Prescription medicines and the risk of road traffic crashes: a French registry-based study.
BACKGROUND
In recent decades, increased attention has been focused on the impact of disabilities and medicinal drug use on road safety. The aim of our study was to investigate the association between prescription medicines and the risk of road traffic crashes, and estimate the attributable fraction.


RESULTS
We extracted and matched data from three French nationwide databases: the national health care insurance database, police reports, and the national police database of injurious crashes. Drivers identified by their national health care number involved in an injurious crash in France, between July 2005 and May 2008, were included in the study. Medicines were grouped according to the four risk levels of the French classification system (from 0 [no risk] to 3 [high risk]). We included 72,685 drivers involved in injurious crashes. Users of level 2 (odds ratio [OR]  = 1.31 [1.24-1.40]) and level 3 (OR  = 1.25 [1.12-1.40]) prescription medicines were at higher risk of being responsible for a crash. The association remained after adjustment for the presence of a long-term chronic disease. The fraction of road traffic crashes attributable to levels 2 and 3 medications was 3.3% [2.7%-3.9%]. A within-person case-crossover analysis showed that drivers were more likely to be exposed to level 3 medications on the crash day than on a control day, 30 days earlier (OR  = 1.15 [1.05-1.27]).


CONCLUSIONS
The use of prescription medicines is associated with a substantial number of road traffic crashes in France. In light of the results, warning messages appear to be relevant for level 2 and 3 medications and questionable for level 1 medications. A follow-up study is needed to evaluate the impact of the warning labeling system on road traffic crash prevention.
Equipe Avenir prévention et prise en charge des traumatismes, Centre de recherche INSERM U897 Epidémiologie et Biostatistiques, Institut de Santé Publique d'Epidémiologie et de Développement (ISPED), Université Victor Segalen Bordeaux 2, France. ludivine.orriols@isped.u-bordeaux2.fr
Ludivine
L
Orriols
Bernard
B
Delorme
Blandine
B
Gadegbeku
Aurore
A
Tricotel
Benjamin
B
Contrand
Bernard
B
Laumon
Louis-Rachid
LR
Salmi
Emmanuel
E
Lagarde
D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D001334:Automobile Driving / Q000706:statistics & numerical data*; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D005602:France; D012042:Registries