Traumatic brain injury, driver aggression and motor vehicle collisions in Canadian adults.
OBJECTIVE
This study examines the associations between lifetime traumatic brain injury (TBI), driver aggression, and motor vehicle collisions among a population sample of adults who reside in the province of Ontario, Canada.


METHODS
A cross-sectional sample of 3993 Ontario adults, aged 18-97 were surveyed by telephone in 2011 and 2012 as part of Center for Addiction and Mental Health's ongoing representative survey of adult mental health and substance use in Canada. TBI was defined as trauma to the head that resulted in loss of consciousness for at least five minutes or overnight hospitalization.


RESULTS
An estimated 91% (95% CI: 90.0, 91.9) of individuals in this sample held a valid Ontario driver's license at the time of testing. Among those, 16.7% reported a history of lifetime TBI and 83.3% reported no TBI. The prevalence of TBI was higher among men than women. Relative to licensed adults without TBI, adults with a history of TBI had significantly higher odds of engaging in serious driver aggression in the past 12 months, such as making threats to hurt another driver, passenger or their vehicle (AOR=4.39). These individuals also reported significantly higher odds (AOR=1.74) of being involved in a motor vehicle collision that resulted in hurting themselves, their passenger(s) or their vehicle.


CONCLUSIONS
This is the first population-based study to demonstrate a relationship between a history of TBI and higher rates of serious driver aggression and collision involvement. Given the large proportion of adult drivers with a history of TBI, these individuals may account for a disproportion burden of all traffic safety problems. Whether the increased road safety risk of adults with a history of TBI is reflective of neurocognitive deficits or is merely evidence of a cluster of unsafe activities produced by a higher risk lifestyles requires further research attention.
Division of Neurosurgery and Injury Prevention Research Office, St. Michael's Hospital, 30 Bond St., Toronto, Ontario M5B 1W8, Canada. Electronic address: ilieg@smh.ca.
Gabriela
G
Ilie
Social and Epidemiological Research, Center for Addiction and Mental Health, 33 Russell Street, Toronto, Ontario M5S 2S1, Canada; Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th floor, Toronto, Ontario M5T 3M7, Canada.
Robert E
RE
Mann
Social and Epidemiological Research, Center for Addiction and Mental Health, 33 Russell Street, Toronto, Ontario M5S 2S1, Canada.
Anca
A
Ialomiteanu
Social and Epidemiological Research, Center for Addiction and Mental Health, 33 Russell Street, Toronto, Ontario M5S 2S1, Canada; Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th floor, Toronto, Ontario M5T 3M7, Canada.
Edward M
EM
Adlaf
Social and Epidemiological Research, Center for Addiction and Mental Health, 33 Russell Street, Toronto, Ontario M5S 2S1, Canada; Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th floor, Toronto, Ontario M5T 3M7, Canada.
Hayley
H
Hamilton
Social and Epidemiological Research, Center for Addiction and Mental Health, 33 Russell Street, Toronto, Ontario M5S 2S1, Canada; Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th floor, Toronto, Ontario M5T 3M7, Canada.
Christine M
CM
Wickens
Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia B3H 4R2, Canada.
Mark
M
Asbridge
Social and Epidemiological Research, Center for Addiction and Mental Health, 33 Russell Street, Toronto, Ontario M5S 2S1, Canada; Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th floor, Toronto, Ontario M5T 3M7, Canada.
Jürgen
J
Rehm
Division of Neurosurgery and Injury Prevention Research Office, St. Michael's Hospital, 30 Bond St., Toronto, Ontario M5B 1W8, Canada; Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th floor, Toronto, Ontario M5T 3M7, Canada.
Michael D
MD
Cusimano
D000063:Accidents, Traffic / Q000523:psychology* / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000374:Aggression / Q000523:psychology*; D001930:Brain Injuries / Q000150:complications / Q000453:epidemiology* / Q000523:psychology*; D015984:Causality; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D009864:Ontario; D055815:Young Adult
Adults; Concussions; Driver aggression; Motor vehicle collision; Traumatic brain injury