Land motor vehicle-related drownings in Sweden.
OBJECTIVE
Knowledge regarding drownings related to land motor vehicle events is limited although reports of these events occur globally. This study elucidates crash and injury mechanisms in motor vehicle-related drownings in a Swedish population during 1992 through 2006 in order to suggest preventive countermeasures.


METHODS
The cases were identified in the National Board of Forensic Medicine database and crosschecked against the official statistics. All available autopsy reports, hospital records, and police records were analyzed. In addition, corresponding in-depth analyses performed by the Swedish Road Administration were reviewed and analyzed.


RESULTS
In total, 83 drownings occurred in 64 vehicles. The great majority of victims had no serious injuries (92% MAIS <or= 2) and would probably have survived if they had not drowned. Most events took place in waters directly adjacent to a roadway (36%) or bridge (34%). The vehicles were most often (72%) found upside down, and most drownings occurred in shallow water (65% depth <2 m). One third (32%) of the drivers tested positive for alcohol (mean BAC of 2.0 g/L; range 0.16-2.6). The majority (69%) of the fatalities could possibly have been prevented if effective guardrails had been in place.


CONCLUSIONS
Drownings in motor vehicles are not negligible events and in many cases they are preventable. Sufficient design and placement of guardrails can minimize these events, but further experimental investigation should be conducted to better understand these events and how to optimize vehicle design, rescue operations, and self-rescue.
Stjernbrandt
Albin
A
Division of Surgery, Department of Surgical and Perioperative Sciences, Umeå University, Umeå, Sweden.
Oström
Mats
M
Eriksson
Anders
A
Björnstig
Ulf
U
D000063:Accidents, Traffic / Q000401:mortality* / Q000517:prevention & control; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual; D004332:Drowning / Q000453:epidemiology* / Q000517:prevention & control; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D018986:Motor Vehicles; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult