Snowmobile fatalities aspects on preventive measures from a 25-year review

During October 1973 through May 1998, 157 snowmobile fatalities were autopsied in Northern Sweden, including 131 riders, 15 passengers, six occupants with unknown position and five victims pulled by a snowmobile. Most fatalities occurred during March and April (41%), on weekends/holidays (75%), between 18:00 and 02:00 h (59%), during darkness (63%), in clear weather (84%) and at leisure time (94%). The median age was 39 years and 92% were men. The most common causes of death were blunt trauma (53%) and drowning (38%). A total of 64% were inebriated by alcohol, with a mean blood alcohol concentration of 1.7 g/l. More inebriated victims were found during weekends/holidays than on weekdays (75 vs. 51%) and during nighttime than during daytime (92 vs. 52). Driving into water was the most common event (38%) followed by collisions with immobile objects (20%). Alcohol and speeding were the most common contributors to the crashes, while flotation snowmobile suit and helmet use were considered to be the most important injury prevention factors.     

Pedestrian fatalities and alcohol

Since the share of alcohol-positive victims has been reported not to show the same reduction in pedestrian fatalities as in other 'road users', this study analysed pedestrian fatalities with special emphasis on the presence of alcohol. Autopsied pedestrian fatalities (286 victims) in northern Sweden from 1977 to 1995 were investigated, using autopsy and police reports. Blood alcohol was detected in 19% of the fatalities, with a median concentration of 1.6 g/l. The proportion of test-positive victims did not change significantly during the period of study. Males more often tested positive for alcohol than females (24 vs. 11%). Further, the test-positive victims had a lower mean age (49 vs. 59 years) and the proportion of test-positive victims was higher during weekends and nights. Pedestrian fatalities testing positive for alcohol differ from those testing negative in several respects. The public should be enlightened of the fact that drinking is a risk not only among users of motor vehicles, but also among pedestrians. Separation of pedestrians from motor vehicles by, e.g. fences, is of greatest importance.     

Preventability of vehicle-related fatalities.

Several different methods have been used to evaluate the survivability of traffic injuries. Previously published methods were reviewed to develop a specific method for vehicle-related fatalities. All fatally injured victims (n = 474) of vehicle-related crashes in the four northern-most counties of Sweden during a 5-year period were studied. Almost half (48%) of the victims had non-survivable injuries. The remaining cases were classified into different injury groups according to the Injury Severity Score (ISS) including 56 (12%) with an ISS < 25, 150 (32%) with ISS 25-49 and 42 (9%) with ISS 50-74. The median distance from the scene to the nearest hospital was 49 km. In the cases with ISS < 50 the medical care was further analyzed. In close to half of these cases, the victim did not receive optimal care in time with transportation time being of major importance. The absence of first aid was judged to have contributed to the death in 4% of the cases.     

Some biases in the alcohol investigative process in traffic fatalities.

This study compares data regarding alcohol involvement from police records and from chemical analyses of body fluids taken prior to or after death of 121 traffic fatalities in Washtenaw County, Michigan. Differences regarding the choice of who will or will not be screened for alcohol were found. The police and emergency room personnel were more likely to focus on males and drivers, while medical examiners were less biased. The police documented whether or not drinking took place in only 36% of the cases and suspected drinking in only half of these cases. Males and at-fault drivers were most likely to be investigated. Blood alcohol level was measured before death in 11 of 29 emergency room treated victims, with 10 (91%) positive samples. All but two of those tested before death were drivers, and all but one were males. After death, blood alcohol was measured in 47% of the 121 cases, with a higher proportion of males and motor-vehicle occupants tested, compared to females and pedestrians. Alcohol was detected in 63% of the samples. A lower mean blood alcohol concentration was found in victims who received intravenous treatment, and a higher proportion of positive samples was found in victims who died immediately in the crash. Thus, the frequency of alcohol-related traffic fatalities varied between the different data sources. The police records revealed 51%, the emergency records 91%, and the medical examiner records 63% with alcohol involvement. This wide discrepancy has the potential of leading to erroneous results here and possibly in studies done elsewhere.(ABSTRACT TRUNCATED AT 250 WORDS)