Doctoral defence: Jana Tuusov “Deaths caused by alcohol, psychotropic and other substances in Estonia: evidence based on forensic autopsies”

On 14 June at 14:00 Jana Tuusov will defend her doctoral thesis “Deaths caused by alcohol, psychotropic and other substances in Estonia: evidence based on forensic autopsies”.

Supervisors: 
Professor Marika Väli, University of Tartu
Associate Professor Kersti Pärna, University of Tartu
Associate Professor Katrin Lang, University of Tartu

Opponent:
Professor Philippe Lunetta, University of Turku (Finland)

Summary
Excessive alcohol consumption has been implicated as a major cause of premature mortality. Other preventable causes of death are poisonings with psychotropic substances. It is important to find out the role of alcohol in causing damage to human body as well as the magnitude of it affecting population health. One of the ways of doing that is to carry out an autopsy-based study. Because of the complicated nature of such study they are quite rare, but still produce valuable information. Similarly, it is important to assess and improve ways of coding causes of death to reveal the role of alcohol in causing deaths, and how this reflects in mortality statistics at population level. This study was the first in Estonia to use in-depth forensic autopsy to explore the role of alcohol in premature mortality.  

The aim of the study was to give an evidence-based overview of deaths among working-aged men caused by alcohol using an in-depth forensic autopsy analysis, to explore the coding problems of underlying cause of death in presence of multiple alcohol-related pathologies of internal organs, and to describe fatal poisonings by alcohol, psychotropic and other substances among general population in 2000–2009 and in 2010–2019.  

This study showed that alcohol-related pathologies were common among working age men subject to forensic autopsy in Estonia, indicating harmful alcohol consumption in this age group. The study showed that several of the novel alcohol biomarkers appeared to perform well in post mortem samples and could be more widely used in forensic practise.  At the same time, in case of multiple alcohol-related pathologies it was not possible to allocate underlying cause of death because of rigidity of classification. Among poisoning deaths, ethanol was the most frequent substance causing death in 2000–2009, but in 2010–2010 narcotic and psychotropic substances prevailed in poisoning deaths in Estonia. 

The findings of the study are useful for policy makers and for Estonian Forensic Science Institute as the institution where forensic autopsies are carried out.