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Prevalance of driver-related risk factors for crashing in mildly injured drivers

Author(s): Jeffrey R Brubacher, MD, MSc, Herbert Chan, PhD, Elizabeth Purssell, Benjamin Tuyp, Ediweera Desapriya, PhD, Vahid Mehrnoush, MD

Slidedeck Presentation:

1A Brubacher_Prevalence of driver-related risk factors for crashing

Abstract:

Background: The majority of crashes cause “minor” injuries that are not captured in road trauma surveillance systems and seldom studied in traffic safety literature. Injury related disability is an important public health concern but the risk of disability following minor crashes is poorly understood. The majority of crashes are due to driver factors. Some driver factors are well understood but, for many potential risk factors, much is unknown.

Aim: To determine the prevalence of driver-related risk factors in drivers involved in minor crashes. To determine the health outcome of drivers after minor crashes

Methods: This study was approved by The University of British Columbia research ethics board. We interviewed a convenience sample of injured drivers who were treated in the emergency department of Vancouver General Hospital. We included injured drivers between the 2 ages of 17 and 75. Our exclusion criteria were: i) non-residents, ii) inability to communicate in English, iii) amnestia for the event, iv) unable to complete interviews due to pain or injuries. Baseline interviews were conducted in person. Follow-up interviews, 6 months after the crash, were conducted by telephone.

Results: We approached 123 injured drivers, 77 agreed to be interviewed, and interviews were completed in 74 (60%). Followup interviews were completed in 47 drivers. Prior to the index crash, 5.4% of drivers reported drinking alcohol, 1.4% reported illicit drug use and 41.9% reported using prescription medications including antidepressants 5.4%, opioids 4.1%, and sedatives 4.1%. In 39 drivers for whom blood alcohol levels (BALs) were measured as part of clinical care, there was perfect agreement between BAL and self-reported alcohol use prior to the crash. Nine drivers (12.2%) were distracted at time of crash: 1.4% were using a cell phone at time of crash, 1.4% adjusting the radio, 6.8% were talking to passengers and 2.7% were distracted by something else. Based on the Dula Dangerous Driving Index, 5.4% were aggressive drivers, 8.1% were risky drivers, and 10.8% drove while experiencing anger or other negative emotions. At 6 month follow-up, many drivers were experiencing health problems due to the crash, 53.2% were not fully recovered, 46.8% had not returned to their usual activities, and 29.8% were not back to work. Of the 44 participants who were back to driving, 15.9% reported a near miss and 4.5% reported another crash. Nine (20.5%) reported drinking and driving and 9.1% reported driving after cannabis use. Cell phone use (15.9%) and use of other electronics while driving (25%) were also common.

Conclusions: Driver-related risk factors are common in drivers involved in minor injury crashes and drivers persist to take risks after being involved in a crash. Despite their name, minor injury crashes are often associated with slow recovery and prolonged absenteeism from work.