Abstract
Road safety has emerged as a major public health and preventative medicine challenge of the twenty-first century. As rapid demographic changes in health demographics and road utilization progress around the world, it has become clear that a significant number of deaths and injuries occur due to impairments in driver health and wellbeing rather than by purely “accidental” means. While legislative focus on speeding, seat-belt non-use and drunk driving have proven effective in many parts of the developed world, focus is now turning to fatigue and sleep loss, inattention/distraction, risk-taking behaviours and other sources of impairments with a primarily medical basis. Cybernetic traffic safety models consider driving in the context of complex and often stochastic states and many chronic or acute medical conditions, particularly those affecting cognitive function, can disturb the neuroergonomic driver/vehicle dyad.
Although reliable, widely used screening tools are currently not available, there is some optimism regarding eventual use of road-side, clinic-based, or in-vehicle screening tools for detection of impairments in driver vigilance. There is also a relative lack of large-scale epidemiologic studies examining contribution of various medical illnesses affecting fitness-to-drive although, in this review, some relevant findings of the 2004 Monash Accident Research Centre Report on this topic are highlighted.
As shifts in commercial and personal transportation patterns continue to evolve around the world, strategies for prevention of fatalities and injuries should be developed. Given the wide array of health conditions that may interfere with driving safety, preventative campaigns should focus on screening based on functional impairment (as opposed to specific diagnosis), education of the public as well specific targeted cohorts (e.g. commercial truck drivers, young novice drivers, elderly drivers) and skills training, which may include rehabilitative efforts in certain conditions (e.g. mild disorders affecting the central nervous system). As well, it is important to promote public awareness among non-commercial drivers about the known crash risks and effective management for particular medical conditions or impairments, including those pertaining to pharmacologic treatments.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsPreview
Unable to display preview. Download preview PDF.
References
Peden, M, Scurfield R, Sleet D. World Report on Road Traffic Injury Prevention. WHO, Geneva (2004).
Cole, T. B. (2004) Global road safety crisis remedy sought: 1.2 million killed, 50 million injured annually. JAMA 291, 2531–2532.
Kopits, E. & Cropper, M. (2005) Traffic fatalities and economic growth. Accid. Anal. Prev. 37, 169–178.
Haddon, W., Jr. (1963) A note concerning accident theory and research with special reference to motor vehicle accidents. Ann. N. Y. Acad. Sci. 107, 635–646.
Haddon, W., Jr. (1974) Editorial: Strategy in preventive medicine: passive vs. active approaches to reducing human wastage. J Trauma 14, 353–354.
Rasmussen, J. New Technology and Human Error. Rasmussen, J., Duncan, K. & Leplat, J. (eds.) (John Wiley & Sons, 1987).
Rosso, G. L., Zanelli, R., Bruno, S., Feola, M. & Bobbio, M. (2007) [Professional driving and safety, a target for occupational medicine]. Med. Lav. 98, 355–373.
Bunn, T. L., Slavova, S., Struttmann, T. W. & Browning, S. R. (2005) Sleepiness/fatigue and distraction/inattention as factors for fatal versus nonfatal commercial motor vehicle driver injuries. Accid. Anal. Prev. 37, 862–869.
Rajaratnam, S. M. & Arendt, J. (2001) Health in a 24-h society. Lancet 358, 999–1005.
Philip, P. (2005) Sleepiness of occupational drivers. Ind. Health 43, 30–33.
Barkley, R. A. & Cox, D. (2007) A review of driving risks and impairments associated with attention-deficit/hyperactivity disorder and the effects of stimulant medication on driving performance. J Safety Res 38, 113–128.
Dingus, T. A., Klauer, S.G., Neale, V. L., Petersen, A., Lee, S. E., Sudweeks, J., Perez, M. A., Hankey, J., Ramsey, D., Gupta, S., et al. (2006). The 100-car naturalistic driving study: Phase II: Results of the 100-car field experiment. National Highway Traffic Safety Administration & Virginia Tech Traffic Insititute, pp 1–422. Transportation Research Board. Washington, DC, USA.
O’Neill, D. (1992) Physicians, elderly drivers, and dementia. Lancet 339, 41–43.
Redelmeier, D. A., Venkatesh, V. & Stanbrook M.B. (2008) Mandatory reporting by physicians of patients potentially unfit to drive. Open Medicine 2(1), 8–17.
Charlton, J. L. Koppel, S., O’Hare, M., Andrea, D., Smith, G., Khodr, B., Langford, J., Odell, M. & Fildes, B. (2004) Influence of chronic illness on crash involvement of motor vehicle drivers. Monash Accident Research Centre Report, Swedish National Road Administration
Fong, G., Frost, D. & Stansfeld, S. (2001) Road rage: a psychiatric phenomenon? Soc. Psychiatry Psychiatr. Epidemiol. 36, 277–286.
Niveau, G. & Kelley-Puskas, M. (2001) Psychiatric disorders and fitness to drive. J Med. Ethics 27, 36–39.
Armstrong, J. L. & Whitlock, F. A. (1980) Mental illness and road traffic accidents. Aust. N. Z. J Psychiatry 14, 53–60.
Canadian Medical Association Determining Medical Fitness to Operate Motor Vehicles: CMA driver’s guide — 7th ed. CMA, Ottawa, Canada (2006).
Niveau, G. & Kelley-Puskas, M. (2001) Psychiatric disorders and fitness to drive. J Med. Ethics 27, 36–39.
Menard, I. Korner-Bitensky N, Dobbs B, Casacalenda N, Beck PR, Dippsych CM, Gélinas I, Molnar FJ, Naglie G. (2006) Canadian psychiatrists’ current attitudes, practices, and knowledge regarding fitness to drive in individuals with mental illness: a cross-Canada survey. Can. J Psychiatry 51, 836–846.
Bulmash, E. L. Moller HJ, Kayumov L, Shen J, Wang X, Shapiro CM (2006) Psychomotor disturbance in depression: assessment using a driving simulator paradigm. J Affect. Disord. 93, 213–218.
Ramaekers, J. G. (2003) Antidepressants and driver impairment: empirical evidence from a standard on-the-road test. J Clin. Psychiatry 64, 20–29.
Palmer, B. W. et al. (2002) Heterogeneity in functional status among older outpatients with schizophrenia: employment history, living situation, and driving. Schizophr. Res 55, 205–215 (2002).
Brunnauer, A., Laux, G., Geiger, E. & Moller, H. J. (2004) The impact of antipsychotics on psychomotor performance with regards to car driving skills. J Clin. Psychopharmacol. 24, 155–160.
Laflamme, L. & Vaez, M. (2007) Car crash and injury among young drivers: contribution of social, circumstantial and car attributes. Int. J Inj. Contr. Saf Promot. 14, 5–10.
Jonah, B. A. (1986) Accident risk and risk-taking behaviour among young drivers. Accid. Anal. Prev. 18, 255–271.
Mayhew, D. R. (2007) Driver education and graduated licensing in North America: past, present, and future. J Safety Res 38, 229–235.
Berg, H. Y. (2006) Reducing crashes and injuries among young drivers: what kind of prevention should we be focusing on? Inj. Prev. 12 Suppl 1, i15–i18.
Lee, J. D. (2007) Technology and teen drivers. J Safety Res 38, 203–213.
Fischer, P., Kubitzki, J., Guter, S. & Frey, D. (2007) Virtual driving and risk taking: do racing games increase risk-taking cognitions, affect, and behaviors? J Exp. Psychol. Appl. 13, 22–31.
Moller, H. J. & Barbera, J. Media Presence, Dreaming and Consciousness. In: From Communication to Presence: Cognition, Emotions and Culture Towards the Ultimate Communicative Experience. Riva, G., Anguera, M. T., Wiederhold, B. K. & Mantovani, F. (eds.), pp. 96–122 (IOS Press, Amsterdam, 2006).
Bunge, S. A., Dudukovic, N. M., Thomason, M. E., Vaidya, C. J. & Gabrieli, J. D. (2002) Immature frontal lobe contributions to cognitive control in children: evidence from fMRI. Neuron 33, 301–311.
Williamson, A. (2007) Predictors of psychostimulant use by long-distance truck drivers. Am. J Epidemiol. 166, 1320–1326.
Looby, A. (2008) Childhood attention deficit hyperactivity disorder and the development of substance use disorders: Valid concern or exaggeration? Addict. Behav. 33, 451–463.
Moller, H. J., Devins, G. M., Shen, J. & Shapiro, C. M. (2006) Sleepiness is not the inverse of alertness: evidence from four sleep disorder patient groups. Exp. Brain Res., 173: 258–66.
Moller, H. J., Shapiro, C. M. & Kayumov, L. (2006) Effects of Psychotropic Medications on Driving. In: Lader, M., Cardinali, D.P. & Pandi-Perumal, S.R. (eds.) Sleep and Sleep Disorders: Neuropsychopharmacological approach. Landes Biosciences, Georgetown, TX, USA, 121–125.
Vaca, F. National Highway Traffic Safety Administration (NHTSA) notes. (2005) Drowsy driving. Ann. Emerg. Med. 45, 433–434.
Shapiro, C. M. Auch C., Reimer M, Kayumov L, Heslegrave R, Huterer N, Driver H, Devins GM. (2006) A new approach to the construct of alertness. J. Psychosom. Res. 60, 595–603.
Otmani, S., Pebayle, T., Roge, J. & Muzet, A. (2005) Effect of driving duration and partial sleep deprivation on subsequent alertness and performance of car drivers. Physiol Behav. 84, 715–724.
Sugerman, J. L. & Walsh, J. K. (1989) Physiological sleep tendency and ability to maintain alertness at night. Sleep 12, 106–112.
Punjabi, N. M. (2008) The epidemiology of adult obstructive sleep apnea. Proc. Am. Thorac. Soc. 5, 136–143.
Millman, R. P., Acebo, C., Rosenberg, C. & Carskadon, M. A. (1996) Sleep, breathing, and cephalometrics in older children and young adults. Part II — Response to nasal occlusion. Chest 109, 673–679.
Redline, S. Tishler P.V., Schluchter M., Aylor J., Clark K., Graham G. (1999) Risk factors for sleep-disordered breathing in children. Associations with obesity, race, and respiratory problems. Am. J Respir. Crit Care Med. 159, 1527–1532.
George, C. F., Boudreau, A. C. & Smiley, A. (1997) Effects of nasal CPAP on simulated driving performance in patients with obstructive sleep apnoea. Thorax 52, 648–653.
Aldrich, M. S. (1989) Automobile accidents in patients with sleep disorders. Sleep 12, 487–494.
Costa, E., Silva, J. A., Chase, M., Sartorius, M. & Roth, T. (1996). Special report from a symposium held by the World Health Organization and the World Federation of Sleep Research Societies: an overview of insomnias and related disorders — recognition, epidemiology, and rational management. Sleep 19, 412–416.
Silber, M. H. (2005) Clinical practice. Chronic insomnia. N. Engl. J. Med. 353, 803–810.
Hening, W. A., Allen, R. P., Earley, C. J., Picchietti, D. L. & Silber, M. H. (2004) An update on the dopaminergic treatment of restless legs syndrome and periodic limb movement disorder. Sleep 27, 560–583.
Shen, J., Barbera, J. & Shapiro, C. M. (2006) Distinguishing sleepiness and fatigue: focus on definition and measurement. Sleep Med. Rev. 10, 63–76.
Leger, D., Massuel, M. A. & Metlaine, A. (2006) Professional correlates of insomnia. Sleep 29, 171–178.
Leger, D. (2000) Public health and insomnia: economic impact. Sleep 23 Suppl 3, S69–S76.
Vanlaar, H., Simpson, H., Mayhew, D. & Robertson, R. (2007) Fatigued and drowsy driving: attitudes, concern and practices of Ontario drivers. Traffic Injury Research Foundation 1–32. Ottawa, Canada.
Laflamme, L. & Vaez, M. (2007) Car crash and injury among young drivers: contribution of social, circumstantial and car attributes. Int. J Inj. Contr. Saf Promot. 14, 5–10.
Dinges, D. F. (2006) The state of sleep deprivation: From functional biology to functional consequences. Sleep Med. Rev. 10, 303–305.
Drake, C. L., Roehrs, T., Richardson, G., Walsh, J. K. & Roth, T. (2004) Shift work sleep disorder: prevalence and consequences beyond that of symptomatic day workers. Sleep 27, 1453–1462.
Pack, A. I. Pack A.M., Rodgman E., Cucchiara A., Dinges D.F., Schwab C.W. (1995) Characteristics of crashes attributed to the driver having fallen asleep. Accid. Anal. Prev. 27, 769–775.
Arnedt, J. T., Owens, J., Crouch, M., Stahl, J. & Carskadon, M. A. (2005) Neurobehavioral performance of residents after heavy night call vs after alcohol ingestion. JAMA 294, 1025–1033.
Breen, D. A., Breen, D. P., Moore, J. W., Breen, P. A. & O’Neill, D. (2007). Driving and dementia. BMJ 334, 1365–1369.
Moller, H. J., Barbera, J., Kayumov, L. & Shapiro, C. M. (2004) Psychiatric aspects of latelife insomnia. Sleep Med. Rev. 8, 31–45.
Uc, E. Y., Rizzo, M., Anderson, S. W., Shi, Q. & Dawson, J. D. (2006) Unsafe rear-end collision avoidance in Alzheimer’s disease. J Neurol. Sci. 251, 35–43.
Uc, E. Y., Rizzo M., Anderson S.W., Sparks J., Rodnitzky R.L., Dawson J.D.. (2006) Impaired visual search in drivers with Parkinson’s disease. Ann. Neurol. 60, 407–413.
Herrmann, N. Rapoport MJ, Sambrook R, Hébert R, McCracken P, Robillard A. (2006) Predictors of driving cessation in mild-to-moderate dementia. CMAJ. 175, 591–595.
Trobe, J. D., Waller, P. F., Cook-Flannagan, C. A., Teshima, S. M. & Bieliauskas, L. A. (1996) Crashes and violations among drivers with Alzheimer disease. Arch. Neurol. 53, 411–416.
O’Neill, D. (2007) Driving and dementia. CMAJ. 176, 351 (2007).
Krauss, G. L., Krumholz, A., Carter, R. C., Li, G. & Kaplan, P. (1999) Risk factors for seizure-related motor vehicle crashes in patients with epilepsy. Neurology 52, 1324–1329.
Meador, K. J., Baker, G., Cohen, M. J., Gaily, E. & Westerveld, M. (2007) Cognitive/behavioral teratogenetic effects of antiepileptic drugs. Epilepsy Behav. 11, 292–302.
Kurtzke, J. F. (1997) Geography in multiple sclerosis. J. Neurol. 215, 1–26.
Haase, C. G., Lienemann, M. & Faustmann, P. M. (2008) Neuropsychological deficits but not coping strategies are related to physical disability in multiple sclerosis. Eur. Arch. Psychiatry Clin. Neurosci. 258, 35–39.
Lincoln, N. B. & Radford, K. A. (2008) Cognitive abilities as predictors of safety to drive in people with multiple sclerosis. Mult. Scler. 14, 123–128.
Carroll, L. J., Cassidy, J. D., Holm, L., Kraus, J. & Coronado, V. G. (2004) Methodological issues and research recommendations for mild traumatic brain injury: the WHO Collaborating Centre Task Force on Mild Traumatic Brain Injury. J Rehabil. Med. 113–125.
Green, P. (2007) The pervasive influence of effort on neuropsychological tests. Phys. Med. Rehabil. Clin. N. Am. 18, 43–68, vi.
Walshe, D. G., Lewis, E. J., Kim, S. I., O’Sullivan, K. & Wiederhold, B. K. (2003) Exploring the use of computer games and virtual reality in exposure therapy for fear of driving following a motor vehicle accident. Cyberpsychol. Behav. 6, 329–334.
Mayou, R., Bryant, B. & Duthie, R. (1993) Psychiatric consequences of road traffic accidents. BMJ 307, 647–651.
Mayou, R. A., Ehlers, A. & Bryant, B. (2002) Posttraumatic stress disorder after motor vehicle accidents: 3-year follow-up of a prospective longitudinal study. Behav. Res Ther. 40, 665–675.
Walshe, D., Lewis, E., O’Sullivan, K. & Kim, S. I. (2005) Virtually driving: are the driving environments “real enough” for exposure therapy with accident victims? An explorative study. Cyberpsychol. Behav. 8, 532–537.
Jang, D. P. Kim IY, Nam SW, Wiederhold BK, Wiederhold MD, Kim SI. (2002) Analysis of physiological response to two virtual environments: driving and flying simulation. Cyberpsychol. Behav. 5, 11–18.
Erren-Wolters, C. V., van Dijk H., de Kort, A. C., Ijzerman, M. J. & Jannink, M. J. (2007) Virtual reality for mobility devices: training applications and clinical results: a review. Int. J Rehabil. Res 30, 91–96.
Akinwuntan, A. E. Feys H, De Weerdt W, Baten G, Arno P, Kiekens C. (2005) Effect of simulator training on driving after stroke: a randomized controlled trial. Neurology 65, 843–850.
Shinar, D. & Schieber, F. (1991) Visual requirements for safety and mobility of older drivers. Hum. Factors 33, 507–519.
Jackson, G. R. & Owsley, C. (2003) Visual dysfunction, neurodegenerative diseases, and aging. Neurol. Clin. 21, 709–728.
Vision Australia Foundation. Statistics on eye health in Australia. 2002. Melbourne, Australia.
Klein, B. E., Klein, R. & Linton, K. L. (1992) Prevalence of age-related lens opacities in a population. The Beaver Dam Eye Study. Ophthalmology 99, 546–552.
Kraut, J. A. & Lopez-Fernandez, V. (2002). Adaptation to monocular vision. Int. Ophthalmol. Clin. 42, 203–213.
Chisholm, C. M., Rauscher FG, Crabb DC, Davies LN, Dunne MC, Edgar DF, Harlow JA, James-Galton M, Petzold A, Plant GT, Viswanathan AC, Underwood GJ, Barbur JL. (2008). Assessing Visual Fields for Driving in Patients with Paracentral Scotomata. Br. J Ophthalmol. 92: 225–30.
Puell, M. C. & Barrio, A. (2008) Effect of driver distraction and low alcohol concentrations on useful field of view and frequency-doubling technology perimetry. Acta Ophthalmol. Scand. 86:634–41.
Mestre, D. Dynamic evaluation of useful field of view in driving. McGehee, D. V., Lee, J. D, Rizzo, M, Raby, M, and Boyle, L. N. Proceedings, 1st International Driving Symposium on Human Factors in Driver Assessment, Training and Vehicle Design (Aspen, CO), 148–152. 2008. Iowa City, USA, University of Iowa Press.
Windham, B. G. Griswold ME, Fried LP, Rubin GS, Xue QL, Carlson MC. (2005). Impaired vision and the ability to take medications. J Am. Geriatr. Soc. 53, 1179–1190.
Inwood, B. (2008) Goal and Target in Stoicism. J. Philosophy 83, 547–556.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2009 Birkhäuser Verlag/Switzerland
About this chapter
Cite this chapter
Moller, H.J. (2009). Driver health and traffic safety: an overview. In: Verster, J.C., Pandi-Perumal, S.R., Ramaekers, J.G., de Gier, J.J. (eds) Drugs, Driving and Traffic Safety. Birkhäuser Basel. https://doi.org/10.1007/978-3-7643-9923-8_1
Download citation
DOI: https://doi.org/10.1007/978-3-7643-9923-8_1
Publisher Name: Birkhäuser Basel
Print ISBN: 978-3-7643-9922-1
Online ISBN: 978-3-7643-9923-8
eBook Packages: Biomedical and Life SciencesBiomedical and Life Sciences (R0)