title: Increased risk of traffic accidents in subjects with latent toxoplasmosis: a retrospective case-control study.
abstract: BACKGROUND
  The parasite Toxoplasma gondii infects 30-60% of humans worldwide. Latent toxoplasmosis, i.e., the life-long presence of Toxoplasma cysts in neural and muscular tissues, leads to prolongation of reaction times in infected subjects. It is not know, however, whether the changes observed in laboratory influence the performance of subjects in real-life situations.
  
  
  METHODS
  The seroprevalence of latent toxoplasmosis in subjects involved in traffic accidents (N=146) and in the general population living in the same area (N=446) was compared by a Mantel-Haenszel test for age-stratified data. Correlation between relative risk of traffic accident and a level of anti-Toxoplasma antibody titre was evaluated with the Cochran-Armitage test for trend.
  
  
  RESULTS
  A higher seroprevalence was found in the traffic accident set than in the general population (Chi2MH=21.45, p<0.0001). The value of the odds ratio (OR) suggests that subjects with latent toxoplasmosis had a 2.65 (C.I.95= 1.764.01) times higher risk of an accident than the toxoplasmosis-negative subjects. The OR significantly increased with level of anti-Toxoplasma antibody titre (p<0.0001), being low (OR=1.86, C.I.95=1.14-3.03) for the 99 subjects with low antibody titres (8 and 16), higher (OR=4.78, C.I.95=2.39-9.59) for the 37 subjects with moderate titres (32 and 64), and very high (OR=16.03, C.I.95=1.89-135.66) for the 6 subjects with titres higher than 64.
  
  
  CONCLUSIONS
  The subjects with latent toxoplasmosis have significantly increased risk of traffic accidents than the noninfected subjects. Relative risk of traffic accidents decreases with the duration of infection. These results suggest that 'asymptomatic' acquired toxoplasmosis might in fact represent a serious and highly underestimated public health as well as economic problem.
authors.affiliation: Department of Parasitology, Faculty of Science, Charles University, Prague, Czech Republic. flegr@cesnet.cz
authors.forename: Jaroslav
authors.initials: J
authors.lastname: Flegr
authors.forename: Jan
authors.initials: J
authors.lastname: Havlícek
authors.forename: Petr
authors.initials: P
authors.lastname: Kodym
authors.forename: Marek
authors.initials: M
authors.lastname: Malý
authors.forename: Zbynek
authors.initials: Z
authors.lastname: Smahel
mesh_terms: D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D000913:Antibodies, Protozoan / Q000032:analysis* / Q000276:immunology; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011634:Public Health; D011930:Reaction Time / Q000502:physiology*; D012189:Retrospective Studies; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D013223:Statistics as Topic; D014122:Toxoplasma / Q000276:immunology; D014123:Toxoplasmosis / Q000453:epidemiology* / Q000276:immunology / Q000469:parasitology
chemical_list: D000913:Antibodies, Protozoan