Sudden death at the wheel due to a disease attack.
OBJECTIVE
To (1) examine the prevalence of fatal disease attacks while driving, (2) evaluate the potential risk of a driver's acute incapacity to drive, (3) compare the risks related to the driver's incapacity to drive with other major risks related to fatal motor vehicle accidents (fMVAs), and (4) assess how these accidents are reported in official statistics.


METHODS
The data consist of information from the Finnish Road Accident Investigation Teams (RAITs) on fMVAs in Finland during 2008-2009, in-depth analyses of accidents in the Uusimaa district in 2008-2009, and data from Statistics of Finland (StatFi) concerning accidents in the Uusimaa district.


RESULTS
In 2008-2009 as a whole, 488 fMVAs were encountered in Finland, and 73 of these were in Uusimaa. From fMVAs of the whole country, 55 driver deaths (11%) were due to a disease attack and in 27 (6%) of the cases, the driver was presumed to have fallen asleep. In Uusimaa approximately 25 percent (N = 18/73) of deaths at the wheel were caused by a driver's acute disease attack, but only 20 percent were recorded in the official StatFi. Cardiac and neurological diseases were the most common causes of disease attacks while driving. Additionally, disease attacks contributed as a background reason in at least 6/73 (8%) fMVAs. Speeding was found to be involved in approximately 1/3 (N = 190) of all fMVAs; however, in the absence of other risk factors, it was relatively rare (9%; N = 43).


CONCLUSIONS
A disease attack while driving is a relatively common cause of death on the road. Severe injuries may mask the role of an initial disease attack. This hypothesis is supported by the data collected on sleeping and background accidents. Thus, the drivers' disease attacks might have an even broader impact than initially assumed. Monitoring driver health and recognizing comorbidity problems could play a large role in the promotion of road safety. The current method of monitoring the fitness to drive and producing accident statistics should be reevaluated.
Department of Ophthalmology, University of Helsinki, Helsinki, Finland.
Timo
T
Tervo
Esa
E
Räty
Pekka
P
Sulander
Juha M
JM
Holopainen
Timo
T
Jaakkola
Kalle
K
Parkkari
D000063:Accidents, Traffic / Q000401:mortality* / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D001334:Automobile Driving / Q000706:statistics & numerical data*; D003645:Death, Sudden / Q000453:epidemiology*; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011996:Records; D018570:Risk Assessment