Pirjo Lillsunde - Academia.edu (original) (raw)
Papers by Pirjo Lillsunde
Background Studying drugged drivers gives complementary information about mortality of drug users... more Background Studying drugged drivers gives complementary information about mortality of drug users, which mainly has been studied among opioid abusers. The aim of this study was to analyse mortality rates and causes of death among driving under the influence of drugs (DUID) suspects in Finland and compare them with the general Finnish population during 1993–2006. Methods We used register data consisting of 5,832 DUID suspects apprehended by the police. A reference group (n=74,809) was drawn from the general Finnish population. Deaths were traced from National Death Register. Survival and differences in mortality hazard were estimated by using Kaplan-Meier plots and Cox regression models. Results The hazard of death was higher among both male (HR 9.6, CI 8.7–10.6) and female (HR 9.1, CI 6.4–12.8) DUID suspects compared to reference population. Among male DUID
Journal of Substance Use, 2010
... Forensic Science International, 85, 95–104. Barbone, F., McMahon, AD, Davey, PG, Morris, AD, ... more ... Forensic Science International, 85, 95–104. Barbone, F., McMahon, AD, Davey, PG, Morris, AD, Reid, IC, McDevitt, DG, (1998). Association of road-traffic accidents with benzodiazepine use. Lancet, 352, 1331–1336. ... Gustavsen, I., Morland, J., & Bramness, JG (2006). ...
Forensic Science International, 2008
Accident Analysis & Prevention, 2009
Our aim was to describe the incidence and trends of driving under the influence of drugs (DUID) a... more Our aim was to describe the incidence and trends of driving under the influence of drugs (DUID) and to examine the main drug findings and their trends in suspected DUID cases in Finland. A register-based study was conducted of all suspected DUID cases during 1977-2007. The data included 31,963 DUID offenders apprehended by the police with a positive finding for illicit/licit drug impairing driving performance. Toxicological results were analyzed in blood and/or urine specimens in one central laboratory. The incidence of suspected DUID cases increased 18-fold during 1977-2007. Most of the suspects were men (89.7%). However, the male-female ratio decreased from 13.9 to 7.3. The mean age decreased from 36.2 years in 1977 to 29.9 years in 2001 but has since reincreased. Most often found substances were benzodiazepines (75.7%), amphetamines (46.0%), cannabinoids (27.7%) and opioids (13.8%). Most common illicit drugs, amphetamines and cannabinoids, started to appear at the end of the 1980s. Poly-drug findings were common (77.1%). Suspected DUID cases have increased sharply after the introduction of a zero tolerance law, especially in regard to amphetamines. DUID is an increasing problem in Finland, and needs serious attention.
Alcohol and Alcoholism, 2011
Acta Obstetricia et Gynecologica Scandinavica, 1994
First, to study tobacco exposure among pregnant Finnish women in 1986 and 1990. Second, to study ... more First, to study tobacco exposure among pregnant Finnish women in 1986 and 1990. Second, to study the objectively measured exposure in different socioeconomic classes and in different geographical regions. Third, to assess the value of serum thiocyanate concentrations in estimating fetal tobacco exposure. Tobacco exposure was measured from maternal and umbilical serum samples by measuring the concentration of nicotine metabolite, cotinine. In addition, the concentrations of thiocyanate were measured from umbilical serum samples. The occupations of the mothers were obtained from the Finnish Birth Registry, and the area of residence from laboratory records. Finland. 1323 infants born in late February-early March in 1991, 1263 mothers of these infants during antenatal visits in Autumn 1990, and 976 pregnant mothers during antenatal visits in Autumn 1986. The mothers and infants studied represented all newborn infants and their mothers during one week in one country. In 1986, 21.3% of Finnish mothers and in 1990 21.2% were exposed to tobacco. In 1986, exposed mothers were on average 1.4 (95% confidence interval 0.9-1.8) years younger than nonexposed mothers, and in 1990, exposed mothers were on average 1.6 years (95% confidence interval 1.1-2.3) younger than nonexposed mothers. 28.5% of mothers classified as unskilled workers were exposed, but only 9.1% of those classified as upper white-collar. There were no significant geographical differences in exposure. Although umbilical serum thiocyanate levels were always elevated in exposed infants, high serum thiocyanate concentrations were detected in infants not exposed to tobacco. More than 20% of pregnant Finnish mothers and their fetuses were exposed to tobacco in 1986 and 1990. Young women and women in low socioeconomic classes were the most seriously exposed. Measurement of serum thiocyanate concentrations did not yield reliable estimates of exposure.
Addiction, 2011
Aims To examine the associations between socioeconomic characteristics and driving under the infl... more Aims To examine the associations between socioeconomic characteristics and driving under the influence of drugs (DUID), and to elaborate determinants of drugged driving. Design A register-based case-control study. Setting Finland. Participants Cases (n = 5859) apprehended by the police and suspected of DUID during 1993-2006 and controls (n = 74 809) drawn from the general Finnish population. Measurements The effects of parents' and own education, urbanization of municipality, socioeconomic position (SEP), main activity, income, marital status and living arrangements on DUID were estimated using logistic regression analysis. The analyses were conducted separately for men and women, age groups of under 45 years and aged 45 or over, and for substance groups of benzodiazepines only, benzodiazepines with alcohol, amphetamines and cannabinoids. Findings Low education, unemployment, disability pension, being divorced and living alone were the strongest individual predictors of DUID in all substance groups. Illicit drug users were more disadvantaged compared to those in the benzodiazepines groups. Contrary to other substance and age groups, higher educational level and higher SEP were associated with DUID among benzodiazepine users aged 45 or over. Conclusions A disadvantaged social background is a significant predictor of driving while under the influence of drugs for all substance use groups in Finland. The gradient is greater for amphetamines and cannabinoids than benzodiazepines.
Duodecim; laaketieteellinen aikakauskirja, 2012
In the DRUID (Driving under the influence of drugs, alcohol and medicines) study, the risk of inj... more In the DRUID (Driving under the influence of drugs, alcohol and medicines) study, the risk of injury and death was calculated for different psychoactive substances on the basis of samples collected from drivers in road traffic and in various accident situations. The number of persons having used alcohol or drugs with negative effects on the ability to drive was lower in Finland than in Europe on the average. Aggravated drunk drivers and mixed substance abusers pose an accident risk that can be several hundredfold higher compared with sober drivers. More attention should be focused on traffic risks due to mixed use of drugs and alcohol.
Journal of Chromatography B: Biomedical Sciences and Applications
A rapid twm-column gas chromatographtc method for the stmultaneous screening and determination
European Journal of Public Health
BMC public health, Jan 19, 2017
Alcohol is a well-known risk factor in unintentional drownings. Whereas psychotropic drugs, like ... more Alcohol is a well-known risk factor in unintentional drownings. Whereas psychotropic drugs, like alcohol, may cause psychomotor impairment and affect cognition, no detailed studies have focused on their association with drowning. Finland provides extensive post-mortem toxicological data for studies on drowning because of its high medico-legal autopsy rates. Drowning cases, 2000 through 2009, for which post-mortem toxicological analysis was performed, came from the database of the Toxicological Laboratory, Department of Forensic Medicine, University of Helsinki, using the ICD-10 nature-of-injury code T75.1. The data were narrowed to unintentional drowning, using the ICD-10 external-injury codes V90, V92, and W65-74. Each drowning case had its blood alcohol concentration (BAC) and concentrations of other drugs recorded. Evaluation of the contribution of psychotropic drugs to drowning was based on their blood concentration by means of a 6-grade scale. Among victims ≥15 years old, unint...
Injury Prevention, 2016
the programme. Thus, to bridge the gaps, in 2015 the Ministry of Public Health adopts the "Merit ... more the programme. Thus, to bridge the gaps, in 2015 the Ministry of Public Health adopts the "Merit Maker for Child Drowning Prevention" measure, aiming to identify the networks working on drowning prevention that covers at least six key measures, emphasising community-based multidisciplinary approach, resource sharing, participation of local agencies, and rewarding Merit Makers whose contributions are in accordance with the established criteria. Conclusion Since the launch of the programme on child drowning prevention, policies and measures have been implemented, resulting in a constant reduction in child drowning fatalities. In such efforts, the Ministry of Public Health has also revised several measures so that they are more effective in the country in achieving the child drowning reduction goal.
Background Studying drugged drivers gives complementary information about mortality of drug users... more Background Studying drugged drivers gives complementary information about mortality of drug users, which mainly has been studied among opioid abusers. The aim of this study was to analyse mortality rates and causes of death among driving under the influence of drugs (DUID) suspects in Finland and compare them with the general Finnish population during 1993–2006. Methods We used register data consisting of 5,832 DUID suspects apprehended by the police. A reference group (n=74,809) was drawn from the general Finnish population. Deaths were traced from National Death Register. Survival and differences in mortality hazard were estimated by using Kaplan-Meier plots and Cox regression models. Results The hazard of death was higher among both male (HR 9.6, CI 8.7–10.6) and female (HR 9.1, CI 6.4–12.8) DUID suspects compared to reference population. Among male DUID
Journal of Substance Use, 2010
... Forensic Science International, 85, 95–104. Barbone, F., McMahon, AD, Davey, PG, Morris, AD, ... more ... Forensic Science International, 85, 95–104. Barbone, F., McMahon, AD, Davey, PG, Morris, AD, Reid, IC, McDevitt, DG, (1998). Association of road-traffic accidents with benzodiazepine use. Lancet, 352, 1331–1336. ... Gustavsen, I., Morland, J., & Bramness, JG (2006). ...
Forensic Science International, 2008
Accident Analysis & Prevention, 2009
Our aim was to describe the incidence and trends of driving under the influence of drugs (DUID) a... more Our aim was to describe the incidence and trends of driving under the influence of drugs (DUID) and to examine the main drug findings and their trends in suspected DUID cases in Finland. A register-based study was conducted of all suspected DUID cases during 1977-2007. The data included 31,963 DUID offenders apprehended by the police with a positive finding for illicit/licit drug impairing driving performance. Toxicological results were analyzed in blood and/or urine specimens in one central laboratory. The incidence of suspected DUID cases increased 18-fold during 1977-2007. Most of the suspects were men (89.7%). However, the male-female ratio decreased from 13.9 to 7.3. The mean age decreased from 36.2 years in 1977 to 29.9 years in 2001 but has since reincreased. Most often found substances were benzodiazepines (75.7%), amphetamines (46.0%), cannabinoids (27.7%) and opioids (13.8%). Most common illicit drugs, amphetamines and cannabinoids, started to appear at the end of the 1980s. Poly-drug findings were common (77.1%). Suspected DUID cases have increased sharply after the introduction of a zero tolerance law, especially in regard to amphetamines. DUID is an increasing problem in Finland, and needs serious attention.
Alcohol and Alcoholism, 2011
Acta Obstetricia et Gynecologica Scandinavica, 1994
First, to study tobacco exposure among pregnant Finnish women in 1986 and 1990. Second, to study ... more First, to study tobacco exposure among pregnant Finnish women in 1986 and 1990. Second, to study the objectively measured exposure in different socioeconomic classes and in different geographical regions. Third, to assess the value of serum thiocyanate concentrations in estimating fetal tobacco exposure. Tobacco exposure was measured from maternal and umbilical serum samples by measuring the concentration of nicotine metabolite, cotinine. In addition, the concentrations of thiocyanate were measured from umbilical serum samples. The occupations of the mothers were obtained from the Finnish Birth Registry, and the area of residence from laboratory records. Finland. 1323 infants born in late February-early March in 1991, 1263 mothers of these infants during antenatal visits in Autumn 1990, and 976 pregnant mothers during antenatal visits in Autumn 1986. The mothers and infants studied represented all newborn infants and their mothers during one week in one country. In 1986, 21.3% of Finnish mothers and in 1990 21.2% were exposed to tobacco. In 1986, exposed mothers were on average 1.4 (95% confidence interval 0.9-1.8) years younger than nonexposed mothers, and in 1990, exposed mothers were on average 1.6 years (95% confidence interval 1.1-2.3) younger than nonexposed mothers. 28.5% of mothers classified as unskilled workers were exposed, but only 9.1% of those classified as upper white-collar. There were no significant geographical differences in exposure. Although umbilical serum thiocyanate levels were always elevated in exposed infants, high serum thiocyanate concentrations were detected in infants not exposed to tobacco. More than 20% of pregnant Finnish mothers and their fetuses were exposed to tobacco in 1986 and 1990. Young women and women in low socioeconomic classes were the most seriously exposed. Measurement of serum thiocyanate concentrations did not yield reliable estimates of exposure.
Addiction, 2011
Aims To examine the associations between socioeconomic characteristics and driving under the infl... more Aims To examine the associations between socioeconomic characteristics and driving under the influence of drugs (DUID), and to elaborate determinants of drugged driving. Design A register-based case-control study. Setting Finland. Participants Cases (n = 5859) apprehended by the police and suspected of DUID during 1993-2006 and controls (n = 74 809) drawn from the general Finnish population. Measurements The effects of parents' and own education, urbanization of municipality, socioeconomic position (SEP), main activity, income, marital status and living arrangements on DUID were estimated using logistic regression analysis. The analyses were conducted separately for men and women, age groups of under 45 years and aged 45 or over, and for substance groups of benzodiazepines only, benzodiazepines with alcohol, amphetamines and cannabinoids. Findings Low education, unemployment, disability pension, being divorced and living alone were the strongest individual predictors of DUID in all substance groups. Illicit drug users were more disadvantaged compared to those in the benzodiazepines groups. Contrary to other substance and age groups, higher educational level and higher SEP were associated with DUID among benzodiazepine users aged 45 or over. Conclusions A disadvantaged social background is a significant predictor of driving while under the influence of drugs for all substance use groups in Finland. The gradient is greater for amphetamines and cannabinoids than benzodiazepines.
Duodecim; laaketieteellinen aikakauskirja, 2012
In the DRUID (Driving under the influence of drugs, alcohol and medicines) study, the risk of inj... more In the DRUID (Driving under the influence of drugs, alcohol and medicines) study, the risk of injury and death was calculated for different psychoactive substances on the basis of samples collected from drivers in road traffic and in various accident situations. The number of persons having used alcohol or drugs with negative effects on the ability to drive was lower in Finland than in Europe on the average. Aggravated drunk drivers and mixed substance abusers pose an accident risk that can be several hundredfold higher compared with sober drivers. More attention should be focused on traffic risks due to mixed use of drugs and alcohol.
Journal of Chromatography B: Biomedical Sciences and Applications
A rapid twm-column gas chromatographtc method for the stmultaneous screening and determination
European Journal of Public Health
BMC public health, Jan 19, 2017
Alcohol is a well-known risk factor in unintentional drownings. Whereas psychotropic drugs, like ... more Alcohol is a well-known risk factor in unintentional drownings. Whereas psychotropic drugs, like alcohol, may cause psychomotor impairment and affect cognition, no detailed studies have focused on their association with drowning. Finland provides extensive post-mortem toxicological data for studies on drowning because of its high medico-legal autopsy rates. Drowning cases, 2000 through 2009, for which post-mortem toxicological analysis was performed, came from the database of the Toxicological Laboratory, Department of Forensic Medicine, University of Helsinki, using the ICD-10 nature-of-injury code T75.1. The data were narrowed to unintentional drowning, using the ICD-10 external-injury codes V90, V92, and W65-74. Each drowning case had its blood alcohol concentration (BAC) and concentrations of other drugs recorded. Evaluation of the contribution of psychotropic drugs to drowning was based on their blood concentration by means of a 6-grade scale. Among victims ≥15 years old, unint...
Injury Prevention, 2016
the programme. Thus, to bridge the gaps, in 2015 the Ministry of Public Health adopts the "Merit ... more the programme. Thus, to bridge the gaps, in 2015 the Ministry of Public Health adopts the "Merit Maker for Child Drowning Prevention" measure, aiming to identify the networks working on drowning prevention that covers at least six key measures, emphasising community-based multidisciplinary approach, resource sharing, participation of local agencies, and rewarding Merit Makers whose contributions are in accordance with the established criteria. Conclusion Since the launch of the programme on child drowning prevention, policies and measures have been implemented, resulting in a constant reduction in child drowning fatalities. In such efforts, the Ministry of Public Health has also revised several measures so that they are more effective in the country in achieving the child drowning reduction goal.