Sudden onset of disease while driving a fourwheeled vehicle: a retrospective analysis for commercial driver in Japan

Recent progress in automotive technologies and continuous upgrades in global safety standards have considerably improved automotive collision safety. Sudden onset of the signs and symptoms of the diseases while driving fourwheeled vehicles is a crucial cause of traffi c accidents. Because such accidents are not due to a human error, and can endanger the lives of other road users, detailed analysis and preventive measures are required to enhance road traffi c safety. We retrospectively analyzed 211 commercial drivers (taxis, 70; trucks, 53; buses, 88) in whom the sudden onset of any signs and symtoms of the diseases had obliged them to stop driving, from data collected by the Ministry of Land, Infrastructure, Transport and Tourism, Japan from 2004 through 2006. Cerebrovascular disease was a major cause of traffi crelated incidents (28.4%), followed by cardiac diseases (23.2%), syncope (8.5%), and digestive diseases (8.1%). Of the 76 fatalities, cardiac disease was the most frequent (50.0%), followed by cerebrovascular (32.5%) and aortic (7.9%) diseases. Of the 187 drivers in whom sudden onset of signs or symptoms of a disease occured while in control of a moving vehicle, 66 (35.3%) avoided collisions by attempting avoidance maneuvers (breaking or steering). However, subsequent traffi c accidents occurred due to drivers losing control (64.7%), also resulting in injury to passengers and other road users. In 76 of 88 incidents involving bus drivers, an avarage of 13.9±14.1 passengers traveled by bus and of those, an average of 5.2±5.6 passengers in 10 buses became injured. Seventeen of 70 taxi drivers caused subsequent accidents that resulted in injury to passengers or road users of 1.7±1.5 (mean±SD) per accident. Ten of 53 truck drivers also caused accidents with a mean injured person among road users of 5.6±6.7. The persons had enough holidays (7 to 9 days) within one month of the onset. Those who had caused accidents had been on 7-9 days of holiday within one month of onset. Concern for the health of commercial drivers is important because driving a vehicle often constitutes signifi cant emotional stress. Furthermore, when driver lose control of a moving vehicle due to sudden signs or symptoms of diseases, other road users and passengers can become injured due to subsequent accidents. Therefore, to minimize the likelihood of such incidents, we investigated the actual condition of professional drivers in Japan. The data are based on comprehensive and highly reliable reports obtained according to Japanese law. To predict the risk of sudden disease onset while driving from annual routine medical checkups is diffi cult. Prventive safety measures that address the physical condition of employees, particularly of commercial drivers should be implemented at the goverment level. Furthermore, fi ndings indicate that active preventive safety measures should also be promoted to prevent secondary accidents.