Accident Analysis and Prevention 81 (2015) 30–50

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Accident Analysis and Prevention

journal homepage: www.elsevier.com/locate/aap

A systematic review of the literature on safety measures to prevent

railway suicides and trespassing accidents
Grigore M. Havârneanu a, * , Jean-Marie Burkhardt b , Françoise Paran b
a
International Union of Railways (UIC), Security division, 16 rue Jean Rey, F-75015 Paris, France
b
IFSTTAR, AME, LPC, F-78000 Versailles, France

A R T I C L E I N F O A B S T R A C T

Article history: This review covers a central aspect in railway safety which is the prevention of suicides and trespassing
Received 16 May 2014 accidents. The paper attempts to answer the following research question: ‘What measures are available
Received in revised form 9 April 2015 to reduce railway suicide and trespass, and what is the evidence for their effectiveness?’ The review is
Accepted 11 April 2015
based on 139 relevant publications, ranging from 1978 to 2014. The analysis aimed to identify the past
Available online 6 May 2015
and current trend in the prevention practice by looking both quantitatively and qualitatively at the
recommended measures. According to the results, there has been a constant focus on suicide prevention,
Keywords:
and only relatively recent interest in trespass countermeasures. The content analysis revealed 19 main
Train-pedestrian fatalities
Railway suicide
preventative categories which include more than 100 specific measures. We identified 16 common
Trespass categories against railway suicide and trespass, and 3 categories of specific measures to prevent suicide.
Prevention There are only 22 studies which provide empirical support for the effectiveness of measures. Actual
Countermeasures combinations of measures are barely evaluated, but several challenges emerge from the literature. The
discussion focuses on the need for a unified approach to suicide and trespass prevention, and on the
importance to consider the effect mechanism of the measures in order to design better interventions.
ã 2015 Elsevier Ltd. All rights reserved.

1. Introduction
Train-pedestrian collisions are a major concern for railway
safety, as they have become the leading cause of fatality in railway
accidents (European Railway Agency, ERA, 2014; Evans, 2003;
Lobb, 2006). Every year, close to 3000 suicides and 800 additional
trespassing accidents occur on EU railways, representing 88% of all
fatalities within the railway system (ERA, 2014). In addition to the
human loss, train-pedestrian collisions cause trauma and work-
related stress to the railway staff and rescue employees, and
discomfort to passengers and eye witnesses (Baumert et al., 2005;
Mishara, 2007; Rådbo et al., 2005). The severe consequences for
train drivers include somatic problems, anxiety, sleep disruption,
and sometimes societal disturbance problems (Briem et al., 2007;
Farmer et al., 1992; Limosin et al., 2006). After such events, 70% of
the drivers are given a temporary sick leave of about 4.4 days long
(Cothereau et al., 2004). Furthermore, there are the costs for
emergency services, investigation, insurance administration, and
legal procedures (Bureau of Transport and Regional Economics,
BTRE, 2002) as well as the indirect costs like the time loss and
* Corresponding author. Tel.: +33 1 44 49 21 25; fax: +33 1 44 49 20 59.
E-mail address: havarneanu@uic.org (G.M. Havârneanu).
delays. When a person is struck by a train, the traffic shut down
time may range from 30 min in Japan (Kadotani et al., 2014) to
about 2 h in most of the EU countries (ERA, 2014). In short, railway
suicides and trespassing accidents have the highest frequency
relative to all fatal incidents occurring in the railway system and
have a negative impact on society and rail operators.
1.1. Suicide and trespass as origins of train-pedestrian collisions
A train-pedestrian collision can occur only when one or more
persons have entered the railway tracks accidentally or inten-
tionally. The presence or absence of intent in getting hit by the train
is the common theoretical criterion to distinguish between
suicides and trespassing accidents (Mishara, 2007). Railway
suicide is the act to deliberately injure oneself resulting in death,
as recorded and classified by the competent national authority
(Directive, 2004/49/EC). In contrast, trespassing accidents are
involuntary collisions between a train and a person whose
presence on the railway tracks is unauthorised (ERA, 2014),
resulting in death or injury. Trespassing behaviour is manifested by
crossing the tracks in illegal places (Silla and Luoma, 2009) and
walking or loitering along the tracks (Lobb et al., 2001; Pelletier,
1997), mostly for taking a shortcut across the railway tracks (e.g.
Rail Safety and Standards Board, RSSB, 2011a,b,c; Robinson, 2003).

http://dx.doi.org/10.1016/j.aap.2015.04.012
0001-4575/ ã 2015 Elsevier Ltd. All rights reserved.
 G.M. Havârneanu et al. / Accident Analysis and Prevention 81 (2015) 30–50 31

In practice, the European Railway Agency (ERA, 2008) has including the intention to commit suicide (Burkhardt et al., 2014).
developed guidelines for determining intent (e.g. existence of a This paper supports this unifying approach.
suicide note, behaviour demonstrating suicidal intent, previous
suicide attempts or prolonged depression). 1.3. Theoretical approaches to prevention measures

Preventative measures associated with railway-pedestrian

1.2. Common or dedicated interventions to prevent suicide and
trespass?
Despite the classification difficulty, some authors (e.g. Mishara,
2007) have argued that the distinction between suicides and
accidents in the context of train-pedestrian collisions can be
essential in advancing prevention efforts tailored in accordance
with the various types of injuries. The rationale is that, as opposed
to accidents, suicides consist of persons deliberately putting
themselves in situations where they will be struck by a train. For
other authors (e.g. Rådbo et al., 2005), suicides and accidental
collisions do not show such differences that would motivate
essentially different technical, organisational, or environmental
measures. Similarly, Limosin et al. (2006) show that regardless of
location or intent, train-pedestrian collisions are frequently caused
by the same mechanisms of injury and can be regarded as ‘person
hit by train’ events with the same severe consequences. In line with
this perspective, our position is that although suicide is rather
different from trespass because it derives from a fundamentally
different and unique motivation, suicide intentions imply partially
similar actions like entering the tracks. Therefore, the measures
aimed to reduce trespassing accidents might also work for suicide,
and vice versa, hence the reason for the current review. For the
infrastructure managers or railway undertakings it may be useful
to approach suicide and trespass as one single problem since
trespassing can be driven by various reasons (RSSB, 2011a,b,c)
safety have been characterised at a very broad level as the E’s of
safety. The most common example is the three E’s (e.g. BTRE, 2002;
C.A.R.E., 2006; DaSilva and Caroll, 2011; Horton, 2009; RSSB,
2011a) that stem for engineering, education, and enforcement.
Although using various labels, several authors have suggested a
simpler dichotomy according to the measures’ main mechanism of
influence on behaviour: engineering (direct barrier) or behavioural
intervention. For example, Brown et al. (2012) and RSSB (2012)
distinguish between ‘situational’ and ‘influential’ measures, while
Offler et al. (2009) and Thompson et al. (2012) separate ‘technical’
deterrents from ‘non-technical’ (social) ones in the prevention of
vandalism and graffiti in the railway industry. Similarly, Ladwig
et al. (2009) refer to ‘structural’ means and ‘communicative’ means
in prevention of suicides. Focussing on the nature of preventative
measures and the targeted stage in the suicide process, Rådbo et al.
(2012a,b) have published a theoretically derived and detailed set of
railway suicide prevention strategies, organised around five barrier
themes: (1) measures reducing the attractiveness of railways as a
means of suicide, (2) measures obstructing accessibility to the
track area, (3) measures influencing the victim’s determination
while awaiting the train, (4) early warning systems, enabling the
train to brake sufficiently for the victim to be removed before
collision, and (5) measures to make the collision less violent. An
attempt to extend this approach to account for both railway suicide
and trespass prevention has been proposed recently and is
discussed elsewhere (see Burkhardt et al., 2014).

Records identified through database Additional records identified through

Identification

searching other sources (reference lists, hand

(n = 8,577) searching, other websites)
(n = 42)

Records after duplicates removed

(n = 4,183)
Screening

Records screened on title Records excluded

and abstract (n = 3,954)
(n = 4,183)

Full-text articles excluded

Eligibility

(descriptive epidemiology
Full-text articles assessed
studies, commentaries, case
for eligibility
reports, no proposed
(n = 229)
measure)
(n = 90)

Full-text publications included in qualitative

synthesis (proposing at least one measure)
Included

(n = 139)

Individual studies included in quantitative

synthesis (evaluating at least one measure)
(n = 22)

Fig. 1. PRISMA flow chart.

32 G.M. Havârneanu et al. / Accident Analysis and Prevention 81 (2015) 30–50

In the context of this paper, we consider as safety preventative
measures all interventions, initiatives, or policies that are
recommended to (a) reduce the number of railway suicides and
trespassing accidents or (b) mitigate the consequences of these
incidents by reducing the injury severity, facilitating the post-crash
interventions, and minimising the service disruption. Engineering
measures include all physical, technological, or environmental
artefacts aimed to prevent train-pedestrian collisions by means of
directly impeding the risky behaviours or by facilitating the
intervention of the railway staff. On the other hand, behavioural
measures are influential, social, enforcement or psychological
measures dedicated to influence the person's knowledge and
attitudes and to call for more responsible actions and voluntary
decisions towards safety.
Despite the large number of countermeasures proposed and
used to prevent train-person collisions (for details see Clarke and
Poyner, 1994; Kerkhof, 2003), there is still no obvious conclusion
on which solution is more effective or relevant for particular
contexts. Most of the proposed measures currently rely on physical
or technological components which aim to change the environ-
ment or deter the risky behaviour. In contrast, only a limited body
of literature deals with measures aiming to encourage behavioural
change and to support correct decisions. Finally, there is no
universally accepted classification of existing measures based on
the mechanisms underlying their effect. It is thus difficult to have a
clear and global view of what is proposed and how it is effective.
This systematic review seeks to address this gap by examining the
recommendations and evidence on the preventative measures in
the relevant literature. The paper attempts to answer the following
research question: ‘What measures are available to reduce railway
suicide and trespass, and what is the evidence for their effectiveness?’
2. Material and methods
Our approach was twofold. First, we examined the core
publication characteristics, the particular relationships between
these characteristics (through chi-square and lambda symmetric
tests), and conducted a quantitative synthesis of the studies that
provide empirical support for different measures. Second, from a
qualitative perspective, we analysed the content of the recom-
mendations to reveal the general and specific measures proposed
by different authors, the focal points in the literature, and possibly
unique measures to prevent suicide or trespass. This review was
conducted in accordance with the preferred reporting items for

Table 1
An overview of the identified categories of measures, their citation rate in the literature, and associated references for existing empirical studies.

ID Categories of measures Citation frequency Existing evidence in evaluation studies

Absolute Relative No. of References suicide References trespass

(%) studies
Common measures against railway suicide and trespass
1 Fencing and other physical barriers 90 65% 6 Law and Yip (2011); Law et al. (2009); Lobb et al. (2001); Silla and Luoma
Pirkis et al. (2013); (2011)
Beautrais et al. (2009)
2 Collaboration between institutions 72 52% 1 Baumert et al. (2011)
3 Environmental design 59 42% 1 Silla and Luoma (2011)
4 Monitoring and detection systems 45 32% 1 DaSilva et al. (2006)
5 Education and information at 41 29% 2 Lobb et al. (2001); Lobb et al. (2003)
individual level
6 Enforcement, punishment and patrols 38 27% 2 Niederkrotenthaler et al. (2012) Lobb et al. (2003)
7 Public safety communication 34 24%
8 Signage 31 22% 3 Lobb et al. (2001); Lobb et al. (2003);
Silla and Luoma (2011)
9 Technical design to reduce the effects 31 22% 2 Coats and Walter (1999); O’Donnell and Farmer
of impact (1994)
10 Staff training 29 21% 1 RSSB (2013)
11 Risk assessment 17 12%
12 Learning from previous research and 17 12%
best practice
13 Lighting systems to influence 17 12% 2 Ichikawa et al. (2014); Matsubayashi et al. (2013)
behaviour
14 Additional technologies for train 16 12%
drivers
15 Design and aesthetics to influence 12 9%
behaviour
16 Operational traffic management 11 8% 1 van Houwelingen et al. (2013)

Measures to prevent only railway suicide

17 Appropriate reporting or broadcast of 37 27% 6 Hegerl et al. (2013) and Ladwig et al. (2012);
critical incidents Yang et al. (2013); Kunrath et al. (2011);
Niederkrotenthaler and Sonneck (2007);
Etzersdorfer and Sonneck (1998); Schmidtke
and Häfner (1988)
18 Emergency information and outreach 22 16%
support at hotspots
19 Decrease the attractiveness of the 2 1%
railways as lethal method
 G.M. Havârneanu et al. / Accident Analysis and Prevention 81 (2015) 30–50 33

systematic reviews and meta-analyses (PRISMA) statement
(Moher et al., 2009) (see Fig. 1).
2.1. Selection of studies
The reviewed material is based upon searches of the databases
most relevant for behavioural science, social science and medicine:
Web of Science, Scopus, PsycINFO, Medline, and PubMed) covering
peer reviewed journal articles published in English language until
February 2014. The title, abstract and keywords were searched
using the following terms: ‘suicid*’ OR ‘trespass’ OR ‘accident’ OR
‘injur*’ OR ‘crossing’ matched in pairs with ‘rail’ OR ‘train’ OR
‘metro’ OR ‘subway’ OR ‘tube’ OR ‘underground’. Relevant railway
reports, research deliverables, safety guidance documents, confer-
ence proceedings, dissertations and other working papers were
also included in the review. We included the ‘grey literature’
because it was highly relevant for the scope of this review. Many
railway safety organisations or national administrations carry out
projects and publish valuable reports on their own websites, not in
peer-reviewed journals. These documents were downloaded from
relevant websites (e.g. RSSB) which were identified by searching
the references of the initially retrieved articles. Although the
general literature on level crossings (LCs) was excluded from the
scope of the review, we included the papers which had level
crossing (LC) as main topic, but made some clear reference to
suicide or illegal crossing in the vicinity of the LC.
2.2. Classifying the characteristics of studies and the preventative
measures
Several characteristics of the publications were recorded:
publication year, country of origin, main thematic area (rail safety,
suicide literature, general), specific topic (suicide, trespass, both
suicide and trespass, crossing/other), and the type of publication
(scientific publication, grey literature). Scientific peer-reviewed
publications included original research articles published in
journals, theoretical reviews, conference proceedings and book
chapters.
The content of each paper was analysed in order to identify the
recommended preventative measures. We used a typical frame for
content analysis, employing categories and subcategories with
absolute frequencies that counted how many different sources
Table 2
The number or publications per country and time periods.
mentioned the same measure. To our knowledge, no integrative
classification systems of preventive measures against suicide and
trespass are available. Consequently, we started from a framework
elaborated and employed in the RESTRAIL project (REduction of
Suicides and Trespasses on the RAILway): a categorisation frame
which includes a list of 38 subsets of measures sharing common
mechanisms and contexts to influence suicidal and trespassing
behaviours (Burkhardt et al., 2013). Thus, each category corre-
sponds to a general preventative strategy which includes several
specific measures that are relatively similar to one another and that
can be mainly engineering, behavioural, or a combination of these.
At the end of the classification process, we checked for
redundancies or errors across categories and some specific
measures were reassigned to other main categories. The final
data set consisted of 19 main categories corresponding to general
preventative measures against suicide and trespass (see Table 1).
3. Results
This review found 139 eligible full-text publications which
discussed railway suicide or trespass and which mentioned at least
one safety measure against suicide, trespass or both problems.
Among these there were only 23 publications describing 22 studies
which actually evaluated the proposed interventions (see
Tables 4–7).
3.1. Descriptive analysis of the corpus of papers
The first set of analysis concerned the core characteristics of the
139 eligible publications.
3.1.1. Type of documents
For 69% of the papers the main thematic area was the railway
context. Sixteen percent of the publications concerned suicide in
general, but made some reference to rail or underground suicides.
The rest of the papers (15%) reported studies conducted in related
fields (e.g. suicide by jumping from a bridge or recommendations
about safety campaigns) but included transferable recommenda-
tions for the railways. Most publications were from the scientific
literature (76%, n = 105) and the rest belonged to the grey literature.
Table 3
The number of publications per time period, main topic and type of proposed
measure.

Country Time period Time period Topic Type of measure

1978–2003 2004–2008 2009–2011 2012–2014 Total Behavioural Engineering Both Total

United Kingdom 8 4 8 6 26 1978–2003 Suicide 5 7 4 16
USA 6 5 5 16 Trespass 3 1 1 5
International 2 6 5 3 16 Suicide and trespass 3 3 5 11
Germany 2 5 5 2 14 Crossing/other 1 1
Australia 3 2 1 5 11 Total 11 11 11 33
Sweden 1 2 4 7
Austria 2 1 2 1 6 2004–2008 Suicide 6 6 10 22
Finland 2 3 5 Trespass 3 5 8
The Netherlands 2 1 2 5 Suicide and trespass 2 5 7
New Zealand 2 2 1 5 Total 11 6 20 37
South Africa 3 2 5
Belgium 2 1 3 2009–2011 Suicide 8 3 7 18
Canada 1 2 3 Trespass 1 5 6
France 2 1 3 Suicide and trespass 3 1 2 6
Hong Kong 1 2 3 Crossing/other 1 6 7
Japan 3 3 Total 11 6 20 37
Switzerland 1 2 3
Turkey 1 1 2 2012–2014 Suicide 5 2 17 24
India 1 1 2 Trespass 1 4 5
Taiwan 1 1 Suicide and trespass 1 2 3
Total 33 37 37 32 139 Total 6 3 23 32
34 G.M. Havârneanu et al. / Accident Analysis and Prevention 81 (2015) 30–50

Table 4
Summary of the studies which provide empirical support for the most cited measures against suicide and trespass.

Reference Location and specific Study design and measures Sample and data Significant results reported and implications for the
(authors, setting collection period effectiveness of the measure
date)
Fencing and other physical barriers: platform screen doors (PSDs)
Law and Yip Hong Kong, railway Study design: quasi-experimental, ecological study 369 incidents in the The PSD installation has effectively reduced railway
(2011) system with before and after measurements, based on railway system injuries (adjusted 5-year average percentage
injury data between 1997–2007 change: 68.8%) with no apparent substitution
effect to the other platforms observed.
Intervention: installation of platform screen doors in 30 stations in year
2002
Outcome variable: number of railway injuries at
platforms (suicidal/accidental) and the severity
(fatal/non-fatal)

Law et al. Hong Kong, Study design: quasi-experimental, ecological study 76 suicides in the Railway suicides decreased by 59% since the
(2009) underground system with before and after measurements, based on underground between installation of platform screen door, adjusted for
suicide data 1997–2007 age and gender.
Intervention: installation of platform screen doors in 30 stations in year 2002 No sign of suicide substitution to unsealed
platforms.
Outcome variable: number of railway suicides Railway suicides decreased by 84% for people with
psychiatric profile.

Fencing and other physical barriers: nets and physical barriers at bridges to avoid climbing and jumping
Pirkis et al. International Study design: meta-analysis Data from 9 studies The reduction in deaths from jumping following the
(2013) literature review of interventions is greater than any increases at
suicide by jumping at neighbouring sites.
known hotspots
Factor: installation of structural means to restrict There was an 86% reduction in jumping suicides per
access at bridges year at the sites in question (95% CI 79–91%).
Outcome variable: number of suicides by jumping There was a 44% increase in jumping suicides per
year at nearby sites (95% CI 15% to 81%), but the net
gain was a 28% reduction in all jumping suicides per
year in the study cities (95% CI 13–40%).

Beautrais New Zealand, Study design: experimental, ecological study, with 24 suicides during Barriers in place (1991–1995): 5 suicides; barriers
et al. Auckland, Grafton before and after measurements in A–B–A reversal 3 time periods from removed (1997–2002): 19 suicides; barriers
(2009) Bridge design (A = intervention, B = baseline) 1991 to 2006 reinstalled (2003–2006): 0 suicides.
Intervention: removal of old barriers (in 1996) and reinstallation of new Removal of barriers was followed by a fivefold
barriers (in 2003) increase in the number and rate of suicides from the
bridge. Since the reinstallation of barriers there
have been no suicides from the bridge.
Outcome variable: number of suicides by jumping

Collaboration between institutions: National Suicide Prevention Strategy (The German Railway Suicide Prevention Project)
Baumert Germany, railway Study design: quasi experimental, longitudinal Year 1998 to 2006. A significant fall in rail suicides compared with the
et al. system ecological study evaluating the impact of the Index period (1998– general reduction in Germany.
(2011) prevention programme, by comparing two 4-year 2001); control period
periods, one before and one after the intervention. (2003–2006)
Intervention: implementation of the German Railway Suicide Prevention The absolute number of railway suicides decreased
Project in 2002 from 1006 in 1998 to 724 in 2006. The mean suicide
Outcome variable: number of railway suicides rate in the control years was 13.9% (95% CI 6.9–20.4)
lower compared to the index years (p < .001).
Adjusting for the overall suicide rate attenuated the
decline of the railway suicide rate (annual
percentage change 4.8%, 95% CI 1.8–7.8) but
significance remained (p = .002).

3.1.2. Spatial and time distribution of the literature
Data and results provided in the papers were usually specific to
one country or area (city, part of a network, etc.) within the
considered country, with the exception of 16 international
publications. Most of the papers came from the UK and the
USA, followed by Germany and Australia (Table 2). Other countries
with five to seven publications were Sweden, Austria, Finland, the
Netherlands, New Zealand, and South Africa. The countries
represented by less than five papers were Belgium, Canada,
France, Hong Kong, Japan, Switzerland, India, Turkey, and Taiwan.
Suicide has been addressed mostly in Germany, Austria, the
Netherlands, Belgium, Sweden, Switzerland, Japan, France, and in
international studies. Trespass has been addressed mostly in
Finland and New Zealand. Suicide and trespass have been
addressed together mostly in UK, USA, Turkey, Australia, South
Africa, Hong Kong, and India. The publication year ranged from
1978 to 2014. Half of the papers were published after 2008 and the
most common year was 2011 (n = 24). One may note that the
number of publications varies considerably between countries
independent from the size of the railway network or the country’s
geographical position. For example, even though India has a large
railway network, daily millions of passengers are commuted, and
many accidents occur on the network (see Wasnik, 2010) the
reporting system is rather poor, which may determine the small
number of papers available in the international literature.
Furthermore, it is not clear if more suicide papers were authored
in countries with more railway suicides (and reciprocally for the
topic of trespass). Our results show for example that the
Netherlands and Sweden have high number of publications
on railway suicide, yet the number of suicide fatalities per
 G.M. Havârneanu et al. / Accident Analysis and Prevention 81 (2015) 30–50 35

Table 5
Summary of the studies which provide empirical support for the common measures against suicide and trespass with medium and low citation frequency.

Reference (authors, Location and Study design and measures Sample and data collection Significant results reported and implications for
date) specific period the effectiveness of the measure
setting
Monitoring and detection systems: automated security system composed of video camera, infrared illuminator, speaker, motion detector and magnetometer
DaSilva et al. (2006) USA, a railway Study design: observational, ecological study, with 3726 alarm events involving Overall decrease in trespassing behaviour
bridge in repeated measurements within 3 years 172 actual trespassing cases was experienced over time: 46 trespassing
Pittsford, New during 3 years (from August events for the first year, 18 for the second year,
York 2001 to August 2004) and 38 for the third year.
Intervention: installation of the automated 60% drop in trespass from the first to the
interactive system on a railway bridge in August second year and just a 17% drop in the third
2001. year compared to the first. An increase from
the second to the third.
Outcome variable: trespassing behaviour

Enforcement, punishment and patrols: visible human presence and surveillance

Niederkrotenthaler Austria, Study design: quasi experimental, ecological study, 292 subway suicidal The presence of a surveillance unit had a
et al. (2012) Vienna measuring the associations between several behaviours: 107 suicide positive effect (crude rate ratio for railway
underground independent station characteristics and subway attempts and 185 suicides in suicide = 1.65; crude rate ratio for railway
suicidal behaviours 1979–2009 suicide attempt = 1.93).
Factor: presence of a surveillance unit
Outcome variable: number of subway suicidal
behaviours (suicides and suicide attempts)

Technical design to reduce the effects of impact: design of tracks (i.e. pits between rails)
Coats and Walter UK, London Study design: quasi experimental, ecological study, 58 cases occurred over 33 patients died (overall mortality 57%) and
(1999) underground based on mortality data recorded in patients hit by 15 months (January 1996 to 25 survived.
trains at platforms with and without a drainage March 1997)
pit.
Factor: presence or absence of a drainage pit The mortality was 44% for platforms with a
pit compared with 76% for platforms without
a pit. This difference was significant
(p = 0.026). The presence of a pit halves the
number of deaths in patients who are hit by a
train.
Outcome variables: number of collisions and
mortality rate

O’Donnell and UK, London Study design: quasi experimental, longitudinal 3240 subway suicidal 66% of incidents happening at stations
Farmer (1994) underground ecological study, based on accident reports, behaviours from 1940 to without suicide pits ended in death as
measuring the association of several 1990 compared to 45% at stations with pits (a
epidemiological factors and environmental statistically significant difference).
contexts with subway suicidal behaviours
Factor: presence or absence of a drainage pit
Outcome variable: number of subway suicidal
behaviours and mortality rate

Staff training: gatekeeper training to identify and approach people at risk of suicide
RSSB (2013) UK, railway Study design: experimental, ecological study, Year 2010 to 2013. By mid - General positive attitude about the training
network in comparing the intervention group with a control 2013, nearly 3500 front line (an average of 4.8 out of 5 on a satisfaction
Great Britain group railway staff had taken the scale): 63.1% of respondents appreciated that
training. the training may decrease the number of
suicides, 5.5% rated that it might increase the
number of suicides and 31.4% thought it
would have no effect either way.
Intervention: a 1-day training course provided by Samaritans to front line railway Attitude about suicide prevention: participants
staff to help them gain confidence in feeling able to approach someone who they reported an increased likelihood of taking
think may be at risk of suicide and to get them to a place of safety, and to make the actions seen to be 'desirable' upon
necessary referral. encountering a potentially suicidal person.
Outcome variables: attitude about the training and Participants had a lower rating in terms of
about suicide prevention, confidence, engaging viewing suicide being a long-lasting issue,
behaviour indicating they were more likely to believe
that once a person has had suicidal thoughts,
these can be overcome.
Confidence: staff felt more confident
following training in making an intervention.
The majority of front line staff are generally
willing to use the programme activities.
Changing staff behaviour: 14% of participants
returning evaluation feedback sheets (n = 66)
reported that they had engaged with a
potentially suicidal person and used the skills
they had learnt
Lighting systems to influence behaviour: calming blue light on station platforms
Ichikawa et al. Japan, railway Study design: quasi experimental, ecological study, 4013 railway deaths and Of the total railway deaths and injuries, 55%
(2014) system based on mortality data, looking at the time and injuries from 2002 to 2009 were suicide attempts, whereas 21% were
spatial distribution of railway incidents to cases of accidentally being hit by a train at the
edge of a platform and another 10% were falls
36 G.M. Havârneanu et al. / Accident Analysis and Prevention 81 (2015) 30–50

Table 5 (Continued)
Reference (authors, Location and Study design and measures Sample and data collection Significant results reported and implications for
date) specific period the effectiveness of the measure
setting
estimate the suicide probability near a blue light onto the track. More than half of railway
lamp. suicide attempts occurred during the day,
with many occurring away from station
premises. According to the most conservative
estimate, only 28% of suicide attempts within
station premises occurred at the end of a
platform at night.
Factors: time (night-time) and location (end of
station platform)
Outcome variables: total number of railway deaths The number of station platforms equipped
and injuries vs. number of railway suicides with blue lights is too small to generate the
occurring at night and at platform end effect reported by Matsubayashi et al. (2013).

Matsubayashi et al. Japan, railway Study design: quasi experimental, ecological study, 71 railway stations between Railway suicides decreased by 84% after
(2013) system based on suicide data measured before and after 2000–2010 installation of blue lights, after controlling for
the installation of blue light the number of suicides in the previous years,
use of faster train and proximity to a
psychiatry hospital.
Intervention: installation of blue light on railway platforms in 11 stations. Comparison with 60 stations without blue light
Outcome variable: number of railway suicides. The
average number of suicides per station-year
observations was 0.164

Operational traffic management: reducing train traffic intensity

van Houwelingen Railway Study design: ecological study, comparing Dutch 1475 Dutch and 6105 German Positive association of railway suicides with
et al. (2013) systems in the and German railway suicides in terms of railway railway suicides in 2000– the train frequency (Dutch–German rate
Netherlands and population parameters 2007 ratio = .74)
and Germany
Factor: train frequency
Outcome variable: number of railway suicides

million-train kilometres in the Netherlands has been the second
highest in Europe, while in Sweden it has been below the EU-28
average (ERA, 2014). In line with Reynders et al. (2011), further
research is needed to clarify this issue.
3.1.3. Content and evolution of covered topics in the literature
The publications addressed four major topics in the following
order: suicide only (58%), both suicide and trespass (19%), trespass
only (17%), and LC or other accidents (6%). A lambda symmetric test
was conducted between the main topic categories (suicide,
trespass, both, LC) and the publication year (absolute ordinal
values). The association between the two variables revealed
unequal distribution of the main topics across the 35-year period
(l = .086; p = .056; Cramer’s V = .486). The marginally significant
association suggests (1) a constant concern for railway suicide
across time, (2) a common approach of suicide and trespass
particularly since 1994, and (3) a relatively recent interest in
trespass prevention (since 2003). In summary, the effort to study
railway suicide has been constant, whereas trespass prevention is a
newer research interest. These results reflect the tendency of the
whole corpus of papers, but may not be representative for all
countries. This tendency may also be affected by the under-
reporting specific to some countries, the publication bias, or the
absence of published work in English language (Table 3).
number of measures, usually up to three. By far, the most extended
and comprehensive information came from the Rail Safety and
Standards Board (RSSB) reports. First, these documents focus on
very specific topics concerning prevention (e.g. improving anti-
trespass signage, lessons learnt from safety campaigns, securing
platform ends, etc.). Second, they usually discuss several preven-
tative measures and provide more details about implementation,
effectiveness, shortcomings, costs and occasionally include infor-
mation about combination of measures.
The lambda symmetric test between the categorical variable
type of measure (behavioural, engineering, both) and the publica-
tion year (absolute ordinal values) indicated no significant
association between the two (l = .067; p = .067; Cramer’s
V = .450), but suggested two tendencies in prevention across time:
there is an increased focus on behavioural measures particularly
since 2003 and there is a higher preference for recommending
behavioural and engineering measures simultaneously since 2011.
A chi-square test was conducted between the categorical
variables type of measure (behavioural, engineering, both) and the
main topic categories (suicide, trespass, both, LC) to check if any
measure type is more or less associated with suicide or trespass.
Overall, the association was not statistically significant (x2 = 7.20;
p = .302; Cramer’s V = .161), suggesting no prevailing solution for a
particular problem.

3.1.4. Type of measures, their distribution in time, and association with
the main topics
According to the type of preventative solutions, the publica-
tions could be classified into three categories and ranked in
decreasing order: both behavioural and engineering measures
(53%), behavioural measures only (28%), and engineering measures
only (19%). The papers in the first category usually proposed
separate behavioural and engineering measures rather than an
actual integration between them. Most papers address a small
3.2. Content analysis of preventative measures
The second set of analyses concerned the content of the
139 papers which proposed at least one measure and those
individual studies among them that evaluated the measures for
their effectiveness (n = 22). The level of detail about preventative
measures ranged from general recommendations or implicit
assumptions of the author (e.g. ‘education seems to be the only
hope’, Nixon et al., 1985, p. 221; ‘other measures are needed such as
 G.M. Havârneanu et al. / Accident Analysis and Prevention 81 (2015) 30–50 37

Table 6
Summary of the studies which provide empirical support for several measures tested independently or in combination.

Reference Location and Study design and measures Sample and data collection period Significant results reported and implications for
(authors, specific setting the effectiveness of the measure
date)
Evaluation of several measures (independent implementation): fencing at hotspots, landscaping, signage
Silla and Finland, 3 different Study design: experimental, ecological study, 2612 trespassing cases. Before- Fencing reduced trespassing by 94.6%,
Luoma locations in the with before and after measurements phase measurements were carried followed by landscaping (91.3%) and
(2011) city of out in May 2006 and after-phase prohibitive signs (30.7%).
Lappeenranta measurements in May 2007
Fencing: fences were installed on both sides of
the railway line were approximately 1.0m high
and extended roughly 100m from the
unofficial path in both directions.
Landscaping: removal of the existing path
across the railway line, steepening the sides of
the railway line, planting trees and bushes to
form a natural fence, planting grass and
decorating the sides with a few large stones.
The landscaping was approximately 1.5m high
and 200m long, the unofficial path being
roughly in the middle of it.
Signage: prohibitive signs widely used in rail
and road transportation were erected on both
sides of the railway line.
Outcome variable: number of trespassers

Evaluation of several measures (successive implementation): communication + education + enforcement

Lobb et al. New Zealand, Study design: experimental, ecological study, 172 male pupils observed during Communication did not decrease unsafe
(2003) inner city platform with repeated measurements 8 months crossings.
close to a school in
Auckland
Communication: large billboard placed near Education significantly reduced trespass
the platforms; distribution of leaflets around behaviour.
the school; and the placement in the school of
posters.
Education: talks during a 4-week period, a Punishment reduced trespass behaviour even
general statement about rail safety made more.
during the school assembly and follow-up
activities during class time.
Enforcement: for 2 weeks, every boy observed
crossing unsafely by the teacher on duty was
given a Friday detention. Rewards (pens and
chocolate bars) were given out intermittently
to boys observed crossing safely.
Outcome variable: trespassing behaviour

Evaluation of several measures (simultaneous implementation): fencing at hotspots reinforced with measures to soil clothes + signage + education
Lobb et al. New Zealand, Study design: experimental, ecological study, 2120 trespassing cases observed The rate of trespass decreased substantially
(2001) Auckand, with before and after measurements during 3 moments: prior to (from 59% to 40%) and the decrease was
Henderson railway campaign, 2-weeks into campaign sustained and even greater three months later
station in and 3-month follow-up. (from 40% to 36%). Educational measures may
Waitakare City have had less effect than the increased access
prevention.
Fencing: installation of new fences and
repairing of old ones. The bars on each side of
the gap were smeared with heavy grease.
Signage: large warning signs on and near
platforms. Posters placed in nearby factories
and similar; larger posters placed on billboards
in the vicinity of the station.
Education: talks given by City Council and Rail
safety officers to pupils at local schools.
Leaflets distributed to workers at railside
factories, and in surrounding residential,
commercial and industrial areas. Planned
media coverage about the safety programme
including comments, photographs of the new
signs and posters in local newspapers.
Outcome variable: trespassing behaviour

an education campaign backed up by enforcement in problem
areas’, Patterson, 2004, p. 14) to specific figures in evaluation
studies. The content analysis of measures described in this corpus
resulted in a panel of 100 specific measures distributed in 19 main
categories (see Table 1). These categories are reported by
descending citation frequency, which essentially reflects the
measures’ popularity in the literature and the degree of debate
and endorsement in the research community. This should not be
understood as a measure of effectiveness, quality of research or
impact on prevention. Sixteen categories of measures are common
38 G.M. Havârneanu et al. / Accident Analysis and Prevention 81 (2015) 30–50
to suicide and trespass prevention, and other three are dedicated to
suicide prevention. All these categories of measures are discussed
in the following section according to the problem they target, their
effect mechanism, and the specific examples that have been
identified.
4. Discussion
4.1. Common measures against suicide and trespass
4.1.1. Fencing and other physical barriers
Physical barriers are by far the most popular measure against
both suicide and trespass. Access restriction to the tracks is
frequently recommended without providing any details about
implementation, whereas other authors propose specific physical
barriers according to the target-problem or location. A large part of
the literature recommends fencing at suicide hotspots: priority
should be given to locations where open-line suicides occur more
frequently (Routley et al., 2004), densely populated areas (Rådbo
et al., 2012a), suicide bridges (Lindqvist et al., 2004) and areas close
to psychiatric hospitals (van Houwelingen, 2011). To be effective
fences at suicide hotspots should be ‘fairly high and wide-ranging’
(Rådbo et al., 2008) or ‘high over long distances’ (Bhui et al., 2013).
One may note that these recommendations are still vague to be
operational. Although the proximity of psychiatric institutions to
the railways is acknowledged as a high-risk factor, to date there is
no study that have assessed how fencing measures at these
locations actually prevent suicide in psychiatric inpatients. In
contrast, there is a consistent support for the effectiveness of safety
barriers at bridges (see Table 4 for details): Beautrais et al. (2009)
reported a 100% suicide reduction at a bridge in New Zealand and
Pirkis et al. (2013) found a global 86% decrease at several fenced
bridges with some increases in neighbouring sites, but with an
overall significant reduction in all suicides by jumping. Similar
effects of this measure are reported by Reisch and Michel (2005)
and Hepp et al. (2012) in Switzerland. The theory behind fencing at
bridges is that by impeding access, it may ‘buy time’ for the
individual to reconsider his or her actions, particularly in situations
where these actions are associated with impulsivity or ambiva-
lence (Cox et al., 2013).
At stations, suicide can be prevented through dedicated barriers
such as intermediate fencing between platforms (Lindberg, 2012)
or mid-platform fencing restricting access to fast lines where trains
pass through without stopping (RSSB, 2013). The latter was rated
65.9% effective by British respondents who believed that it would
decrease the number of suicides on fast lines (RSSB, 2013).
However, there is no published study that shows that the number
of suicides at stations with mid-platform fencing is actually lower
compared to stations not equipped with this measure. Platform
screen doors (PSD), are another type of anti-suicide fencing (e.g.
O’Donnell and Farmer, 1992). Two studies have shown positive
results in Hong Kong (see Table 4 for details), where it reduced
suicide with 59–84% (Law et al., 2009) and all injuries at platforms
with 68.8% (Law and Yip, 2011) with no displacement of suicide
attempters to unsealed platforms. This measure might not only
restrict access but also ‘delethalise’ the image of railway suicide by
giving the railway environment a much safer ‘look’ (Law et al.,
2009). However, it is only applicable to underground railways or
subways, but not to open railway networks (Too et al., 2014). The
installation of noise barriers has been proposed as another anti-
suicide solution to reduce accessibility to the tracks because they
are usually robust structures, harder to surmount than traditional
fences (Rådbo et al., 2012a). However, they can be problematic
since they might provide undesired visual seclusion (Rådbo et al.,
2012a) and their effectiveness as physical barrier has not been
evaluated yet. Fences can also be used in symbolic ways, indicating
the boundary of an area with restricted access (Bhui et al., 2013).
This specific approach of using fences is mainly discussed in the
context of suicide prevention. For example, Rådbo et al. (2008)
argued that less rigorous fences may as well influence people's
behaviour by indicating the boundary of an area with restricted
admission, while van Houwelingen (2011) suggested putting
transparent intermittent fences on the platforms, which do not
obstruct boarding and getting off the train, and which mark a no-
standing area on the platform until a train has stopped. Symbolic
fencing is less costly than traditional fencing and indicates that
measures with a clear physical effect (e.g. access restriction) can be
implemented as psychological barrier for suicide candidates (van
Houwelingen, 2011) and probably implicit prohibitive sign for
potential trespassers. However, there is no evidence concerning
the effectiveness of these symbolic barriers and it remains unclear
how they would influence the decision to enter the tracks.
Particular types of fences at stations are equally recommended
against suicide and trespass. For example, fencing at platform ends
has been proposed as a useful method to reduce suicide attempts
(Holdaway et al., 2012; Lindberg, 2012; van Houwelingen, 2011)
and should be considered for any specific location where trespass is
a major factor (RSSB, 2005). However, the level of evidence is
questionable since fencing in Cape Town rail stations has done
little to reduce injury rates (Lerer and Matzopoulos, 1996).
Some physical barriers are specifically targeted towards
trespass: for example, anti-trespass grids are recommended only
to prevent trespass behaviour by making potential shortcuts
impracticable (RSSB, 2005), with unknown effects on suicidal
people. These grids can be steel or wood and can be mounted onto
the platform ramp surface between the edge of the ramp and the
security fence (RSSB, 2005). It is also recommended to lock up
service entrances and unofficial pedestrian paths (Bhui et al., 2013;
Debbaut et al., 2013) to prevent people from entering the tracks or
reaching tunnels or technical cabinets. Additionally, higher fences
are recommended at train holding areas to prevent vandalism and
the associated trespassing behaviour (Offler et al., 2009). These
physical barriers are recommended to prevent trespass in absence
of clear evidence for effectiveness. In contrast, two studies have
shown that fencing at trespass hotspots is highly effective (see
Table 6 for details). In Finland, trespassing behaviour dropped by
94.6% after 1.0 m high fences were installed on both sides of the
railway line 100 m in both directions from an unofficial path (Silla
and Luoma, 2011). In New Zealand, fencing reduced trespassing
behaviour at a station hotspot from 59% to 36% (Lobb et al., 2001)
when combined with signage and education measures. At
trespassing locations the physical effect of a fence may be boosted
by different adjustments to reinforce their restrictive effect:
smearing the bars with heavy grease in order to soil the clothes of
trespassers (Lobb et al., 2001) or making deep trenches on both
sides of the fence (Silla and Luoma, 2009). However, the effect of
these adjustments was not evaluated in comparison to simple
fencing.
4.1.2. Collaboration between institutions
Collaboration between institutions at local or national level to
prevent suicide and trespass is frequently mentioned with no
detailed recommendations. At a very general level, it is proposed
that railway stakeholders find new partners for collaboration: local
businesses, parent and other community groups (Federal Railroad
Administration, FRA, 2011), chambers of commerce, local stores,
unions, youth services, city planners, transportation engineers,
manufacturers, survivors and bystanders (Cohen et al., 2003). The
involvement of businesses in both intentional and unintentional
injury prevention efforts can indeed raise awareness of prevention
issues, while bystanders can discourage risk taking (Cohen et al.,
2003).
 G.M. Havârneanu et al. / Accident Analysis and Prevention 81 (2015) 30–50
Finding and establishing collaboration between institutions
and stakeholders is actually a transversal measure which under-
pins or supports the implementation of other categories of
measures. For example, cooperation achieved across different
levels of government, railway companies, public safety organ-
isations, police, unions and community groups to promote rail
safety is essential for carrying out effective education campaigns
(BTRE, 2002). Similarly, school boards and local school officials can
partner by participating in educational programs such as
presentations, sending notices home to parents, and by ensuring
the safety of children in schoolyards adjacent to rail operations
(FRA, 2011). Other partners may include police forces, local
government representatives, agencies and councils, non-profit
organisations, mental health services, specialized professional
resources, emergency services and primary care trusts (Brown
et al., 2012; C.A.R.E., 2006; Lobb et al., 2001; RSSB, 2005).
The proposed ways of collaboration to prevent suicide are
twofold. The former is consultation with psychiatric hospitals
situated in the proximity of railway lines (Lindekilde and Wang,
1985; van Houwelingen et al., 2010) and health authorities such as
epidemiologists, injury specialists, and health care providers
(Cohen et al., 2003). It encompasses several principles or goals
that might be achieved thanks to such collaboration. Planning and
development of psychiatric facilities at a distance within a circle of
about 2–3 miles from a railway line should be prevented by law
and the visibility of railway tracks from psychiatric facilities should
be strictly inhibited (Ladwig et al., 2009). In addition, communi-
cation to mental health professionals in psychiatric hospitals near
railways should raise awareness about the devastating effects of
suicides on train drivers and promote measures that these
hospitals can take to prevent their patients' access to the nearby
railway track (Kerkhof, 2003) such as actions to monitor in-patient
whereabouts and suicidal intent (Ratnayake et al., 2007). Mental
health services could proactively inform rail companies of any
changes occurring in the accommodation of populations at risk or
of new housing plans (van Houwelingen, 2011). The introduction of
procedures and guidelines regarding identification and treatment
of suicidal patients, and relevant staff training, might also
contribute to a lower number of railway suicides among the
patients (Debbaut et al., 2013). However, no study has clearly
evaluated this type of collaboration.
The second collaborative measure against suicide is having a
national suicide prevention strategy (e.g. Florentine and Crane,
2010). In England for example, this strategy has three goals
(Holdaway et al., 2012): (1) to reduce risk of suicide in key high
groups, with men under 25 years of age as the priority group; (2) to
establish a cross-government network to address a range of social
issues that have an impact on people with mental health problems
(inter-agency work); (3) to help local services identify their suicide
hotspots and to take steps to improve safety at them. In the
Netherlands, the national strategy resulted in introducing an
online suicide prevention service in September 2009 (www.113on-
line.nl) with the aid of an 18-month government subsidy (van
Houwelingen, 2011). This service offers direct help to suicidal
persons, to those who are worried about a person at risk of suicide
and to those who have lost a family member or friend by suicide. In
Belgium, a strategy is run by a national working group (Andriessen,
2011) and includes nine distinct actions among which awareness
events, radio and poster campaigns, annual publications, and
trainings. One study (Baumert et al., 2011) shows the positive
result of the German national railway suicide prevention strategy.
This project carried out in 2002 reduced the number of suicides on
the German Railway network by almost 14% by implementing a
combination of measures like inter-agency meetings, media
communication strategy and access restriction (see Table 4 for
details).
39
The remaining means of collaboration were associated to both
trespass and suicide prevention, although they were proposed by
different publications. Collaboration can be established with mass
media as they can assist in educating the public about the potential
hazards of trespassing on the railways and build awareness and
support for problem-solving efforts. Establishing a good working
relationship with local editors and reporters can help get
community trespass prevention activities prominently displayed
in the media (FRA, 2011). The collaboration may focus on particular
trespass-related issues such as media reporting positively on
successes in alleviating vandalism and graffiti (Offler et al., 2009).
Collaboration with media should also be part of the public health
strategy (Leenaars, 2005) and may encourage people who
contemplate suicide to seek help (Andriessen, 2011). Collaboration
with media is also recommended to avoid publicising the high-risk
locations and railway suicide cases (Debbaut et al., 2013 Yip et al.,
2012), and can result in media guidelines to avoid copycat suicide
(Media guideline is discussed later as the measure ‘Appropriate
reporting or broadcast of critical incidents’, see Section 4.2.1).
Collaboration with police, other law enforcement authorities,
and justice departments has been recommended against trespass
(e.g. Offler et al., 2009) and applied to rail suicide prevention
(Brown et al., 2012; RSSB, 2013). The police can be very helpful in
conducting site evaluations of problem areas and tracking of
incidents; officers can assist in trespass enforcement and educa-
tion efforts, assist in data collection, and provide specialized
knowledge of rail operations and crime prevention (FRA, 2011).
Thus, one specific recommendation is that schools should
collaborate with police (Offler et al., 2009). Local law enforcement
can assist with information about social and economic problems
within the community, which may be beneficial in reaching out to
specific neighbourhoods and population groups (FRA, 2011).
Collaboration with police forces has been proposed for preventing
suicides as well. One good example is the British Transport Police
PIER plans (Brown et al., 2012; RSSB, 2013). British Transport Police
(BTP) is the key organisation undertaking Great Britain’s nation-
wide work on railway suicide outside the Network Rail/Samaritans
programme (Samaritans is the largest suicide prevention charity
network in the UK, providing support to people in distress through
helpline, local interventions in the community, etc.). PIER plans
include four actions plans (prevention, intelligence, enforcement
and reassurance) generated by BTP for identified vulnerable
persons. These plans include amending the missing persons
procedure, such that they can now be notified of any missing
person where there is some concern that they may use the railway
network to attempt suicide; establishing a third party referral
protocol with Samaritans, whereby they can facilitate a contact
between a vulnerable person and Samaritans; and the production
and management of PIER Plans for identified vulnerable people
known to be a suicide risk to the rail system (Brown et al., 2012;
RSSB, 2013).
Local community partnership is another type of collaboration. It
can provide an effective and relatively low cost means of deterring
trespass (RSSB, 2005). Local authorities, government and commu-
nity based agencies (e.g. mayors, city managers, or local leaders
involved in developing solutions) can provide key resources since
they know who is likely to help and because protecting the citizens
in their community is an important part of their job. They also
know the representatives at regional and local government
agencies who are uniquely qualified to address rail or community
issues (FRA, 2011). A volunteer workforce from the local
community can take responsibility for stations and their environ-
ments, for example in community mural projects that intend to re-
focus the attention of graffiti writers (Offler et al., 2009). As the
volunteers are resident in the local community, the level of
attention paid to vandalism issues is greatly increased
40 G.M. Havârneanu et al. / Accident Analysis and Prevention 81 (2015) 30–50
(RSSB, 2005). For suicide prevention, developing local suicide
prevention plans (RSSB, 2013) and working in partnership with
local authorities (Brown et al., 2012) are also recommended. Public
health agencies like local government, Health and Wellbeing
boards, commissioners of health and social care services, and
providers of health and social care services can work more closely
with other agencies (Bhui et al., 2013).
Strategies for better inter-agency communication are recom-
mended to improve suicide (Andriessen and Krysinska, 2011) and
trespass prevention (RSSB, 2006). Cohen et al. (2003) recommend
sharing resources, reducing duplication of efforts, coordinating
services, and attaining greater credibility on the issue. Brown et al.
(2012) report that communication might raise difficulties in the
collaboration to prevent railway suicides and that a good
communication is needed between: (a) the infrastructure manager
and train operating companies, (b) train operating companies and
(c) between Samaritans head office and its local branches.
Regarding the prevention of trespass, clarification of responsibili-
ties for different agencies and organisations is essential (RSSB,
2006).
4.1.3. Environmental design
Environmental design refers to changing the landscape or the
terrain near the railway, so that suicide becomes more difficult and
trespass less attractive. For example, demolishing abandoned
buildings or kiosks situated close to the tracks will discourage
trespassers motivated by occupying a quiet place (RSSB, 2005), will
reduce opportunities for graffiti by removing potential surfaces
(Thompson et al., 2012) and will eliminate concealment places for
suicidal persons (Brown et al., 2012; van Houwelingen, 2011). In
addition, vegetation hindering the driver’s view and providing
hiding place for suicidal people should be removed (Debbaut et al.,
2013).
Spatial separation and structural design can be used to prevent
suicides by maximising the distance between fast tracks with non-
stopping trains and densely populated areas (Rådbo et al., 2008) or
platforms with waiting commuters (Brown et al., 2012; van
Houwelingen, 2011). This measure may create practical difficulties
for the capacity of railway networks (Holdaway et al., 2012) and
has not been evaluated yet.
Impeding access with impenetrable vegetation, ditches or
slopes (Lindberg, 2012) or elevated tracks or tunnels (Rådbo et al.,
2008) is thought to be effective against suicide although no study
has evaluated its effect on suicide cases. Silla and Luoma (2011)
evaluated the effectiveness of landscaping on trespass behaviour in
one study (see Table 6 for details): they removed of the existing
path across the railway line, steepening the sides of the railway
line, planting trees and bushes to form a natural fence, planting
grass and decorating the sides with a few large stones. The
landscaping was approximately 1.5 m high and 200 m long, and led
to a 91.3% reduction in the number of trespass (Silla and Luoma,
2011).
Other environmental solutions against trespass are to replace
high risk or unauthorised footpaths with footbridges (Morse and
Taberneso, 2013), underground tunnels or more safe and ‘inviting’
footpaths. In Finland, building of an over- or underpass was
supported by 65.3% of people living close to a railway line as one of
the most effective countermeasures against trespass (Silla and
Luoma, 2012b). However, Finnish train drivers somewhat hesitated
to recommend underpasses because of the high building costs
(Silla and Luoma, 2009). RSSB (2005) suggests that with well-
presented, enclosed footbridges there is less temptation to cross at
track level. Well-designed footbridges should provide good sight-
lines across the station, include ramp access or lifts, and
accommodate the requirements of disabled passengers and station
staff who need to cross the tracks (RSSB, 2005). Enclosed
footbridges can be made more ‘inviting’ by adding suitable viewing
panels allowing view of the track, of a type easily maintained and
serviced from the bridge walkway (RSSB, 2005). Authorised
walking routes should be established along the illegal short cuts
and the authorised routes should be made more attractive to use
(RSSB, 2005). These measures would support the correct behaviour
for trespassers. Once again, no study has clearly established their
effectiveness on the actual trespassing behaviour.
Closing LCs (Nixon et al., 1985) or replacing them with over or
under-passes is recommended to prevent suicide (Debbaut et al.,
2013; van Houwelingen, 2011, 2013) and trespass especially in
areas with dense train traffic (Silla and Kallberg, 2012). The safety
operation of remaining LCs should be improved by ensuring
appropriate physical conditions and sufficient warnings (Ozdog an
et al., 2006), as well as active warning devices (Evans, 2011; Savage,
2006). Redesigning LCs to increase visibility is recommended to
prevent suicide (Rådbo et al., 2012) and trespass (Horton, 2009;
Silla and Kallberg, 2012), allowing pedestrians to be detected more
easily if they enter the tracks illegally from a LC. The least safe
LCs – the passive ones – should be designed is such ways that
pedestrians are able to judge whether or not it is safe to enter the
tracks (BTRE, 2002).
4.1.4. Monitoring and detection systems
The literature is divided between publications that refer to this
measure in general (e.g. Holdaway et al., 2012; Lindberg, 2012;
Rådbo and Andersson, 2012), publications that provide some sort
of recommendations and others focus on rich technical details, for
example about the implementation of closed-circuit television
(CCTV). In most cases the systems are recommended to detect (and
sometimes warn) the persons at risk. The papers focus either on
trespass or suicide prevention; therefore we keep this distinction
in what follows.
Regarding trespass, RSSB (2005) points out that CCTV will not
necessarily stop intrusions on its own. CCTV has the potential to
reduce the incidence of teenage trespass, provided that offenders
are apprehended and publicly dealt with (RSSB, 2006). The
coverage area of the surveillance cameras should be extended to
monitor the platform end (RSSB, 2005) with the image visible to
staff at both the platform level and in the control room (Holdaway
et al., 2012). There are many technical possibilities to improve the
effect of surveillance cameras. The first is to combine CCTV with
sound warnings or megaphones (DaSilva, 2011). However, linking
CCTV with public address-system-announcements may be effec-
tive in deterring children but less effective for adults (RSSB, 2005).
Other recommended systems are composed of motion detectors
combined with sound warnings (RSSB, 2005) or flashcams which
take photographs of trespassers (RSSB, 2005). DaSilva et al. (2006)
have shown the effectiveness of video camera combined with
infrared illuminator, speaker, motion detector and magnetometer
on a railway bridge in the USA (see Table 5 for details): the trespass
rate dropped by 60% from the first to the second year and by 17% in
the third year compared to the first one. A low-cost alternative to
these intelligent CCTV systems is to use dummy cameras
(Thompson et al., 2012) to deter the access to high risks areas
by means of implied surveillance. However, it is unknown from the
literature what the cost difference is and whether fake cameras
indeed have short-term or long-term effectiveness at preventing
trespass.
Regarding suicide, surveillance systems have been recom-
mended mostly to detect suicidal or pre-suicidal behaviour and to
alert the railway staff. For example, Burrows and Laflamme (2007)
proposed surveillance to be used to better understand the
epidemiological information on suicide mortality statistics. This
means that the cameras are used to collect information about the
occurring suicide events. Similarly, Kerkhof (2003) recommends
 G.M. Havârneanu et al. / Accident Analysis and Prevention 81 (2015) 30–50
the use of cameras at hotspots close to psychiatric hospitals to
warn the staff in the proximity. Passengers waiting on the platform
may also contribute to suicide prevention by being provided with
video feedback to encourage them to be more vigilant in detecting
peers at risk and to notify the station staff when they see abnormal
behaviours (Bhui et al., 2013). The effectiveness of surveillance in
preventing suicides depends upon the availability of vigilant
observers monitoring the video screens and the potential to
dispatch help to the scene or notify train drivers in time to prevent
the suicide, thus a railway system with hundreds of cameras to
monitor requires many people available throughout the day
(Mishara, 2007). There is no published evidence that such systems
have actually reduced the number of suicidal behaviours.
4.1.5. Education and information at individual level
Mainly proposed for trespass prevention, this measure has been
sometime proposed with specific contents dedicated to suicide
prevention. Trespass and suicide prevention are discussed
sequentially in what follows.
To prevent trespass, increasing individual knowledge about
risks and safe behaviours in railways area is most frequently
mentioned (e.g. DaSilva and Carroll, 2011; FRA, 2011; Lobb, 2006;
RSSB, 2005; Silla and Luoma, 2009). It is also proposed as a general
safety strategy against accidents (Horton, 2009; Mohanty et al.,
2007; Nixon et al., 1985; Patterson, 2004). Education can be
conducted in and outside of schools. In schools, various
educational tools are used, separately or jointly, to this purpose:
lessons, communication specifically aimed at teachers, educational
tool kits, thematic school calendars and even the integration of
safety messages and information about track safety in disciplines
within different curricula such as mathematics, science, literacy,
history or geography (Patterson, 2004; RSSB, 2003a). Education
programs in schools may also employ drama, filmmaking, and
lectures to make students aware of the dangers and impact of
vandalism on others and the environment (Offler et al., 2009).
Education at school about the dangers of trespassing was
supported by 36.5% of the people living close to a railway line
(Silla and Luoma, 2012b), and helped reduce trespass behaviour
when combined with communication and enforcement (Lobb
et al., 2003) or fencing and signage (Lobb et al., 2001; see Table 6
for details). Additionally, it has been proposed to carry out
interventions outside of schools, i.e. the development of education
programs for adults, communities or social workers. For example, a
campaign amongst the parents of very young children may
improve their awareness of the dangers of railway trespass and
encourage them to prepare their children better to avoid these
(RSSB, 2006). Risk awareness should be raised at ‘strategic’
locations close to the tracks such as bars and taverns (Savage,
2007), or places where vandalism is the main root of trespassing
behaviour (Thompson et al., 2012), although one may question if
education would really work on intoxicated people or vandals.
Other recommendations point to the combination of education
with enforcement (Patterson, 2004) or environmental interven-
tions (Wasnik, 2010). For example, Lobb et al. (2001) reported that
educational message distributed to workers at railside factories,
and in surrounding residential, commercial and industrial areas in
combination with fencing and signage significantly reduced
trespass, although education may have had a weaker effect than
the other two measures.
Suicide prevention using education has been recommended in a
few cases to improve individual awareness about suicide risks (e.g.
Rådbo et al., 2008). Such recommendations include programs to
increase suicide awareness in general (helping peers, knowledge
about suicide) (Leenaars, 2005) and among clinicians in commu-
nities (Yip et al., 2012). Interventions in schools can be used to raise
awareness among pupils and school teachers and to identify young
41
people at early risk of suicide (du Roscoät and Beck, 2013).
However, no evidence was published until now.
4.1.6. Enforcement, punishment and patrols
The enforcement of safety rules through visible human
presence and surveillance is recommended as a general preventa-
tive direction, with a few papers making specific recommenda-
tions for suicide or trespass prevention. Police presence and
suicide patrols are recommended at hotspots to intervene when
suicide attempts are identified (Cox et al., 2013). Video surveillance
and CCTV systems to facilitate the intervention of security staff at
stations may increase the difficulties for suicide attempters to
complete the act (Lindberg, 2012; Ratnayake et al., 2007). This is
supported by Niederkrotenthaler et al. (2012) who have shown
that the presence of a surveillance unit at stations is associated
with a decrease of suicidal behaviours (see Table 5 for details). In
addition, the mere presence of human personnel at stations is
believed to be a deterrent in itself: station staffing and the presence
of human personnel at stations may discourage suicide (Clarke and
Poyner, 1994), but also trespass (RSSB, 2005). To improve suicide
prevention, Kadotani et al. (2014) recommend the station staff to
increase railway surveillance after several consecutive days
without sunshine when suicides are more likely to occur.
Additionally, Lindberg (2012) recommends that personnel from
the track area wears visible clothing (e.g. reflective jackets); on the
one hand this communicates to potential suicide candidates that
they can be seen and stopped during the attempt. On the other
hand and more generally, the systematic use of visible clothing by
railway staff contributes to trespass prevention since it dictates
that those people are authorised to be in the track area.
Improved enforcement procedures are also recommended to
prevent trespass and vandalism. In this respect, Offler et al. (2009)
and Thompson et al. (2012) propose an increased presence and
visibility of staff on trains, introduction of a professional security
service, employing young people to staff patrols, or establishing a
‘railwatch’ for staff and public. Some recommendations are similar
to those from suicide prevention; for example patrolling should be
done particularly during the peak periods for trespass and
vandalism (Offler et al., 2009; RSSB, 2002). Other recommenda-
tions to prevent trespass are different; for example Thompson et al.
(2012) recommend that security staff should wear plain clothes
because it is more effective to identify and stop trespassers,
although passengers frequently report feeling more safe when
security staff are highly visible. Visible clothing is still required
when intervening out of the authorised pathways. Trespass
prevention requires the additional ability of security patrols to
detect and fine illegal and unsafe behaviour (Akkaş et al., 2011; C.A.
R.E., 2006; Lobb, 2006) which may also include legislative efforts
(DaSilva and Carroll, 2011). The risk of being caught has the power
to act as a real deterrent in some area, but only if the risk is real
(RSSB, 2006). Implementation of special security patrols in the
Cape Town rail system has failed to show any reduction in both
suicide rates and trespassing injury (Lerer and Matzopoulos, 1996).
A study by Lobb et al. (2003) indicated that combining punishment
with intermittent reinforcement of desired behaviour (i.e.
rewards) significantly reduced trespass behaviour in male pupils
(see Table 6 for details). One questionable measure involving
punishment to prevent suicide is to charge the victim's family for
disrupting the rail system (Routley et al., 2004).
4.1.7. Public safety communication
The literature refers to mass media campaigns, public
communication, or public awareness raising, defined as any
purposeful attempts to inform, persuade and motivate a targeted
subgroup of the population to change its attitudes and behaviours
to improve rail safety. Segmentation of vulnerable groups is
42 G.M. Havârneanu et al. / Accident Analysis and Prevention 81 (2015) 30–50
recommended for trespass (RSSB, 2003b; Searle et al., 2012) and
suicide (Baumert et al., 2008). Pedestrian high-risk categories
comprise school children, youth, people with physical disabilities
or mobility aids, and elderly over 60 years (Searle et al., 2012).
Survivors of railway and metro suicide attempts are at particular
risk of repetition, thus represent a high-risk group (Mishara, 2007)
that requires specific communication to prevent future attempts.
Education campaigns have a higher likelihood of success for
pedestrians (Morse and Taberneso, 2013; Searle et al., 2012) and
mass media is a key partner in promoting them. Safety
communication against trespass (RSSB, 2012) consists of organised
communication through different media channels in a given time
period, describing the dangers related to being on the tracks and
the consequences of an accident (BTRE, 2002; Pelletier, 1997).
Planned media coverage may also include comments of local
authorities or photographs of other implanted measures through-
out the campaign (Lobb et al., 2001). Lobb et al. (2003) evaluated
the effectiveness of public communication (safety message
displayed on billboards, leaflets and posters) in combination with
school education and enforcement and showed that communica-
tion was the least effective of the three measures (see Table 6 for
details).
While public communications to prevent trespass typically
evokes danger or death on the railways to influence the knowledge
of regulations and awareness of risks, it does not necessarily take
into account the issues related to suicide (e.g. the need to be
positively primed). Their effect on the latter can thus be negative
by spreading the message that entering the tracks can be fatal, but
there are no studies to evaluate if this is indeed the case. In
contrast, targeted safety communications to prevent suicide work
differently, since they are included into wider action plans such as
national/local prevention campaigns along with other measures
(e.g. posters, helplines, gatekeeper training). Community media
campaigns advertise local crisis intervention centres (Symonds,
1994) or inform commuters what they can do to help prevent
railway suicides (Kerkhof, 2003). The internet and the new social
media can also be used to promote helplines for people at risk of
suicide (Hepp et al., 2012). As yet, little research has tested
whether all forms of today’s media can be used to positively affect
vulnerable individuals in a way that promotes good mental health
or adaptive help seeking at times of distress (Yip et al., 2012).
Public communication should be tailored more precisely to the
need of specific locations (Dinkel et al., 2011). For example, in-
hospital communication (Ladwig et al., 2009) may help increase
awareness in psychiatric units (Mishara, 1999) on the identification
of suicide risk and the need to educate patients about the false
beliefs that rail suicides provide for a certain, painless, and
immediate death (Mishara, 2007). A public health campaign may
have a dual role to play in simultaneously raising public awareness
of mental health concerns, while also reducing the possibility of
copycat suicides (Bhui et al., 2013). An improved public health
policy should focus not only on mental health problems but also on
the use of alcohol and drugs (Silla and Luoma, 2012a).
4.1.8. Signage
Signage is mostly an anti-trespass measure, but some
recommendations can be found in the suicide literature as well.
In the context of trespass (e.g. DaSilva and Carroll, 2011; Lobb et al.,
2001; RSSB, 2005), the measure is partly linked to education in
order to support people's interpretation and awareness about
prohibited actions or about risks and/or recommended actions.
Warning signs and prohibitive signs are equally recommended (e.g.
C.A.R.E., 2006; DaSilva and Carroll, 2011; RSSB, 2005; Silla and
Luoma, 2009; RSSB, 2011a; Savage, 2007) and should be placed at
hotspots (BTRE, 2002; RSSB, 2005, 2006). Silla and Luoma (2011)
evaluated the effectiveness of prohibitive signs at a hotspot in
Finland and found that trespass dropped by 30.7% providing
support for this measure (see Table 6 for details). RSSB (2011b)
recommends extending the yellow warning lines from the high-
speed platforms to the non-high-speed platforms as other
important markings at stations. Station signage can be an effective
way of reducing trespass (RSSB, 2005) but the potential of signs to
change behaviour in the absence of any other activity is limited
(RSSB, 2006), therefore they are usually part of wider interven-
tions. For example Lobb et al. (2001) evaluated the effect of
warning signs and posters in combination with fencing and
education and found that it significantly decreased trespass at a
railway station from New Zealand (see Table 6 for details).
In the context of suicide prevention, signage is most often used
as posters and signs placed at priority locations to encourage
people at risk of suicide to contact help (RSSB, 2013). We will
discuss this as a separate measure (point 4.2.2). In addition,
Andriessen and Krysinska (2011) propose ‘No Entry’ signs placed at
the most dangerous places, while visible markings and warning
signs may keep people away from platform edges (Bhui et al., 2013;
Lindberg, 2012). These recommendations are quite general, and it
is not clear if they are really effective on people who contemplate
suicide. Lindberg (2012) notes that even though signs prohibiting
access can hardly in themselves prevent suicide attempts, they do
provide an indication that something is wrong when someone goes
out onto the tracks, providing people in the area with an
opportunity to react.
4.1.9. Technical design to reduce the effects of impact
Some publications recommend an improved ergonomic design
of trains against general injury without providing further details or
evidence for effectiveness (e.g. Akkaş et al., 2011; Lerer and
Matzopoulos, 1996; Matzopoulos and Lerer, 1998; Nixon et al.,
1985). The train front should be designed to dissipate the collison
energy as greatly as possible, considering the human tolerance of
mechanical impacts: instead of a blunt crash into persons on the
tracks redesign of fronts may help to push them aside (Beskow
et al., 1994). In addition to the front geometry (Routley et al., 2004),
this can be achieved through smooth surfaces, shock absorbing
structures, deflecting devices (Rådbo et al., 2008), or trains with
more ground clearance (Coats and Walter, 1999). Specific examples
include nets on trains (Ladwig et al., 2009), the redesign of the axel
box dampers along the sides of the rolling stock (Rådbo et al.,
2012a), and inflatable airbags mounted in front of trains (Beskow
et al., 1994; Kerkhof, 2003; Rådbo et al., 2012a). An airbag, which
inflates after the use of an emergency brake, can cushion and
reduce the impact of collision between a body and a train, and a
rigid skirt can prevent the body from falling underneath the train
(Clarke and Poyner, 1994). It has been suggested that a well-
designed protective skirt also has a psychological effect on people
contemplating train suicide by reducing the appeal of the front of a
train as a tool for suicide (Clarke and Poyner, 1994). However, it is
not clear to which extent these recommendations are actually
implemented in practice or even considered by designers and
engineers in the industry. Moreover, we could not identify any
study to show the effect of such measures.
The design of tracks to reduce the injuries to people hit by trains
(Beskow et al., 1994; Rådbo et al., 2008) is also taken into account.
One recommendation is to place the third electric rail further from
the platform (Hawton, 2007) to decrease the chances of
electrocution, but it is yet unknown if this measure would really
make a difference. Nevertheless, the most common and effective
measure is to deepen the space between the rails at stations in
order to create a pit (Hawton, 2007; Holdaway et al., 2012; Ladwig
et al., 2009; Mishara, 2007; Ratnayake et al., 2007; Rådbo et al.,
2008; Routley et al., 2004; van Houwelingen, 2011). This pit has the
same length as the platform (Coats and Walter, 1999) and is usually
 G.M. Havârneanu et al. / Accident Analysis and Prevention 81 (2015) 30–50
Table 7
Summary of the studies which provide empirical support for appropriate reporting or broadcast of suicides.
Reference (authors, Location and Study design and measures
date) specific
setting
Hegerl et al. (2013); Germany, Study design: quasi experimental,
Ladwig et al. railway ecological study, based on suicide data
(2012) system measured before and after the railway
suicide of a famous German football
player
No intervention: observation of the
copycat effect by comparing the suicide
rates two-years before and two-years
after the celebrity’s suicide
Outcome variable: number of railway
suicidal behaviours (suicides and suicide
attempts)
Yang et al. (2013) Taiwan Study design: quasi experimental,
longitudinal ecological study, based on
suicide rates in the general population
No intervention: observation of the
copycat effect by correlating the number
of suicides with news reports of suicide
Outcome variable: number of general
suicides
Kunrath et al. Germany, Study design: quasi experimental,
(2011) railway ecological study, based on suicide data
system measured before and after a presumed
railway suicide incident
Intervention: widespread media Index period: first 2 months after the
reporting of a presumed critical railway presumed railway suicide incident
incident involving suicide; two control (January and February 2007)
periods compared with study period
Outcome variable: number of railway
suicidal behaviours (suicides and suicide
attempts)
Niederkrotenthaler Austria, Study design: quasi experimental,
and Sonneck Vienna ecological study, with before and after
(2007) underground measurements, based on injury data
Intervention: introduction of media guidelines in 1987–1988.
Outcome variable: number of subway
suicides
Etzersdorfer and Austria, Study design: quasi experimental,
Sonneck (1998) Vienna ecological study, with before and after
underground measurements, based on injury data
Intervention: implementation of guidelines for responsible media reporting on suicide
in mid-1987.
Outcome variable: number of subway
suicidal behaviours (suicides and suicide
attempts)
Sample and data collection period
498 railway suicidal behaviours in the
same index period of 4 different years
(index period = 11 November to
31 December of the year): 310 suicidal
behaviours in index period of 2006–
2008 and 188 in index period of 2009
All suicides in Taiwan (n = 31,364) between Increased suicide deaths during major
2003–2010
747 railway suicidal behaviours in
2004–2007.
Year 1982–1983 to 2004–2005
155 subway suicidal behaviours between
1980–1996
43
Significant results reported and implications
for the effectiveness of the measure
Significant increase in rail suicide, and
higher than the general increase in German
suicide. Railway suicidal behaviours in the
index period increased by 1.81 (incidence
ratio), after adjusted for daily temperature,
leading to an overall percentage change of
81%.
Comparing the number of suicides 28 days
before and after the incidence revealed a
more pronounced increase. Railway
suicidal behaviours increased by 2.2
(incidence ratio) after 28 days of the
incidence, after adjusted for daily
temperature. Railway suicidal behaviours
increased by 18.8% in the following two
years.
suicide events such as celebrity death and
delayed effect of copycat suicide following
media reports of minor suicide events. The
means of suicide reported in the media
diversely affected the suicide models:
media reports of jumping had a wide
association with various suicide models.
Media reports of suicide had a higher
association with suicide deaths in urban
than in rural areas.
The daily number of suicidal acts was
43–53% higher during the 2 month index
period (following extensive media
coverage of a disastrous accident) in
comparison to the control period days.
Daily railway suicidal behaviours increased
by 44% following extensive media coverage
of the presumed railway suicide incident in
the index period, after controlling for
unemployment rates and temperature.
Subway suicides decreased by
approximately 62 cases following the
introduction of media guidelines, after
controlling the passenger number.
A sharp drop of suicides and attempts can
be found after the intervention. The
decrease from the first half of 1987 to the
second half is 84.2% for suicides and
attempts taken together (n = 19 to n = 3). In
the subsequent years the number of
suicides and attempts stayed low, although
up to five events per half-year can be found.
The level of 1983 to 1987, nevertheless, has
not been reached until 1996.
44 G.M. Havârneanu et al. / Accident Analysis and Prevention 81 (2015) 30–50
Table 7 (Continued)
Reference (authors, Location and Study design and measures
date) specific
setting
Schmidtke & Häfner Germany, Study design: quasi experimental,
(1988) railway ecological study, based on suicide data
system measured before and after a twice-
broadcast of a railway suicide in a
A–B–A–B–A design (A = baseline,
B = broadcast phase)
Factor: a twice-broadcast 6-episode
weekly serial showing the railway
suicide of a 19-year old male student;
first broadcast in 1981; second broadcast
in 1982
Outcome variable: number of railway
suicides
one-metre deep (Bhui et al., 2013). The ditch may decrease the
contact between train and body (Beskow et al., 1994), but even
when present, if the casualty has not fallen into it then he or she is
unlikely to survive (Coats and Walter, 1999). This measure is
popular in underground systems which have pits for water
drainage. There is evidence that pits are highly effective in
reducing injury and mortality following a collision. In the London
underground they reduced suicide mortality from 66% to 45%
(O’Donnell and Farmer, 1994) and the overall number of deaths
from 76% to 44% (Coats and Walter, 1999; see Table 5 for details).
Although most recommendations come from the suicide
literature, this category of measures is effective against both
suicide and trespassing accidents by decreasing the mortality rate
after collision. The effect is however not to prevent the incidents
but to mitigate the consequences.
4.1.10. Staff training
Staff training involves at least two distinct directions that cover
the primary, secondary and tertiary prevention of suicides and
trespassing accidents. The gatekeeper training teaches specific
groups of people to identify and approach people at risk of suicide
and to manage the situation appropriately. Local gatekeepers can
be staff, police, traffic officers, security guards or ambulance
personnel, who might in the course of their day-to-day work
encounter suicidal individuals (Beautrais, 2007). Railway staff are
trained to understand the behaviour patterns of subjects at suicide
risk (Andriessen and Krysinska, 2011; Dinkel et al., 2011) and
vulnerable time windows of excess risk for railway suicides (Erazo
et al., 2004b). They are also trained to manage suicidal contacts
(RSSB, 2011c) and to assist them by initiating relevant protocols
and managing the situation until emergency services arrive
(Ratnayake et al., 2007). These educational efforts can take into
account the knowledge and skills of experienced police officers
regarding recognisable risk factors (Lukaschek et al., 2011) and give
the staff the tools and the confidence to intervene in a potential
suicide attempt where appropriate (Brown et al., 2012). Such
programmes have led to successful primary and secondary
interventions (for example in the Montreal metro system)
resulting in a substantial number of people being intercepted
before a possible suicide attempt (Ladwig et al., 2009). A more
thorough evaluation of a 1-day gatekeeper course conducted in the
UK (RSSB, 2013) indicates that participants had a positive attitude
about the training and gained confidence to take action if needed.
Sample and data collection period Significant results reported and implications
for the effectiveness of the measure
From 1976 to 1984 Imitation effects were most clearly
observable in the groups whose age and
sex were closest to those of the model. Over
extended periods (up to 70 days after the
first episode), the number of railway
suicides increased most sharply among
15- to 19-year-old males (up to 175%).
The effect steadily decreased in the older
age groups, so that no effect was
observable for males over 40 years and
females over 30 years.
However, there are no studies which show an effect of this measure
on the actual suicide figures.
In addition, a more general and not so intensive training (Cohen
et al., 2003) not restricted to suicide could brief the staff at stations
or LCs (RAIB, 2011) to increase awareness (Wasnik, 2010), identify
and report signs of previous trespass such holes in access fences
(RSSB, 2005). In the UK, a quick initial training with volunteers
encouraged to report ‘live’ trespass, proved a cost-effective
addition to existing formal monitoring and reporting systems
(RSSB, 2005). Another important dimension of staff training
concerns secondary or tertiary prevention such as: raising
awareness about the impact of post-traumatic events and the
prevention of post-traumatic stress (e.g. BTRE, 2002; RSSB, 2013)
and providing the necessary psychological support in response to
the trauma caused by suicide or trespass events (see Cothereau
et al., 2004; Limosin et al., 2006; Occupational Health and Safety
Group – UIC, 2011, for details).
4.1.11. Risk assessment
Risk assessment is frequently mentioned as an indispensable
procedure in suicide and trespass prevention, because it helps
stakeholders in deciding what measures are appropriate, what
their aim is or where they should be implemented. Organisations
or industries can identify the risk of suicide associated with
particular groups or individuals: patients in services that are
located near railways (Bhui et al., 2013), patients with affective and
psychotic disorders (van Houwelingen and Kerkhof, 2008), drug
users in subway stations (Niederkrotenthaler et al., 2012), or the
causes of suicide in different age groups (Routley et al., 2004).
Other risk assessment recommendations include the identification
and monitoring of regional and local suicide hotspots (Brown et al.,
2012; Debbaut et al., 2013; Erazo et al., 2004a) and station audits
(RSSB, 2013). Although most recommendations come from the
suicide literature, one report (RSSB, 2012) discusses risk assess-
ment in a wider context which includes both suicide and trespass
prevention, in particular related to safety performance monitoring
and follow-up processes. Furthermore, the approach described by
Debbaut et al. (2013) to characterize suicide hotspots can be easily
adapted to identifying trespass hotspots: analysing and mapping
incident data, gathering information during field visits, and
conducting semi-structured interviews with relevant actors. We
could not identify any study evaluating the effectiveness of risk
assessment procedures per se.
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4.1.12. Learning from previous research and best practice
This measure refers to forms of organisational learning to
acquire and update knowledge for prevention practice. This
includes learning from research studies (Botha et al., 2010; Searle
et al., 2012), developing specific research topics (RSSB, 2012),
collecting data on incidents type and frequency (Thompson et al.,
2012), and sharing and completing databases (Lerer and Matzo-
poulos, 1996). Learning can benefit from international experience
(ERA, 2011) for example by creating an international train suicide
database with standardized definitions, similar to the International
Road Traffic and Accident Database (van Howelingen, 2011).
Previous national experience (Andriessen and Krysinska, 2011) is
also important for learning, considering all the information
collected through systematic case investigations (Rådbo et al.,
2012c). Although no study has directly evaluated their effective-
ness for suicide or trespass, some publications provide a few
successful examples in this direction. Anderson et al. (2003) have
shown for instance that benchmarking has proven to be a valuable
methodology to improve performance in the railway sector, and
that safety is one mandatory success factor for the key perfor-
mance indicators. Similarly, RSSB (2013) provides a good
collaborative practice between several stakeholders to improve
suicide prevention methods on the rail network in Great Britain
(i.e. infrastructure manager, railway undertakings, Samaritans,
British Transport Police, and organisations outside the rail
industry).
4.1.13. Lighting systems to influence behaviour
The use of lighting systems to influence behaviour is a relatively
recent measure recommended against both suicide and trespass.
For suicide prevention, the goal is to increase the visibility of the
potential victim, decrease the privacy and anonymity, and
positively influence the impulsive/ambivalent suicidal phase
(e.g. Mishara, 2007). Specific examples include improved lighting
in dark sections of the platform and high-risk locations (van
Houwelingen, 2011), using photoelectric breams or flash lights at
stations (Erazo et al., 2005), combining lighting with movement
tracking sensors (van Houwelingen, 2011), and increasing light
exposure (bright white or blue light) in railway platforms or in
trains when consecutive days without sunshine are forecasted
(Kadotani et al., 2014). The installation of ‘calming’ blue light at
station platforms and crossings is a new and intriguing measure
that has only been examined in one location. An initial study from
Japan (Matsubayashi et al., 2013) reported that blue light reduced
railway suicide with 84%, but a follow-up study by Ichikawa et al.
(2014) criticises this result and argues that it is severely
overestimated (see Table 5 for details). As Too et al. (2014) point
out the longer-term effect of this measure, the underlying causal
mechanism of why this is effective and substitution effect to other
stations and other suicide methods over time should be evaluated.
Blue light is the only measure with some empirical support in this
category. For trespass, light has a different effect mechanism: it
signals to the people who cross the tracks that the area is
monitored by the railway organisation. In this case, lighting is
proposed to be used at high-risk railway locations (Savage, 2007)
such as holding yards (Offler et al., 2009) where it is useful to
prevent vandalism (Thompson et al., 2012). No published study has
evaluated the effect of light on trespassers.
4.1.14. Additional technologies for train drivers
Technology for train drivers to help them take some actions to
reduce the risk of collision are another recommended measure.
Some technologies are installed outside the cabin and used to warn
and encourage people to leave the track (e.g. horns; BTRE, 2002) or
improve visibility for train drivers. The latter may include
spotlights on the front of trains (Savage, 2007), locomotives with
45
ditch lights (Savage, 2006) and auxiliary alerting lights in addition
to the headlight for all fast locomotives (Horton, 2009). Other
papers refer to improved speed control and ability to brake earlier
by facilitating emergency stops (Clarke and Poyner, 1994).
Magnetic brakes on more trains to shorten the stopping distance
(Rådbo et al.,, 2012a) could be a technical solution in this respect,
but there are no details about the cost difference and technical
difficulties related to implementation. Another solution is to alert
the driver beforehand thereby given a chance to brake earlier and
avoid the collision (Rådbo et al., 2008). This can be achieved
through in-cab CCTV (Beskow et al., 1994; Holdaway et al., 2012;
Mishara, 2007; RSSB, 2010) displaying in advance the current
picture of risk locations (bridge, station, LC, etc.) which allows
drivers to monitor the situations and to react if needed. An
alternative can be the reduced spot speed limits for trains
(Holdaway et al., 2012; Silla and Kallberg, 2012) giving the drivers
some extra reaction time and the possibility to stop the train faster.
However, it is unknown how much time would be needed to make
a difference. Rådbo et al. (2012a) propose warning feedback from
train drivers, when they observe trespassers, to train-dispatchers
and other train drivers in order to reduce speed and increase
watchfulness at the actual spot. Although most recommendations
come from the suicide literature, these technologies for train
drivers are expected to have the same effect for trespass. The level
of evidence is weak since evaluations are missing.
4.1.15. Design and aesthetics to influence behaviour
New stations should be designed to reduce the probability of
people to move into high risk locations (Ratnayake et al., 2007), to
avoid overcrowding and to ensure a culture of safety and care
signalled to all passengers through a transformed environment
that mitigates impulsivity (Bhui et al., 2013). This category of
interventions includes specific measures such as redesigning the
platforms by removing old unused platforms used as ‘spring-
boards’ for suicide (Andriessen and Krysinska, 2011; Debbaut et al.,
2013) or enforcing the gap (of at least 2 ft) between the edge of the
platform and where passengers can stand (Holdaway et al., 2012).
The measure also includes visual artefacts to influence the moods
and behaviours of people such as the installation of mirrors to
reduce the feeling of privacy (Erazo et al., 2005; Ladwig et al., 2009)
or painting of the platform sides (Lindberg, 2012). A calmer colour
(such as green or blue) may be less likely to trigger impulsive and
self-destructive acts and should be used to paint the exterior of the
trains; moreover, painting trains in red should be avoided since red
is perceived as a demanding or aggressive colour, and associated
with blood (Bhui et al., 2013).
The aesthetic interventions are mostly discussed in the context of
suicide prevention, with only a few recommendations in the
trespass literature. Improving the physical and social environment of
stations, carriages and public walkways and establishing a colour
palette for public spaces is assumed to reduce trespassing behaviour
derived from vandalism intentions. Stations should be designed with
an open layout and in such a way to reduce the opportunities for
graffiti by removing potential surfaces or by planting vegetation in
front of the walls (Offler et al., 2009). The surfaces should not be very
light coloured since light surfaces are targeted more than dark ones
(Offler et al., 2009). In addition, mobile teams of graffiti spotters and
clean-up trailers should regularly identify and remove graffiti from
station surfaces and trains (Offler et al., 2009; Thompson et al., 2012),
ensuring a clean railway environment. There is no published
evidence that these interventions actually reduce the incidence of
suicides or trespassing accidents.
4.1.16. Operational traffic management
This measure consists of traffic planning and special procedures
in accordance with risks already identified to prevent further
46 G.M. Havârneanu et al. / Accident Analysis and Prevention 81 (2015) 30–50
incidents. Some recommendations are to reduce the average speed
of trains as they approach station platforms (Mishara, 2007;
Ratnayake et al., 2007; Routley et al., 2004; van Houwelingen,
2011) or previously identified hotspots (Erazo et al., 2005; Silla and
Luoma, 2012a). Others propose to reduce train traffic intensity
(BTRE, 2002), although this may be difficult or even inappropriate
to implement especially in densely populated suburban areas at
rush hour. A study by van Houwelingen et al. (2013) provides some
support for this recommendation since it identified a positive
association between the train frequency and railway suicide in the
Netherlands and Germany (see Table 5 for details). The lower
frequency of commuter trains can be compensated by increasing
the capacity of each individual train, for example by making trains
longer, using double-decker trains, or introducing compartments
with standing places (van Houwelingen, 2011; van Houwelingen
et al., 2013).
This measure is proposed mostly in the suicide literature but
also applies to prevent trespass accidents. In fact, operational
measures are implemented more extensively than it appears in the
literature at least because they refer to safety rules that any driver
should follow (included in the usual driver training). In practice,
many railway undertakings have clear rules which request train
drivers to reduce the speed in case they see persons in the vicinity
of tracks. This measure partially overlaps with other general
measures identified in the current review. For example it may
require the collaboration and efficient communication between the
multiple concerned institutions such as railway undertaking,
infrastructure manager, police, fire services, etc. It may also rely on
previous risk assessment and the additional technologies for train
drivers which facilitate their information and communication with
train-dispatchers and other train drivers.
4.2. Measures to prevent railway suicides
In this section we discuss three suicide-specific interventions
which have not been addressed previously.
4.2.1. Appropriate reporting or broadcast of critical incidents
This measure is mentioned in the suicide literature as an
important intervention (e.g. Beskow et al., 1994; Cox et al., 2013;
Daigle, 2005; Etzersdorfer and Sonneck, 1998; Hepp et al., 2012;
Holdaway et al., 2012; Leenaars, 2005; Mishara, 2007; Niederkro-
tenthaler et al., 2009, 2012; Sarchiapone et al., 2011; Sonneck et al.,
1994; Sisask and Värnik, 2012; Stack, 2005; Too et al., 2014; Yip
et al., 2012). The main goal of this measure is to provide mass
media with guidelines and tips on how to adequately report
suicides in order to avoid a copycat effect. The first and most
popular recommendation is to withhold information about
suicides from the public (Rådbo et al., 2008), in particular the
details about the method and site (Beautrais, 2007), in order not to
inspire future suicide candidates. The competitive reporting of
minor suicide events must also be avoided (Yang et al., 2013).
Media should insist on the successful coping strategies of people
who intended to commit suicide (Niederkrotenthaler et al., 2010)
and on persons with suicidal ideation who succeeded not to
attempt suicide (van Houwelingen, 2011). Evaluation studies
conducted in different countries (see Table 7 for details) have
reported significant increase in railway suicide following media
reports of suicide incidents (Kunrath et al., 2011), strong copycat
effect following celebrity suicide (Hegerl et al., 2013; Ladwig et al.,
2012), imitation of suicide means reported in the media (Yang
et al., 2013), and contagion especially in the groups whose age and
sex were closest to those of the model (Schmidtke and Häfner,
1988). Implementation of media guidelines in Vienna under-
ground in 1987 determined an immediate 84.2% drop in suicidal
behaviours (Etzersdorfer and Sonneck, 1998) and more recently a
reduction by 62 completed suicides, after controlling for passenger
numbers (Niederkrotenthaler and Sonneck, 2007). An additional
approach is to reward the well behaving journalists or good quality
reporting on suicides with ‘Media Awards’ (Andriessen, 2011; Dare
et al., 2011). The awards can increase the likelihood that media
professionals will embrace the guidelines and can help raising
community awareness about suicide (Dare et al., 2011). Although
its effect on actual suicide rates is still unknown, Media Award was
well received by journalist associations in Belgium, hence is a
promising method to improve collaboration between suicide
prevention and media sector (Andriessen, 2011).
Appropriate reporting also concerns announcements made in
trains or at stations about suicide and subsequent delays (Bhui
et al., 2013). These announcements may reach tens of thousands of
passengers simultaneously, thus railway companies are advised to
design announcement protocols that inform passengers and
bystanders about a critical incident but avoid promotion and
further implementation of railway suicide into the subconscious of
the passengers (Ladwig et al., 2009). The message should be
neutral about the nature of the incident (e.g. ‘Delay because of an
accident’) (van Houwelingen, 2011).
Finally, it is recommended that death memorials should be
removed from the railway environment due to risk of copycat
suicides and upset to staff involved (RSSB, 2013). We can observe,
however, that in related areas such as road safety memorials for
deceased have occasionally been used to remind road users of the
danger. Research is thus required to clarify this issue in the railway
context.
4.2.2. Emergency information and outreach support at suicide
hotspots
This measure aims to encourage the people who contemplate
suicide to seek help and find support (du Roscoät and Beck, 2013;
Holdaway et al., 2012; Ladwig et al., 2009; Mishara, 2007). This
measure is particularly recommended at station platforms
(Routley et al., 2004), LCs (Savage, 2007) and bridges (Beautrais,
2007). Specific interventions include installing signs and tele-
phones (Cox et al., 2013), posters to promote hotlines, crisis
intervention and mental health services (Debbaut et al., 2013;
Krysinska and De Leo, 2008; Mishara, 1999) and assuring an
outreach support by trained staff on call (Brown et al., 2012).
Outreach work consists of a rapid response by prevention services,
who will visit stations to offer emotional support to those
identified in need 24 h a day, 7 days a week (RSSB, 2013). This is
based on a call to prevention services by railway staff (Brown et al.,
2012) and requires enhanced response readiness among train-
dispatchers and rescue services (Rådbo et al., 2012a).
This measure also enables people who notice problematic
behaviour to ensure a rapid intervention, before the suicidal
person collides with the train (e.g. Kerkhof, 2003) by signalling the
risk or triggering an alarm. Placing communication poles with
instructions on platforms could serve as a clear intermediate for
commuters to ask for help when spotting a possible suicide
candidate on the station platform (van Houwelingen, 2011). Stop
plungers (Routley et al., 2004) and emergency buttons on
platforms allow staff to stop trains before they come into stations
(Holdaway et al., 2012). Electronic information billboards for
passengers, equipped with an emergency button allow passengers
to quickly contact railway safety services aims to improve safety at
suicide hotspots (Andriessen and Krysinska, 2011). No evidence
has been published yet concerning the effectiveness.
4.2.3. Decrease the attractiveness of the railways as lethal method
This category has sometimes been referred as ‘alternative’ to
railway suicide, since people who contemplate suicide can be
provided with the possibility to choose another method than the
 G.M. Havârneanu et al. / Accident Analysis and Prevention 81 (2015) 30–50
railways (Sarchiapone et al., 2011; van Houwelingen, 2011). This
scarcely mentioned measure is controversial due to legal and
ethical issues and has not been evaluated. Some authors question
the probability of ‘replacement’ of one suicidal method with
another (e.g. Beskow et al., 1994), and its implementation remains
problematic.
5. Challenges for the future prevention practice
5.1. Investigating the whole range of measures with evidence-based
and theory-based approaches
Despite more than 35 years of research into rail-pedestrian
safety, current prevention practice lacks consistent empirical
support for effectiveness and relies on general recommendations
or mere assumptions. The actual effect of most measures on the
number of railway suicides and trespassing accidents is not clear,
and this calls for more research on the whole range of proposed
measures. The general classification and the specific approaches
described in this paper can serve as a frame to structure the future
research and evaluation. Most of the available evidence comes
from the scientific literature, with only one study (RSSB, 2013)
from the grey literature, of these only 4 of the 22 are from trespass
literature (DaSilva et al., 2006; Lobb et al., 2001, 2003; Silla and
Luoma, 2011).
Two measures have evidence coming from multiple studies
conducted in various countries: (a) fencing and other physical
barriers and (b) appropriate reporting or broadcast of suicides to
avoid a copycat effect. Fencing has been shown to reduce fatalities
at suicide hotspots between 59% (Law et al., 2009) and 100%
(Beautrais at al., 2009) and trespassing behaviour between 23%
(Lobb et al., 2001) and 95% (Silla and Luoma, 2011) at trespass
hotspots. Six studies about media guidelines have been conducted
in different time periods and during longer and shorter time
intervals in Germany, Austria and Taiwan, and suggested that
guidelines might reduce suicidal behaviour between 19% on the
long term (i.e. two years after the broadcast) (Hegerl et al., 2013)
and about 84% on the short term (i.e. six months after
implementation) (Etzersdorfer and Sonneck, 1998).
The measures with stronger evidence still leave room to
unanswered questions. For example, the current review was not
able to identify any study that compares trespasser and suicide
rates in the UK (where all railways are fenced by law) with rates in
similar countries where railways are not fenced. For the rest of the
measures, the level of evidence is weaker because (a) the results
come from fewer or single studies, (b) the studies were conducted
in one country or limited contexts, and (c) the effect of the
measure was not quantified as the reduction in the number of
suicide or trespass cases. Future evaluations could benefit from
the elaboration of a theory-based evaluation framework (Weiss,
1997) dedicated to rail suicide and trespass prevention. This is an
explicit conceptualisation of the chosen prevention measures in
terms of the desired effect (e.g. increasing risk awareness in a
specific target-group; improving detection rate of persons at risk
through CCTV and surveillance staff) in relation to the expected
outcomes (e.g. significantly decreasing the number of train-
pedestrian collisions) as well as the impact on other consequen-
ces (e.g. time loss and delays). Recently a model has been
proposed to describe the chain of events leading to railway
suicides and trespassing accidents (Burkhardt et al., 2014). It is
the first attempt to integrate both suicide and trespass sequential
processes and the corresponding classes of prevention measures
depending on their type of effect mechanism (e.g. influence
decision, deter access, influence behaviour in the track area or
reduce the collision consequences). This model could provide the
basis for a theory-based approach to evaluate the effectiveness
47
and socio-economic value of safety measures against rail suicide
and trespass.
5.2. Considering potential interactions between measures early in the
selection step
The countermeasures evoked in the literature on suicide and
those from the publications on trespass often overlap. This brings a
major advantage for the safety practice because most measures
help preventing suicide and trespass simultaneously. However, the
specific way of implementation and the effect mechanism of a
given measure may be different for suicide and trespass and this
should be carefully considered before the implementation stage.
Physical measures like fencing or landscaping make the access to
the tracks more difficult, with no large differences in how they are
implemented against suicide or trespass. Similarly, technical design
to reduce the effects of impact is implemented in similar ways and
has similar effects on suicide and trespass, with no risk of negative
interference between the two. Other engineering measures, such
as lighting systems or design and aesthetics influence suicidal and
trespassing behaviours in fundamentally different ways. The same
can be said for collaborative and behavioural measures, where the
different effect mechanisms should be carefully considered before
the implementation process together with the potential negative
outcomes on either suicidal people or trespassers (see for example
the previous discussion on education, public safety communication,
or staff training). Decision makers should carefully choose the
measures most adapted to the target-problem or location
characteristics and consider their potential interactions or side
effects in regard to the various categories of people at risk.
5.3. Integrating measures into systems of intervention against both
suicide and trespass
In the last decade there has been a high preference for
recommending both behavioural and engineering measures. Even
if multiple measures are proposed in the same paper, the authors
usually discuss them separately and not in combination. There are
two direct consequences of this: there are actually few publica-
tions which suggest a real ‘multi-method’ approach and there is
little knowledge about the effects of combining multiple measures
into a strategy aimed at reducing train-pedestrian collisions in
specific circumstances. In fact, only two studies on trespassing
have evaluated the effect of combined measures (Lobb et al., 2001,
2003) and showed that it significantly improved the outcome. The
results of this review are thus in line with the literature which
posits that injury prevention is a complex problem that cannot be
solved with simple solutions (Cohen et al., 2003). A multifaceted
approach, using a mix of measures directed at specific issues, can
be effective in discouraging access to the railway lines (RSSB,
2005). It is noteworthy that some behavioural measures are
actually interdependent and are most likely to naturally work in
combination. For example, education-related measures are closely
linked to media communication and to other means of information
such as posters or signs and can be used altogether during a
preventative campaign as they eventually serve the same purpose.
The engineering/behavioural classification points out that meas-
ures influence behaviour in fundamentally different ways. One
major challenge for the prevention practice is to achieve an optimal
effect by considering the complementarities between these two
types of measures. Engineering measures create a first line of
defence against hazards by blocking or detecting risky behaviours
but might be more effective when supplemented with behavioural
measures which point towards the correct behavioural alternative
(Ladwig et al., 2009; Offler et al., 2009; Thompson et al., 2012) as
shown in one study (Lobb et al., 2001).
48 G.M. Havârneanu et al. / Accident Analysis and Prevention 81 (2015) 30–50
In practice, it is important to consider that one engineering
measure can achieve multiple functions. For example, detection
systems may deter trespassers, warn trespassers, alert the safety
staff and facilitate their intervention in case of suspect behaviour,
record information about the occurring incidents, and allow to
better understand the behaviour of people or the incident
statistics. In addition, such technical systems are rarely fully
automatic. Unless they use intelligent CCTV, they require human
assistance and intervention, which means they are most likely to
be combined with behavioural measures such as staff training and
enforcement and patrols. Moreover, their effect on behaviour is
mainly behavioural because they only deter risky behaviour and do
not physically block it. Although detection systems are technical
measures at origin, from the implementation viewpoint they are
actually a mixture of technical and behavioural elements. <**In
sum, combined solutions should include engineering and behav-
ioural measures and consider their multiple functions.
6. Conclusions
In summary, this review has shown that: (1) suicide is the older
and dominant topic related to train-pedestrian collisions and is the
focus for 58% of the papers; (2) during the last decade the focus
seems to have expanded on trespass prevention, yet only 17% of the
publications address trespass alone; less than a quarter of the
studies (19%) have an integrative topic, discussing both suicide and
trespass; (3) the last decade also corresponds to an increase of
proposals for behavioural interventions, either alone or in
combination with engineering measures; (4) sixteen out of the
19 classes of measures are common to suicide and trespass and
only 3 categories are suicide-specific; and (5) there are few studies
on the actual application of the measures; where present, most
evidence of effectiveness comes from ecological studies based on
accident data or quasi-experiments.
These conclusions should be noted while keeping in mind
several limitations of the current review. First, most of the
reviewed publications include data from a single country and
therefore the results are too limited or specific to a particular
railway environment to be directly useful to railway undertakings
and infrastructure managers in other countries. Second, there is a
risk of publication bias in the sense that (a) researchers may be
eager to report mostly meaningful positive results, but could keep
silent if the results are negative and (b) we reviewed publications
in English language only. Third, the results can be slightly biased
because of the classification process or because some papers may
have been missed. The categories identified from the literature are
not exhaustive and may be redundant when judged from a
practical perspective. For example, some specific measures
concerning the environmental design are similar to design and
aesthetics to influence behaviour mostly when it comes to station
and platform design.
However, to our knowledge, this is the first attempt to review,
analyse and provide an integrated classification of safety measures
against railway suicide and trespassing accidents. This paper
summarises the last decades of railway safety research in suicide
and trespass prevention providing a global view on the common
measures proposed in the scientific literature, as well as the
dedicated measures to prevent suicide or trespass. In addition, this
paper quantifies the existing body of evidence concerning the
effectiveness of these measures. Therefore, the results are useful
both for the researchers and for the railway community concerned
with the analysis, evaluation, planning, and implementation of
measures to reduce the number of fatalities on the railways.
Future studies should evaluate the efficiency of measures and
point out the conditions that make a measure productive or
counterproductive. Further research should also make clear the
circumstances when measures to prevent suicides can stimulate
trespassing and vice versa, as well as those when there is no
interaction between combined measures. From a practical
viewpoint, an integrative overview of all cost-effective measures
pretested and organised in a single application guideline could be
helpful for the future preventative interventions. This work has
begun during the RESTRAIL project through the development of a
toolbox for decision-makers (www.restrail.eu/toolbox).
Acknowledgements
This study has been conducted as part of the project RESTRAIL
(REduction of Suicides and Trespasses on RAILway property) which
was coordinated by the International Union of Railways (UIC). This
project has received funding from the European Union’s Seventh
Framework Programme for research, technological development
and demonstration under grant agreement no. 285153. The
authors would like to thank all collaborators for their support
during the development of this work.
References
Akkaş, M., Ay, D., Metin Aksu, N., Günalp, M., 2011.10-Year evaluation of train accidents.
Turk. J. Trauma Emergency Surg. (Ulus. Travma Acil Cerr.) 17 (5), 440–444.
Anderson, R., Hirsch, R., Trompet, M., Adeney, W., 2003. Developing benchmarking
methodologies for railway infrastructure management companies. Proceedings
of the European Transport Conference 2003 .
Andriessen, K., Krysinska, K., 2011. Railway suicide in Belgium 1998–2009. J. Crisis
Intervention Suicide Prev. 26, 1–7.
Andriessen, K., 2011. A media award for the responsible media portrayal of suicide in
Flandern–Belgium: rationale and qualitative evaluation. Pogled – The View Acta
Suicidologica Slovenica, V/1–2. Slovenian Association for Suicide Prevention,
pp. 28–38.
BTRE, 2002. Rail accident costs in Australia. Report No. 108. Canberra, Australia,
Bureau of Transport and Regional Economics.
Baumert, J., Erazo, N., Ladwig, K.H., 2005. Ten-year incidence and time trends of
railway suicides in Germany from 1991 to 2000. Eur. J. Pub. Health 16 (2),
173–178.
Baumert, J., Erazo, N., Ruf, E., Ladwig, K.H., 2008. Time trends in suicide mortality
vary in choice of methods an analysis of 145,865 fatal suicide cases in Germany
1991–2002. Soc. Psychiatry Psychiatr. Epidemiol. 43, 913–919.
Baumert, J., Lukaschek, K., Kunrath, S., Erazo, N., Ladwig, K.-H., 2011. Decrease in
railway suicides between 1998 and 2006: evaluation of the German railway
suicide prevention project. J. Epidemiol. Community Health 65 (1), A91.
Beautrais, A.L., Gibb, S.J., Fergusson, D.M., Horwood, L.J., Larkin, G.L., 2009. Removing
bridge barriers stimulates suicides: an unfortunate natural experiment. Aust. N.
Z. J. Psychiatry 43 (6), 495–497.
Beautrais, A., 2007. Suicide by jumping: a review of research and prevention
strategies. J. Crisis Intervention Suicide Prev. 28, 58–63.
Beskow, J., Thorson, J., Öström, M., 1994. National suicide prevention programme
and railway suicide. Soc. Sci. Med. 38 (3), 447–451.
Bhui, K., Chalangary, J., Jones, E., 2013. Railway suicides in the UK: risk factors and
prevention strategies. Cultural Consult. Ser..
Botha, J.L., Elmasu, K.A., Leitzell, P.J., 2010. Suicides on commuter rail in California:
possible patterns – a case study. Research Report No. MTI- Report 10-05. Mineta
Transportation Institute – San Jose State University, San Jose, CA, USA.
Briem, V., de Lima, S., Siotis, C., 2007. Train drivers and fatal accidents on the rails:
psychological aspects and safety. In: Wilson, J.R., Norris, B., Clarke, T., Mills, A.
(Eds.), People and Rail Systems, Human Factors at the Heart of the Railway.
Ashgate Publishing Limited, Hampshire, England.
Brown, R., Evans, E., Webb, S., 2012. Improving suicide prevention methods on the
rail network in Great Britain Annual Report 2011.
Burkhardt, J-M., Beurskens, E., Ryan, B., Hedqvist, M., Kallberg, V-P., Silla, A., Rådbo,
H., Kuijlen, H., Bruyelle, J-L., Paran, F., El Kourssi, E.M., Benard, V., Havârneanu, G.
M., 2013. Assessment of suitable measures (technical and soft measures) for the
prevention of suicides and trespasses (deliverable RESTRAIL_D23-32-B-
280213).
Burkhardt, J.-M., Rådbo, H., Silla, A., Paran, F., 2014. A model of suicide and
trespassing processes to support the analysis and decision related to preventing
railway suicides and trespassing accidents at railways. Transport Research
Arena 2014, 14–17. Paris La Défense, France (April).
Burrows, S., Laflamme, L., 2007. Assessment of accuracy of suicide mortality
surveillance data in South Africa – investigation in an urban setting. J. Crisis
Intervention Suicide Prev. 28 (2), 74–81.
C.A.R.E., (Community, Analysis, Response and Evaluation) 2006. Trespassing on
Railway Lines. A Community Problem-Solving Guide: Direction 2006.
Clarke, R.V., Poyner, B., 1994. Preventing suicide on the London underground. Soc.
Sci. Med. 38 (3), 443–446.
 G.M. Havârneanu et al. / Accident Analysis and Prevention 81 (2015) 30–50
Coats, T., Walter, D., 1999. Effect of station design on death in the London
underground: observational study. Brit. Med. J. 319, 957.
Cohen, L., Miller, T., Sheppard, M.A., Gordon, E., Toni, G., Atnafou, R., 2003. Bridging
the gap: bridging together intentional and unintentional injury prevention
efforts to improve health and well being. J. Saf. Res. 34, 473–483.
Cothereau, C., de Beaurepaire, C., Payan, C., Cambou, J.P., Rouillon, F., Conso, F., 2004.
Professional and medical outcomes for French train drivers after person under
train accident: three year follow up study. Occup. Environ. Med. 61, 488–494.
Cox, G.R., Owens, C., Robinson, J., Nicholas, A., Lockley, A., Williamson, M., et al.,
2013. Interventions to reduce suicides at suicides hotspots: a systematic review.
BMC Public Health 13, 214.
DaSilva, M., 2011. Railroad Infrastructure Trespass Detection Performance
Guidelines. US DOT, Office of Research and Development, Washington D.C.
DaSilva, M., Carroll, A., 2011. Preliminary results of the trespass prevention research
study in West Palm Beach, Florida. ASME Conf. Proc. 2011 (54,594), 571–577.
DaSilva, R., Baron, W., Carroll, A.A., 2006. Highway rail-grade crossing safety
research: Railroad infrastructure trespassing detection systems research in
Pittsford, New York No. Form Approved OMB No. 0704-0188). This document is
available to the public through the National Technical Information Service,
Springfield, Virginia 22,161.: U.S. Department Railroad Infrastructure of
Transportation.
Daigle, M.S., 2005. Suicide prevention through means restriction: assessing the risk
of substitution a critical review and synthesis. Accid. Anal. Prev. 37, 625–632.
Dare, A.J., Andriessen, K., Nordentoft, M., Meier, M., Huisman, A., Pirkis, J., 2011.
Media awards for responsible reporting of suicide: experiences from Australia,
Belgium and Denmark. Int. J. Ment. Health Syst. 5 (15) .
Debbaut, K., Krysinska, K., Andriessen, K., 2013. Characteristics of suicide hotspots
on the Belgian railway network. Int. J. Inj. Contr. Saf. Promot. doi:http://dx.doi.
org/10.1080/17457300.2013.825630.
Dinkel, A., Baumert, J., Erazo, N., Ladwig, K.H., 2011. Jumping, lying, wandering:
analysis of suicidal behavior patterns in. J. Psychiatr. Res. 45, 121–125.
Directive 2004/49/EC of the European Parliament and of the Council of 29 April
2004 on safety on the Community's railways. Official Journal of the European
Union. L 220/16. 21.6.2004.
du Roscoät, E., Beck, F., 2013. Efficient interventions on suicide prevention: a
literature review. Revue d’Epidemiologie et de Sante Publique 61, 363–374.
ERA, 2008. Implementation guidance for annex 1 and appendix to directive 2004/
49/EC. European Railway Agency.
ERA, 2011. Railway safety performance in the European union. European Railway
Agency. The Publications Office of the European Union, Luxembourg.
ERA, 2014. Railway safety performance in the European Union. European Railway
Agency http://www.era.europa.eu/Document-Register/Documents/
SPR2014pdf (retrieved June 2014).
Erazo, N., Baumert, J., Ladwig, K.H., 2004a. Regional and local clusters of railway
suicides. Nervenarzt (May 5) .
Erazo, N., Baumert, J., Ladwig, K.H., 2004b. Sex-specific time patterns of suicidal act
on the German railway system. An analysis of 4003 cases. J. Affect. Disorders 83,
1–9.
Erazo, N., Baumert, J., Ladwig, K.H., 2005. Factors associated with failed and
completed railway suicides. J. Affect. Disorders 88, 137–143.
Etzersdorfer, E., Sonneck, G., 1998. Preventing suicide by influencing mass-media
reporting. The Viennese experience 1980–1996. Arch. Suicide Res. 4 (1), 67–74.
Evans, A.W., 2003. Accidental fatalities in transport. J. R. Stat. Soc. Series A (Statistics
in Society) 2, 253–260.
Evans, A.W., 2011. Fatal accidents at railway level crossings in Great Britain
1946–2009. Accid. Anal. Prev. 43 (5), 1837–1845.
Farmer, R., Tranah, T., O’Donnell, I., Catalan, J., 1992. Railway suicide: the
psychological effects on drivers. Psychol. Med. 22 (2), 407–414.
Florentine, J.B., Crane, C., 2010. Suicide prevention by limiting access to methods: a
review of theory and practice. Soc. Sci. Med. 70, 1626–1632.
Federal Railroad Administration, 2011. Community Trespassing Prevention Guide.
U.S. Department of Transportation.
Hawton, K., 2007. Restricting access to methods of suicide – rationale and
evaluation of this approach to suicide prevention. Crisis 28, 4–9.
Hegerl, U., Koburger, N., Rummel-Kluge, C., Gravert, C., Walden, M., Mergl, R., 2013.
One followed by many? – Long-term effects of a celebrity suicide on the number
of suicidal acts on the German railway net. J. Affect. Disord. 146, 39–44.
Hepp, U., Stulz, N., Unger-Köppel, J., Ajdacic-Gross, V., 2012. Methods of suicide used
by children and adolescents. Eur. Child Adoles. Psychiatry 21 (2), 67–73.
Holdaway, S., Evans, E., Webb, S., 2012. Improving suicide prevention measures on
the rail network in Great Britain. Literature Review. Rail Safety and Standard
Board (T845).
Horton, S., 2009. Success Factors in the Reduction of Highway-rail Grade Crossing
Incidents. U.S. Department of Transportation, Research and Innovative
Technology Administration, Volpe National Transportation Systems Center,
Cambridge, MA USA.
Ichikawa, M., Inada, H., Kumeji, M., 2014. Reconsidering the effects of blue-light
installation for prevention of railway suicides. J. Affect. Disord. 152–154,
183–185.
Kadotani, H., Nagai, Y., Sozu, T., 2014. Railway suicide attempts are associated with
amount of sunlight in recent days. J. Affect. Disord. 152–154, 162–168.
Kerkhof, A., 2003. Railway suicide: who is responsible? Editorial. J. Crisis
Intervention Suicide Prev. 24 (2), 47–48.
Krysinska, K., De Leo, D., 2008. Suicide on railway networks: epidemiology, risk
factors and prevention. Aust. N.Z. J. Psychiatry 42 (9), 763–771.
49
Kunrath, S., Baumert, J., Ladwig, K., 2011. Increasing railway suicide acts after media
coverage of a fatal railway accident? An ecological study of 747 suicidal acts. J.
Epidemiol. Commun. Health 65 (9), 825–828.
Ladwig, K.H., Ruf, E., Baumert, J., Erazo, N., 2009. Prevention of metropolitan and
railway suicide. In: Wasserman, D., Wasserman, C. (Eds.), Oxford Textbook of
Suicidology and Suicide Prevention. Oxford University Press, Oxford, pp.
589–594.
Ladwig, K.H., Kunrath, S., Lukaschek, K., Baumert, J., 2012. The railway suicide death
of a famous German football player: impact on the subsequent frequency of
railway suicide acts in Germany. J. Affect. Disord. 136 (1–2), 194–198.
Law, C.K., Yip, P.S.F., 2011. An economic evaluation of setting up physical barriers in
railway stations for preventing railway injury: evidence from Hong Kong. J.
Epidemiol. Commun. Health 65 (10), 915–920.
Law, C.K., Yip, P., Chan, W., Fu, K.W., Wong, P., Law, Y.W., 2009. Evaluating the
effectiveness of barrier installation for preventing railway suicides in Hong
Kong. J. Affect. Disord. 114 (1–3), 254–262.
Leenaars, A.A., 2005. Effective public health strategies in suicide prevention are
possible: a selective review of recent studies. Clin. Neuropsychiatry 2, 21–31.
Lerer, L., Matzopoulos, R., 1996. Meeting the challenge of railway injury in a South
African city. Lancet 7 (348), 664–666.
Limosin, F., Loze, J.Y., Cothereau, C., De Beaurepaire, C., Payan, C., Conso, F., et al.,
2006. A prospective study of the psychological effects of person under train
incidents on drivers. J. Psychiatr. Res. 40 (8), 755–761.
Lindberg, E., 2012. Prevention of suicide in the transport system: Trafikverket.
Lindekilde, K., Wang, A., 1985. Train suicide in the county of Fyn 1979–82. Acta
Psychia. Scand. 72 (2), 150–154.
Lindqvist, P., Jonsson, A., Eriksson, A., Hedelin, A., Björnstig, U., 2004. Are suicides by
jumping off bridges preventable? An analysis of 50 cases from Sweden. Accid.
Anal. Prev. 36, 691–694.
Lobb, B., Harré, N., Suddendorf, T., 2001. An evaluation of a suburban railway
pedestrian crossing safety programme. Accid. Anal. Prev. 33 (2), 157–165.
Lobb, B., Harré, N., Nicola, T., 2003. An evaluation of four types of railway pedestrian
crossing safety intervention. Accid. Anal. Prev. 35 (4), 487–494.
Lobb, B., 2006. Trespassing on the tracks: a review of railway pedestrian safety
research. J. Saf. Res. 37 (4), 359–365.
Lukaschek, K., Baumert, J., Ladwig, K.H., 2011. Behaviour patterns preceding a
railway suicide: explorative study of German federal police officers’
experiences. BMC Public Health 4 (11), 620.
Matsubayashi, T., Sawada, Y., Ueda, M., 2013. Does the installation of blue lights on
train platforms prevent suicide? A before-and-after observational study from
Japan. J. Affect. Disord. 147 (1–3), 385–388.
Matzopoulos, R., Lerer, L.B., 1998. Hours to hell and back: a social epidemiology of
railway injury in a South African city. Soc. Sci. Med. 47 (1), 75–83.
Mishara, B., 1999. Suicide in the Montreal subway system: characteristics of the
victims. Can. J. Psychiatry (Revue Canadienne De Psychiatrie) 44 (7), 690–696.
Mishara, B., 2007. Railway and metro suicides – understanding the problem and
prevention potential. J. Crisis Intervention Suicide Prev. 28, 36–43.
Mohanty, M.K., Panigrahi, M.K., Mohanty, S., Patnaik, K.K., 2007. Death due to
traumatic railway injury. Med. Sci. Law 47 (2), 156–160.
Moher, D., Liberati, A., Tetzlaff, J., Altman, D.G., The PRISMA Group, 2009. Preferred
reporting items for systematic reviews and meta-analyses: the PRISMA
statement. PLOS Med. 6 (6), e1000097.
Morse, G., Taberneso, S., 2013. Learning from Operational Experience Annual Report
2012/13. Rail Safety and Standards Board. http://www.rssb.co.uk.
Niederkrotenthaler, T., Sonneck, G., 2007. Assessing the impact of media guidelines
for reporting on suicides in Austria: interrupted time series analysis. Aust. N.Z. J.
Psychiatry 41, 419–428.
Niederkrotenthaler, T., Till, B., Kapusta, N.D., Voracek, M., Dervic, K., Sonneck, G.,
2009. Copycat effects after media reports on suicide: a population-based
ecologic study. Soc. Sci. Med 69 (7), 1085–1090.
Niederkrotenthaler, T., Voracek, M., Herberth, A., Till, B., Strauss, M., Etzersdorfer, E.,
et al., 2010. Role of media reports in completed and prevented suicide: Werther
v. Papageno effects. Brit. J. Psychiatry 197 (3), 234–243.
Niederkrotenthaler, T., Sonneck, G., Dervic, K., Nader, I.W., Voracek, M., Kapusta, N.
D., Etzersdorfer, E., Mittendorfer-Rutz, E., Dorner, T., 2012. Predictors of suicide
and suicide attempt in subway stations: a population-based ecological study. J.
Urban Health 89, 339–353.
Nixon, J., Corcoran, A., Fielding, L., Eastgate, J., 1985. Fatal and nonfatal accidents on
the railways – a study of injuries to individuals, with particular reference to
children and to nonfatal trauma. Accid. Anal. Prev. 17 (3), 217–222.
O’Donnell, I., Farmer, R., 1992. Suicidal acts on metro systems: an international
perspective. Acta Psychia. Scandin. 86 (1), 60–63.
O’Donnell, I., Farmer, R., 1994. The epidemiology of suicide on the London
underground. Soc. Sci. Med. 38 (3), 409–418.
Occupational Health & Safety Group – UIC, 2011. Management of Distressing Events
and Prevention of Post-traumatic Stress. International Union of Railways – UIC,
Paris.
Offler, N., Thompson, K., Hirsch, L., Thomas, M., Dawson, D., 2009. A Review of the
Literature on Social Non Technical Deterrents for Vandalism in the Rail Industry
No RT 106. CRC for Rail Innovation, Brisbane.
Ozdog an, M., Cakar, S., Ag alar, F., Eryilmaz, M., Aytaç, B., Aydinuraz, K., 2006. The
epidemiology of the railway related casualties. Turk. J. Trauma Emergency Surg.
(Ulus. Travma Acil Cerr.) 12 (3), 235–241.
Patterson, T., 2004. Analysis of trespasser accidents. Land Transport Safety
Authority (LTSA).
50 G.M. Havârneanu et al. / Accident Analysis and Prevention 81 (2015) 30–50
Pelletier, A., 1997. Deaths among railroad trespassers. The role of alcohol in fatal
injuries. J. Am. Med. Assoc. 277 (13), 1064–1066.
Pirkis, J., Spittal, M.J., Cox, G., Robinson, J., Cheung, Y.T., Studdert, D., 2013. The
effectiveness of structural interventions at suicide hotspots: a meta-analysis.
Int. J. Epidemio. 42 (2), 541–548.
Rådbo, H., Andersson, R., 2012. Patterns of suicide and other trespassing fatalities on
state-owned railways in greater Stockholm; implications for prevention. Int. J.
Environ. Res. Public Health 9 (772–780) .
Rådbo, H., Svedung, I., Andersson, R., 2005. Suicides and other fatalities from train-
person collisions on Swedish railroads: a descriptive epidemiologic analysis as a
basis for systems-oriented prevention. J. Saf. Res. 36 (5), 423–428.
Rådbo, H., Svedung, I., Andersson, R., 2008. Suicide prevention in railway systems:
application of a barrier approach. Saf. Sci. 46, 729–737.
Rådbo, H., Renck, B., Andersson, R., 2012a. Feasibility of railway suicide prevention
strategies; a focus group study. In: Bérenguer, C., Grall, A., Soares, C. (Eds.),
Advances in Safety, Reliability and Risk Management. London, Taylor & Francis
Group.
Rådbo, H., Silla, A., Lukaschek, K., Burkhardt, J.-M., Paran, F., 2012b. Current
knowledge of railway suicides and trespassing accidents (Deliverable
RESTRAIL_WP1_KAU_WOP_001_310712_A1).
Rådbo, H., Svedung, I., Andersson, R., 2012c. Suicide and potentials for suicide
prevention on the swedish rail network; a qualitative multiple case study. In:
Bérenguer, C., Grall, A., Soares, C. (Eds.), Advances in Safety, Reliability and Risk
Management. London, Taylor & Francis group.
RAIB, 2011. Trail passed over Lydney level crossing with crossing barriers raised
23 march No. 20. Rail Accident Investigation Branch, Department for transport.
RSSB, 2002. Public behaviour. Railway Crime – Industry Perceptions. Railway Safety
Research Programme.
RSSB, 2003a. Development of rail safety material for teachers and schools. Rail
Education Framework D4133 – Trespass Part 2a: Assessment of the potential
usage by teachers of rail safety meta-tagged material (Final report – Issue 1, No.
D4133/008/001).
RSSB, 2003b. Trespass – transferable lessons from a review of safety campaigns.
Desk Research Report.
RSSB, 2005. Trespass and access via the platform end. Final Report. Halcrow Group
Limited in partnership with Human Engineering.
RSSB, 2006. Improving the content and placement of anti-trespass signs. Final
Report No. T555. Halcrow Group Limited in partnership with Human
Engineering Limited.
RSSB, 2011a. A Guide to RSSB Research in Community Safety. Rail Safety and
Standards Board, London. http://www.rssb.co.uk.
RSSB, 2011. A guide to RSSB research in Station safety. London: Rail Safety and
Standards Board, http://www.rssb.co.uk.
RSSB, 2011. Annual safety performance report 2010/2011. Rail Safety and Standards
Board, http://www.rssb.co.uk.
RSSB, 2012. Learning from Operational Experience Annual Report 2011/12. Rail
Safety and Standards Board.
RSSB, 2013. Improving suicide prevention methods on the rail network in Great
Britain. Annual Report 2013 (T845). Rail Safety and Standards Board.
Ratnayake, R., Links, P.S., Eynan, R., 2007. Suicidal behaviour on subway systems: a
review of the epidemiology. J. Urban Health 84 (6), 766–781.
Reisch, T., Michel, K., 2005. Securing a suicide hot spot: effects of a safety net at the
bern muenster terrace. Suicide Life Threat. Behav. 34 (4), 460–467.
Reynders, A., Scheerder, G., Van Audenhove, C., 2011. The reliability of suicide rates:
an analysis of railway suicides from two sources in fifteen European countries. J.
Affect. Disord. 131 (1–3), 120–127.
Robinson, B., 2003. Railway Suicide Strategy. Paper to Rail Safety and Standards
Board.
Routley, V., Staines, C., Haworth, N., Symmons, M., Ozanne-Smith, J., 2004. Rail-
related suicides in Victoria, Analysis of databases and literature review. Monash
University Accident Research Centre – Report #215.
Sarchiapone, M., Mandelli, L., Iosue, M., Andrisano, C., Roy, A., 2011. Controlling
access to suicide means. Int. J. Environ. Res. Public Health 8 (12),
4550–4562.
Savage, I., 2006. Does public education improve rail–highway crossing safety?
Accid. Anal. Prev. 38 (2), 310–316.
Savage, I., 2007. Trespassing on the railroad. Res. Transp. Econ. 20, 199–224.
Schmidtke, A., Häfner, H., 1988. The Werther effect after television films: new
evidence for an old hypothesis. Psychol. Med. 18 (3), 665–676.
Searle, A., Di Milia, L., Dawson, D., 2012. An investigation of risk-takers at railway
level crossings. Project no: R2.114. CRC for Rail Innovation.
Silla, A., Kallberg, V.P., 2012. The development of railway safety in Finland. Accid.
Anal. Prev. 45, 737–744.
Silla, A., Luoma, J., 2009. Trespassing on Finnish railways: identification of problem
sites and characteristics of trespassing behaviour. Eur. Transp. Res. Rev. 1 (1),
47–53.
Silla, A., Luoma, J., 2011. Effect of three countermeasures against the illegal crossing
of railway tracks. Accid. Anal. Prev. 43 (3), 1089–1094.
Silla, A., Luoma, J., 2012a. Main characteristics of train-pedestrian fatalities on
Finnish railroads. Acci. Anal. Prev. 45, 61–66.
Silla, A., Luoma, J., 2012b. Opinions on railway trespassing of people living close to a
railway line. Saf. Sci. 50 (1), 62–67.
Sisask, M., Värnik, A., 2012. Media roles in suicide prevention: a systematic review.
Int. J. Environ. Res. Public Health 9, 123–138.
Sonneck, G., Etzersdorfer, E., Nagel-Kuess, S., 1994. Imitative suicide on the Viennese
subway. Soc. Sci. Med. (3), 453–457.
Stack, S., 2005. Suicide in the media: a quantitative review of studies based on
nonfictional stories. Suicide Life Threat. Behav. 35 (2), 121–133.
Symonds, R., 1994. Psychiatric and preventative aspects of rail fatalities. Soc. Sci.
Med. 38 (3), 431–435.
Thompson, K., Offler, N., Hirsch, L., Every, D., Thomas, M.J., Dawson, D., 2012. From
broken windows to a renovated research agenda: A review of the literature on
vandalism and graffiti in the rail industry. Transp. Res. Part A: Policy Pract. 46
(8), 1280–1290.
Too, L.S., Milner, A., Bugeja, L., McClure, R., 2014. The socio-environmental
determinants of railway suicide: a systematic review. BMC Public Health 14, 20.
Wasnik, R.N., 2010. Analysis of railway fatalities in Central India. J. Ind. Acad.
Forensic Med. 32 (4), 311–314.
Weiss, C.H., 1997. Theory-based evaluation: past, present, and future. New Dir. Eval.
1997 (76), 41–55.
Yang, A.C., Tsai, S.J., Yang, C.H., Shia, B.C., Fuh, J.L., Wang, S.J., Peng, C.K., Huang, N.E.,
2013. Suicide and media reporting: a longitudinal and spatial analysis. Soc.
Psychiatry Psychiatr. Epidemiol. 48 (3), 427–435.
Yip, P., Caine, E., Yousuf, S., Chang, S.S., Wu, K.C.C., Chen, Y.Y., 2012. Means restriction
for suicide prevention. Lancet 379 (9834), 2393–2399.
van Houwelingen, C., 2011. Studies into Train Suicide: The Contribution of
Psychopathology, Railway Parameters and Environmental Factors. PhD Thesis.
Vrije Universiteit, The Netherlands.
van Houwelingen, C., Kerkhof, A., 2008. Mental healthcare status and psychiatric
diagnoses of train suicides. J. Affect. Disord. 107, 281–284.
van Houwelingen, C., Kerkhof, A., Beersma, D., 2010. Train suicides in the
Netherlands. J. Affec. Disord. 127, 281–286.
van Houwelingen, C., Baumert, J., Kerkhof, A., Beersma, D., Ladwig, K.-H., 2013. Train
suicide mortality and availability of trains: a tale of two countries. Psychiatry
Res. 209, 466–470.