[Death behind the wheel]

In Norway traffic accidents are increasing with 12,000 casualties and more than 300 deaths every year. This retrospective study is based on 230 forensic reports of drivers involved in fatal car accidents. There was a male preponderance (85%) and the average age was 42.5 years. In 78% of the cases the cause of death was a direct consequence of the accident, multitraumas and head injuries representing the majority, while drowning occurred in 11% of the cases. Death from natural causes was established in 27 cases; the main cause was acute cardiovascular disease. These accidents occurred at low speed. In 17 cases (7%) serious cardiac disease, CNS pathology or diabetic complications contributed significantly to the accidents that inflicted greater injuries on the vehicles and occupants. Raised blood alcohol levels were found in 21% of the drivers. Hepatic steatosis was observed in 16% of all drivers, most of whom were not under the influence of alcohol. Suicide was recorded in six cases (2.5%). This study shows that in addition to drunkenness, organic disease, especially cardiovascular disease and alcoholic liver disease represent risk factors of major importance in fatal road accidents.