title: The role of drug and alcohol use and the risk of motor vehicle crashes in Shiraz, Iran, 2014: A case-crossover study.
abstract: Traffic accidents and traffic-related injuries and mortality have become a major public health concern in Iran. This study aimed to examine the role of drug and alcohol use in motor vehicle accidents in Iran.
  
  
  
  This case-crossover study was conducted on 441 drivers who survived a road traffic crash and were taken to the emergency department of Shahid Rajaee trauma hospital in Shiraz, southern Iran. Data were collected using checklists that included demographic characteristics and drug and alcohol use prior to driving. Alcohol and drug use was identified through self-report, and cannabis, morphine, and methamphetamine urine tests were used to confirm drug abuse among drivers.
  
  
  
  In total 17.9% of drivers reported using drugs (cannabis, opium, or metamphetamine) and 8.84% of drivers reported consuming alcohol prior to the collision. The crude odds ratios (ORs) for having a crash for opium, cannabis, and metamphetamine were 1.94 (95% interval confidence [CI], 1.11-3.38), 2.37 (95% CI, 1.03-5.42), 5.5 (95% CI, 1.21-24.81), respectively, and for all drugs was 3.83 (95% CI, 2.28-6.43). The OR for alcohol was 3.5 (95% CI, 1.73-7.06) based on self-report.
  
  
  
  Drug and alcohol use are increasing the risk of traffic crashes in Iran. Risk-reducing programs must be designed and implemented.
authors.affiliation: a Environmental Health Engineering Research Center , School of Public Health, Kerman University of Medical Sciences , Kerman , Iran.
authors.forename: Narges
authors.initials: N
authors.lastname: Khanjani
authors.affiliation: b Shiraz University of Medical Sciences , Shiraz , Iran.|c Department of Epidemiology and Biostatistics , School of Public Health, Kerman University of Medical Sciences , Kerman , Iran.
authors.forename: Masoomeh
authors.initials: M
authors.lastname: Mousavi
authors.affiliation: d Trauma Research Center , Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences , Shiraz , Iran.|e Department of Pathology , Shiraz Medical School, Shiraz University of Medical Sciences , Shiraz , Iran.
authors.forename: Amirreza
authors.identifier: 0000-0003-0360-7468
authors.initials: A
authors.lastname: Dehghanian
authors.affiliation: f Department of Biostatistics and Epidemiology , School of Public Health, Kerman University of Medical Sciences , Kerman , Iran.
authors.forename: Yunes
authors.initials: Y
authors.lastname: Jahani
authors.affiliation: g Safety Promotion and Injury Prevention Research Center , Shahid Beheshti University of Medical Sciences , Tehran , Iran.
authors.forename: Hamid
authors.initials: H
authors.lastname: Soori
mesh_terms: D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology*; D018592:Cross-Over Studies; D000066448:Driving Under the Influence / Q000706:statistics & numerical data*; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D007492:Iran / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012306:Risk; D057566:Self Report; D015813:Substance Abuse Detection / Q000706:statistics & numerical data; D019966:Substance-Related Disorders / Q000453:epidemiology*; D055815:Young Adult
keywords: Alcohol use; case–crossover; collisions; drug use