English summaries
Fatal poisonings in Finland during 2008–2010
Julkaistu 01.06.2012 00.01
At the beginning of 2010, the organization of medicolegal cause-of-death investigations changed in Finland. Forensic pathologists moved from a province-based system to a new system of central organization under the National Institute for Health and Welfare. The rate of forensic autopsies has remained high, at 24% of all deaths, i.e. about 12,000 autopsies annually. Post mortem forensic toxicological investigations are centralized at the Hjelt Institute, University of Helsinki. The number of post mortem toxicological investigations has increased, and in 2010 these cases numbered 7,105, covering approximately 14% of all deaths and 60% of all forensic autopsies. Apart from a 2-year-old girl who died of carbon monoxide poisoning in a fire, there were no accidental fatal poisonings in children in 2008–2010.
The numbers of fatal poisonings detected during the period 2008–2010 were 1,213, 1,211 and 1,048, respectively. The exceptionally low number in 2010 was due to a decrease in the numbers of both alcohol poisonings and drug poisonings. However, opioids maintained their major position. The consumption of alcohol, especially spirits, declined. Looking at drug-related deaths in relation to drug consumption, the most dangerous medicine in Finland was by far levomepromazine (methotrimeprazine), followed by the two antidepressants mirtazapine and doxepin. Opioid deaths involved buprenorphine, tramadol, codeine, fentanyl, methadone or oxycodone, and typically involved abuse. Buprenorphine was the most abused opioid in Finland. Heroin and cocaine were found only 1–2 times annually. The most common designer drug was methylenedioxypyrovalerone (MDPV), which was detected for the first time in 2009.
In the long term, carbon monoxide fatalities have declined, mainly due to the falling number of suicides involving car exhaust gas. The total number of carbon monoxide suicides during the three study years was 41, compared with 50 such cases in 1998 alone.
Erkki Vuori, M.D., Ph.D., M.Sc., Professor Emeritus, E-mail: erkki.o.vuori@helsinki.fi
Ilkka Ojanperä, Ph.D., Professor
Terhi Launiainen, Ph.D., Postdoctoral Researcher
Jari Nokua, M.Sc., Forensic Toxicologist
Riitta-Leena Ojansivu, M.Sc., Forensic Toxicologist
Hjelt Institute, University of Helsinki
Finnish Medical Journal 2012;67:1735–41.
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