Fatal railway injuries in Cape Town, South Africa

To describe the features of railway-related deaths in Cape Town, South Africa, we reviewed demographic, autopsy, and accident report data on all such deaths between 1 April 1992 and 30 September 1994. Of the 379 railway-related deaths, 27 were among pedestrians or commuters who were hit by a train while crossing the track, 38 were among commuters who fell from moving trains, 32 were suicides, 43 were the result of criminal violence on trains or at railway stations, and 38 were due to other causes. Most railway fatalities were among men between the ages of 25 and 44 years. About half of all railway fatalities occurred at peak commuting times, with high levels of violence (often robbery related) recorded during the evening peak. A blood alcohol concentration > 0.1 g/100 ml was found in 35% of the people who died from crossing the track or falling from moving trains. Fatal railway injury is characterized by extensive disruption of more than one body region. The high levels of fatal railway injury make a strong case for a range of injury control interventions, including ticket control, surveillance, law enforcement, and safety engineering.