We investigated the recent court precedents regarding reinstatement when there is a discrepancy between the employerʼs decision and a medical certificate. We examined cases involving ten male professional drivers. The causes of absence from work（ with some overlap） included cerebrovascular disease, other chronic disease, low back pain and neck injury for two cases in each, heart disease, cancer and adverse drug effect for one case in each. Of these, four cases were deemed to be wrongful dismissals, and six resulting in effective dismissals. It was considered that there were three reasons as to why drivers were not reinstated, notwithstanding a medical certificate: 1. The driver was not diagnosed with a complete recovery; 2. The employer discredited the medical certificate; 3. Performing a task would worsen the symptoms. In either case, when there is ambiguous description on the medical certificate, it is important to consult the driversʼ attending physician or industrial physician of the office for confirming the description. The propriety of reinstatement is basically judged upon whether or not the individualʼs job performance was equal to that of their premorbid state. Therefore, although assessing the health condition of the individual at the time of reinstatement of the offer is vital, this assessment is increasingly being considered from the aspect of ensuring the individual can meet the required job fitness in the future. It is important to set medical criteria for drivers returning to driving work after an injury or illness for both a driverʼs attending physician （who issues medical certificate） and the employer who makes the judgement on the employee’ s reinstatement.

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To contribute to the prevention of traffic-related accidents involving pedestrians with visual impairments, we conducted an analysis of 14 accident cases. In all 14 cases, we identified a lack of awareness among vehicle drivers about their surroundings. Additionally, it was not uncommon for drivers to flee the scene without exiting their vehicles after an accident occurred. In most of these accidents, the paths of pedestrians and vehicles intersected, resulting in contact with the sides of the vehicles. While it is crucial to emphasize that drivers must adhere to traffic rules and exhibit proper social manners, we also believe that in addition to these soft measures, we should explore more concrete approaches. One potential solution is the implementation of auditory signals to indicate vehicle movements. Furthermore, we should also consider incorporating visual signals to alert drivers to the presence of pedestrians with visual impairments.

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Women are increasingly driving automobiles during pregnancy. Pregnant women （33 weeks） with no abnormalities in the course of pregnancy were subjected to fetal heart rate monitoring during motor vehicle driving on highways and open roads, and the effects on the in-utero environment were examined. Fetal heart rate and uterine contractions were monitored remotely using a mobile delivery monitoring device iCTG. A drive recorder was installed in the car and observed along with the driving conditions. Results showed that fetal heart rate baseline during highway driving was within the normal range; however, the upper limit of the baseline showed a waveform transitioning to tachycardia, and the number of transient tachycardias increased significantly. Variability showed a trend toward an increase in its elevated range and fecundity on highways, whereas it was moderate and transient on open roads. Based on these findings, it was inferred that various psychological factors influenced the nervousness of the pregnant women driving on the highway, which in turn led to an autonomic nervous system excitation state of increased fetal heart rate. Further verification of the safety of driving on highways for pregnant women is suggested.

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Background: Drowning deaths due to motor vehicle submersion have been overlooked in current statistics worldwide. To establish effective preventive measures against vehicle submersion, we identified all motor vehicle passenger fatalities due to motor vehicle submersion in a specific area and classified the cause and manner of death. Furthermore, we propose collecting data on all victims of motor vehicle submersion and establishing a comprehensive database or statistics to guide the development of preventive measures. Methods: Among all motor vehicle-related deaths that occurred in Shiga Prefecture between January 2013 and December 2019, we selected cases of vehicles that were immersed in water and involved the death of passengers. Using the results of police investigations and forensic autopsies, the cause of the event and the cause and manner of death were determined. Results: Sixteen victims comprising 13 men and three women with a mean age of 52.6 ± 22.3 years were selected for analysis. For the nine victims who died from drowning following operation errors or land motor vehicle collisions, the manner of death was determined as a“ traffic accident”. These deaths accounted for 5.3% of fatal motor vehicle collisions and 1.2% of all unintentional drownings in this area. The remaining three victims had suffered from severe trauma when entering the water following land motor vehicle collisions and subsequently died of trauma. Therefore, 12 deaths were classified as“ accidental traffic deaths”. Because two of the remaining victims had suffered from ischemic heart disease and their vehicles had plunged into the water, the manner of death was classified as“ disease”. Given that the last two victims intentionally ran their vehicles into the water and subsequently died of drowning, the manner of death was determined as“ suicide”. Conclusions: Because traditional drowning prevention strategies may not be effective in motor vehiclerelated drownings, specific coding or supplemental information specific to drowning is required. To prevent drowning fatalities due to vehicle immersion, promoting education, improving the conditions of hot spots, and developing vehicle safety systems based on further detailed surveys are required.

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