Int. J. Environ. Res. Public Health 2012, 9, 772-780; doi:10.3390/ijerph9030772 OPEN ACCESS International Journal of Environmental Research and Public Health ISSN 1660-4601 www.mdpi.com/journal/ijerph Article Patterns of Suicide and Other Trespassing Fatalities on State-Owned Railways in Greater Stockholm; Implications for Prevention Helena Rådbo * and Ragnar Andersson Department of Health and Environmental Sciences, Karlstad University, Karlstad 65188, Sweden; E-Mail: ragnar.andersson@kau.se * Author to whom correspondence should be addressed; E-Mail: helena.radbo@kau.se; Tel.: +46-54-700-1977; Fax: +46-54-700-2220. Received: 13 January 2012; in revised form: 22 February 2012 / Accepted: 2 March 2012 / Published: 5 March 2012 Abstract: Each year, approximately 80–100 people are killed on state-owned railways due to train-person collisions in Sweden. Underlying causes are suicide and accidents; suicide constituting a vast majority. Earlier Swedish studies at a national level revealed a relation between population density and incident frequency, however, with places of occurrence often located to the outskirts of cities some distance away from station areas where victims can await approaching trains in seclusion. The aim of this study was to investigate whether this national pattern also applies to larger urban areas such as greater Stockholm, and to discuss preventative implications based on these observations. All registered incidents (N = 41) where people were hit or run-over by trains with a fatal outcome over the four-year period 2005–2008 were investigated. Results deviating from the national pattern include that most incidents occur at station areas, and that most victims enter the tracks from platforms. Passing express trains appear to be overrepresented, compared to commuter trains. Due to a low number of cases, our observations must be interpreted with caution. However, they imply that preventative measures in this type of area should focus on platform safety foremost, especially protection against rapid trains passing by station areas. Keywords: suicide; railway; railroad; suicide prevention; railway safety