Suicide and Natural Deaths in Road Traffic: Review

Monash University Accident Research Centre - Report #216 - 2003

Author(s): V. Routley, C. Staines, C. Brennan, N. Haworth, J. Ozanne-Smith

Full report in pdf format  [400KB]

Abstract:

Aim: To determine current knowledge concerning incidence and prevention, data collection practices and any associated inadequacies, relating to suicide and natural deaths in road traffic. Method: The research involved (1) a review of literature from refereed journals, electronic resources and appropriate agency reports, (2) a search of international road safety and vital statistics data available from the internet, published reports and other sources to determine the extent to which suicide and natural death crashes are included and (3), emailing questionnaires to vital statistics and road traffic organisations to collect information on current practices in the treatment of suicide and natural deaths in national data systems. 

Results: Relative to other methods of suicide and injury, literature on suicide and natural deaths in road traffic was scarce, particularly for pedestrian suicides. Available data and literature suggested that driver suicides and natural driver deaths are relatively minor components of road traffic fatalities but may be underestimated. Driver suicides are mostly male and aged 25-34 years. Risk factors are previous suicide attempts, a history of mental illness and the presence of alcohol. Most natural driver deaths are male, aged 50 to 70 years, caused by cardio-vascular disease and involve little or no property damage. Data on driver but not pedestrian suicide or natural deaths was located on some electronic national vital statistics sites. The data located on national and international road safety electronic sites appeared to be unintentional and no more detailed than conveyance eg pedestrian hit by truck. The ICD-10 definitions and codes appear to be more detailed, comprehensive and uniformly adopted than those of road safety data systems. Australia has an electronic National Coroners Information System which provides detailed fatality data to approved users. Responses were received from all 10 national vital statistics and 16 of the 22 national road traffic organisations surveyed. Vital statistics respondents used ICD-10, unspecified location coding commonly hindered pedestrian suicide identification and only half of the respondents used multi-cause coding (natural deaths). Responding road safety statistics organisations mostly excluded suicides and natural deaths. The Czech Republik, Sweden, Switzerland, Poland and Finland were exceptions. In almost all road safety systems, suicides and natural deaths were treated similarly. Pedestrian and driver protection measures which may be applicable to suicide prevention are outlined. 

Conclusion: Literature on road traffic suicides and natural deaths, especially pedestrian suicides, is scarce. Road safety data systems mostly exclude these deaths. The ICD-10 vital statistics coding system has the most potential for identifying relevant data. Reported cases are a small proportion of total road traffic deaths but are probably underestimated. Prevention measures should be drawn from general driver and pedestrian injury prevention measures since specific measures were not noted in the literature.

Sponsoring Organisation: Swedish National Road Administration