Fatal Road Accidents among Finnish Military Conscripts: Fatigue-Impaired Driving

Military Medicine, Nov 2007 by Radun, Igor, Radun, Jenni E, Summala, Heikki, Sallinen, Mikael

The aims of the present study were to determine the current prevalence of personal car usage for holiday trips among Finnish conscripts and to analyze conscripts' fatal road accidents. The data included questionnaire data collected from 259 young conscripts at a garrison in southeastern Finland and data on 46 fatal road accidents caused by conscripts during the years 1991-2004, extracted from the national database of fatal road accidents studied in depth. The questionnaire data showed that one-third (35.9%) of young Finnish conscripts had used personal cars to travel to or from the garrison in the preceding 2 months. More than one-half of them reported driving while fatigued (a majority reported several occasions of such driving). In addition to those driving themselves, 41.6% of the conscripts rode at least occasionally as a passenger in a car driven by a fellow conscript. Analysis of the fatality data showed that one-half of the conscripts' fatal accidents occurred on the way to or from the garrison or while on duty. Falling asleep was the main cause of all conscripts' accidents (34.8%), with the largest proportion occurring when departing for leave (42.9%). Haste (including speeding) was the second greatest factor contributing to accidents occurring on the way to or from the garrison (26.1%), whereas drunk driving (22.7%) and suspected suicides (18.2%) were typical of accidents occurring on leave.

Introduction

More than 80% of men in Finland complete compulsory military service; therefore, injuries during military service are recognized as a public health issue.1 Although only 5.5% of the hospitalizations for injuries among Finnish conscripts in 1990-1999 were caused by traffic accidents,1 leisure-time traffic accidents were the leading cause of conscripts' deaths.2 Similarly, in Sweden, a considerable number of conscripts the in traffic accidents every year, with more than one half of the deaths occurring off duty.3 Although conscription is not currently being practiced in the United States and it may be questioned whether results from a professional army are applicable to a conscript army,1 it seems that motor vehicle accidents represent a major problem for both types of armies. Motor vehicle accidents are the leading cause of deaths among active personnel in the U.S. armed forces4; moreover, they are the leading cause of hospitalizations for treatment of injuries, especially in the U.S. Army.5 Most of the accidents happen off duty.5

Finnish conscripts enjoy certain travel benefits while traveling to and from the garrisons. During their usual 6 months of service, the conscripts have 12 paid round-trip journeys to be used when traveling to or from the garrison on leave.6 The free travel applies to the collective transport organized by military authorities or public transport. For additional trips above the free quota, conscripts can obtain major discounts on public transportation. Unlike in some other countries with conscription (e.g., Croatia), Finnish conscripts are allowed to use personal vehicles to travel to and from the garrisons; however, gasoline refunds are not available.

Previous research showed that falling asleep was the greatest individual causal factor (36%) in 25 fatal accidents caused by conscripts during the years 1980-1988.7 In most cases, service-related fatigue contributed to falling asleep behind the wheel.7 This is not surprising, because a survey of 2,537 conscripts in the late 1970s showed that 53.8% of the conscripts complained of having an insufficient amount of sleep while in the army and 39.2% felt tired often or always.8 In a more recent ethnographic study, conscripts reported that having to stay awake during field maneuvers was the most difficult part of training.9 In addition to irregular working hours, including night work, the training includes hard physical exercise that can produce fatigue. Young men are also one of the groups of drivers at highest risk for sleep-related accidents.1011 Besides their being the most prevalent group of road users at times with the greatest sleep propensity (during the night hours),12 several other risk factors are typical for young adults. They are more susceptible to acute sleep loss than are adults more advanced in age.13 Because of their driving inexperience, young drivers can overestimate their capabilities and fall asleep without realizing the risks.14 In addition, so-called extra motives (e.g., peer pressure) typical for young people15 can push such drivers to continue driving despite increased sleepiness. Conscripts may indeed be at high risk of fatigue-related accidents while driving fatigued from the garrison to home or driving and partying while on leave (usually on weekends), instead of using that time to recover from their tiring military duties.

In recent years, some attention in the Finnish Parliament has been given to this issue of conscripts' fatigue-related road accidents. A group of members of parliament raised the question of conscripts' fatigue following an accident caused by a conscript who fell asleep while driving home after a difficult training week.16 In response, the Minister of Defense claimed that, according to military records, not a single road fatality from 1999 to 2003 had been caused by service-related fatigue. The minister also emphasized that measures had been introduced to improve the traffic safety education of conscripts. For example, a nongovernmental organization (the Finnish Health Association, i.e., Terveys ry) organized a few educational courses for the Finnish military forces in 2005. Among others, the topics included drunk driving, fatigue, and speeding. Additionally, following the recommendations of the Conscripts' Traffic Safety Work Group,17 commanders should recommend that conscripts use public transportation. In a more recent address in Parliament, the minister announced the further improvement of collective transport.18