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Chronic medical conditions and their association with crash risk and changes in driving habits: a prospective study of the GAZEL cohort
  1. Juan Naredo Turrado1,2,
  2. Ludivine Orriols1,2,
  3. Benjamin Contrand1,2,
  4. Marie Zins3,4,
  5. Louis-Rachid Salmi1,2,
  6. Sylviane Lafont5,
  7. Emmanuel Lagarde1,2
  1. 1 ISPED, Université de Bordeaux, Bordeaux, France
  2. 2 Team IETO, INSERM U1219, Bordeaux, France
  3. 3 Faculty of Medicine, Université Paris Descartes, Paris, France
  4. 4 Population-based Epidemiological Cohorts, INSERM UMS 011, UVSQ, Villejuif, France
  5. 5 UMRESTTE UMR T 9405, Université Lyon, IFSTTAR, Université Lyon 1, Bron, France
  1. Correspondence to Dr Juan Naredo Turrado, Team IETO, INSERM U1219, Bordeaux, Aquitaine, France; juan.naredo-turrado{at}


Objectives To assess crash risk and driving habits associated with chronic medical conditions among drivers entering old age.

Design Prospective cohort study.

Setting French cohort GAZEL.

Participants 12 460 drivers in the analysis of road traffic crash, among whom 11 670 completed the follow-up period (2007–2014). We assessed driving cessation among 11 633 participants over the same period, and mileage and driving avoidance among the 4973 participants who returned a road safety questionnaire in 2015.

Main outcome measures Yearly occurrence of at least one road crash as a driver; time to driving cessation; mileage; driving avoidance: at night, with bad weather, in heavy traffic, with glare conditions, over long distances.

Results Several potentially risky conditions (angina, myocardial infarction, coronary disease; stroke; nephritic colic, urinary stones; glaucoma) were associated with lower mileage and/or driving avoidance and did not increase crash risk. Neither driving avoidance nor lower mileage was found for other conditions associated with an increased crash risk: hearing difficulties (adjusted OR 1.19, 95% CI 1.06 to 1.34); joint disorders (1.17, 95% CI 1.06 to 1.30). Depression, anxiety and stress was associated with an increased crash risk (1.23, 95% CI 1.01 to 1.49) despite increased driving avoidance. Parkinson’s disease was associated with driving cessation (adjusted HR 32.61, 95% CI 14.21 to 65.17).

Conclusions Depending on their condition, and probably on the associated risk perception, drivers entering old age report diverse driving habits. For example, hearing difficulties is a frequent condition, rarely considered a threat to road safety, and nonetheless associated with an increased crash risk.

  • older people
  • risk factor research
  • driver
  • behavior
  • attitudes
  • public health

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  • Contributors Conception of the work: LO, BC, MZ, L-RS, SL and EL; data analysis and interpretation: JNT, LO and EL; drafting the article: all; critical revision of the article: all; final approval of the version to be published: all. The corresponding author attests that all listed authors meet authorship criteria and that no others meeting the criteria have been omitted. All the authors had full access to all the data (including statistical reports and tables) in the study and can take responsibility for the integrity of the data and the accuracy of the data analysis.

  • Funding This project was funded by the Délégation à la sécurité routière (DSR), the Fondation Sécurité Routière (FSR) and the Institut de Recherche en Santé Publique (IReSP).

  • Disclaimer The funding sources did not contribute to the study design and had no role in the collection, analysis, or interpretation of data, in the writing of the report, or in the decision to submit the article to publication.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The study protocol was approved by the French authority for data confidentiality (Commission Nationale Informatique et Libertés).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data may be obtained from a third party and are not publicly available. UMS 011 Inserm is responsible for any decision regarding the possible reuse of the data. Scientific department: UMS 011 Inserm UVSQ Hôpital Paul Brousse Bât.15/16 16 avenue Paul Vaillant-Couturier 94807 VILLEJUIF CEDEX (France). Email address:

  • Author note The lead author (JNT) affirms that the manuscript is an honest, accurate and transparent account of the study being reported; that no important aspects of the study have been omitted; and that any discrepancies from the study as originally planned (and, if relevant, registered) have been explained.