Self-harm fatalities

Wheeler BW et al The population impact on incidence of suicide and non-fatal self harm of regulatory action against the use of selective serotonin reuptake inhibitors in under 18s in the United Kingdom Ecological study. Br Med J 2008 336(7643) 542. [PMID 18276667]... 

Martinez, C., Rietbrock, S., Wise, L., Ashby, D., Chick, J., Moseley, J., Evans, S., Gunnell, D. 2005, Antidepressant treatment and the risk of fatal and non-fatal self harm in first episode depression nested case-control study, Br.Med.J., vol. 330, no. 7488, p. 389. 

In a matched case-control, primary-care study of over 150 000 patients who received at least one prescription for an antidepressant between 1993 and 1999, in which dosu-lepin was used as the reference standard, there was no relative increased risk of non-fatal self-harm for fluoxetine (OR = 1.16 95% Cl = 0.90,1.50), while the risk for paroxetine approached significance (OR = 29 95% Cl = 0.97, 1.70) (24). The authors suggested that the latter finding might have been due to uncontrolled confounding by severity of depression or apparent suicide risk. In the small number of cases of fatal suicide there was no... 

Finally, the effect of the warning issued by the UK Medicines and Healthcare products Regulatory Authority (MHRA) in December 2003, not to prescribe SSRI antidepressants, except fluoxetine, for those younger than 18 years, has been examined [12 ]. Prescriptions fell significantly (by 51%) during 2000-2006. However, there were no changes in the rates of non-fatal self-harm or self-poisoning. 

It is easier to write about a culture that includes safety as a core value than it is to factually describe a situation in which the culture deteriorates over time, the effect the deterioration has on increasing risk and the position in which such deterioration places a safety professional. The following are excerpts taken from a report that was internally produced by BP Products North America (2005) pertaining to a fire and explosion that occurred on March 23,2005, at an owned and operated refinery in Texas City, Texas. As a result of that incident, 15 people were killed and over 170 were harmed. It is important to note that these excerpts, taken from the Executive Summary— Fatal Accident Investigation Report, represent a self-evaluation. 

---