title: Roadway crash risks in recent immigrants.
abstract: Adult immigrants are sometimes characterized as unsafe drivers and responsible for excess road crashes. We analyzed Canada's largest and most ethnically diverse province to assess whether recent immigrants had an increased risk of involvement as drivers in serious motor vehicle crashes. Overall, the study included 4,238,222 individuals followed for a median duration of 8.0 years. In total, 10,975 individuals were subsequently admitted to hospital as drivers involved in a crash, with a rate per 100,000 significantly lower among recent immigrants compared to long-term residents (158 vs 289, p<0.001). This difference was equal to a 45% relative reduction in the incidence of a crash (odds ratio=0.55, 95% confidence interval 0.52-0.58), persisted after adjustment for baseline characteristics (hazard ratio=0.61, 95% confidence interval 0.58-0.65), extended to extremes of crash severity, and was accentuated during initial years following immigration. These findings suggest that, contrary to popular opinion, recent immigrants are less prone to be drivers in serious motor vehicle crashes.
authors.affiliation: Department of Medicine, University of Toronto, Canada; Clinical Epidemiology Program, Sunnybrook Health Sciences Centre, Canada; Institute for Clinical Evaluative Sciences in Ontario, Canada; Patient Safety Service, Sunnybrook Research Institute, Canada. Electronic address: dar@ices.on.ca.
authors.forename: Donald A
authors.initials: DA
authors.lastname: Redelmeier
authors.affiliation: Department of Medicine, University of Toronto, Canada; Institute for Clinical Evaluative Sciences in Ontario, Canada.
authors.forename: David
authors.initials: D
authors.lastname: Katz
authors.affiliation: Institute for Clinical Evaluative Sciences in Ontario, Canada.
authors.forename: Hong
authors.initials: H
authors.lastname: Lu
authors.affiliation: Department of Medicine, University of Toronto, Canada; Institute for Clinical Evaluative Sciences in Ontario, Canada; Division of Neurology, St. Michael's Hospital, Canada.
authors.forename: Gustavo
authors.initials: G
authors.lastname: Saposnik
mesh_terms: D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D000368:Aged; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data*; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009864:Ontario / Q000453:epidemiology; D018570:Risk Assessment; D012309:Risk-Taking; D055815:Young Adult