title: Impact of vestibular disorders on fitness to drive: a census of the American Neurotology Society.
abstract: BACKGROUND
  Legislation for reporting unfit-to-drive patients by physicians varies dramatically among U.S. states and Canadian provinces. The impact of vestibular disease on driving safety is not well described in the literature.
  
  
  OBJECTIVE
  (1) to learn more about the critical issues and current practices of neurotologists regarding reporting of vestibular patients and (2) to make recommendations for reporting patients with vestibular disorders.
  
  
  METHODS
  A mailed census of members of the American Neurotology Society using a questionnaire based on a modified Dillman Total Design Survey Method.
  
  
  RESULTS
  Most respondents are aware of the potential safety risks of patients who drive with vestibular diseases, most notably those with Tumarkins' attacks. Although many have counselled patients (94%) and considered reporting vestibular patients (75%), few actually have (14%). There was no consensus of opinion on a method of reporting unfit-to-drive patients. Only 18.9% of respondents supported mandatory physician reporting. Respondents who live in states where reporting is not mandatory and who are aware of this fact are (a) more satisfied with their state's legislation (chi 2 = 60.1, p = 0.001) and (b) less likely to report patients who they consider unfit-to-drive (chi 2 = 10.6, p = 0.03).
  
  
  CONCLUSIONS
  In that there is no general consensus amongst respondents and the relative safety risks seem low in comparison to other disorders, at present we do not advocate mandatory reporting of patients with vestibular disorders.
authors.affiliation: Department of Otolaryngology, University of Western Ontario, London, Canada.
authors.forename: L S
authors.initials: LS
authors.lastname: Parnes
authors.forename: R
authors.initials: R
authors.lastname: Sindwani
mesh_terms: D000063:Accidents, Traffic / Q000517:prevention & control; D000328:Adult; D001334:Automobile Driving / Q000331:legislation & jurisprudence; D005260:Female; D006801:Humans; D007878:Legislation as Topic; D008297:Male; D008875:Middle Aged; D011795:Surveys and Questionnaires; D015837:Vestibular Diseases / Q000150:complications* / Q000503:physiopathology*