Injurious crash risk and medical condition and medication use among senior drivers

by Cui, Xinjie

The objective of this study was to identify medical factors associated with injurious crash risk arnong senior drivers. A population-based case-control design was used. Senior drivers with at least one emergency room visit in 1997/98 or 1998/99 due to injuries related to motor vehicle crashes were identified as cases (n=915). A random sample of senior drivers fiom the study population was selected as controls (controlkase ratio 10:1; total N=10,064). Cornprehensive information on driver characteristics (age, sex, residence and driver license), medical diagnosis and prescription medication Lise for the strrdy snmple was obtained from Alberta Goverment computerized administrative databases. The relationslips between injunous crash risk and medical diagnoses in the two years preceding crash date and prescription medications dispensed during the G months prior to crash were exarnined using rnultivariate logistic regression modeling tecluiiques. In the following the major findings of the stildy are described. Use of nontricyclic aritidepressants, benzodiazepines, ophthalmic solutions, antibiotics, or topical antifungal medications was associated with an increased risk of injurious crash. Adjusted odds ratios (OR) for these medications ranged From 1.17 to 1.80. The relationship between diseases and injurious crash risk was comple:; and often involved interactions with comorbid conditions and medications. Diabetic drivers who also had disorders ofjoints/spine but were not on diuretic medications had an increased injurious crash risk (adjusted OR, 2.36). Female drivers with sleep disorders who were free fiom acute pulmonary infection had a 3-tirne increase in injurious crash risk (adjusted OR, 2.98) compared to healthy male drivers, while the nsk for male drivers with sirnilar conditions was close to 2 and half times (adjusted OR, 2.42). The presence of ischemic heart disease was associated with an increase of crash risk only when patients were not using cardiovascular medications (adjusted OR: 1.38). Finally, intestinal diseases were associated with an increased injurious crash risk of 1.27 (adjusted OR: 1.27) and a history of injury was associated with an increased nsk of 1.5 1 (adjusted OR, 1.51). These and other results are discussed in the context of driving-related physical, psychomotor and cognitive changes caused by disease conditions andor use of medications. fit iroduction