Background Distracted driving may have serious consequences on road safety. Yet little is known about the impact of some forms of inattention such as executive dysfunctions. In this study we aimed to evaluate the association between working memory, selective attention, and the risk of being responsible for a road crash.

Methods We conducted a responsibility case-control study in an adult emergency department of the Bordeaux university hospital in France (2013–2015). Participants were 954 drivers injured in a road crash. The main outcome measure was responsibility for the crash. Covariates were external distraction, working memory, selective attention, alcohol use, psychotropic drug use, and sleep deprivation.

Results A high working memory was associated with responsibility for a traffic crash (odds ratio 1.9, 95% confidence interval 1.3 to 2.6). Regarding selective attention, the group displaying an hyper focus on stimuli was also associated with responsibility for a traffic crash (odds ratio 1.6, 95% confidence interval 1.1 to 2.3).

Conclusions Contrary to our expectations unimpaired executive function variables were associated with responsibility for the crash. It is possible that a better level of executive functioning may be linked to a higher focus on internal stimuli thus limiting attention to external and road stimuli.