title: The occupational risk of motor vehicle collisions for emergency medicine residents.
abstract: OBJECTIVE
  To determine the prevalence and risk factors associated with motor vehicle collisions (MVCs) and near-crashes as reported by emergency medicine (EM) residents following various ED shifts.
  
  
  METHODS
  A survey was sent to all allopathic EM-2-EM-4 residents in May 1996 asking whether they had ever been involved in an MVC or near-crash while driving home after an ED shift. The residents' night shift schedules, self-reported tolerance of night work, ability to overcome drowsiness, sleep flexibility, and morningness/eveningness tendencies also were collected.
  
  
  RESULTS
  Seventy-eight programs participated and 62% of 1,554 eligible residents returned usable surveys. Seventy-six (8%, 95% CI = 6% to 10%) residents reported having 96 crashes and 553 (58%, 95% CI = 55% to 61%) residents reported being involved in 1,446 near-crashes. Nearly three fourths of the MVCs and 80% of the near-crashes followed the night shift. Stepwise logistic regression of all variables demonstrated a cumulative association (R = 0.19, p = 0.0004) that accounted for 4% of the observed variability in MVCs and near-crashes. Univariate analysis showed that MVCs and near-crashes were inversely related to residents' shiftwork tolerance (p = 0.019) and positively related to the number of night shifts worked per month (p = 0.035).
  
  
  CONCLUSIONS
  Residents reported being involved in a higher number of MVCs and near-crashes while driving home after a night shift compared with other shifts. Driving home after a night shift appears to be a significant occupational risk for EM residents.
authors.affiliation: Department of Emergency Medicine, Truman Medical Center, University of Missouri, Kansas City School of Medicine, 64108, USA. msteele@cctr.umkc.edu
authors.forename: M T
authors.initials: MT
authors.lastname: Steele
authors.forename: O J
authors.initials: OJ
authors.lastname: Ma
authors.forename: W A
authors.initials: WA
authors.lastname: Watson
authors.forename: H A
authors.initials: HA
authors.lastname: Thomas
authors.forename: R L
authors.initials: RL
authors.lastname: Muelleman
mesh_terms: D000063:Accidents, Traffic; D004635:Emergency Medicine; D006801:Humans; D007396:Internship and Residency; D011597:Psychomotor Performance; D012892:Sleep Deprivation; D014481:United States; D014940:Work Schedule Tolerance