{
  "abstract": "Introduction Globally, reports of suicide by sodium nitrite poisoning have been growing. To determine whether sodium nitrite poisoning in suicide is an issue in the UK, we conducted an analysis of the cohort of cases analysed by the sole provider of nitrite assessment for postmortem sample in the UK.Methods Retrospective cohort analysis of biochemical measures for nitrite and nitrate anion in postmortem samples of 201 cases provided by HM coroners of suspected suicide over a period from March 2019 to August 2024. Secondary measures included sample collection and analysis dates, age and sex of deceased, sample number per case, sample types, and coroner regional location.Results Of the 201 cases assessed by the laboratory during the inclusive time period, permission to include data was received from HM coroners for 164 of the cases. Suspected suicide by sodium (or potassium) nitrite/nitrate was confirmed in 87% of cases, with measured nitrite and/or nitrate concentrations ~100× normal physiological levels. Sex was known for 98% of cases and 68% were men. The age range was 14–82 years, and most (71%) cases were from Generation Z and Millennial generation. Cases came from across the UK, with the greatest proportion from Greater London, South East England, the Republic of Ireland, and the Midlands.Conclusions The data indicate that suicide associated with the ingestion of nitrite or nitrate salts is substantial in the UK, with a disproportionately high prevalence in young men. There is an urgent public health need for policy makers to consider strategies aimed at preventing and mitigating the harms associated with free access to these salts. This could include restrictions to purchase to facilitate prevention and adoption of easy to implement treatment protocols for both prehospital and emergency healthcare staff in suspected suicide by sodium nitrite/nitrate.",
  "authors": [
    {
      "affiliations": [
        "Barts and the London Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK"
      ],
      "name": "Jonathan W Ho"
    },
    {
      "affiliations": [
        "Department of Mathematics, King’s College London, London, UK"
      ],
      "name": "Rohan Hobbs"
    },
    {
      "affiliations": [
        "Toxicology, Clinical Chemistry, Wansbeck General Hospital, Ashington, UK"
      ],
      "name": "Nigel Brown"
    },
    {
      "affiliations": [
        "Clinical Toxicology, Guy's and St Thomas's Foundation Trust, King’s College London, London, UK",
        "Faculty of Life Sciences and Medicine, King’s College London, London, UK"
      ],
      "name": "Paul Dargan"
    },
    {
      "affiliations": [
        "Toxicology Unit, Sheffield Teaching Hospitals Foundation Trust, Northern General Hospital, Sheffield, UK"
      ],
      "name": "Laura J Hikin"
    },
    {
      "affiliations": [
        "Biochemistry, Immunology and Toxicology, Queen Elizabeth Hospital, Birmingham, UK"
      ],
      "name": "Alexander Lawson"
    },
    {
      "affiliations": [
        "HM Coroner for Coventry, Coventry City Council, Coventry, West Midlands, UK"
      ],
      "name": "Sean Mcgovern"
    },
    {
      "affiliations": [
        "Department of Toxicology, Royal Sussex County Hospital, University Hospitals Sussex NHS Foundation Trust, Brighton, UK"
      ],
      "name": "Robert Moore"
    },
    {
      "affiliations": [
        "Forensic Toxicology Service, University Hospitals of Leicester NHS Trust, Leicester, UK"
      ],
      "name": "Paul Smith"
    },
    {
      "affiliations": [
        "Biochemistry, Immunology and Toxicology, Queen Elizabeth Hospital, Birmingham, UK"
      ],
      "name": "Jessica Winfield"
    },
    {
      "affiliations": [
        "Department of Toxicology, Royal Sussex County Hospital, University Hospitals Sussex NHS Foundation Trust, Brighton, UK"
      ],
      "name": "Rebecca Wood"
    },
    {
      "affiliations": [
        "Barts and the London Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK"
      ],
      "name": "Amrita Ahluwalia"
    }
  ],
  "title": "Retrospective cohort analysis of nitrite and nitrate levels in postmortem biological samples after suspected suicide, 2019-24",
  "uid": "52d37f1d-81c2-5f3d-bfdb-3c27c3017696"
}