Alcohol Intoxication and Suicide by Hanging in Poland.

AIMS: An integral part of the World Health Organization (WHO) plan to reduce suicide by 10% by 2020 is to identify areas and demographic groups, which should be priority target groups for preventive activities. This study aimed to present the demographic differences between victims of suicide by hanging in the Warsaw metropolitan area, in Poland, by examining the sobriety of victims. METHODS: Data for analysis were obtained from the documentation of the Department of Forensic Medicine (DFM) at the Medical University of Warsaw (MUW). The retrospective analysis included 358 out of 466 victims of suicides by hanging in the Warsaw metropolitan area, in Poland, recorded in the DFM documentation covering 2011-2013. The data gathered included age, gender, the cause of death, a post-mortem examination as well as the level of ethanol in the blood and muscles of victims. RESULTS: In both groups, men accounted for a larger percentage of victims than women, P = 0.068. In the no-alcohol group, the victims were older than in the alcohol group (47.52 ± 19.21 vs. 40.88 ± 12.77) (P < 0.001). The majority of the studied population were victims aged 25-34 (22.90%), mainly men (20.95%). Young men were also the largest group among victims in the alcohol group (28.33%). The most numerous age group among no-alcohol group were older victims aged 55-64 (19.10%), especially men (16.29%). CONCLUSION: Regardless of sobriety, men were the largest group of suicide victims in the study population, which means that men die suicide more often than women. Differences in gender proportions are related to age. In the studied population, it was primarily young victims, mainly men. These are the groups that should be priority target groups for preventive activities aimed at reducing the number of suicides. The presence of ethanol in more than half of the victims of suicide in the study population indicates that alcohol is an important suicidal risk factor.

Risk indicators for road accident in Poland for the period 2004-2017.

OBJECTIVE: The aim of the research was to assess the prevalence, effects and risk factors for motor vehicle accidents (MVA) in the years 2004-2017 in Poland. METHOD: We merged secondary data from the Prevention and Analysis Office of Road Traffic Headquarters of Police and Central Statistical Office of Poland. RESULTS: Our results suggest that several thousand people are killed on Polish roads annually, and tens of thousands are injured. Road crashes represent the leading cause of death for Polish men up to 44 years of age. The most common causes of road crashes in Poland include failure to comply with the road traffic rules and low driving skills. We also found drivers who poorly assessed road situations, roads characterized by a lack of adequate road infrastructure, and many vehicles in poor condition. Road crashes have become a significant public health and social problem globally. Drivers caused most MVA in Poland in the years 2004-2017, whereas the underlying cause was inadequate speed regarding the road traffic condition as well as not respecting the right-of-way. Despite various measures that are being taken to improve safety on Polish roads, the number of the dead and wounded as a result of road accidents is still high and the losses to the society are considerable as well. CONCLUSION: It is necessary to continue multidirectional actions to improve safety on the roads in Poland resulting in a systematic increase in the level of road traffic security.

[First aid education - a questionnaire survey].

OBJECTIVE: Introduction: The ability to provide first aid, especially cardiopulmonary resuscitation (CPR) in accordance with the guidelines of the European Resuscitation Council (ERC) is a key element in helping and rescuing people with pre-hospital cardiac arrest. As recommended by the ERC 2015 guidelines, one of the most important steps to be taken to increase the rate of CPR appraisal by participants or cardiac arrest witnesses is to teach these skills to all children in schools. Numerous studies have shown that school-age children are positive about learning resuscitation, and moreover, they are important multipliers of knowledge because they are happy to transmit the information they receive to family members and the closest surroundings. The aim: To get to know the opinions of young people about the need for first aid education and the period in which it is best to start learning in this area. PATIENTS AND METHODS: Materials and methods: The study was attended by 498 people, students of various types of universities, the research method was an online diagnostic survey, a self-help questionnaire tool. RESULTS: Results: The study involved 309 women (62%) and 189 (38%) men. The respondents are young people between 18-30. Almost all respondents (97.2%) are of the opinion that learning first aid should be compulsory in the course of school education. The majority of respondents (76.7%) expressed the opinion that the knowledge regarding first aid should be updated, 16.3% had no opinion on this subject, while only 7.0% of respondents believed that there was no need to do so. Almost half of respondents (48.3%) are of the opinion that learning first aid should take place from the elementary school, while 30.3% of respondents think that they should be educated at pre-school age. CONCLUSION: Conclusions: The vast majority of respondents consider first aid education to be significant and needed during education. Young people are aware of the need to practice skills and to repeat and update information on first aid. The majority of respondents are of the opinion that education in this area should be started very early, even in the pre-school period.

Road safety in Poland: magnitude, causes and injuries.

Road accidents are a serious problem of the modern world. They are one of the main causes of injuries and are the third most frequent cause of death. Every year, about one million people, adults and children, die on the roads and several millions get injured. Mortality rate due to injuries from road accidents amounts to 2.2% of all deaths in the world. The research presents epidemiology of road accidents in the period 2004-2015 with particular emphasis on the key issues of road safety in Poland, related to the dangerous behaviour of road users (disregard toward traffic rules). Between years 2004 and 2015 on Polish roads took place more than 508000 accidents with 53155 fatalities and more then 572000 casualties. Despite the various measures which are taken to improve safety on Polish roads, the number of dead and wounded in the vehicle mishap is still large, and losses borne by society are high. To improve safety on Polish roads, it is necessary to continue multi- action plan to systematically progress in the level of road safety.

Influence of experience, tenure, and organisational preparedness on nurses' readiness in responding to disasters: An exploration during the COVID-19 pandemic.

Background: The coronavirus 2019 (COVID-19) pandemic has placed unprecedented challenges on the nursing practice, particularly in Poland. Nurses, as crucial healthcare service providers, have faced organisational disruptions, altered working conditions, and heightened professional anxieties. Methods: We undertook a comprehensive survey across all medical centres in Lublin, Poland in 2020 to understand nurses' attitudes towards their roles and working conditions during the pandemic. This involved 470 nurses completing a questionnaire which focused on four pivotal areas: readiness to be on call in a disaster situation (even when not formally asked); willingness to work overtime in a disaster without additional compensation, preparedness to undertake health risks by caring for individuals with infectious diseases or exposure to hazardous substances, and willingness to be transferred to other departments during a disaster. Results: We found that excessive workload, fear of infection, and feelings of helplessness significantly influenced nurses' readiness to work overtime, particularly when unpaid. We also presented the ethical dilemmas that nurses encountered during the pandemic and how these dilemmas affected their decision-making processes. We further explored the impact of variables such as nurses' professional experience, tenure, and level of organisational preparedness on their readiness to respond to crisis situations. Conclusions: Gaining an understanding of nurses' perspectives is key for formulating strategies to bolster their professional engagements and resilience during crises. Addressing these issues can help build a more robust and well-prepared healthcare system that can effectively navigate future crises.

Suicide Attempts and Suicides as a Result of Poisoning and under the Influence of Xenobiotics in Poland in 1999-2020.

BACKGROUND: The most common method of suicide in Poland is hanging, especially among men. However, women tend to overdose on medications to commit suicide. Considering suicide attempts, poisoning, which involves overdosing various substances, is the most commonly used method. The purpose of the present study was to analyze suicide attempts by intoxication, suicides, and substances that influenced the state of consciousness of suicide victims in Poland in the years covered by the study. METHODS: A descriptive analysis was made based on the data obtained from the registers of the General Police Headquarters of Poland and the Statistics Poland for the years 1999-2020. RESULTS: During the 21-year study period, 161,655 cases of suicide attempts were recorded in Poland, 106,169 of which resulted in suicides. Results showed that out of 14,660 self-poisoning suicide attempts, there were 2258 cases of suicide poisoning deaths in the analyzed study period. According to the data of the General Police Headquarters of Poland, the total number of suicides of all causes was 106,169. Self-poisoning suicides accounted for 2.1% of all cases of suicides. CONCLUSION: Due to the distribution of suicide registration systems in Poland, data available in this area should be interpreted with caution.

The Over-the-Counter Medicines Market in Poland.

The market of over-the-counter drugs, so-called OTC drugs, is a dynamically developing market driven primarily by self-medication. Their use does not require consultation with a physician, and the patients themselves decide to take them. The distribution of OTC medications in the pharmaceutical market in Poland is diversified. These drugs could be purchased at a pharmacy but also at a supermarket, gas station, or via the internet. The low involvement of public funds in spending on drugs, a relatively small percentage of pharmacy sales of reimbursable prescription drugs, and the difficult access to physicians or general consent to drug advertising all create ideal conditions for creating demand for these drugs. Among the European countries, Poland also has the largest share of OTC drugs in the entire pharmaceutical market, and the percentage of OTCs (without supplements) in the whole drug market in Poland continues to grow. Unfortunately, the non-pharmacy market for the sale of OTC drugs is not adequately controlled in practice, and Polish legal regulations regarding the sale of medicines outside pharmacies are among the most liberal in the European Union. However, this does not change the general attitude of consumers toward purchasing OTC drugs. In fact, further growth of the OTC drug market is forecast. Self-medication will undoubtedly play an important role in the trends which may shape this market in the coming years.

The Moral, Ethical, Personal, and Professional Challenges Faced by Physicians during the COVID-19 Pandemic.

The COVID-19 pandemic, apart from the main problems concerning the health and life of patients, sparked a discussion about physicians' moral and social professional attitudes. During a pandemic, physicians have the same ethical, moral, and medical responsibilities, however, the situation is different since they are self-exposed to a danger, which may influence their willingness to work. The problem of the professional moral attitudes of health care workers, recurring in ethical discussions, prompts us to define the limits of the duties of physicians in the event of a pandemic, hence this research aimed to assess these duties from an ethical perspective and to define their boundaries and scope. The study was conducted in May and June 2020 in the city of Lublin, covering all medical centers, and the questionnaire was completed by 549 physicians. The research was conducted in four areas: emergency standby in the event of a disaster, even if it is not requested; willingness to work overtime in the event of a disaster, even without payment; willingness to take health risks by caring for people who are infectious or exposed to hazardous substances; readiness to be transferred to other departments in the event of a disaster. Although most of the respondents declared to be agreed on personal sacrifices in the performance of professional duties, they were not prepared for a high level of personal risk when working in a pandemic. Excessive workload, its overwhelming nature, and personal risk are not conducive to readiness to work overtime, especially without pay. Research shows how important it is to respect the rights and interests of all parties involved in a pandemic. Physicians' duty to care for a patient is also conditioned by the duty to protect themselves and should not be a tool for intimidating and depersonalizing their social and professional lives.

Analysis of Suicide Methods and Substances Influencing the State of Consciousness of Their Victims in Poland.

An integral part of the World Health Organization's (WHO) mental health action plan for 2013-2020 is suicide prevention, and a 10% reduction in the suicide rate. A key element of the preventive measures taken is, among other things, limiting access to means enabling and facilitating committing suicide. However, this requires detailed knowledge of community suicide patterns and preferences. Unfortunately, such information is not usually collected, and the recorded method of committing suicide is often imprecise and untrue, which means that such knowledge has limited application in presuicidal prophylaxis. The statistical data on suicides recorded as part of the Police Statistics in Poland during the years 2009-2019 was analyzed. The analysis included suicide deaths and suicide attempts, taking into account the suicide methods and substances influencing the state of consciousness of their victims. The number of suicides in Poland in the analyzed period tended to increase. The most common method of suicide was hanging, and alcohol was the substance influencing the state of consciousness of suicide victims. The statistics for 2017-2019 showed the presence of new methods of suicide, such as taking drugs other than hypnotics, intoxication with narcotic drugs, poisoning with designer drugs, suffocation and self-immolation, as well as new psychoactive substances affecting the state of consciousness of victims, i.e., drugs and narcotic drugs. The effectiveness of actions taken in Poland in the field of suicide prevention does not bring the desired effects, as evidenced by growing number of suicides. This low effectiveness is mainly due to the lack of a national suicide prevention strategy. The effectiveness of these activities may be improved by creating a uniform database of suicides, which is a source of reliable information which will allow the taking of actions aimed at limiting the availability of means enabling and facilitating the committing of suicide. The study aimed to analyze the types of suicide methods and substances influencing the state of consciousness of their victims in Poland in the years covered by the study.

Ethanol as a stimulus to risky and auto-aggressive behaviour.

According to the World Health Organization (WHO), ethyl alcohol occupies the third place among health risks for the general population, causing damage to health as well as social damage. Ethanol is also considered the greatest risk factor in injuries. Both alcohol and its main metabolite, acetaldehyde, are directly toxic to tissues and lead to several systemic pathologies. Alcohol abuse may also lead to mental health disorders. Although one-in-eight adult Poles abstains from drinking alkohol, 10-20% of adult Poles drink alcohol regularly. It is estimated that this group includes about 900,000 addicts, and over 2,000,000 people who drink alcohol at a risky or harmful level. It affects their occurrence and their consequences Drink- driving is one of the problems most often raised, although alcohol is a documented risk factor in pedestrian accidents. It is also an important risk factor for suicidal behaviour with people under the influence of alcohol choosing more radical and effective methods of committing suicide, such as hanging or 'throwing themselves under a moving vehicle.' Only properly selected and consistently taken preventive actions can improve the tragic statistics related to ethanol stimulating risky and auto-aggressive behaviours. It is also necessary to improve the system for reporting such events because only reliable statistics enable proper assessment of the scale of the problem, and the effectiveness of these activities.

Bioterrorism Preparedness and Response in Poland: Prevention, Surveillance, and Mitigation Planning.

OBJECTIVES: Biological weapons are one of the oldest weapons of mass destruction used by man. Their use has not only determined the outcome of battles, but also influenced the fate of entire civilizations. Although the use of biological weapons agents in a terrorist attack is currently unlikely, all services responsible for the surveillance and removal of epidemiological threats must have clear guidelines and emergency response plans. METHODS: In the face of the numerous threats appearing in the world, it has become necessary to put the main emphasis on modernizing, securing, and maintaining structures in the field of medicine which are prepared for unforeseen crises and situations related to the use of biological agents. RESULTS: This article presents Poland's current preparation to take action in the event of a bioterrorist threat. The study presents both the military aspect and procedures for dealing with contamination. CONCLUSIONS: In Poland, as in other European Union countries fighting terrorism, preparations should be made to defend against biological attacks, improve the flow of information on the European security system, strengthen research centers, train staff, create observation units and vaccination centers, as well as prepare hospitals for the hospitalization of patients-potential victims of bioterrorist attacks.

Alcohol and Road Accidents Involving Pedestrians as Unprotected Road Users.

According to the World Health Organization (WHO), more than half of all road fatalities involve vulnerable road users, i.e., pedestrians, cyclists, and motorcyclists. Poland is classified as one of the European Union (EU) countries marked by low road safety, with a higher frequency of accidents involving pedestrians compared to other EU countries (31% of all fatalities). Among unprotected road users, a significant group of victims are pedestrians, who are often under the influence of alcohol. This study aims to analyze the impact of alcohol on the risk of occurrence and consequences of road accidents among pedestrians. The source of data was the medical documentation of the Department of Forensic Medicine of the Medical University of Warsaw. In more than half of pedestrian deaths, the presence of alcohol was found; regardless of the place of the event and the place of death, among the victims under the influence of alcohol, males dominated; the average age of the victims under the influence of alcohol was significantly lower compared to the average age of sober victims, with younger victims being significantly more likely to die at the scene of the accident, especially in rural areas; significantly higher alcohol concentrations were found in males, in victims who died at the scene of the accident, and with victims of accidents in rural areas. Among pedestrian traffic accident fatalities, the most numerous group comprised young men under the influence of alcohol. In rural areas, a higher percentage of pedestrian victims died at the scene as a result of excessive alcohol consumption. These areas should be subject to intensive preventive measures to increase the safety of pedestrians as unprotected road users.

Effects of ethyl alcohol on injuries severity according to injury severity scales in pedestrian fatal injury in traffic crashes.

INTRODUCTION: The dominant cause of injuries in traffic crashes. A significant portion of them affects victims under the influence of ethyl alcohol. The goal of the studies was to assess the correlation between the state of sobriety and the severity of injuries expressed by injury severity scales in fatal pedestrian victims of traffic crashes. Research Material and Method: The data were obtained from the Warsaw Medical University's Department of Forensic Medicine. The analysis covered the data for 2009-2013 and included 200 fatal pedestrian victims hit by passenger cars. The assessment of the effect of risk factors on injury severity expressed in terms of injury severity scales such as Life Threat Indicator (LTI), International Classification based Injury Severity Score (ICISS), Injury Severity Score (ISS) and New Injury Severity Score (NISS), was made using adequately selected methods of statistical analysis. RESULTS: As alcohol concentration increases in women, the values of LTI, ICISS-10 and ICISS-15 decrease, which denotes more severe injuries. In the ISS and NISS, the effect of alcohol concentration on the severity of injuries turned out to be negligible. However, these injuries are significantly heavier in women than in men. According to all the scales used, the older the victims, the milder injuries cause their death. CONCLUSIONS: The studies show that ethyl alcohol concentration may harm injury severity, especially in the case of women. The assessment of the severity of injuries in traffic crash victims is significantly influenced by their age and gender. The more risk factors the scale takes into consideration, the more precise is the assessment.

Alcohol and the Risk of Railway Suicide.

Suicide is one of the ten most common causes of death in the world. Of all deaths from suicide, 22% can be attributed to the use of alcohol, which means that every fifth suicide would not occur if alcohol were not consumed by the population. People under the influence of alcohol choose more radical and effective methods of dying by suicide, e.g., throwing themselves under a moving vehicle, such as a train. The presented analysis aimed to determine important risk factors affecting railway suicide in Poland and their relation to the state of alcohol intoxication of the victims, and the relationship between ethyl alcohol consumption and the phenomenon of suicide. Documentation obtained from the Department of Forensic Medicine at the Medical University of Warsaw, in the form of death registers and forensic medical records concerning examination and autopsy, was analyzed. This made it possible to identify suicide victims from among pedestrian victims of railway accidents recorded during the period under study. The research was carried out using unidimensional and multidimensional statistical analyses with IBM SPSS Statistics, version 25. Sober suicide victims were statistically significantly older than victims under the influence of alcohol; alcohol concentration was correlated with the age of the victims-the older the victims were, the higher the alcohol concentration. A significantly higher number of deaths attributed to suicide by sober victims was observed in autumn compared to other seasons. Multidimensional analysis showed a statistically significant effect of age and season on the probability of dying by suicide under the influence of alcohol-this probability decreases with the age of the victims and is also significantly lower in autumn. The observed relationship between age and the presence of alcohol in suicide victims can be the cause of railway suicides. Knowledge of the mechanisms of seasonal variability of suicidal behavior can help to develop effective strategies to prevent railway suicides. It is necessary to improve the system of reporting railway suicides, as only reliable statistics provide the possibility of assessing both the scale of the problem and the effectiveness of actions taken.

Seasonality of Suicides among Victims Who Are under the Influence of Alcohol.

INTRODUCTION: Suicide is one of the most frequent causes of death. According to the World Health Organization (WHO), each year, over eight hundred thousand people worldwide die as a result of suicide. The most common risk factors for suicide are depressive disorders and alcohol dependence. Alcohol can directly influence a decision about suicide, or be a factor facilitating this decision. The aim of the study was to analyse the seasonality of suicides among persons under the influence of alcohol. MATERIAL AND METHODS: Data for analysis were obtained from the Department of Forensic Medicine (DFM) of the Medical University of Warsaw. A retrospective analysis was performed on 317 victims of suicides by hanging, those which were entered into the registry of deaths kept by the DFM in the years 2009-2013. The analysis took into account the age and sex of victims, initial cause of death, date of post-mortem examination, autopsy result and alcohol concentration in the blood or muscles of the victims. Statistical analysis was performed using IBM SPSS Statistics version 20. RESULTS: In the analysis, a spring peak of suicides was found for men, and an autumn peak was revealed for women. In addition, a significant correlation was observed between the age of victims and the concentration of alcohol; the older the victims, the higher the alcohol concentration. However, this correlation was reported only in the spring months. CONCLUSIONS: The results of the analysis seem to be consistent with seasonal patterns observed in other studies, and they indicate the occurrence of suicide seasonality. In order to improve the strategies of suicide prevention, it is necessary to identify factors which are related to the seasonal variation of suicidal behaviours, as well as to gain knowledge about the mechanisms behind this phenomenon.

The Effect of Ethyl Alcohol upon Pedestrian Trauma Sustained in Traffic Crashes.

INTRODUCTION: Every year more than 1.2 million people worldwide die due to trauma sustained in road crashes, with an additional number of people injured exceeding 50 million. To a large extent, this applies to so called "unprotected road users", including pedestrians. The risk involved in a traffic crash for pedestrians can result from many factors, one of which is participation in road traffic when under the influence of alcohol. The aim of this study was to analyze the impact of alcohol use among pedestrians as unprotected road traffic participants, and the consequences of them being struck by motor vehicles. MATERIAL AND METHODS: The source of data was the medical documentation of the Department of Forensic Medicine at the Medical University of Warsaw. The sample for this research consisted of 313 pedestrians who were victims of fatal road crashes resulting from a collision with a mechanical vehicle. The obtained results were subjected to statistical analysis using the STATISTICA version 12.5 program (StatSoft Polska, Cracow, Poland). RESULTS: Male fatalities constituted the majority of the study sample. Nearly half of the fatal pedestrian victims were found to be under the influence of alcohol. The statistical analysis demonstrated a significant relationship between the gender and age of the victims, as well as between the place of the event, the place of death, the mechanism of the event, and the presence of alcohol in pedestrians. CONCLUSIONS: Among pedestrians, victims of road crashes who were under the influence of alcohol were predominantly drunk young males. Victims under the influence of alcohol were more likely to become fatalities in crashes where the mechanism of the incident was being struck by a passenger car, and when the place of the incident was a rural area, in these cases the rates of death directly at the scene were much more frequent. The eradication of alcohol consumption by all road users should be the overriding objective of all measures aimed at reducing the number of road crashes.

The effect of ethyl alcohol on the severity of injuries in fatal pedestrian victims of traffic crashes.

INTRODUCTION: A substantial percentage of traffic crashes involve people under the influence of ethyl alcohol. In such circumstances, we speak of the possible effect of ethanol upon trauma outcomes. The present research aimed to assess the state of sobriety fatal pedestrian victims and the correlation between the level of sobriety and the severity of injuries. RESEARCH MATERIAL AND METHOD: The data was obtained from the Warsaw Medical University's Department of Forensic Medicine. The analysis covered the data for the period of 2009-2013; it encompassed 158 fatal pedestrian victims hit by passenger cars. The appropriate methods of statistical analysis were applied. RESULTS: The majority of the fatal pedestrian victims were individuals under the influence of ethyl alcohol (72.15%). Significant correlations were observed between the concentration of ethyl alcohol and the victims' gender (p<0.0001) and age (p = 0.0026). The analysis showed that pedestrians under the influence of ethyl alcohol more often died on the scene (78.95%). CONCLUSIONS: Pedestrians under the influence of ethyl alcohol are a significant group of victims of traffic crashes. Ethyl alcohol is not an independent factor affecting the severity of injuries. A higher percentage of pedestrian victims die on the scene, especially in rural areas.