title: Circadian Sleep Propensity and Alcohol Interaction at the Wheel.
abstract: The study was aimed at estimating the effect of alcohol consumption, time of day, and their interaction on traffic crashes in a real regional context.
  
  
  
  Blood alcohol concentration (BAC) data were collected from drivers involved in traffic accidents during one year in an Italian region and in a control group of drivers over the same road network. Mean circadian sleep propensity was estimated from a previous study as function of time of day. Accident risk was analyzed by logistic regression as function of BAC and circadian sleep propensity.
  
  
  
  BAC values greater than zero were found in 72.0% of the drivers involved in crashes and in 40.4% of the controls. Among the former 23.6% of the drivers exceeded the BAC legal threshold of 0.05 g/dL, while illegal values were found in 10.4% of the controls. The relative risk showed a significant increase with both BAC and circadian sleep propensity (as estimated from time of day) and their interaction was significant.
  
  
  
  Due to the significant interaction, even low BAC levels strongly increased accident risk when associated with high sleep propensity.
authors.affiliation: Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal-Child Health, University of Genoa, Italy.
authors.forename: Sergio
authors.initials: S
authors.lastname: Garbarino
authors.affiliation: Center of Sleep Medicine, Niguarda Hospital, Milan, Italy.
authors.forename: Lino
authors.initials: L
authors.lastname: Nobili
authors.affiliation: University de Bordeaux, Sommeil, Attention et Neuropsychiatrie, Bordeaux, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Philip
authors.affiliation: Department of Biomedical and Neuromotor Sciences, University of Bologna and IRCCS Institute of Neurological Sciences, Bologna, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Plazzi
authors.affiliation: Italian Institute of Technology (IIT), Department of Robotics, Brain and Cognitive Sciences.
authors.forename: Claudio
authors.initials: C
authors.lastname: Campus
authors.affiliation: Sleep Center, Fondazione Salvatore Maugeri, IRCCS, Scientific Institute of Pavia, Italy.
authors.forename: Elisa
authors.initials: E
authors.lastname: Morrone
authors.affiliation: Institute of Bioimaging and Molecular Physiology, National Research Council (CNR), Genoa, Italy.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: De Carli
mesh_terms: D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000428:Alcohol Drinking / Q000453:epidemiology*; D001334:Automobile Driving; D000067401:Blood Alcohol Content; D002940:Circadian Rhythm; D015897:Comorbidity; D006801:Humans; D007558:Italy; D012892:Sleep Deprivation / Q000453:epidemiology*
chemical_list: D000067401:Blood Alcohol Content
keywords: alcohol consumption; crash risk; driving; sleepiness