Evidence map›Paper›PMID 38898445›Full record

ArticleBMC public health2024

Spatiotemporal epidemiology of substance-related accidental acute toxicity deaths in Canada from 2016 to 2017.

Mohammad Howard-Azzeh, Rania Wasfi, Tanya Kakkar, Mallory Flynn, Jenny Rotondo, Emily Schleihauf, Matthew Bowes, Erin E Rees

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC public health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Mohammad Howard-AzzehHealth Promotion and Chronic Disease Prevention Branch, Substance-Related Harms Division, Public Health Agency of Canada, Ontario, Canada. hhazzeh@gmail.com.
Rania WasfiPublic Health Risk Sciences Division, National Microbiology Laboratory, Public Health Agency of Canada, Quebec, Canada.
Tanya KakkarHealth Promotion and Chronic Disease Prevention Branch, Substance-Related Harms Division, Public Health Agency of Canada, Ontario, Canada.
Mallory FlynnDepartment of Statistics, University of British Columbia, British Columbia, Canada.
Jenny RotondoHealth Promotion and Chronic Disease Prevention Branch, Substance-Related Harms Division, Public Health Agency of Canada, Ontario, Canada.
Emily SchleihaufCanadian Public Health Service, Public Health Agency of Canada, Ontario, Canada.
Matthew BowesNova Scotia Medical Examiner Service, Department of Justice, Nova Scotia, Canada.
Erin E ReesPublic Health Risk Sciences Division, National Microbiology Laboratory, Public Health Agency of Canada, Quebec, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesIn Canada, substance-related accidental acute toxicity deaths (AATDs) continue to rise at the national and sub-national levels. However, it is unknown if, where, when, and to what degree AATDs cluster in space, time, and space-time across the country. The objectives of this study were to 1) assess for clusters of AATDs that occurred in Canada during 2016 and 2017 at the national and provincial/territorial (P/T) levels, and 2) examine the substance types detected in AATD cases within each cluster.

methodsTwo years of person-level data on AATDs were abstracted from coroner and medical examiner files using a standardized data collection tool, including the decedent's postal code and municipality information on the places of residence, acute toxicity (AT) event, and death, and the substances detected in the death. Data were combined with Canadian census information to create choropleth maps depicting AATD rates by census division. Spatial scan statistics were used to build Poisson models to identify clusters of high rates (p < 0.05) of AATDs at the national and P/T levels in space, time, and space-time over the study period. AATD cases within clusters were further examined for substance types most present in each cluster.

resultsEight clusters in five regions of Canada at the national level and 24 clusters in 15 regions at the P/T level were identified, highlighting where AATDs occurred at far higher rates than the rest of the country. The risk ratios of identified clusters ranged from 1.28 to 9.62. Substances detected in clusters varied by region and time, however, opioids, stimulants, and alcohol were typically the most commonly detected substances within clusters.

conclusionOur findings are the first in Canada to reveal the geographic disparities in AATDs at national and P/T levels using spatial scan statistics. Rates associated with substance types within each cluster highlight which substance types were most detected in the identified regions. Findings may be used to guide intervention/program planning and provide a picture of the 2016 and 2017 context that can be used for comparisons of the geographic distribution of AATDs and substances with different time periods.

Indexed as

Spatio-Temporal AnalysisAdolescentAdultAgedCanadaCluster AnalysisFemaleHumansMaleMiddle AgedSubstance-Related DisordersYoung AdultAcute toxicityCanadaChart review studyCoronerDeath investigationsDrugEpidemiologyGeographic distributionMedical examinerMortalityOverdosePoisoningSaTScanSpatial scan statisticSpatiotemporal

Identifiers

PMID38898445
PMCPMC11188508

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.