Controlled register-based study of road traffic accidents in 12,651 Finnish cancer patients during 2013-2019.

BACKGROUND: Little controlled evidence exists on road traffic accident (RTA) risk among patients diagnosed with cancer, while clinicians are often requested to comment their ability to drive. The aim of this study was to evaluate RTA risk in a population-based cohort of cancer patients living in Southwest Finland. PATIENTS: All adult patients diagnosed with cancer in 2013-2019 were included. Acute appendectomy/cholecystectomy and actinic keratosis patients without cancer were selected from the same region as the control cohort. Participants were cross-referenced to a national driving licence database, yielding 12,651 cancer and 6334 control patients with a valid licence. Due to marked differences in their clinical presentation, the cancer cohort was divided into nine cancers of interest (breast, prostate, colorectal, lung, melanoma, head & neck, primary brain tumours, gynaecological and haematological malignancies). The nationwide law-regulated motor liability insurance registry was searched for all RTAs leading to injury with claims paid to not- or at-fault participants. At-fault drivers were verified based on sex and birth year. RESULTS: During a median follow-up of 34 months, 167 persons were at-fault drivers in RTAs leading to injury. Among the nine cancers of interest, RTA risk did not differ from the control cohort. Among cancer patients, multivariable regression suggested male sex and opioid use, but not advanced cancer stage or given systemic therapy, as the most influential risk factors for RTA. CONCLUSIONS: Cancer diagnosis itself was not associated with increased RTA risk, but other associated symptoms, medications, comorbidities or specific cancer subgroups may.

Suicide by crashing into a heavy vehicle: a focus group study of professional drivers.

Professional heavy vehicle drivers can experience a traumatic event at work when suicidal drivers deliberately crash into their vehicles or a pedestrian jumps in front of them. This study adopts a qualitative approach, aiming to gain an understanding about the psychological and other consequences that these crashes have for this occupational group. We organized a semi-structured focus group meeting with six drivers who reported experiencing a deliberate crash into their vehicle. The meeting was moderated by two psychologists. The participants reported that avoiding the crash was difficult. These events can have long-lasting effects on drivers' well-being although individual differences in the response to the event and coping strategies do exist. Participation in our meeting was regarded as a positive experience. This encourages us to believe that organizing similar meetings that allow drivers under the supervision of professionals to share their own experiences with those who experienced similar events, could perhaps be one way of providing support to such drivers who experienced a traumatic event at work.

Suicide by crashing into a heavy vehicle: Professional drivers' views.

Objective: Every profession has its own safety and health risks. In addition to the risk of being involved in a "normal" road crash, professional heavy vehicle drivers are at risk of becoming victims of people attempting suicide by crashing into their vehicles. Road suicides are not that rare, at least not in Finland, where they represent about 12% of all fatal road crashes. The purpose of this study was to survey professional heavy vehicle drivers about their experiences, views and opinions regarding road suicides.Methods: The sample included heavy vehicle drivers (N = 863) randomly recruited from a transport workers' union.Results: About 18% of the respondents reported a suspected suicide attempt of a motor vehicle driver crashing into their vehicle, with 15% of these (i.e.2.8% of the whole sample) also reporting a resulting crash. More than half of the respondents reported personally knowing another professional driver who had experienced a crash caused by a suicidal driver. Almost 80% of the drivers reported being afraid that someone would attempt suicide by crashing into their vehicle; however, thinking about such a possibility produces a level of anxiety in less than half of all respondents. Most respondents agreed about the challenges of avoiding a crash if somebody deliberately drives their car towards their vehicle.Conclusion: Heavy vehicle drivers perceive road suicides as an occupational risk in their profession. We discuss possible preventive measures against suicide attempts by crashing into a heavy vehicle.

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.

Driver suicides in Finland--are they different in northern and southern Finland?

OBJECTIVES: This study focused on driver suicides in Finland. The first aim was to find out what the prevalence of these suicides was during the years 1974-2006. The second aim was to find out whether there were differences between northern and southern Finland in regards to the number of cases and the backgrounds of the drivers who committed suicide this way. Study design. All case reports of fatal motor vehicle accidents from the years 2005-2006 were investigated (n=528). Results were compared to the years previously investigated: 1974-1975, 1984-1985, 1987-1988, 1991-1992, 1993-1994 and 1997-1998 (n=3482). METHODS: As driver suicides were classified, only those crashes in which the driver's intention had notably influenced the progress of the crash and the driver's background information clearly supported suicide. Driver suicides in northern and southern Finland were compared. Driver suicides were related to both the number of fatal motor vehicle accidents and the number of inhabitants. RESULTS: Driver suicides increased during the period under study. However, both the number and the proportion of driver suicides have been quite constant since the beginning of the 1990s, averaging 20 per year, which is 8% of all fatal motor vehicle accidents in Finland. There were no differences in northern and southern Finland regarding driver suicides. CONCLUSIONS: Driver suicides represent a small proportion (2%) of all suicides committed in Finland every year. However, the proportion of driver suicides of all fatal motor vehicle accidents is greater, around 8%-9%. As a majority of driver suicides are collisions, they affect an even larger group of people. Possible preventive measures are discussed.