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

¹ INSERM, U593, Équipe Avenir Santé et Insécurité Routière, ISPED, Université Victor Segalen Bordeaux 2, Bordeaux, F-33000, France
² CHU Bordeaux, Service d’information médicale, Bordeaux, F-33000, France
³ Division of Clinical Epidemiology, Royal Victoria Hospital, McGill University Health Centre, West Montreal, Quebec H3A 1A1, Canada

Correspondence to:
Professor L R Salmi, ISPED, Université Victor Segalen Bordeaux 2, 146, rue Léo-Saignat, F-33076 Bordeaux cedex, France; rachid.salmi{at}isped.u-bordeaux2.fr

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.

Abbreviations: RAMQ, Quebec Health Insurance Agency; SAAQ, Universal Quebec Automobile Insurance Agency; TBI, traumatic brain injury