes the confirmation of a case of accidental aconitine poisoning using a liquid chromatography-tandem mass spectrometry (LC-MS/MS) method. The case involved a 25-year-old man who died suddenly following a recreational outing with friends where he consumed a number of wild berries and plants including one that was later identified as Monkshood (Aconitum napellus). Postmortem blood and urine samples were available for analysis. All routine urine and blood toxicology screens were negative. The LC-MS/MS method allowed sensitive quantification of aconitine, the main toxin in A. napellus, and showed 3.6 and 149 microg/L in blood and urine, respectively. These concentrations were similar to that reported in other aconitine-related deaths. This case illustrates the dangers of consuming unidentified plants, and documents concentrations of aconitine in blood and urine in a fatal case of A. napallus-related poisoning.