Observational failures/distraction and disease attack/incapacity as cause(s) of fatal road crashes in Finland.
OBJECTIVE
To study the incidence of health-related conditions and observational failures/distraction (OFD) as an immediate cause for fatal motor vehicle accidents (FMVA) and to correlate them with driver's age.


METHODS
Retrospective study of all FMVA in Finland secondary to OFD from January 1995 to December 2005 and FMVA secondary to a disease attack/incapacity (DA) from January 2003 to December 2004. The data were based on the final investigation reports of the Finnish Motor Insurers' Centre. The cases were categorized into the three following groups: 1) vehicle crashes due to OFD of the driver, 2) pedestrian-vehicle accidents due to the driver's OFD, and 3) pedestrian-vehicle accidents due to the pedestrian's OFD. In the second part, 54 autopsy reports from FMVA resulting from a DA of the driver between the years 2003-2004 were revisited and the health-related causes of the accident were investigated.


RESULTS
Oldest age group (> 65 years) had the highest prevalence of FMVA secondary to an OFD. We estimated that in 20-30% of all FMVA affecting subjects > 65 years an impairment of cognitive functions might have played a role. Analysis of the DA that the inspection teams had concluded to have been the immediate risk factor for the FMVA revealed that these accidents accounted for 10.3% of all FMVA in 2003-2004. Cardiovascular diseases were most often involved.


CONCLUSIONS
OFD as an immediate cause of FMVA began to play a role from the age of 60 years onwards. The role of health conditions as a cause of FMVA was higher than expected. Cardiovascular disease (70%) was found to be the leading medical condition that inhibited the driving task among the DA related to FMVA in Finland.
Department of Ophthalmology, University of Helsinki, Finland. timo.tervo@hus.fi
Timo M T
TM
Tervo
Waldir
W
Neira
Aarne
A
Kivioja
Pekka
P
Sulander
Kalle
K
Parkkari
Juha M
JM
Holopainen
D000063:Accidents, Traffic / Q000401:mortality*; D000293:Adolescent; D000328:Adult; D000368:Aged; D001288:Attention; D001334:Automobile Driving; D003645:Death, Sudden / Q000453:epidemiology; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D019370:Observation; D012189:Retrospective Studies