Karolinska Institutet, Department of Global Public Health, Solnavägen 1E, Stockholm SE-11365, Sweden; Swedish Transport Agency, Department of Road and Rail, Isafjordsgatan 1, Kista SE-16440, Sweden.
Karolinska Institutet, Department of Global Public Health, Solnavägen 1E, Stockholm SE-11365, Sweden.
Accid Anal Prev. 2023 Sep;190:107149. doi: 10.1016/j.aap.2023.107149. Epub 2023 Jun 24.
Road traffic fatalities among drivers result not only from erroneous driving manoeuvres. They can also be triggered by poor mental or physical health like suicidal acts and acute disease attacks, the latter being more frequent with age. There are few studies comprising all the different triggers of fatal crashes among older drivers and on how these triggers evolve over time. This Swedish national study aims to investigate this, considering drivers 50+ years.
For the period 2010-2019, data on non-commercial car drivers aged 50 and older were extracted from the Swedish Transport Administration's in-depth studies of fatal crashes, compiled in a register encompassing all road traffic fatalities. The crash triggers reported were classified as suicide, acute disease, own manoeuvre (single or other type of crash), external, and undetermined. Total and annual frequencies were presented by crash trigger, overall and stratified by sex and age groups.
In total, 762 fatalities were identified and with 709 of them, it was possible to classify the crash trigger: 12% resulting from suicide; 29% from acute disease; 49% from the driver's own manoeuvre; and 10% from an external crash trigger. Suicides increased from 9% in average 2010-2014 to 15% in 2015-2019 while acute disease decreased (from 32% to 27%). The overall male-to-female ratio was 4.5, and as high as 8.7 for acute disease. The relative importance of each trigger varied with age with, for instance, acute disease being more frequent in the two younger age groups; 31% for 50-64 and 52% for 65-79 years old drivers, while own manoeuvre was more prominent for drivers aged 80 and older (23%).
The distribution of the four different triggers of road traffic fatalities varies only slightly over time and, a majority are triggered by the driver's own manoeuvre. However, a substantial proportion, about four out of ten,are triggered by a health condition, of which some are suicide but the major part an acute disease, mainly cardiovascular. In some instances, such crashes can be harmful to other road users. Having in mind the need for safety and mobility of older drivers and the protection of all road users, there is a need for the promotion of road safety policies that encompass a wider range of measures to help reducing the likelihood of fatal and severe crashes to happen e.g., targeting incapacitated drivers.
驾驶员的道路交通死亡不仅源于错误的驾驶操作。自杀行为和急性疾病发作等较差的心理或身体健康状况也可能引发事故，后者随着年龄的增长更为常见。很少有研究包含导致老年驾驶员致命事故的所有不同诱因，以及这些诱因随时间的演变。这项瑞典全国性研究旨在针对 50 岁以上的驾驶员进行调查。
在 2010 年至 2019 年期间，从瑞典运输署对致命事故的深入研究中提取了 50 岁及以上非商业汽车驾驶员的数据，这些数据被汇编到一个登记册中，涵盖了所有道路交通死亡事故。报告的碰撞触发因素被归类为自杀、急性疾病、自身操作（单一或其他类型的碰撞）、外部和不确定。按碰撞触发因素、总体和按性别和年龄组分层呈现总频率和年度频率。
共确定了 762 例死亡，其中 709 例可对碰撞触发因素进行分类：12%是自杀导致的；29%是急性疾病引起的；49%是驾驶员自身操作造成的；10%是外部碰撞触发的。自杀事件从 2010-2014 年的平均 9%增加到 2015-2019 年的 15%，而急性疾病则有所减少（从 32%降至 27%）。总体男女比例为 4.5，急性疾病的男女比例高达 8.7。每个触发因素的相对重要性随年龄而变化，例如，急性疾病在两个较年轻的年龄组中更为常见；50-64 岁司机中为 31%，65-79 岁司机中为 52%，而 80 岁及以上司机中则更为突出的是自身操作（23%）。
道路交通致命事故的四个不同触发因素的分布随时间仅略有变化，其中大多数是由驾驶员自身操作引起的。然而，相当一部分（约十分之四）是由健康状况引起的，其中一些是自杀，但主要部分是急性疾病，主要是心血管疾病。在某些情况下，此类事故可能对其他道路使用者造成伤害。考虑到老年驾驶员的安全和机动性以及所有道路使用者的保护，需要推广涵盖更广泛措施的道路安全政策，以帮助降低致命和严重事故发生的可能性，例如，针对丧失能力的驾驶员。
