Light motor vehicle collisions with heavy vehicles - Psychosocial and health related risk factors of drivers being at-fault for collisions.

BACKGROUND: Fatal head-on collisions between passenger cars and trucks are sometimes thought as self-inflicted death of the passenger car drivers.

METHODS: A total of 378 Finnish drivers of light motor vehicles (LMV) died in collisions with heavy vehicles between the years 2002-2011. These male and female drivers, who were considered as being at fault, and whose collisions with heavy vehicles occurred in the oncoming vehicle's lane, were explored in relation to information on their socio-demographics, physical and mental health condition and driving-related factors.

RESULTS: Cause of death of at-fault LMV drivers, as defined in medico-legal examination, was most commonly accidental (51%), followed by suicide (32%), undetermined intent (17%) and acute illness (0.3%). Ten-year time trend in rates of LMV drivers has remained stable (Annual Percentage Change, APC=-0.03; p=0.983), the annual proportion varying between 14%-21%. However, a statistically significantly increasing time trend was observed in fatal accidents due to suicides (APC=5.31, p=0.028). Generally, at-fault LMV drivers were characterized as having mental health problems susceptibility to risk (44%), personal relationship problems (33%), long-term physical illness (68%) or medication (35%) or driving under influence of alcohol (24%). Male LMV drivers, compared to women, were more commonly unmarried, farm/wood/industrial workers and drove alone and without a planned destination. Female LMV drivers were, more commonly than men, widowed, third degree students, skilled workers, had long term mental illnesses/disturbances, drove with family member(s) and their fatal accidents occurred in winter.

CONCLUSION: The findings give support to the recommendation that suicidal ideation must be considered when assessing fitness-to-drive.