Significant decrease in the rate of fatal alcohol poisonings in Finland validated by blood alcohol concentration statistics

Highlights

• 32-year prevalence of fatal alcohol poisonings in Finland was investigated.
• high medico-legal autopsy rate enabled consistent accumulation of data.
• post-mortem toxicology rate ranged between 8.1 % and 14.0 %.
• median fatal blood alcohol level was 3.2 g/kg showing a slightly decreasing trend.
• significant decrease in alcohol poisoning mortality was found valid.

Abstract

Background

Alcohol may cause death directly by acute poisoning, as well as induce illnesses or accidents that lead to death. Our research question was whether the current decreasing trend in acute fatal alcohol poisonings in Finland is a real phenomenon or an artefact caused by possible changes in the process of determining the cause of death.

Methods

All cases in the national post-mortem toxicology database in which the underlying cause of death was acute alcohol poisoning in 1987–2018 were investigated in terms of blood alcohol concentration (BAC), age and gender. The number of acute alcohol poisonings was compared to the number of deaths from alcohol induced illness in the post-mortem toxicology database.

Results

A total of 12 126 acute alcohol poisoning cases were retrieved. Between 2004 and 2017 the number of acute alcohol poisonings decreased 60.1 %. At the same time the number of alcohol induced illnesses in the study material remained stable or decreased marginally.

The median BAC in all acute alcohol poisonings was 3.2 g/kg. The annual median BAC values showed a small but significant decrease over the study period. The proportion of women in acute alcohol poisonings increased significantly over the study period, from 17.1%–22.3%. Women were on average 2.5 years older than men.

Conclusions

On grounds of the BAC statistics and supporting evidence, we conclude that the significant decrease in the number of fatal alcohol poisonings is true and likely reflects changes in the overall consumption of alcohol.