The impact of medicinal drugs on traffic safety: A systematic review of epidemiological studies
Pharmacoepidem. Drug Safe.. 2009-08-01; 18(8): 647-658
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1. Pharmacoepidemiol Drug Saf. 2009 Aug;18(8):647-58. doi: 10.1002/pds.1763.
The impact of medicinal drugs on traffic safety: a systematic review of
Orriols L(1), Salmi LR, Philip P, Moore N, Delorme B, Castot A, Lagarde E.
(1)Equipe Avenir prévention et prise en charge des traumatismes, Centre de
recherche INSERM U897 Epidémiologie et Biostatistiques, Université Victor Segalen
Bordeaux 2, France.
PURPOSE: To evaluate the quality of epidemiological research into effects of
medicinal drugs on traffic safety and the current knowledge in this area.
DATA SOURCES: The bibliographic search was done in Medline electronic database
using the keywords: ((accident* or crash*) and traffic and drug*) leading to 1141
references. Additional references were retrieved from the Safetylit website and
the reference lists of selected studies. Original articles published in English
or French, between 1 April 1979 and 31 July 2008, were considered for inclusion.
We excluded descriptive studies, studies limited to alcohol or illicit drug
involvement and investigations of injuries other than from traffic crashes.
Studies based on laboratory tests, driving simulators or on-the-road driving
tests were also excluded. Eligible studies had to evaluate the causal
relationship between the use of medicinal drugs and the risk of traffic crashes.
Study quality was assessed by two independent experts, according to a grid
adapted from the strengthening the reporting of observational studies in
epidemiology (STROBE) statement.
RESULTS: Twenty two studies of variable methodological quality were included.
Definition of drug exposure varied across studies and depended on the data
sources. Potential confounding due to the interaction between the effects of the
medicinal drug and disease-related symptoms was often not controlled. The risk of
motor-vehicle crashes related to benzodiazepines has been amply studied and
demonstrated. Results for other medicinal drugs remain controversial.
CONCLUSION: There is a need for large studies, investigating the role of
individual substances in the risk of road traffic crashes.
Copyright 2009 John Wiley & Sons, Ltd.
PMID: 19418468 [Indexed for MEDLINE]