Motor Vehicle Exhaust Gas Suicide.

In many motorized countries, inhalation of carbon monoxide from motor vehicle exhaust gas (MVEG) has been one of the leading methods of suicide. In some countries it remains so (e.g., Australia 16.0% of suicides in 2005). Relative to other methods it is a planned method and one often used by middle-aged males. The study provides a review of countermeasures aimed at restricting this method of suicide. The prevention measures identified were catalytic converters (introduced to reduce carbon monoxide for environmental reasons); in-cabin sensors; exhaust pipe modification; automatic idling stops; and helpline signage at suicide "hotspots." Catalytic converters are now in 90% of new vehicles worldwide and literature supports them being associated with a reduction in exhaust-gassing suicides. There remain, however, accounts of exhaust-gas fatalities in modern vehicles, whether accidentally or by suicide. These deaths and also crashes from fatigue could potentially be prevented by in-cabin multi-gas sensors, these having been developed to the prototype stage. Helpline signage at an exhaust-gassing suicide "hotspot" had some success in reducing suicides. The evidence on method substitution and whether a reduction in MVEG suicides causes a reduction in total suicides is inconsistent.