Association between road vehicle collisions and recent medical contact in older drivers: a case-crossover study.

Sandy Leproust, Emmanuel Lagarde, Samy Suissa, L Rachid Salmi
Author Information
  1. Sandy Leproust: INSERM, U593, Equipe Avenir Santé et Insécurité Routière, ISPED, Université Victor Segalen Bordeaux 2, Bordeaux, F-33000, France.

Abstract

OBJECTIVE: To estimate the association between past medical contacts and the risk of vehicle collision in a population of older drivers from the province of Quebec, Canada.
DESIGN: Case-crossover study.
SETTING: Quebec.
PARTICIPANTS: 111 699 older drivers involved in at least one vehicle collision between January 1988 and December 2000.
MAIN OUTCOME MEASURES: For each driver, the risk of having a vehicle collision while exposed and not exposed to a medical contact was compared. Separate conditional logistic regression analyses were conducted for all drivers and in four diagnostic-specific subgroups.
RESULTS: The study found a weak but statistically significant increased risk of all collisions being associated with a medical contact within 1 month before the collision, for all drivers (OR=1.10, 95% CI 1.08 to 1.11) and for drivers with diabetes (OR=1.07, 95% CI 1.03 to 1.11).
CONCLUSION: Older drivers who have a collision are more likely to have been in contact with a physician shortly before the collision. These findings suggest that there might be an opportunity to detect medical conditions that put older drivers at higher risk of collision; however, further research is needed to assess the potential effectiveness and practical modalities of screening.

References

  1. J Am Geriatr Soc. 1991 Nov;39(11):1132-6 [PMID: 1753055]
  2. Epidemiology. 1996 May;7(3):231-9 [PMID: 8728434]
  3. Am J Epidemiol. 1991 Jan 15;133(2):144-53 [PMID: 1985444]
  4. Inj Prev. 2002 Jun;8(2):116-20 [PMID: 12120829]
  5. J Safety Res. 2003;34(4):343-51 [PMID: 14636656]
  6. Accid Anal Prev. 2006 Sep;38(5):1038-45 [PMID: 16725099]
  7. Alzheimer Dis Assoc Disord. 1997 Jun;11 Suppl 1:62-9 [PMID: 9194971]
  8. Neurology. 2000 Jun 27;54(12):2205-11 [PMID: 10881240]
  9. Annu Rev Public Health. 2000;21:193-221 [PMID: 10884952]
  10. Neurologist. 2002 Mar;8(2):61-70 [PMID: 12803692]
  11. Clin Geriatr Med. 1993 May;9(2):279-96 [PMID: 8504379]
  12. Conn Med. 1993 May;57(5):277-80 [PMID: 8319442]
  13. Accid Anal Prev. 2004 Nov;36(6):993-1001 [PMID: 15350877]
  14. J Am Geriatr Soc. 1995 Jul;43(7):776-81 [PMID: 7602030]
  15. JAMA. 2004 Jun 16;291(23):2840-6 [PMID: 15199034]
  16. Am J Prev Med. 2004 Apr;26(3):222-9 [PMID: 15026102]
  17. CMAJ. 2002 Oct 1;167(7):747-51 [PMID: 12389835]
  18. Int J Epidemiol. 2000 Apr;29(2):315-22 [PMID: 10817131]
  19. Brain Inj. 2005 Mar;19(3):213-9 [PMID: 15832895]
  20. J Gerontol B Psychol Sci Soc Sci. 2000 Nov;55(6):S334-40 [PMID: 11078110]
  21. Annu Proc Assoc Adv Automot Med. 2003;47:181-94 [PMID: 12941225]
  22. J Int Neuropsychol Soc. 2000 May;6(4):480-90 [PMID: 10902417]
  23. Epidemiol Rev. 2003;25:24-42 [PMID: 12923988]
  24. Neuropsychology. 2004 Jan;18(1):85-93 [PMID: 14744191]
  25. J Gerontol B Psychol Sci Soc Sci. 2001 Nov;56(6):S343-51 [PMID: 11682595]
  26. Am J Epidemiol. 2002 Feb 1;155(3):234-41 [PMID: 11821248]
  27. Gerontology. 2000 May-Jun;46(3):146-52 [PMID: 10754372]
  28. Diabetes Care. 2006 Aug;29(8):1942-9 [PMID: 16873810]
  29. Milbank Q. 2001;79(4):517-45, iii-iv [PMID: 11789116]
  30. Brain Inj. 2005 Mar;19(3):159-63 [PMID: 15832890]
  31. J Safety Res. 2005;36(4):399-407 [PMID: 16226768]

MeSH Term

Accidents, Traffic
Aged
Epidemiologic Methods
Female
Humans
Male
Middle Aged
Patient Acceptance of Health Care
Quebec
Time Factors

Word Cloud

Created with Highcharts 10.0.0collisiondriversmedical1riskvehicleoldercontactstudyQuebecexposedcollisionsOR=195%CI11OBJECTIVE:estimateassociationpastcontactspopulationprovinceCanadaDESIGN:Case-crossoverSETTING:PARTICIPANTS:111699involvedleastoneJanuary1988December2000MAINOUTCOMEMEASURES:drivercomparedSeparateconditionallogisticregressionanalysesconductedfourdiagnostic-specificsubgroupsRESULTS:foundweakstatisticallysignificantincreasedassociatedwithinmonth1008diabetes0703CONCLUSION:OlderlikelyphysicianshortlyfindingssuggestmightopportunitydetectconditionsputhigherhoweverresearchneededassesspotentialeffectivenesspracticalmodalitiesscreeningAssociationroadrecentdrivers:case-crossover

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