Second-generation antihistamines exhibit a protective effect on drivers in traffic-a preliminary population-based case-control study.
BACKGROUND
Although there have been experimental studies concerning driving and drugs, studies on the risk of antihistamines are not numerous. This is the first population-based epidemiological study concerning the association of sedating/nonsedating antihistamines and fatal traffic accidents.


METHODS
Car drivers (n = 428) who died in accidents before reaching the hospital and controls (n = 688) matched for accident area and driving season were studied for antihistamines in blood. At the time of the fatal road traffic accident, 6 drivers had a detectable amount of sedating antihistamines in blood, and the corresponding number for controls was 4; nonsedating antihistamines in blood were detected in 12 accident cases and 28 controls. The fatal accidents occurred between 1998 and 2002 and the information on the controls was collected between 2000 and 2002 in Finland.


RESULTS
Regarding fatal traffic accident causality, the nonsedating antihistamines proved to have a protective effect after adjusting for age and gender (relative risk = 0.40, 95% confidence interval [CI], 0.20 to 0.82; P =.01). The risk of fatal traffic accident of those driving under the influence of sedating antihistamines was 1.61 (0.38 to 6.77, P =.51) times the risk of those without medication.


CONCLUSIONS
This preliminary study supports the protective effect of second-generation antihistamines with respect to fatal traffic accidents. Due to the small sample size the results are not conclusive.
a Division of Forensic Toxicology, Hjelt-Institute , University of Helsinki, University of Helsinki , Helsinki , Finland.
Antti
A
Perttula
Janne
J
Pitkäniemi
Olli-Pekka
OP
Heinonen
William D
WD
Finkle
Timothy
T
Triche
Merja
M
Gergov
Erkki
E
Vuori
D000063:Accidents, Traffic / Q000401:mortality*; D000328:Adult; D001334:Automobile Driving / Q000706:statistics & numerical data*; D016022:Case-Control Studies; D005260:Female; D005387:Finland / Q000453:epidemiology; D006634:Histamine H1 Antagonists / Q000009:adverse effects / Q000097:blood; D039563:Histamine H1 Antagonists, Non-Sedating / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012306:Risk
D006634:Histamine H1 Antagonists; D039563:Histamine H1 Antagonists, Non-Sedating
Finland; accidents; antihistamines; case control; population-based; traffic