title: High Ambient Temperatures and Risk of Motor Vehicle Crashes in Catalonia, Spain (2000-2011): A Time-Series Analysis.
abstract: BACKGROUND
  Experimental studies have shown a decrease in driving performance at high temperatures. The epidemiological evidence for the relationship between heat and motor vehicle crashes is not consistent.
  
  
  OBJECTIVE
  We estimated the impact of high ambient temperatures on the daily number of motor vehicle crashes and, in particular, on crashes involving driver performance factors (namely distractions, driver error, fatigue, or sleepiness).
  
  
  METHODS
  We performed a time-series analysis linking daily counts of motor vehicle crashes and daily temperature or occurrence of heat waves while controlling for temporal trends. All motor vehicle crashes with victims that occurred during the warm period of the years 2000-2011 in Catalonia (Spain) were included. Temperature data were obtained from 66 weather stations covering the region. Poisson regression models adjusted for precipitation, day of the week, month, year, and holiday periods were fitted to quantify the associations.
  
  
  RESULTS
  The study included 118,489 motor vehicle crashes (an average of 64.1 per day). The estimated risk of crashes significantly increased by 2.9% [95% confidence interval (CI): 0.7%, 5.1%] during heat wave days, and this association was stronger (7.7%, 95% CI: 1.2%, 14.6%) when restricted to crashes with driver performance-associated factors. The estimated risk of crashes with driver performance factors significantly increased by 1.1% (95% CI: 0.1%, 2.1%) for each 1 °C increase in maximum temperature.
  
  
  CONCLUSIONS
  Motor vehicle crashes involving driver performance-associated factors were increased in association with heat waves and increasing temperature. These findings are relevant for designing preventive plans in a context of global warming.
authors.affiliation: Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.
authors.forename: Xavier
authors.initials: X
authors.lastname: Basagaña
authors.forename: Juan Pablo
authors.initials: JP
authors.lastname: Escalera-Antezana
authors.forename: Payam
authors.initials: P
authors.lastname: Dadvand
authors.forename: Òscar
authors.initials: Ò
authors.lastname: Llatje
authors.forename: Jose
authors.initials: J
authors.lastname: Barrera-Gómez
authors.forename: Jordi
authors.initials: J
authors.lastname: Cunillera
authors.forename: Mercedes
authors.initials: M
authors.lastname: Medina-Ramón
authors.forename: Katherine
authors.initials: K
authors.lastname: Pérez
mesh_terms: D000063:Accidents, Traffic / Q000401:mortality / Q000706:statistics & numerical data*; D001334:Automobile Driving / Q000523:psychology; D006358:Hot Temperature; D006801:Humans; D011891:Rain; D012306:Risk; D013030:Spain / Q000453:epidemiology; D013997:Time Factors