University of Oulu

Koskela, L., Raatiniemi, L., Bakke, H., Ala-Kokko, T., Liisanantti, J. (2017) Fatal poisonings in Northern Finland: causes, incidence, and rural-urban differences. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 25 (1), doi:10.1186/s13049-017-0431-8

Fatal poisonings in Northern Finland : causes, incidence, and rural-urban differences

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Author: Koskela, Lauri1,2,3; Raatiniemi, Lasse2,4; Bakke, Håkon Kvåle5,6,3;
Organizations: 1Oulu University Hospital, Department of Anesthesiology, Division of Intensive Care Medicine
2Oulu University, Medical Research Center, Study Group of Surgery, Anesthesiology and Intensive Care
3Department of Anaesthesiology and Intensive Care, University Hospital of North Norway
4Centre for Pre-Hospital Emergency Care, Oulu University Hospital
5Anaesthesia and Critical Care Research Group, University of Tromsø
6Mo i Rana Hospital, Helgeland Hospital Trust
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.6 MB)
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Language: English
Published: Springer Nature, 2017
Publish Date: 2017-11-08


Background: In this study we evaluate differences between rural and urban areas in the causes and incidence of fatal poisonings.

Methods: Data from all fatal poisonings that occurred in Northern Finland from 2007 to 2011 were retrieved from Cause of Death Registry death certificates provided by Statistics Finland. The demographics and causes of fatalities were compared between rural and urban areas. Incidences were calculated based on the population data.

Results: There were a total of 684 fatal poisonings during the study period and 57.9% (n = 396) occurred in the urban population. Ethanol was the most common primary poisoning agent in cases of fatal poisoning, accounting for 47.5% of cases in urban areas and 68.1% in rural areas (P < 0.001). Fatal poisonings caused by psychoactive pharmaceutical products and opioids were more common in urban areas (28.3% compared to 18.0%, P < 0.001). The crude incidence of fatal poisonings in the study area was 18.8 (17.4–20.2) per 100,000 inhabitants per year and there was no difference in incidence between urban and rural areas. In the youngest age group (15 to 24 years), the incidence of fatal poisonings observed in urban areas was two times higher than that in rural areas.

Discussion: Higher rate of fatal ethanol poisonings in rural areas could be linked to higher alcohol consumption in rural areas and also differences in drinking behaviour. Higher incidence of poisoning suicides in urban areas could be due to availability of different toxic agents as a suicidal method. Preventive measures could be key in reducing the number of fatal poisonings in both areas, as most of the fatal poisonings still occur outside hospital.

Conclusion: There was a higher rate of fatal ethanol poisoning in rural areas and higher rate of fatal poisoning related to psychoactive pharmaceutical products and opioids in urban areas. There were twice as many fatal poisonings in the youngest age group (15–24 years) in urban areas compared to rural areas, and suicide was more common in urban areas.

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Series: Scandinavian journal of trauma, resuscitation and emergency medicine
ISSN: 1757-7241
ISSN-E: 1757-7241
ISSN-L: 1757-7241
Volume: 25
Issue: 1
Article number: 90
DOI: 10.1186/s13049-017-0431-8
Type of Publication: A1 Journal article – refereed
Field of Science: 3126 Surgery, anesthesiology, intensive care, radiology
Funding: The study was funded by grants from Oulu University Hospital and North Finland Support Foundation for Health Care.
Copyright information: © The Author(s) 2017. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.