title: Ischaemic heart disease as a natural cause of death in motorists.
abstract: A study of 2,709 fatalities among road users, arising from a total of 59,164 accidents resulting in injury or death, between 1983-1992 in Singapore, showed that 1,134 and 904 deaths involved drivers of motor vehicles and motorcyclists (excluding pillion riders) respectively. In 13 cases of the former and 2 of the latter, death was deemed to have occurred naturally as a consequence of ischaemic heart disease. Two taxi drivers and both motorcyclists had apparently either collapsed "at the wheel" or whilst mounted on their motorcycles without their vehicles having been involved in actual accidents. In the remaining 11 cases, the vehicles had collided with other vehicles, fixed roadside structures or had veered off the road. However, none of these resulted in injury or death to passengers, occupants or other vehicles or to passing pedestrians. Thus, the prevalence of fatal ischaemic heart disease, as a natural cause of death, among motorists during this time was 0.7% (SD +/- 0.5), corresponding to 0.25 per 1000 (SD +/- 0.18) accidents resulting in injury or death; with less than 0.5% (SD +/- 0.4), corresponding to 0.19 per 1,000 accidents (SD +/- 0.17) resulting in injury or death, being associated with actual collisions. Although significant and dramatic metabolic derangements may occur during driving, thereby predisposing motorists to ischaemic heart disease, or aggravating pre-existing disease, these results and those of earlier studies would appear to suggest that serious road accidents are rarely caused by, or contributed to, coronary atherosclerosis and its attendant complications.
authors.affiliation: Department of Forensic Medicine, Institute of Science and Forensic Medicine, Singapore.
authors.forename: G
authors.initials: G
authors.lastname: Lau
mesh_terms: D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000328:Adult; D000368:Aged; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000401:mortality*; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D012846:Singapore / Q000453:epidemiology