Sudden Illness While Driving a Vehicle - a Retrospective Analysis of Commercial Drivers in Japan

Article excerpt

Objective We performed a retrospective analysis of commercial drivers to clarify the background of incidents of sudden illness while driving.

Methods The analysis used reports submitted by employers to the Japan Ministry of Land, Infrastructure, Transport, and Tourism regarding commercial drivers who had been ordered to stop driving as a result of health problems.

Results Of 211 cases with an average work history of 15.2 years, there were 88 bus drivers, 70 taxi drivers, and 53 truck drivers, 36.0% of who had died as a result of their disease. Among taxi and truck drivers, more than 70% of incidents were due to cardiac, aortic, and cerebrovascular disease. More than 80% of these were unable to avoid traffic accidents caused by sudden illness. However, among bus drivers, cardiac, aortic, and cerebrovascular disease accounted for only 23.5% of incidents, and accidents were avoided in more than half of the cases. The duration between starting work and the incident time was significantly shorter among bus drivers [mean 3.3 hours, standard deviation (SD) 3.1] than taxi (7.7 hours, SD 5.8) and truck (7.2 hours, SD 6.3) drivers (PO.01).

Conclusions The difference between the sudden illness rates of taxi and truck drivers and those of bus drivers is due to both reporting bias and differences in the awareness needed to prevent disabling events while driving. As a precaution, physicians should advise commercial drivers to stop driving as soon as they detect slight discomfort. To prevent accidents, more assertive health promotion aimed at professional drivers is needed.

Key terms bus; disease; prevention; restrospective study; sudden death; taxi; traffic accident; transportation; truck.

As many occupations require people to drive as part of their work, work-related road traffic accidents represent a significant public health problem.

Although delayed recognition, flawed judgment, and faulty maneuvering are major causes of automotive accidents, the sudden onset of signs and symptoms of disease while driving can also cause accidents (1). In some cases, drivers suffer from sudden illness leading to subsequent death (2). Therefore, the health of commercial drivers must be promoted to minimize the likelihood of sudden-illness-related traffic accidents.

Japanese employers are required to report instances of commercial drivers being forced to stop driving because of sudden onset of disease signs and symptoms to the Ministry of Land, Infrastructure, Transport, and Tourism (MLIT). Using this data, we provide useful information for both promoting occupational drivers' health and preventing traffic accidents.


Between 2004-2006, the MLIT received 211 reports from Japanese employers regarding commercial drivers (bus, taxi, or truck drivers) who had been ordered to stop driving as a result of a health problem. Because detailed descriptions of the reports were not publicly released, we asked the secretary of the MLIT for access to detailed contents of the reports for our research. Following MLIT approval, we obtained a portion of the information in the reports. Although we were not given access to some items in the reports (eg, drivers' age, hospitalization duration, and previous medical histories), the data allowed us to perform the analyses below. The information about the circumstances surrounding the sudden illness incident, health condition of the drivers, and working conditions were collected from the reports.

One-way analysis of variance (ANOVA) was used to compare the average values of three groups. Our evaluation using ANOVA with the Tukey-Kramer method showed significant individual differences. The chisquare test was used to compare the rate of various items between the different groups. Differences with a P-value <0.05 were considered significant.


General overview

The 211 cases involved 88 bus drivers, 70 taxi drivers, and 53 truck drivers with an average work history of 15. …


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