Suicidal behavior by motor vehicle collision

BACKGROUND: The ability for suicides of drivers to be disguised as traffic accidents raises the possibility that suicidal behaviors of this nature are far more prevalent than previously thought, potentially impacting health, road safety, and insurance companies. METHOD: Persons residing at the Gold Coast, Australia, identified as having a history of suicidal ideation and behaviors (n = 1,196), were sent a mail-out survey after their consent was obtained in initial telephone contact (CATI random digit-dialing). Among those responding, 412 had made suicide plans or arrangements and 228 suicide attempts. RESULTS: Of those who reported planning a suicide, 14.8% (19.1% of male planners and 11.8% of female planners) had conceived to have a motor vehicle "accident" (n = 61). Of all attempters, 8.3% (13.3% of male attempters) had previously attempted via motor vehicle collision (n = 19). All attempters reported having emotional or mental problems at the time of the event. Suicide planners were significantly more likely to be in full-time employment and have a partner and children compared with other planners. CONCLUSION: The study gives a rare insight into driver suicide plans and attempts, via a large-scale community survey, to provide the best opportunity of collecting unbiased data on the driver suicide behavior. Results suggest the use of this method, particularly in attempts made by males, may be underreported leading to inaccuracy of statistics. The motives behind choosing this method are somewhat different to those behind other methods, including financial benefits and eliminating stigma in the aftermath of a suicide.     

Child passengers injured in motor vehicle crashes

IntroductionDuring 2010, 171,000 children aged 0–14 were injured in motor vehicle crashes. Despite the severity of the problem, research has been limited, and most of what we know about these children emanates from fatal crash databases.MethodUsing information from the General Estimates System, this effort examines the occurrence of non-fatal crashes among children aged 0–14 over the last decade.ResultsWe found that about 1% of the non-injured children in the file had been driven by a driver who was positive for alcohol. This percentage climbed to about 2% among children who had suffered injuries. Compared with the proportion of alcohol-positive drivers at the time of the crash, the proportion of drivers who sped or failed to obey a traffic signal was significantly higher.Practical applicationsThe finding that drinking and driving with children did not decrease over time questions the adequacy of the extant child endangerment laws.     

The use of seat belt by motor vehicle occupants in South Africa

OBJECTIVE: The purpose of this article was to examine the use of seat belt by motor vehicle users in the various provinces in South Africa. METHODS: Data were abstracted from published reports of the national Department of Transport. Percentage distribution and correlation of road safety variables and seat belt wearing rates for motor vehicle users were calculated for the different provinces. RESULTS: High seat belt wearing rates by the drivers (between 75.1% and 88.1%, national rate was 81%). The seat belt wearing rates for the front and back seat passengers were much lower than for the drivers. The seat belt wearing rates for front seat passengers (44.5% to 60.5%, national - 50.1%) and back seat passengers (1% to 16%, national - 7.6%) were much lower than for the drivers. The national seat belt wearing rate for all vehicles between 1982 and 1995 was between 46.9% and 69.2%, but this has generally declined. CONCLUSION: There is a need for the implementation of strategies to increase the use of seat belts to reduce injuries and fatalities.     

Driver's alcohol and passenger's death in motor vehicle crashes

OBJECTIVE: Previous studies on alcohol involvement associated with fatal injury in traffic crashes have focused on the drivers, but the passenger's view is not well known. This study (1) analyzes the relationship between passenger's death and alcohol inebriation of the driver and (2) estimates the role of alcohol as the cause of a crash by examining who was at fault, sober, or inebriated. METHOD: The study includes all motor vehicle passengers (n = 420) who died in crashes in Sweden 1993 through 1996 and were medicolegally autopsied. Autopsy reports from the Departments of Forensic Medicine, including toxicological analyses, and police reports were studied. Presence of alcohol among drivers was based on blood and breath tests. RESULTS: One-fifth of the fatally injured passengers and one-fifth of the tested drivers were under the influence of alcohol. The youngest drivers had the highest prevalence of drunken driving. Drivers at fault were alcohol positive in 21% of these crashes and drivers were not at fault in 2% of these crashes. In 53% of the crashes where both the passenger and driver were alcohol positive, the passenger had a lower alcohol concentration than the driver. Children (<16 years) comprised 15% of the killed passengers. Notably, the children were riding with a driver who was under influence of alcohol in 13% of these crashes. Alcohol involvement was not tested in half of the surviving drivers. CONCLUSIONS: The data show that 20% of both passengers and drivers were under the influence of alcohol. Increased testing of surviving drivers regarding alcohol and other drugs is recommended.     

Suicide by crashing into a heavy vehicle: Focus on professional drivers using in-depth crash data

Objective: Road traffic suicides typically involve a passenger car driver crashing his or her vehicle into a heavy vehicle, because death is almost certain due to the large mass difference between these vehicles. For the same reason, heavy-vehicle drivers typically suffer minor injuries, if any, and have thus received little attention in the research literature. In this study, we focused on heavy-vehicle drivers who were involved as the second party in road suicides in Finland.

Methods: We analyzed 138 road suicides (2011–2016) involving a passenger car crashing into a heavy vehicle. We used in-depth road crash investigation data from the Finnish Crash Data Institute.

Results: The results showed that all but 2 crashes were head-on collisions. Almost 30% of truck drivers were injured, but only a few suffered serious injuries. More than a quarter reported sick leave following their crash. Injury insurance compensation to heavy-vehicle drivers was just above €9,000 on average. Material damage to heavy vehicles was significant, with average insurance compensation paid being €70,500. Three out of 4 truck drivers reported that drivers committing suicide acted abruptly and left them little opportunity for preventive action.

Conclusions: Suicides by crashing into heavy vehicles can have an impact on drivers’ well-being; however, it is difficult to see how heavy-vehicle drivers could avoid a suicide attempt involving their vehicle.     

机动车尾气污染及防治对策研究

汽车是当今社会中人们最重要的代步工具,在人们的日常生活中占据着不可替代的位置。随着我国经济快速发展,城市机动车数量不断增加,导致尾气污染问题也日益严重,这不仅对大气质量造成了不良影响,同时也严重危害到了人们的身体健康。因此,机动车尾气污染问题必须得到有关部门高度重视,并且结合造成污染加剧的主要原因,找到机动车尾气污染防治的有效对策。本文将针对机动车尾气污染危害及防治对策进行分析。     

County-level prohibition and alcohol-related fatal motor vehicle accidents

The 50 states and the District of Columbia were grouped according to whether or not they had county-level alcohol prohibition. Several motor vehicle fatality rates were calculated for each type of jurisdiction, including the single-vehicle fatality rate (an index of alcohol-related motor vehicle accidents). In all cases, motor vehicle fatality rates for drivers in states with county-level prohibition were significantly greater than in nonprohibition states. This suggests that drivers residing in counties with prohibition are compelled to drive to adjacent counties or states to drink and consequently have increased involvement in motor vehicle accidents.     

Potentially preventable prehospital deaths from motor vehicle collisions

Background: In 2011, about 30,000 people died in motor vehicle collisions (MVCs) in the United States. We sought to evaluate the causes of prehospital deaths related to MVCs and to assess whether these deaths were potentially preventable.

Methods: Miami–Dade Medical Examiner records for 2011 were reviewed for all prehospital deaths of occupants of 4-wheeled motor vehicle collisions. Injuries were categorized by affected organ and anatomic location of the body. Cases were reviewed by a panel of 2 trauma surgeons to determine cause of death and whether the death was potentially preventable. Time to death and hospital arrival times were determined using the Fatality Analysis Reporting System (FARS) data from 2002 to 2012, which allowed comparison of our local data to national prevalence estimates.

Results: Local data revealed that 39% of the 98 deaths reviewed were potentially preventable (PPD). Significantly more patients with PPD had neurotrauma as a cause of death compared to those with a nonpreventable death (NPD) (44.7% vs. 25.0%, P =.049). NPDs were significantly more likely to have combined neurotrauma and hemorrhage as cause of death compared to PPDs (45.0% vs. 10.5%, P <.001). NPDs were significantly more likely to have injuries to the chest, pelvis, or spine. NPDs also had significantly more injuries to the following organ systems: lung, cardiac, and vascular chest (all P <.05). In the nationally representative FARS data from 2002 to 2012, 30% of deaths occurred on scene and another 32% occurred within 1 h of injury. When comparing the 2011 FARS data for Miami–Dade to the remainder of the United States in that year, percentage of deaths when reported on scene (25 vs. 23%, respectively) and within 1 h of injury (35 vs. 32%, respectively) were similar.

Conclusions: Nationally, FARS data demonstrated that two thirds of all MVC deaths occurred within 1 h of injury. Over a third of prehospital MVC deaths were potentially preventable in our local sample. By examining injury patterns in PPDs, targeted intervention may be initiated.     

Alcohol is a predictor of mortality in motor vehicle collisions

IntroductionIt is well recognized that driving while intoxicated increases the probability of a motor-vehicle collision (MVC). The effect of alcohol on the chance of surviving the MVC is less clear. Method: Using data from the Fatality Analysis Reporting System (FARS) we conducted analyses for the outcome of mortality using alcohol and other variables as predictors. We also selected alcohol positive (AP) and alcohol negative (AN) persons from the same MVC and vehicle to control for confounding characteristics. Results: The odds ratio (OR) for mortality for alcohol positive drivers was 2.57, (p < 0.001 for all the following OR). Other harmful predictive factors were age OR 1.01 per year, vehicle age OR 1.05 per year, male sex OR 1.23, avoidance maneuver OR 1.09, speed related OR 2.89, rollover mechanism OR 2.75, and collision with a fixed object OR 6.70. Protective factors were proper restraint use – OR 0.19 and collision with another moving vehicle, OR 0.21. In the multivariate analysis the OR of mortality for AP vs AN was 1.46. Proper restraint use (OR 0.27) remained protective along with collision with another moving vehicle. When AP and AN persons from the same MVC and the same vehicle were compared, the adjusted OR’s for mortality were 1.46 and 2.08, respectively. Conclusions: Alcohol is an independent predictor of mortality in an MVC. Proper restraint use is the strongest protective factor. This finding allows a more complete understanding of the risks of driving while intoxicated, not only a higher probability of an MVC, but decreased survival once the MVC occurs. Practical Applications: Identification of alcohol as an independent predictor of mortality in an accident may improve risk assessment and influence drivers to avoid driving while intoxicated.     

Diseases and motor vehicle fatalities in Finland in 2001 and 2002

OBJECTIVES: The possible connection between diseases among drivers and traffic accidents was examined for traffic safety purposes. METHODS: We studied medical conditions of drivers and passengers in all motor vehicle crashes with fatalities in Finland in 2001 and 2002 by using reports of road accident investigation teams, including autopsy reports. We analyzed a total of 542 crashes with 640 fatalities. Findings were also compared with available epidemiological data in Finland. RESULTS: An insignificant difference in the number of reported diseases was present between the different parties involved in crashes. However, among killed key drivers, so-called A-parties, psychiatric diseases, especially alcoholism, depression, and unspecific mental disorders, were diagnosed more often than in the groups of other drivers or passengers. In addition, A-parties were reported to more frequently suffer from cerebral arteriosclerosis and arterial hypertension. CONCLUSIONS: Drivers' diseases can be a risk factor for traffic accidents. Fitness to drive should therefore be considered in medical practice, particularly in patients with alcoholism and other psychiatric disorders.     

事故车辆影响下的城市道路交通仿真研究

为研究事故车辆影响下城市道路交通的特征，构建考虑车辆抢道行为的元胞自动机交通流模型，研究给定冲突区域长度下不同进车率和不同事故持续时间对城市道路交通流的影响。研究结果表明:事故车辆会诱发交通瓶颈，对城市交通产生显著干扰并形成拥堵带，且拥堵带向事故车辆上游传递。不同事故持续时间下交通流演化存在差异，道路平均车流量、车流平均密度随着事故持续时间的增加而增加，车辆平均速度随之减小。当道路中车辆较少（pin=0.3）且事故持续时间达到15 min时，交通处于严重拥堵状态；当道路中车辆较多（pin=0.5）、事故持续时间达到5 min时，交通即处于严重拥堵状态。研究结果可为优化城市交通事故处理机制提供依据。     

Fibromyalgia after motor vehicle collision: evidence and implications

OBJECTIVE: Assess currently available evidence regarding the ability of a motor vehicle collision (MVC) to trigger the development of fibromyalgia (FM). METHODS: Consensus standards developed by the American College of Rheumatology Environmental Disease Study Group were used to assess the ability of an MVC to trigger FM. RESULTS: Increasing evidence suggests that FM and related disorders are characterized by abnormalities in central nervous system function related to sensory processing, autonomic regulation, and neuroendocrine function. MVC trauma appears capable of triggering FM, but generally not through direct biomechanical injury. Instead, the evidence suggests that MVC trauma can act as a "stressor," which in concert with other factors, such as an individual's biologic vulnerability, psychosocial factors, cultural factors, and so on, may result in the development of chronic widespread pain and other somatic symptoms. MVC trauma is only one of many stressors which can trigger such disorders, and the environment within which the stressor is experienced (biological and psychosocial) may largely determine whether there is an adverse physiologic result or not. CONCLUSIONS: The evidence that MVC trauma may trigger FM meets established criteria for determining causality, and has a number of important implications, both for patient care, and for research into the pathophysiology and treatment of these disorders.     

事故车辆影响下的城市三车道道路交通流仿真

为探究事故车辆对城市三车道道路交通影响机制,首先,分析考虑事故车辆的城市三车道道路交通流特征;然后,构建左车道优先且考虑主动抢道和被动抢道行为的元胞自动机交通流模型;最后;研究事故持续时间td变化时事故车辆分别位于M道和R道的城市道路交通流演化.结果 表明:事故车辆会形成交通瓶颈,呈现上游车辆聚集下游车辆稀疏的时空特征...     

Mortality in rural locations after severe injuries from motor vehicle crashes

BackgroundMortality from traffic crashes is often higher in rural regions, and this may be attributable to decreased survival probability after severe injury.MethodsData were obtained from the National Automotive Sampling System – General Estimates System (NASS-GES) for 2002–2008. Using weighted survey logistic regression, three injury outcomes were analyzed: (a) Death overall, (b) Severe injury (incapacitating or fatal), and (c) Death, after severe injury. Models controlled for (pre-crash) person, event, and county level factors.ResultsThe sample included 883,473 motorists. Applying weights, this represented a population of 98,411,993. Only 2% of the weighted sample sustained a severe injury, and 9% of these severely injured motorists died. The probability of death overall and the probability of severe injury increased with older age, safety belt nonuse, vehicle damage, high speed, and early morning crashes . Males were less likely to be severely injured, but more likely to die if severely injured. Motorists in southern states were more likely to have severe injuries, but not more likely to die if severely injured. Motorists who crashed in very rural counties were significantly more likely to die overall, and were more likely to die if severely injured.ConclusionsMotorists with severe injury are more likely to die in rural areas, after controlling for person- and event-specific factors.