Impact of medical fitness to drive policies in preventing property damage,injury, and death from motor vehicle collisions in Ontario,Canada |
| |
| Institution: | 1. Ontario Ministry of Transportation, Safety Program Development Branch, Research and Evaluation Office, Toronto, Canada;2. The University of New South Wales, School of Population Health, Sydney, Australia;3. The George Institute for Global Health, Sydney, Australia;4. Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Canada;1. Spectrum Health/Michigan State University General Surgery Residency, Grand Rapids, MI, United States;2. Spectrum Health/Michigan State University Plastic Surgery Residency, Grand Rapids, MI, United States;3. Department of Surgery, Michigan State University, Grand Rapids, MI, United States;4. Trauma Research Institute, Division of Acute Care Surgery, Spectrum Health Hospital, Michigan State University College of Human Medicine, Grand Rapids, MI, United States;5. Division of Surgical Oncology, Spectrum Health Hospital, Michigan State University College of Human Medicine, Grand Rapids, MI, United States;6. Division of Acute Care Surgery, Spectrum Health Hospital, Michigan State University College of Human Medicine, Grand Rapids, MI, United States;7. Trauma Research Institute, Division of Acute Care Surgery, Spectrum Health Hospital, Grand Rapids, MI, United States;1. National Programme Office for Traffic Medicine, Royal College of Physicians of Ireland, Dublin, Ireland;2. Irish College of General Practitioners, Dublin, Ireland;3. Division of Geriatrics and Nutritional Science, Washington University, St Louis, MO, USA;1. Agricultural and Biological Engineering, University of Florida, 1741 Museum Road, PO Box 110570, Gainesville, FL 32611, USA;2. National Farm Medicine Center, Marshfield Clinic Research Institute 1000 N. Oak Ave., Marshfield, WI 54449, USA;3. Department of Agricultural and Biological Engineering, Pennsylvania State University, University Park, PA 16802, USA;1. University of Gothenburg, Box 100, SE-405 30 Gothenburg, Sweden;2. Chalmers University of Technology, SE-412 96 Gothenburg, Sweden;3. Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden;1. Kharazmi University, Department of Civil Engineering, Faculty of Engineering, Tehran, Iran;2. School of Civil Engineering, Iran University of Science and Technology, Tehran, Iran;3. Norwegian University of Science and Technology (NTNU), Department of Psychology, Trondheim, Norway;1. School of Labor and Employment Relations, University of Illinois at Urbana-Champaign, 504 E. Armory Ave, 247E LER Building, Champaign, IL 61820, United States;2. Department of Psychology, North Carolina State University, 640 Poe Hall, 2310 Katharine Stinson Dr., Raleigh, NC 27695-7650, United States;3. Department of Management and International Business, College of Business, Florida International University, Modesto A. Maidique Campus, 11200 S.W. 8th St, MANGO 472, Miami, FL 33199, United States |
| |
| Abstract: | Introduction: Drivers with medical conditions and functional impairments are at increased collision risk. A challenge lies in identifying the point at which such risk becomes unacceptable to society and requires mitigating measures. This study models the road safety impact of medical fitness-to-drive policy in Ontario. Method: Using data from 2005 to 2014, we estimated the losses to road safety incurred during the time medically-at-risk drivers were under review, as well as the savings to road safety accrued as a result of licensing decisions made after the review process. Results: While under review, drivers with medical conditions had an age- and sex-standardized collision rate no different from the general driver population, suggesting no road safety losses occurred (RR = 1.02; 95% CI: 0.93–1.12). Licensing decisions were estimated to have subsequently prevented 1,211 (95% CI: 780–1,730) collisions, indicating net road safety savings resulting from medical fitness to drive policies. However, more collisions occurred than were prevented for drivers with musculoskeletal disorders, sleep apnea, and diabetes. We theorize on these findings and discuss its multiple implications. Conclusions: Minimizing the impact of medical conditions on collision occurrence requires robust policies that balance fairness and safety. It is dependent on efforts by academic researchers (who study fitness to drive); policymakers (who set driver medical standards); licensing authorities (who make licensing decisions under such standards); and clinicians (who counsel patients on their driving risk and liaise with licensing authorities). Practical Applications: Further efforts are needed to improve understanding of the effects of medical conditions on collision risk, especially for the identified conditions and combinations of conditions. Results reinforce the value of optimizing the processes by which information is solicited from physicians in order to better assess the functional impact of drivers’ medical conditions on driving and to take suitable licensing action. |
| |
| Keywords: | Medical condition Functional impairment Motor vehicle collision Motor vehicle accident Road traffic injury Road safety Driver fitness Fitness to drive |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
