Suicide by carbon monoxide from car exhaust-gas in Denmark 1995-1999.

In the period 1995-1999 there were 388 car exhaust-gas suicides in Denmark. Of these 343 (88.4%) were men and 45 (11.6%) were women, the average age being 47 years. The car exhaust-gas suicides made up 9.3% of all suicides in Denmark in the period. The corresponding rate was 11.7% for men and 3.7% for women. In rural areas a larger part of all suicides were committed with car exhaust-gas compared to the more densely populated areas. Mental disease was diagnosed in 124 (32.0%) cases. A suicide note was found in 165 (42.5%) cases. A hose was fitted to the exhaust pipe in 334 (86.1%) cases. Of these the 234 (60.3%) occurred outside, typically in a forest area, while 76 (19.6%) occurred in a closed garage. All the 54 (13.9%) cases with no hose fitted to the exhaust pipe occurred in a garage. Seven (1.8%) victims were found in a burning or burnt-out car, where the following investigation revealed that it was actually a car exhaust-gas suicide. Carboxyhemoglobin was measured in 26 (6.7%) victims. In two of these victims no carboxyhemoglobin was found, as they had survived for some time after the poisoning. The average saturation of the remaining victims was 67%, the lowest saturation being 20% and the highest being 84%. In the period 1969-1987 the number of car exhaust-gas suicides in Denmark increased from 50 to approximately 190 per year and the rate of car exhaust-gas suicides compared to all suicides increased from approximately 5% to approximately 13%. In 1987-1999 these figures decreased from approximately 190 to 63 per year and from 13% to approximately 8%. During these 30 years the number of passenger cars in Denmark doubled, which explains the increase in car exhaust-gas suicides during 1969-1987. A possible explanation for the decrease in 1987-1999 is the introduction of the catalytic converter, which was made mandatory in 1990. We anticipate that car exhaust-gas suicides will continue to decrease in numbers, as more cars are equipped with catalytic converters.