title: The influence of stimulants on truck driver crash responsibility in fatal crashes.
abstract: BACKGROUND
  Given the monotony and extended driving periods inherent in transport truck driving, drivers might rely on stimulants to sustain attention and combat fatigue. Research indicates that stimulant use improves some cognitive functions but impairs driving ability and is linked to crashes. The research on crash responsibility among stimulant-positive truck drivers is inconclusive due to small sample sizes and a lack of control over confounding variables. The present study investigated the influence of stimulants on unsafe driving actions (UDAs) in fatal crashes contained in the Fatality Analysis Reporting System (FARS) database.
  
  
  METHODS
  Logistic regression was used to calculate the odds ratio of an UDA (cases committed an UDA; controls did not) by stimulant status (present; absent) while accounting for the influence of confounding variables (age, previous driving record, and other drug use).
  
  
  RESULTS
  For all truck drivers, we found that 372 truck drivers tested stimulant-positive representing 0.57% of the entire truck driver sample and 3.7% of truck drivers who were actually tested for drug use. Stimulant-positive truck drivers had a greater proportion of driving record infractions and narcotic drug use compared to stimulant-negative truck drivers. The adjusted odds of committing an UDA were 78% greater for truck drivers who were stimulant-positive (OR: 1.78, 95% CI: 1.41-2.26) compared to truck drivers stimulant-negative.
  
  
  CONCLUSIONS
  The results suggest stimulants are associated with crash responsibility and warrant further study into their impact on truck drivers.
authors.affiliation: Centre for Research on Safe Driving, Lakehead University, Thunder Bay, Ontario, Canada P7B-5E1.
authors.forename: Justin
authors.initials: J
authors.lastname: Gates
authors.forename: Sacha
authors.initials: S
authors.lastname: Dubois
authors.forename: Nadia
authors.initials: N
authors.lastname: Mullen
authors.forename: Bruce
authors.initials: B
authors.lastname: Weaver
authors.forename: Michel
authors.initials: M
authors.lastname: Bédard
mesh_terms: D000063:Accidents, Traffic; D000328:Adult; D001334:Automobile Driving; D000697:Central Nervous System Stimulants / Q000097:blood*; D016208:Databases, Factual; D005221:Fatigue / Q000517:prevention & control; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D018986:Motor Vehicles; D009656:North America; D015995:Prevalence; D011996:Records; D015813:Substance Abuse Detection; D019966:Substance-Related Disorders / Q000453:epidemiology
chemical_list: D000697:Central Nervous System Stimulants