Preventing railway suicides through level crossing removal: a multiple-arm pre-post study design in Victoria, Australia. 2022

Angela Clapperton, and Jeremy Dwyer, and Matthew J Spittal, and Leo Roberts, and Jane Pirkis
Melbourne School of Population and Global Health, The University of Melbourne, Carlton, VIC, Australia. angela.clapperton@unimelb.edu.au.

OBJECTIVE Rail level crossing removals to improve transport performance across metropolitan Melbourne (state of Victoria) resulted in new rail fencing and grade-separation of tracks from the surrounding environment at several sites. These design changes restricted pedestrian access to the rail tracks, which is a countermeasure known to prevent railway suicide in other settings. We examined whether any such suicide prevention effect followed the removals. METHODS We used a multiple-arm pre-post design to test whether a decrease in monthly frequency of railway suicides occurred at level crossing removal sites (intervention sites), compared to randomly matched sites where level crossings had not yet been removed (control sites). We used data available in the Victorian Suicide Register covering the period 1st January 2008 to 30th June 2021. RESULTS The mean monthly number of railway suicides decreased by 68% within a 500 m radius of intervention sites (RR: 0.32; CI 95% 0.11-0.74) and by 61% within a 1000 m radius of intervention sites (RR: 0.39; CI 95% 0.21-0.68). There was no evidence that the mean monthly number of railway suicides changed at the control sites, either within a 500 m radius (RR: 0.88; CI 95% 0.47-1.56) or a 1000 m radius (RR: 0.82; CI 95% 0.52-1.26). CONCLUSIONS The reduction in railway suicides at locations where level crossings were removed, demonstrates the suicide prevention benefits that can be derived from a major infrastructure project even if not initially intended. Planning for major infrastructure projects should include consideration of these benefits, with designs incorporating features to maximise suicide prevention impact.

UI MeSH Term Description Entries
D011890 Railroads Permanent roads having a line of rails fixed to ties and laid to gage, usually on a leveled or graded ballasted roadbed and providing a track for freight cars, passenger cars, and other rolling stock. Cars are designed to be drawn by locomotives or sometimes propelled by self-contained motors. (From Webster's 3d) The concept includes the organizational and administrative aspects of railroads as well. Subways,Railroad,Subway
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000092864 Suicide Prevention Specific strategies for averting suicides. These include mental HEALTH PROMOTION and monitoring PSYCHOLOGICAL WELL-BEING and other intervention programs targeting susceptible individuals. Suicide Awareness,Awareness, Suicide,Prevention, Suicide,Suicide Preventions
D014739 Victoria A state in southeastern Australia, the southernmost state. Its capital is Melbourne. It was discovered in 1770 by Captain Cook and first settled by immigrants from Tasmania. In 1851 it was separated from New South Wales as a separate colony. Self-government was introduced in 1851; it became a state in 1901. It was named for Queen Victoria in 1851. (From Webster's New Geographical Dictionary, 1988, p1295 & Room, Brewer's Dictionary of Names, p574)

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