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Fatalities in Swedish fire-related car crashes from a toxicologic perspective
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
Umeå University, Faculty of Social Sciences, Umeå School of Business and Economics (USBE), Statistics.ORCID iD: 0000-0002-8601-0159
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery. Department of Anaesthesia and Intensive Care Medicine, Karolinska University Hospital, Huddinge, Sweden.
2023 (English)In: Traffic Injury Prevention, ISSN 1538-9588, E-ISSN 1538-957X, Vol. 24, no 1, p. 21-25Article in journal (Refereed) Published
Abstract [en]

Objective: Vehicle materials developments raise concerns about new patterns of vehicle fire toxic gas emissions. This study aimed to describe toxicologic components in a recent material of fatal car crashes on Swedish roads in which the vehicle caught fire and compare the results to a previous material.

Methods: Retrospective registry study. All fatal car crashes with fire in Sweden 2009–2018 were extracted from the Swedish Transport Administration’s In-Depth Studies Database and compared with an earlier study of the time period 1998–2008.

Results: A total of 79 crashes and 94 fatalities were included. Carbon monoxide (COHb) blood levels >10% were found in 13 cases. Hydrogen cyanide (HCN) blood levels 0.1–1.7 µg/g were found in 10 cases. In 31 of the cases the person had a blood alcohol level (BAC) >0.2‰, which is the legal driving limit in Sweden. A total of 15 people died due to burn injuries and 2 individuals died due to toxic gas emissions without any other fatal traumatic injury. Total number of deaths in fire-related crashes halved from 181 (1998–2008) to 94 (2009–2018) but the percentage of fatalities in burning vehicles was unaltered (5% vs. 6%). The proportion of fatalities with HCN in the blood increased from 2% between 1998–2008 to 10% during 2009–2018 (p = 0.006). The age of the car involved in a crash increased by 0.26 years per calendar year (p = 0.001).

Conclusions: The proportion of fatalities with measured levels of HCN in the blood has increased. Eleven of the 15 burn injury fatalities had high levels of alcohol, HCN, or COHb, possibly contributing to an inability to leave a burning vehicle. Faster rescue brought by improved specific education and training of ambulance and rescue services personnel may be of future importance, as may on-scene antidote administration and revised regulations of vehicle flammability.

Place, publisher, year, edition, pages
Taylor & Francis Group, 2023. Vol. 24, no 1, p. 21-25
Keywords [en]
car crashes, carbon monoxide, hydrogen cyanide, Toxic gas emissions, vehicle fire
National Category
Vehicle Engineering Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:umu:diva-202004DOI: 10.1080/15389588.2022.2148831ISI: 000894957000001PubMedID: 36480228Scopus ID: 2-s2.0-85144170224OAI: oai:DiVA.org:umu-202004DiVA, id: diva2:1722510
Funder
Swedish Civil Contingencies Agency, 2019-11351Available from: 2022-12-29 Created: 2022-12-29 Last updated: 2023-09-26Bibliographically approved

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Björnstig, UlfSvensson, JohanWestman, Anton

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