Charaacteristics of railway suicides in Canada and comparison with accidental railway fatalities: Implications for prevention.

Highlights
Over 10 years, we identified 460 railway accidental deaths and 428 suicides in Canada.
In accidents, impairment (illness, substance abuse, age) plays an important role.
More intense warnings of approaching trains may help prevent accidental deaths.
More than one-third of suicides occur on rails near psychiatric facilities.
Improved training in psychiatric facilities near rails may prevent suicides.