title: Long-term chronic diseases and crash responsibility: a record linkage study.
abstract: OBJECTIVE
  To assess the population impact of chronic conditions on the risk of road traffic crashes.
  
  
  METHODS
  Data from three French national databases were extracted and matched: the national health care insurance database, police reports and the national police database of injurious crashes. Exposure to chronic conditions were compared between responsible and nonresponsible drivers. Analysis was performed using the Lasso (least absolute shrinkage and selection operator) method.
  
  
  RESULTS
  69,630 drivers involved in an injurious crash in France between 2005 and 2008, were included. 6210 (8.9%) were suffering from at least one long-term disease. When adjusted for prescription of medicines, blood alcohol, demographic driver characteristics and crash characteristics, increased risk of being responsible for a crash was found in drivers registered in the French healthcare database with the following long-term diseases: epilepsy (odds ratio [OR]=2.53 [1.53-4.20]), type 1 diabetes (OR=1.47) [1.12-1.92], alcoholic liver disease (OR=3.37 [1.40-8.13]), asthma (OR=1.72 [1.13-2.60]) and specific personality disorders (OR=1.35 [1.05-1.74]). No association was found for cardiovascular diseases or Alzheimer's disease.
  
  
  CONCLUSIONS
  The results update the list of medical conditions that may impair driving skills. However, results should be considered cautiously with regards to potential regulatory driving judgments that could have a negative impact on patients' social life.
authors.affiliation: Univ. Bordeaux, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, F-33000 Bordeaux, France; INSERM, Equipe Prévention et prise en charge des traumatismes, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, F-33000 Bordeaux, France. Electronic address: ludivine.orriols@isped.u-bordeaux2.fr.
authors.forename: Ludivine
authors.initials: L
authors.lastname: Orriols
authors.affiliation: Univ. Bordeaux, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, F-33000 Bordeaux, France; INSERM, Equipe Biostatistique, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, F-33000 Bordeaux, France.
authors.forename: Marta
authors.initials: M
authors.lastname: Avalos-Fernandez
authors.affiliation: INSERM U657, CIC-P0005, Département de Pharmacologie, Université Bordeaux Segalen, Bordeaux, France.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Moore
authors.affiliation: USR CNRS SANPSY 3413, Université Bordeaux Segalen, Bordeaux, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Philip
authors.affiliation: Pôle information des professionnels et du public, Direction de la communication et de l'information, Agence nationale de sécurité du médicament et des produits de santé (ANSM), Saint-Denis, France.
authors.forename: Bernard
authors.initials: B
authors.lastname: Delorme
authors.affiliation: Université de Lyon, F-69000 Lyon, France; IFSTTAR, UMR T 9405, UMRESTTE, F-69500 Bron, France; Université Lyon 1, UMRESTTE, F-69000 Lyon, France.
authors.forename: Bernard
authors.initials: B
authors.lastname: Laumon
authors.affiliation: Université de Lyon, F-69000 Lyon, France; IFSTTAR, UMR T 9405, UMRESTTE, F-69500 Bron, France; Université Lyon 1, UMRESTTE, F-69000 Lyon, France.
authors.forename: Blandine
authors.initials: B
authors.lastname: Gadegbeku
authors.affiliation: Univ. Bordeaux, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, F-33000 Bordeaux, France; INSERM, Equipe Prévention et prise en charge des traumatismes, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, F-33000 Bordeaux, France; Service d'information médicale, CHU de Bordeaux, France.
authors.forename: Louis-Rachid
authors.initials: LR
authors.lastname: Salmi
authors.affiliation: Univ. Bordeaux, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, F-33000 Bordeaux, France; INSERM, Equipe Prévention et prise en charge des traumatismes, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, F-33000 Bordeaux, France.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Lagarde
mesh_terms: D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D000368:Aged; D001249:Asthma / Q000453:epidemiology*; D002908:Chronic Disease; D016208:Databases, Factual; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology*; D004827:Epilepsy / Q000453:epidemiology*; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D008108:Liver Diseases, Alcoholic / Q000453:epidemiology*; D016015:Logistic Models; D008297:Male; D008498:Medical Record Linkage; D008875:Middle Aged; D010554:Personality Disorders / Q000453:epidemiology*; D012307:Risk Factors; D055815:Young Adult
keywords: Chronic diseases; Diabetes; Epilepsy; Lasso; Responsibility study; Road traffic crashes