Railway suicide in Belgium 1998-2009: Incidence and prevention

Background: Belgium is a country with a high suicide rate (19.1/100,000 in 2004), and railway suicide poses a substantial safety and public health problem. This problem was addressed by the Suicide Prevention Unit of Infrabel (Manager of the Belgian Railway Infrastructure), which collects relevant data and implements a prevention program. Aims: To present data on fatal and nonfatal suicidal behavior on the Belgian railway network, including monthly and regional distribution and identification of hotspots; and to present the Infrabel suicide prevention program. Methods: Analysis of Infrabel data on railway suicide (1998-2009) and comparison with data on suicide in Belgium. Results: A total of 1,092 railway suicides (1998-2009) and 557 suicide attempts (2003-2009) in Belgium (fatality rate of 54%) were studied. Monthly fluctuations were observed, with the majority of suicides occurring in Flanders, followed byWallonia and Brussels. We identified 34 hotspots accounting for 35% of cases, mostly in Flanders. Conclusions: In 2004 railway suicide accounted for 5.3% of all suicides in Belgium (railway suicide rate of 1.03/100,000). Such a major human and economic loss warrants implementation of prevention measures. Infrabel has initiated a comprehensive suicide prevention program which focuses mainly on safeguarding the suicide hotspots.