Overview

We have included in this overview studies of suicides in railway systems that provide long distance transportation and deliver freight between cities, suburban and rural areas and studies of urban rail transportation systems, generally referred to as a “metro,” “subway” or “underground.” There are usually physical differences between railway and metro systems, including the fact that in railways, access to the tracks between stations is generally less controlled by physical barriers and railway passenger trains may enter stations at a slower speed than metro trains. Metro systems are generally more controlled environments, they may be hidden underground and access is usually limited to passengers in stations. In railway systems, vast stretches of track are usually unprotected and crossings may have physical barriers and signals that are activated when a train is approaching. However, physical barriers at crossings do not effectively limit access to the open rails. Thus, persons who die by suicide in train-person collisions on railway systems may be on foot or in a vehicle, and need not be potential rail passengers. These and other characteristics, such as the fact that metros serve high population density urban areas and railways may cross rural and isolated areas as well, might lead one to believe that the phenomenon of suicide in metros and railways are different. However, since there do not appear to be substantial differences in research results on railway and metro suicides, we will present data for both types of rail systems in this review.

We begin by discussing the extent of the problem and review studies of factors related to railway and metro suicides. We then present a critical review of potential suicide prevention activities in railways and conclude with a discussion of potential prevention activities that may be pilot tested of in Canada.

 

Data Sources

We obtained data from the following sources using the methodology described below:

Railway companies: We contacted 147 railway companies across the world by email asking them to inform us about any studies, statistics, programmes, procedures or interventions to help personnel deal with railway fatalities in general, and suicide in particular. Of these, only 16 provided us with some information on railway suicides. We also contacted by telephone each of the Canadian railway companies who experienced a suicide within the past 10 years to enquire about their post incident protocols and interventions.

“Grey literature”: We searched databases from governing bodies in Europe and North America to identify unpublished reports about railway fatalities and safety.

Published studies: We explored the major scientific data bases to identify the published studies on the impact of railway critical incidents and post incident management and intervention. Table 1 summarize the research strategy used.

Table 1: Data sources and research strategy

DATA SOURCE

KEY WORDS AND   SEARCH CRITERIA

PubMed

PTSD and AND (driver* OR engineer* OR train OR trains OR railway* OR

railtrack* OR rail*)

("Stress Disorders, Post-Traumatic"[Mesh] OR "Stress, Psychological"[Mesh]

OR   "Stress Disorders,   Traumatic, Acute"[Mesh] OR   "Stress Disorders,   Traumatic"[Mesh]) AND "Workplace"[Mesh])

("Stress Disorders, Post-Traumatic"[Mesh] OR "Stress Disorders, Traumatic,

Acute"[Mesh]      OR       "Stress       Disorders,       Traumatic"[Mesh])       AND "Workplace"[Mesh])

("Stress Disorders, Post-Traumatic"[Mesh] OR "Stress Disorders, Traumatic,

Acute"[Mesh] OR "Stress Disorders, Traumatic"[Mesh]) AND (driver* OR   engineer* OR trains OR railway*   OR railtrack* OR rail*   OR subway* OR   metro)

Scopus

TITLE-ABS-KEY(ptsd   AND (driver* OR engineer*   OR train OR trains OR

railway* OR railtrack* OR rail*))

(driver* OR engineer* OR trains OR tain   OR   railway* OR railtrack* OR   rail*) AND (fatalit* OR accident* OR trauma* OR suicid*)

TITLE-ABS-KEY-AUTH((driver* OR engineer*   OR trains OR railway* OR

railtrack* OR rail*) AND   (fatalit* OR trauma* OR suicid*)) AND   (LIMIT-

TO(SUBJAREA,   "MEDI") OR LIMIT-TO(SUBJAREA, "ENGI") OR LIMIT-   TO(SUBJAREA, "SOCI") OR LIMIT-TO(SUBJAREA,   "MULT"))

PAIS

CONDUCTEUR &   PTSD

14/12/2010

(PTSD or ASD   or traumatic* or stress* or   "post-traumatic" or "post

traumatic") AND (railway* and railroad* or train or trains or rail* OR metro

OR subway* OR "public   transport")

(EAP or PTSD or ASD or traumatic* or stress* or "post-traumatic" or "post

traumatic") AND (railway* and railroad* or train or trains or rail* OR metro

OR subway* OR "public   transport")

PsychInfo

( (EAP or intervention or PTSD or ASD or traumatic* or stress* or "post-

traumatic" or "post traumatic")   AND (railway* and railroad* or train   or trains or   rail* OR metro OR subway* OR underground OR "public transport") )

Scopus

(suicid* or fatalit* or trepass* or "person under train") and (railway* and railroad* or train or trains or rail* OR metro OR subway* OR underground

OR locomotive OR "public   transport")

WEB

Suicid OR fatalit

Railway or railtrack or   train

Driver engineer   “train crew”