Medicine consumptions and occupational road risk

Applying a Health Equity Lens to Work-Related Motor Vehicle Safety in the United States

Motor vehicle crashes (MVCs) are the leading cause of fatal work-related injuries in the United States. Research assessing sociodemographic risk disparities for work-related MVCs is limited, yet structural and systemic inequities at work and during commutes likely contribute to disproportionate MVC risk. This paper summarizes the literature on risk disparities for work-related MVCs by sociodemographic and employment characteristics and identifies worker populations that have been largely excluded from previous research. The social-ecological model is used as a framework to identify potential causes of disparities at five levels-individual, interpersonal, organizational, community, and public policy. Expanded data collection and analyses of work-related MVCs are needed to understand and reduce disparities for pedestrian workers, workers from historically marginalized communities, workers with overlapping vulnerabilities, and workers not adequately covered by employer policies and safety regulations. In addition, there is a need for more data on commuting-related MVCs in the United States. Inadequate access to transportation, which disproportionately affects marginalized populations, may make travel to and from work less safe and limit individuals' access to employment. Identifying and remedying inequities in work-related MVCs, whether during the day or while commuting, will require the efforts of industry and multiple public sectors, including public health, transportation, and labor.

The association between diabetes and safe driving: A systematic search and review of the literature and cross-reference with the current guidelines

AIMS

We conducted this review to characterize the quality of evidence about associations between diabetes and safe driving and to evaluate how these findings are reflected within current guidelines available to support clinicians and their patients with diabetes.

METHODS

The first stage entailed a systematic search and review of the literature. Evidence surrounding harms associated with diabetes and driving was identified, screened, extracted and appraised for quality utilizing the Newcastle Ottawa Scales (NOS). Next, relevant guidelines regarding driving and diabetes were sourced and summarized. Finally, the identified guidelines were cross-referenced with the results of the systematic search and review.

RESULTS

The systematic search yielded 12,461 unique citations; 52 met the criteria for appraisal. Fourteen studies were rated as 'high', two as 'medium' and 36 as 'low'. Studies with ratings of 'high' or 'medium' were extracted, revealing a body of inconsistent methods and findings. These results, cross-referenced with the guidelines, suggest a lack of agreement and a limited evidence base to justify recommendations.

CONCLUSIONS

The results presented emphasize the need for a better understanding of the impacts of diabetes on safe driving to inform evidence-based guidelines.

Meta-analytic study on substance intake and work-related accidents calls for attention to bio-psycho-social factors

Accidents at work are a major concern because of their social and economic impact. The causes are highly variable and often linked to risk behaviors that could be avoided, of which substance use is a prime example. The aim of this paper was to meta-analytically review the scientific literature on substance intake and its link to work-related accidents. From an initial pool of 19954 papers, we considered a final sample of 27 clustered in three groups according to substances class (alcohol, recreational drugs, medicines). Despite different pharmacological effects, substances consumed for recreational purposes significantly increased the risk of work-related accidents (odds ratio: alcohol 1.78, recreational drugs 1.47), whereas medicines did not: however, these results require caution due to the heterogeneity of the included studies and suspected publication bias. While bio-psycho-social factors could have helped to understand this association, selected studies neglected both the variegated effects and the root causes of recreational substance consumption. Future studies and interventions should consider these complexity factors to transcend the mere description of the phenomenon.

A Systematic Review on the Role of Substance Consumption in Work-Related Road Traffic Crashes Reveals the Importance of Biopsychosocial Factors in Prevention

Objective: Since many jobs imply driving, a relevant part of all road traffic crashes (RTC) is related to work. Statistics considering all crashes suggest that they are significantly associated with consumption of substances, but the root causes are not yet clear. The objective of the present paper was to systematically review the scientific literature concerning substances consumption and work-related RTC. We queried the PubMed and Scopus electronic databases according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Articles were included if they reported all necessary data and survived a quality assessment. We selected a final sample of 30 articles from an initial pool of 7113. As hypothesized, taking any of the considered substances was found to increase the risk of work-related RTC. Descriptive statistics on work-related RTC showed a higher average positivity rate for medicines (14.8%) than for alcohol (3.02%) and drugs (0.84%). Interestingly, the impact of some medications found an unconvincing explanation in the mere occurrence of side effects, and it suggests that psychosocial and/or medical conditions could be better predictors of RTC. We therefore propose an intervention and prevention model that also considers biopsychosocial factors, for which further studies are needed in future research.