title: Substance use and social, health and safety-related factors among fatally injured drivers.
abstract: OBJECTIVE
  The aim of this study was to examine different socio-demographic, health and safety-related factors, and psychoactive substance use among fatally injured drivers in road traffic accidents in Finland during 2006-2008.
  
  
  METHODS
  An accident information register maintained by the Traffic Safety Committee of Insurance Companies (VALT) of the Finnish Motor Insurers' Centre was used as basic data, and the basic data were complemented with further toxicological analytical information retrieved from autopsy reports from the Department of Forensic Medicine, Helsinki University. The data included all the drivers (n=556) who were driving a motor vehicle and who died in a road traffic accident in Finland during 2006-2008.
  
  
  RESULTS
  Of all the 556 fatally injured drivers 43% (n=238) had psychoactive substance findings. 51% (n=121) of substance positive drivers had a finding for alcohol only, the rest had a finding for one or more illicit/medicinal drugs impairing driving ability, and possibly also alcohol. Fatally injured drivers with alcohol findings were significantly younger (mean age 34 years) than sober drivers (mean age 44 years) or drivers with findings for drugs (mean age 45 years). Socio-demographic background did not differ substantially among drunken/drugged and sober drivers, although drivers with alcohol findings had a slightly lower education and socioeconomic position. Previous substance abuse problems were highly prevalent among drivers with substance findings and mental or both mental and physical health problems were more common among drivers with drug findings. The non-use of safety equipment and driving at a high speed were more common among fatally injured drivers with substance findings.
  
  
  CONCLUSIONS
  Substance abuse and mental health problems, as well as reckless driving behavior were more pronounced among fatally injured drivers with substance findings when compared to sober drivers. Thus, prevention and early intervention concerning substance abuse, mental health problems and DUI are essential. Improved traffic safety cannot be achieved by means of traffic policy only, but integration with other policies, such as health and social policy should be strengthened.
authors.affiliation: National Institute for Health and Welfare, P.O. Box 30, FI-00271 Helsinki, Finland. karoliina.karjalainen@thl.fi
authors.forename: Karoliina
authors.initials: K
authors.lastname: Karjalainen
authors.forename: Tom
authors.initials: T
authors.lastname: Blencowe
authors.forename: Pirjo
authors.initials: P
authors.lastname: Lillsunde
mesh_terms: D000063:Accidents, Traffic / Q000401:mortality* / Q000517:prevention & control; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000435:Alcoholic Intoxication / Q000150:complications* / Q000401:mortality / Q000517:prevention & control; D015897:Comorbidity; D004522:Educational Status; D005260:Female; D005387:Finland; D015438:Health Behavior; D006801:Humans; D013287:Illicit Drugs; D008297:Male; D001523:Mental Disorders / Q000150:complications / Q000453:epidemiology; D008875:Middle Aged; D011619:Psychotropic Drugs; D012042:Registries; D012307:Risk Factors; D012449:Safety; D012737:Sex Factors; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000150:complications* / Q000401:mortality / Q000517:prevention & control; D014947:Wounds and Injuries / Q000401:mortality* / Q000517:prevention & control; D055815:Young Adult
chemical_list: D013287:Illicit Drugs; D011619:Psychotropic Drugs