Review of 69 cases of lethal asphyxia in individuals aged from 10 to 18 years was undertaken in South Australia. There were 62 cases of suicide due to hanging (89.9%) (age range 10-18 years; mean = 16.6 years; M:F = 3.4:1), 4 accidents (5.8%) (3 crush asphyxias in motor vehicle rollovers, and 1 positional asphyxia associated with marked alcohol intoxication) and 3 homicides (4.3%). In the suicide group, there were 46 whites (74.2%), 12 Aboriginal (19.4%), 3 Asians (4.8%) and 1 African (1.6%). There were no deaths due to sexual asphyxia or the "choking game". However, the percentage of Aboriginal victims was disproportionately high compared to the percentage of the population aged 10-19 years listed as Aboriginal (approximately 3%). Thus, constant monitoring of local trends in mortality will identify if new activities such as the "choking game" have emerged, and also characterize specific problems that may exist in particular communities or cultural groups.
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