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Forensic Science, Medicine and Pathology

, Volume 14, Issue 1, pp 4–17 | Cite as

The significance of preexisting medical conditions, alcohol/drug use and suicidal behavior for drivers in fatal motor vehicle crashes: a retrospective autopsy study

  • Jan Mario BreenEmail author
  • Paal Aksel Naess
  • Hallvard Gjerde
  • Christine Gaarder
  • Arne Stray-Pedersen
Original Article

Abstract

Driver fatalities in motor vehicle collisions (MVCs) encompass accidents, suicides, and natural deaths when driving. The objective of this study was to determine the significance of pathology and other autopsy findings for drivers in fatal MVCs. Forensic autopsy records of driver fatalities in southeast Norway between 2000 and 2014 were studied retrospectively. Data from individual police and collision investigation reports were also collected and analyzed. In 406 driver fatalities, the male/female ratio was 340/66; 9% died from natural causes, 9% were suicides, 65% were culpable accidental deaths, 14% were nonculpable deaths, and 3% were undetermined deaths. Head injuries and thoracic injuries were the most common causes of death. A seatbelt had been worn in 50% of the fatalities, and its prevalence did not differ between accidental deaths and suicides. Blood levels of alcohol and/or drugs that indicated impairment at the time of the collision were found in 40% (105/262) of all culpable accidental deaths but in 50% (64/127) of drivers aged up to 35 years. Pathology (most often cardiovascular disease) suggestive of sudden incapacitation before the collision was present in 24% (62/264) of drivers who were culpable in the accident and in 70% (46/66) of culpable drivers older than 55 years. A substantial proportion of drivers are killed in accidental collisions that may have occurred as a result of either alcohol/drug impairment or preexisting disease. Suicides and natural deaths both constitute significant proportions of MVC fatalities and may be misclassified unless a full inquest including an autopsy is performed.

Keywords

Motor vehicle collisions Driver-related deaths Medical incapacitation when driving Toxicology Autopsy Forensic pathology 

Notes

Funding information

The authors acknowledge financial support from the Gjensidige Foundation (grant number 1022396) and the Norwegian Ministry of Transport and Communication (grant number 11/1950). These funders had no role in the design and conduct of the study, the collection, analysis, and interpretation of the data, or in the preparation, review, and approval of the manuscript.

Compliance with ethical standards

Conflict of interest

The authors have no conflict of interest.

Ethical approval

Thisretrospective study of cases was approved by the Regional Committee for Medical and Health Research Ethics, the Data Protection Official for Research, and the Higher Prosecution Authority of Norway.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2017

Authors and Affiliations

  • Jan Mario Breen
    • 1
    • 2
    Email author
  • Paal Aksel Naess
    • 2
    • 3
  • Hallvard Gjerde
    • 4
  • Christine Gaarder
    • 3
  • Arne Stray-Pedersen
    • 1
    • 2
  1. 1.Department of Forensic Sciences, Section of Pediatric Forensic MedicineOslo University HospitalOsloNorway
  2. 2.Institute of Clinical Medicine, Faculty of MedicineUniversity of OsloOsloNorway
  3. 3.Department of TraumatologyOslo University HospitalOsloNorway
  4. 4.Department of Forensic Sciences, Section of Drug Abuse ResearchOslo University HospitalOsloNorway

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