Acidentes de trânsito com condutores de veículos: incidência e diferenciais entre motociclistas e motoristas em estudo de base populacional

Prevalence and factors associated with driving under the influence of alcohol in Brazil

OBJECTIVES

To estimate the prevalence and factors associated with Driving Under the Influence of Alcohol (DUIA) among car drivers and motorcyclists in Brazil and to evaluate the association between DUIA and self-reported Road Traffic Injuries (RTIs) in these groups.

METHODS

A cross-sectional study was conducted using data from adults aged 18 or older who participated in the 2019 National Health Survey. Probability sampling was used to recruit participants, and data collection was carried out through home visits. Data from 31,246 car drivers and 21,896 motorcyclists were analyzed. Key indicators included the proportion (%) of car drivers who consumed alcohol and then drove in the past 12 months and the proportion (%) of motorcyclists who consumed alcohol and then drove in the past 12 months. Multiple Poisson regression was used to determine factors associated with DUIA and the association of this variable with RTIs in both groups.

RESULTS

DUIA prevalence was 9.4% (95% Confidence Interval [95% CI] = 8.8-10.0) among car drivers and 11.2% (95% CI = 10.4-12.1) among motorcyclists. Among car drivers, DUIA prevalence was higher in men, young adults, those without a spouse/partner, and lower in individuals with lower income and education level. Among motorcyclists, DUIA prevalence was higher in men, young adults, those living outside the capitals and metropolitan regions, and lower in individuals with lower income. DUIA increased the prevalence of self-reported RTIs in the previous 12 months among car drivers and motorcyclists.

CONCLUSIONS

A high prevalence of DUIA was evident among drivers, particularly motorcyclists. The DUIA was more prevalent among men and young adults. The DUIA was associated with an increased magnitude of self-reported RTIs among car drivers and motorcyclists. Despite the extensive legislation for zero tolerance toward DUIA in the country, actions need stricter enforcement.

Maternal outcomes in association with motor vehicle crashes during pregnancy: a nationwide population-based retrospective study

BACKGROUND

Limited studies have assessed the association of motor vehicle crashes (MVCs) during pregnancy with adverse maternal outcomes using a population-based nationwide dataset that covers all MVCs.

METHODS

A total of 20 844 births from women who had been involved in MVCs during pregnancy were obtained from the National Birth Notification (BN) Database in Taiwan. We randomly selected 83 274 control births from women in the BN matched on age, gestational age and crash date. All study subjects were linked to medical claims and the Death Registry to identify the maternal outcomes after crashes. Conditional logistic regression models were used to estimate the adjusted odds ratio (aOR) and 95% CI of adverse outcomes associated with MVCs during pregnancy.

RESULTS

Pregnant women involved in MVCs had significantly higher risks of placental abruption (aOR=1.51, 95% CI 1.30 to 1.74), prolonged uterine contractions (aOR=1.31, 95% CI 1.11 to 1.53), antepartum haemorrhage (aOR=1.19, 95% CI 1.12 to 1.26) and caesarean delivery (aOR=1.05, 95% CI 1.02 to 1.09) than the controls. Such elevated risks tended to be higher in the MVCs with greater severity. Scooter riders had higher ORs of various adverse maternal outcomes than car drivers.

CONCLUSIONS

Women involved in MVCs during pregnancy were at increased risk of various adverse maternal outcomes, especially in those with severe MVCs and riding scooters at MVCs. These findings suggest that clinicians should be aware of these effects, and educational materials that include the above information should be provided as part of prenatal care.

Factors associated with serious vehicular accidents: A cross-sectional study in hospital emergency rooms

AIMS

Pictograms on medicine boxes warn of potential drug-related driving hazard; we studied their association with serious accidents.

METHODS

Prospective study in emergency departments of the hospitals in Bordeaux and Périgueux (France), of drivers with serious (admitted at least 24 hours) or nonserious vehicular accidents. Minors, passengers, pedestrians or subjects incapable of answering an interview were excluded. Interviews ascertained driver and accident characteristics, use of drugs with or without pictograms, use of alcohol and abuse substances, sleepiness, distractions, and mind wandering at the time of the accident, RESULTS: Between 18 October 2016 and 26 December 2018, 1200 of the 6212 drivers admitted to the hospital emergency rooms, 741 nonserious, 459 serious, were interviewed. Serious accidents were associated with male sex (odds ratio 1.89, 95% confidence interval [1.36-2.64]), age above 60 years (3.64 [2.21-6.00]), driving on local roads (3.34 [2.34-4.76]), driving a motorcycle (3.39 [2.29-5.00]), having drunk alcohol within 6 hours (2.89 [1.85-4.51]) and using a drug with a pictogram during the 24 hours previous to the accident (1.57 [1.06-2.32]). From 207 police reports, 101 drivers were not responsible, and 106 were responsible, associated with age below 40 years, driving in overcast or rainy weather (2.62 [1.29-5.33]), on local roads (3.89 [1.90-7.95]), and use of at least 1 pictogram drug in the previous week (3.12 [1.31-7.41]).

CONCLUSION

The known risks of alcohol and pictogram drugs, of riding motorcycles and using local roads were confirmed. As measured, behavioural sleepiness did not predict accidents.