Abstract
INTRODUCTION: To prevent motor vehicle collisions caused by drivers' health problems, proactive safety measures against impaired driving should be promoted. We assessed the status of both motor vehicles and drivers immediately after sudden and fatal changes in the health of motor vehicle drivers. We also evaluated the factors contributing to multi-vehicle collisions where several people were injured or killed. METHODS: From 70 forensic autopsy cases performed between 1998 and 2023, we found 68 cases in which a vehicle collided with something after the driver experienced a sudden and fatal change in their health. Data about both drivers and vehicles were analyzed. RESULTS: Heart disease was the most common cause of death (52 drivers), followed by aortic disease (seven) and cerebrovascular disease (five). In total, 25 drivers collided with objects at ≥40 km/hour, and 35 collided at <40 km/hour; 17 drivers collided with other vehicles, and 51 with something other than a vehicle. Multivariable logistic regression analysis suggested that maneuvering forward and to the left (toward the side of the road) rather than straight ahead was a significant predictive factor for avoiding collision with other vehicles (odds ratio of 0.026). CONCLUSION: The findings from our study aim to enhance the development of driver monitoring systems and pre-crash safety technologies, with the ultimate goal of reducing the number of casualties in motor vehicle collisions.