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1.1 Sudden cardiac death of drivers The annual number of sudden cardiac deaths is increasing in Japan, and is estimated to be more than 50,000 on the basis of findings from the multicenter research group (Toyoshima et al., 1996). In the United States, sudden cardiac death is the greatest cause of natural death, causing more than 400,000 adult fatalities each year (Zipes & Wellens, 1998) and it is the most common lethal manifestation of heart disease (Bauer et al., 2006). The high incidence makes sudden cardiac death a major challenge in public health. In most cases, the mechanism is abrupt occurrence of ventricular tachyarrhythmia, rapidly progressing to ventricular fibrillation and causing cardiac pump failure with unconsciousness. It is supposed that sudden cardiac death sometimes occurs while the subject is driving an automobile. A Japanese newspaper (March 29, 2010) reported, “While a bus driver (65 years old) was driving a bus, he suffered severe chest pain and gave up steering so that the bus ran in a zigzag and crashed into a wall to be on fire. ” Although such cases can easily be found on web sites, there has been little reported study. Lam and Lam reported that among older drivers aged 60 or above in New South Wales, Australia from 1996 to 2000, 409 (1.1%) of 36,595 were recognized as having suffered a sudden illness immediately prior to a crash, and that 254 (0.7%) of those episodes resulted in the driver’s death and injury in the crash (Lam & Lam, 2005). According to “Suicide and Natural Deaths in Road Traffic — Review” from Accident Research Centre of Monash University, the percentages of natural driver deaths out of all vehicle deaths were reported to vary from 0.2% to 19% in 10 studies (Routely et al., 2003). The Review listed 19 studies in total in the Appendix. It was reported that the percentages of cardiovascular disease in drivers who met natural deaths were from 68% to 97%. We speculated, on examination of a summary of those studies, that the total number of natural driver deaths and the number of natural driver deaths due to cardiac events were, respectively, 5 -10% and about 5% as percentages of all vehicle deaths. There may also be cases in which a patient receives a warning from his own heart of imminent sudden cardiac death, and is able to survive, or at least to prevent injury to others.

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Customized Heart Check System by Using Integrated Information of Electrocardiogram and Plethysmogram Outside the Driver’s Awareness from an Automobile Steering Wheel