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Railway accidents in Canada
There is an annual average of 49 accidental deaths on the Canadian railway network, with a peak in 2005 (when 35 accidents occurred in Ontario). Accidents represent 46% of all railway fatalities.
Where and when do accidents occur?
Accidents are more frequent when weather conditions are more difficult. Accidents also appear to be most frequent during mid to end of the afternoon and on weekends
- This weekend peak is in part explained by higher levels of alcohol presence in the blood of victims – people drink more on weekends.
- Accidents are more frequent in Alberta, Ontario, and Québec
- They occur more often at crossings and are more often seen in rural areas than suicides
- Accidents victims are more often familiar with the tracks, because they live nearby
Railway accident prevention should target more specifically people who may be impaired (younger and older people). Since weather conditions can affect the number of accidents, signage could be adapted to poor weather (fog, snow, ice).
Accidents vary in time, as described bellow:
Who dies in railway accidents?
Railway accident victims are primarily male, are in a relationship, and are employed at the time of death. A significant proportion had chronic health problems, mental health, or substance abuse problems.
Railway accident prevention campaigns could use this information to target at risk groups or to increase awareness of health related impairment.
People who died by accident on the railway network in Canada display the following characteristics:
Railway Suicide in the World
Last update: Aug. 2018
Railway suicides vary from country to country. Therefore, one has to be very careful when drawing conclusions from analyses and preventive measures that have been developed elsewhere. It is also important to note that data in different countries do not necessarily use the same criteria for classifying suicidal deaths. In order to properly compare countries in terms of their suicide mortality, it would be necessary to develop standardised indicators and data collection tools. However, some elements can be identified for comparison in various studies across the world. The following table summarises the main findings.
|
Country |
Number of railway suicides and suicide attempts |
Railway as proportion of all suicides |
Location of suicides in the railway network | Peak times of year of incidents |
Characteristics of suicidal people | Behaviours on and near the tracks |
|
ASIA |
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India Badiadka, Dsouza, & Vasu, 2016 |
Kerala 78 railway fatalities, 33 of which were suicides |
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| Chowdurry,Dutta & Chowdurry, 2000
|
15% psychiatric diagnosis | |||||
| Seemeen & Devaraju, 2018 |
Hyderabad and Secunderabad 16% of railway fatalities are suicides (Nov. 2014-Oct. 2016) |
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Japan Araki & Murata, 1986; Kerkhof 2003; Kadotani et al., 2014 |
Tokyo, Kanagawa, and Osaka prefectures 971 suicides (2002-2006) |
6.3% | When there is less sunlight in the prior 7 days, there are more attempts | |||
| Ichikawa, Inada, & Kumeji, 2013 | 5,841 suicide attempts (April 2002-March 2012) | Most suicide attempts occur in daytime | ||||
| Ueda, Sawada, & Matsubayashi, 2015 |
1 railway company in Tokyo Met. Area 2004-2013: 144 railway suicides |
Stations without platform screen doors (95%) | ||||
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EUROPE |
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Twelve (12) countries Havârneanu, Bonneau, Colliard, 2016 |
Even distribution throughout the year Weekdays |
Males, aged between 20-59. Committed by persons alone. |
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Austria Ememrson & Cantor, 1993; Deisenhammer et al., 1997 |
5.7% | 48% close to the Regional psychiatric hospital (Brisbane) | ||||
| Koburger et al., 2015 |
2008-2009 : Mean=98.5 railway suicides 2010-11 : Mean=85 |
2008-09: 7.76% 2010-11: 6.675% |
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|
Belgium Andriessen, Krysinska, 2011 |
91 suicides per year (1998-2009) 80 suicides attempts per year (2003-2009) |
5.3% | Suicides occur in densely populated areas Hotspots Near mental health facilities (>6 suicides per 2 km of track) |
March and June |
54% fatality rate |
|
| Debbaut, Krysinska, & Andriessen, 2014 | 2003-2009: 664 suicides and 557 suicide attempts on Belgian railway network | 43 railway hotspots identified. Common characteristic of hotspots are: accessibility, anonymity, and vicinity of mental health institution | ||||
| Strale, Krysinska, Van Omermeiren, & Andriessen, 2017 | 2008-2013: 563 railway suicides in Belgium (Brussels=58, Wallonia=167, Flanders=338) |
Most frequent in city suburbs, least frequent in central cities and rural areas. Overrepresentation of north-western part of Belgium More suicides in wealthy areas, with more elderly people (higher railway density); less in areas with younger population, more unemployment, and higher population density (lower railway density). |
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Denmark Lindekilde, 1986 |
3.1% | 81% are psychiatric patients (versus 38% for other means) | ||||
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Germany Baumert et al., 2006; Erazo et al., 2005; Dinkel et al., 2011; Lukaschek, et al., 2011 |
955 suicides per year (1997-2002) |
7% and increasing | 30% in stations A majority on open track (specially in urban areas) |
April and September for men No seasonal variations for women |
Risk factors for train suicides Railway density Passenger traffic density |
Jumping, lying on track, wandering on tracks
Behaviour prior to the attempt
|
| Lukaschek et al., 2008; Van Houwellingen et al., 2013; Lukaschek et al., 2014 | 6105 suicides, 8 years (2000-2007) |
Hotspots |
Daily pattern remains stable over time (Monday and Tuesday, between 6:00 and 12:00 and between 18:00 and 24:00) | |||
| Krauss, Graw, & Gleich, 2015 | 107 railway suicides (2009-2011) | 10%, fourth most frequent suicide method in the study |
Most often males Mean age (both sexes): 48.3 |
Railway suicide is often the result of a spontaneous decision | ||
| Koburger et al., 2015 |
2008-2009 : Mean=794 railway suicides 2010-11 : Mean=875 |
2008-09: 8.32% 2010-11: 8.68% |
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| Lukaschek, 2014 | Ca. 3 deaths per day | |||||
|
Hungary Veress, 1980 |
2.7% | |||||
| Koburger et al., 2015 |
2008-2009 : Mean = 119.5 railway suicides 2010-11 : Mean = 133 |
2008-09: 4.845% 2010-11: 5.425% |
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Italy Kerkoff, 2003 |
52% depression 8.4% schizophrenia |
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Netherlands Kerkhof, 2003; van Houwelingen et al., 2001 |
180 suicides per year |
10-14% |
Hotspots Near psychiatric hospitals
|
Early evening for men
Morning for women
|
74% between 20-59 years old (younger than general suicide) More bipolar and psychotic disorders than with other means Risk factors for train suicides
|
|
| van Houwellingen et al., 2013 | 1475 suicides, 8 years (2000-2007) |
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| Koburger et al., 2015 |
2008-2009 : Mean=180.5 railway suicides 2010-11 : Mean=208.5 |
2008-09: 12.175% 2010-11: 12.835% |
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Portugal Sousa et al., 2015 |
Northern Portugal 59 railway suicides (2008-2012) |
3.8% (2008-2012) |
Weekdays
Afternoon but not rush hour
No seasonality observed |
Males (1.3 male for each female)
Age: 40-49 for males, 50-59 for females
Under the influence of substance, most often alcohol |
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Slovenia Koburger et al., 2015 |
2008-2009 : Mean=15.5 railway suicides 2010-11 : Mean=19.5 |
2008-09: 3.69% 2010-11: 4.545% |
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Sweden
Ceccato & Uittenbogaard, 2016 |
Stockholm county (2006-2013) 2516 suicides |
53% of suicides north of Central Station. Five clusters identified. Inner city stations identified as hotspots Speed trains Less suicides where barriers along tracks are installed Half of all suicides occur on open tracks (more than 1-KM away from station) |
No seasonality was observed for suicides. Weekdays (esp. Mondays). Small pikes were observed around the rush hours (9 am and 5 pm), the off-peak hours of 3 pm and 7 pm and midnight (12 pm). |
Most victims are men age 45-64. | ||
|
Radbo et al., 2005
|
48 suicides per year (2000-2002)
|
6.2% |
Suicides occur in densely populated areas | Most suicides in the daytime |
Male/Female ratio 2.6:1 (similar to other means ) Mean age 43 (younger than other means) |
75% of suicide victims were waiting or loitering close to on the tracks before the train arrived |
| Radbo et al., 2012 | Greater Stockholm(2005-2008) 47 collisions, average:1 per month 41 fatal 30 suicides |
93% in stations (including 53% on platforms) Deviates from national patterns (more often on open tracks) Commuter trains |
Weekdays Daytime (afternoon) |
66% male Mean age 40 |
Standing, walking on tracks (37%) Lying, sitting on tracks (30%) Jumping running (30%) |
|
|
Switzerland Steck et al., 2017 |
1991-2013: 156 railway suicides in teenagers (10-18 year-olds) |
26.4% (for teenagers) Railway suicide has increased in past years |
Most railway suicide victims are boys; but in girls, railway suicide is the most common method (30.8% of all suicides). | |||
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Turkey Ozdogan et al., 2006 |
65 per year (1997-2003) |
Level crossings | Majority between 20-60 years old | |||
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United Kingdom Abott et al., 2003; Clarke, 1994; Farmer et al., 1994; Kerkhof, 2003; Hudson, 1999; Farmer et al., 1991; Symonds, 1985 |
163 per year (1995-1999) | 5% | Clustering near psychiatric hospitals | The majority are seen waiting for the train | ||
| Bhui, 2014 | Every year, 350 fatalities on the railway in the UK, 84% of which are believed to be suicides. | 41% of suicide victims have a mental health history | ||||
| Ryan, 2017 |
Great Britain Over 250 suicides on the railway each year 257 fatalities in the study |
70% occurred at stations 70% occurred on fast lines |
Daylight Lowest on Sundays Numbers are highest in July and September, lowest in June and August |
Higher proportion of males Mean age (both sexes) = 40.6 |
Most common behavior: jumping or stepping in front of train from platform (n=86) | |
| Taylor, Knipe, & Thomas, 2016 |
England and Wales (2000-2013) 2,517 railway suicides (1,985 in males, 532 in females) |
4.1% (England and Wales, 2000-2013) Proportion increased from 3.5% in 2000 to 4.9% in 2013 (men: 3.7 to 5.3%) |
Males, 35-64 years old | |||
|
OCEANIA |
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Australia De Leo et al., 2008 |
57% treated for schizophrenia (Brisbane) 40.4% with psychiatric diagnosis (in Queensland) 29.8% had alcohol in their blood |
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|
Too, Bugeja, Milner, McClure, & Spittal, 2017; Too et al., 2016; Too et al., 2015. |
Victoria 2009-2012: 105 railway suicides 2001-2012: 343 |
7% for the state of Victoria (2009-2012) |
2009-2012: 66% male, 34% female. 2001-2012: 71% male, 29% female. Males 14-34 had highest risk. Diagnosis of mental illness Living in area with railway tracks, within a city, with high suicide rate |
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NORTH AMERICA |
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|
Canada Mishara et Bardon, 2013; Transport Canada, 1996 |
43 per year (1999-2007) | 1.5% | 63% within 1km of home 66% on open tracks 85% in densely populated areas Important variations by province |
July and August |
Males 4:1 43% unemployed, retired, on a pension 46% had a spouse 57% Depression, bipolar 22% were under psychiatric care |
Running from embankment, lie on track, stand/sit on track Very rarely in stations (6%) |
|
USA McLone, Loharikar, Sheehan, & Mason, 2016 |
Illinois, 2005-2010 |
3.9% |
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|
|
| Savage, 2016 |
United States: 274 confirmed railway suicides (annual average for 2012, 2013, 2014)
Metropolitan Chicago: 161 apparent railway suicides (2004-2012) |
4% (Chicago) |
Commuter passenger trains (67%) Municipalities with higher income and lower population density (esp. suburbs) |
March-May Friday Between 4:00 PM and 7:00 PM |
Significantly higher proportion of 15-24 year-olds More males, but females represent 27% or railway suicides |
|
Badiadka, Dsouza, & Vasu, 2016
Information about suicide
To obtain general information on suicide, suicide risks or interventions to help reduce suicidal risks, you may visit the following web sites:
- The World Health Organization (WHO) provides up-to-date statistics and information on suicide worldwide. WHO has also published a first report on suicide prevention in 2014, Preventing Suicide: A Global Imperative. This report offers a knowledge base on suicide and suicide attempts, as well as actionable steps for countries.
- In Canada, the Canadian Association for Suicide Prevention (CASP) provides general information about suicide and suicide in Canada. You may also consult CASP Media Guidelines online. Statistics Canada also provides the latest data on suicide in Canada, as well as a list of publications on this topic.
- The complete 2016 Inuit Suicide Prevention Strategy for Canada is available for consultation on Inuit Tapiriit Kanatami's website.
- In Quebec, the Association québécoise de prévention du suicide provides information in French on suicide and resources available throughout the province.
- In the rest of the world, most countries have a suicide prevention network that can be found locally. General information on the issue is also available from the International Association for Suicide Prevention (IASP).
- Befrienders Worldwide is an international organisation that provides help and offers services to people at risk of suicide.
Help if you or someone you know is considering suicide
To find help for you or someone you know,
If you live in Canada, you may find a local suicide prevention center by visiting the Canadian Assiciation for Suicide Prevention (CASP): http://www.suicideprevention.ca/in-crisis-now/
Elsewhere, the befrienders offer advice, support and strategies to help reduce the suicidal risk: http://www.befrienders.org/
Information for media
In contrast with many European countries, railway suicides constitute a very small proportion of deaths by suicide in Canada and we hope that Canadian railway suicides will not increase in future years. Several dramatic examples in Europe, particularly in Austria and Germany, have shown that when news reports appeared about railway suicides, the number of deaths by railway suicides increased dramatically. There was a parallel increase in overall suicide rates, indicating that the increase was not due to a change in preferred method, but rather an increase in suicides by people who were affected by reading reports about rail suicides. Publicizing any suicide method, even when the intent is to call attention to the need for prevention, has often resulted in increased tragic deaths by suicide. For example, deaths by burning charcoal in a sealed room were rare in Hong Kong until newspapers reported on deaths using this method. The impact was so great that this manner of death became a preferred suicide method and suicide rates increased as this method was used more often. For this reason, the World Health Organization (WHO) and the International Association for Suicide Prevention (IASP) have published recommendations and guidelines for the media on the reporting of suicides (Media guideline by WHO, update 2017). In Canada, the Canadian Association for Suicide Prevention (CASP) also provides simple guidelines for reporting on suicide. The Canadian Psychiatric Association also published a 2017 update of its Media Guidelines for reporting on suicide.
All suicides are tragic events because suicides are usually preventable. Suicides are usually associated with the presence of a mental disorder. Railway suicides are even more tragic because there are additional victims besides the person who takes his or her own life. Crew members who are involuntarily involved in the death have a severe impact which in many cases affects them for the rest of their lives. For this reason, Transport Canada and Canadian Railways are very concerned with doing everything possible to prevent suicides and accidental deaths on the rails. As previous research has shown, any media coverage of this phenomenon and reports on the findings in this report have a high probability of increasing the use of this method for suicides, particularly by people who suffer from mental health problems. For this reason, extreme caution is advised for those considering news reports about the findings presented in this document. Journalists considering media reports on railway suicide should consult the WHO Guidelines and also are encouraged to consult with the authors of this report in order to minimize the risks of tragic increases in railway suicides in Canada that could result from their well-intentioned media coverage if they ignore those recommendations.
Observed impact on Canadian railway crew members
This page informs you about :
- Origins of the project
- Objectives of the project
- Research Methodology
- Sample
- Observed impact of railway fatalities
Origins of the project
This study was commissioned by Transport Canada in 2009, as part of a larger project to assess the nature and extent of railway suicides in Canada and propose prevention strategies. Data collection took place in 2010 with the collaboration of the Teamsters of Canada, Rail Conference (Union) and class one railway carriers across the country.
Objectives of the project
The main objective of the project is to understand the impact of train fatalities on crew members in order to identify ways to better intervene to reduce the negative effects.
Research Methodology
Retrospective interviews were conducted with crew members who had experienced at least one suicide during the course of their career. These interviews were conducted face to face or over the telephone.
Interviews included questions asking the crew member to describe the suicides and other fatalities they experienced, close calls and non-fatal incidents that were notable to the interviewee, the interventions and actions of emergency services called to the scene, the intervention and actions of the supervisor and railway company officials in the aftermaths of the incidents, the consequences of the incident (short and long term), help provided and recommendations made by the interviewees for better help for them and how to prevent suicides on the railway network.
Interviews were audio taped, transcribed and analysed using a qualitative analysis methodology.
Sample
Interviewees came from across Canada
| Province | Number | % of sample |
| New Brunswick | 1 | 2.5 |
| Saskatchewan | 1 | 2.5 |
| British Columbia | 2 | 5.0 |
| Alberta | 4 | 10.0 |
| Manitoba | 9 | 22.5 |
| Québec | 9 | 22.5 |
| Ontario | 10 | 35.0 |
40 interviews were included in the final analysis, describing 132 incidents:
- 48 accidents
- 55 suicides
- 20 non fatal accidents
- cases of found bodies
- 4 close calls
Overall, the participants had a mean of 4.5 incidents during their career, ranging from one to 22.
These incidents took place between the early nineteen seventies and 2010.
The mean seniority in the industry of the interviewees was 28.6 years at the time of interview.
Observed impact of railway fatalities
The description of the observed impacts on Canadian crew members follows the description of potential impacts .
Resilience
Only five participants mentioned that they experienced no reaction after a fatality and things were back to normal very quickly. They also are the ones who felt that going back to work quickly helped them return to normal.
Short term (within hours and days)
The most common reactions in the moments and hours following the impact (after the initial reaction at impact) were feelings of guilt, anger/irritability, feeling of detachment, exhaustion, being upset, emotional upheaval, difficulty sleeping, and nightmares.
These symptoms were reported to quickly recede within the following days.
Other effects were mentioned, such as intense disbelief or empathy for the victim. These feelings can be associated with longer term impacts.
A very intense short term reaction can be a strong predictor of long term effects of incidents. Those who experienced high levels of stress, intense immediate shock, strong feelings on site and in the following days are more at risk to develop longer term symptoms, diagnosed problems and difficulties.
Stress and non diagnosed effects
All participants in the present study experienced at least one symptom that is indicative of stress after the incident. This contrasts with Malt et al. (3), who found one third of drivers with stress symptoms in Sweden.
Previous studies have shown that the impact of suicides and accidents on train crews tends to diminish over time (3, 4, 6, 7). This reduction in symptoms occurs for both accidents and suicides. People “learn to live with it.” However, we have found that after the initial shock recedes, there are still mid and long-term effects (after 3 months) for 40% of the incidents. The impact usually manifests itself in the form of flashbacks in situations that recall the incident. They can also be observed in dreams, in hyper- vigilant behaviour and generalized anxiety. None of these effects seem to reach the level where a mental disorder can be diagnosed but they still result in significant suffering and impairment to crew members Sub threshold symptoms .
Non diagnosed effects can also be observed in symptoms associated with Acute Stress Disorder (ASD). Most of those interviewed in the present study showed signs of ASD although they might not have displayed enough symptoms to qualify for an ASD diagnosis. The most common responses identified at the time of impact were: rush of adrenaline, horror/shock, feelings of helplessness, feeling upset, a sense of disbelief as well as anger. Feelings of responsibility are also common at this stage. These feelings are common immediately after the incident but generally disappear between a week and a month following the event.
PTSD
Of the 40 train crews interviewed, seven reported being diagnosed with PTSD, which is similar to Farmer et al. (5), who found 16% in England. but more than Theorell (6) who found 4% of PTSD in their driver sample in Sweden.
Cumulative effects
Fatalities rarely occur only once in the life of a conductor or an engineer. The mean number of fatalities experienced by the participants was 4.5, ranging from one to 22.
There appeare to be four ways of handling more than one fatality:
- Some people responded to one incident at a time and did not show signs of a cumulative effect. Once the effect of the first incident had time to recede, the next one was experienced as separate.
- A majority of respondents, on the other hand, reported a cumulative effect. Fifteen of them said that the more fatalities they were involved in, the harder it was to return to normal.
- A small number of participants said that the accumulation of incidents had hardened them.
- Some said that having had previous incidents helped them understand what was happening during an incident. This knowledge and familiarity may have diminished the traumatic effect of the subsequent incidents.
We found that of the 7 persons with PTSD, only two developed PTSD after their first fatality. The others developed PTSD after their second to seventh incident. In two cases, the repercussions of the last event lead the person to stop working completely.
Cumulative effects are not always easy to identify. They may appear as long term mood shifts, in changing perceptions about life or work, flash backs in varied circumstances, general edginess, as well as fatigue and long recovery periods for minor incidents. Another sign of a cumulative effect is loss of commitment to work and hope that they will live to retire.
Cumulative effects have been documented before (Malt et al;., 1993, Karlehagen et al., 1993, Theorell et al., 1992), but they were limited to ASD and PSTD. In this study, we found that the cumulative effect can be insidious for crew members, affecting them in more subtle ways in the long term (for example in changing moods, fatigue, etc.) that do not necessarily appear when only Acute Stress Disorder (ASD) and Post Traumatic Stress Disorder (PTSD) are measured.<
Coexistence of other events
Personal life events, such as bereavement or a divorce, occurring around the time of the incident will add to the difficulty crew members experience. These events and their emotional impact get intertwined with the fatalities and the emotions experienced and memory of both tend to be linked together. Remembering one brings up the other, increasing the extent of emotional turmoil. This co-occurrence of events were not common in our sample, but those who experienced both work related and personal events in the same period took longer to recover.
Delayed onset
Although it is documented in the trauma literature (2), none of the interviewees reported delayed development of PTSD after fatalities. In our sample, the strongest predictor of long term symptoms was the presence of an intense immediate reaction after the event. However, several interviewees described very strong subsequent reactions to lesser events. Close calls or non fatal incidents, which previously had little impact, induced a traumatic reaction after the traumatic even t. This could account for delayed symptoms, where a later stimulus triggers the traumatic symptoms that did not develop at the time of the main event.
Accidents versus suicides
Generally, we found that suicides induced more short-term reactions (partly due to the anger we discussed before). We also noted differences in the long term effects. Of the 7 persons who were diagnosed with PTSD, 6 were involved in suicides (15% of the 40 crew members, 10.9% of suicides).
Participants were asked to reflect upon the difference it made to be involved in a suicide versus an accident. Whatever the type of incident, the initial reactions are of shock and pain. However, after these initial, almost physiological reactions, crew members developed different attitudes, sometimes quite contradictory.
The intent of the person
Knowing that the person chose to put himself in front of their train seemed to make it easier for some crew members to come to terms with the incident. This knowledge alleviated their sense of responsibility because they felt there was nothing they could have done differently. They tended to get angry, which is an emotion they found easier to deal with.
The avoidability of the incident
When the crew member thought that the incident could have been avoided it was more difficult to deal with. Crew members tended to get upset with those who could have prevented it, whether it was a reckless driver or a psychiatrist who let a patient out of hospital. They tended to see accidents as more avoidable than suicides, in part because of the notion of intent, but also in part because of the timing of the events. They tended to think in terms of “what if...” and some crew members obsessively wondered how an accident could have been avoided. They might also feel more responsible for the incident, even if they were operating according to regulations at the time of impact.
The ability to make sense of what happened
Being able to understand why things happened seemed to play a part in lessening the trauma. When drivers were faced with a suicide that they were able to understand, it made it easier to deal with. Making sense of things helped them come to terms with the event.
Accueil
Origins of this Website
This website was developed from a research project funded by Transport Canada in 2009 – 2013 and includes our research results and research from other studies around the world. It is maintained by the Centre for Research and Intervention on Suicide, Ethical Issues and End-of-Life Practices (CRISE) at the Université du Québec à Montréal (UQAM).
Last update: August 2018
Objectives
- To provide railway stakeholders from Canada and around the world with relevant scientific information to improve prevention of railway fatalities and reduce their impact on employees
- To promote sharing of information among railway network stakeholders regarding suicide prevention and support for employees
- To encourage and support the development of evidence based suicide prevention practices
- To encourage and support the development of evidence based support and trauma prevention practices
- To encourage and support the evaluation of practices in order to improve practices and insure continuing quality control
News
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August 10 2020
Fencing and railway suicide prevention in Australia
A 2019 article shows that: (i) fencing appears to lead to a reduction in some types of rail suicides and thus; (ii) contributes to a lower overall rate of suicide by train; and (iii) even with...
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March 09 2020
NEW VIDEO: Preventing Negative Psychological Effects in Locomotive Engineers and Train Conductors
Watch this video produced by IRSST based on the work by Prof. Cecile Bardon and her team at CRISE :
Existing partners
Several groups and organisations involved in the railway network and in suicide prevention have been involved at some point with the CRISE in the development of this project and the understanding of railway suicide and its impact.
Railway companies
The Canadian Pacific Railway (CP)
Via Rail Canada (VIA)
Occupational Health
Local Governments
Institutional partners
Railway Association of Canada
Federal Railroad Administration (FRA)
Union
Healthcare Institutions
Employee and Family Assistance Programmes
Research teams
Suicide prevention services
Distress Centers of Ontario
BC Distress Centers
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