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PLoS Med. 2017 Jul 18;14(7):e1002347. doi: 10.1371/journal.pmed.1002347. eCollection 2017 Jul.

Prescription medicine use by pedestrians and the risk of injurious road traffic crashes: A case-crossover study.

Author information

1
Institut de Santé Publique, d'Epidémiologie et de Développement (ISPED), Université de Bordeaux, Bordeaux, France.
2
Team IETO, Bordeaux Population Health Research Center, UMR U1219, INSERM, Université de Bordeaux, Bordeaux, France.
3
Team Biostatistique, Bordeaux Population Health Research Center, UMR U1219, INSERM, Université Bordeaux, Bordeaux, France.
4
Service d'Information Médicale, Pôle de Santé Publique, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France.
5
Team Pharmacoepidemiology, Bordeaux Population Health Research Center, UMR U1219, INSERM, Université Bordeaux, Bordeaux, France.
6
Pharmacologie Medicale, Pôle de Santé Publique, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France.
7
Centre d'Investigation Clinique Bordeaux, INSERM CIC 1401, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France.
8
Université de Lyon, Lyon, France.
9
UMRESTTE, UMR T9405, l'Institut Français des Sciences et Technologies des Transports, de l'Aménagement et des Réseaux (IFSTTAR), Bron, France.
10
UMRESTTE, Université Lyon 1, Lyon, France.

Abstract

BACKGROUND:

While some medicinal drugs have been found to affect driving ability, no study has investigated whether a relationship exists between these medicines and crashes involving pedestrians. The aim of this study was to explore the association between the use of medicinal drugs and the risk of being involved in a road traffic crash as a pedestrian.

METHODS AND FINDINGS:

Data from 3 French nationwide databases were matched. We used the case-crossover design to control for time-invariant factors by using each case as its own control. To perform multivariable analysis and limit false-positive results, we implemented a bootstrap version of Lasso. To avoid the effect of unmeasured time-varying factors, we varied the length of the washout period from 30 to 119 days before the crash. The matching procedure led to the inclusion of 16,458 pedestrians involved in an injurious road traffic crash from 1 July 2005 to 31 December 2011. We found 48 medicine classes with a positive association with the risk of crash, with median odds ratios ranging from 1.12 to 2.98. Among these, benzodiazepines and benzodiazepine-related drugs, antihistamines, and anti-inflammatory and antirheumatic drugs were among the 10 medicines most consumed by the 16,458 pedestrians. Study limitations included slight overrepresentation of pedestrians injured in more severe crashes, lack of information about self-medication and the use of over-the-counter drugs, and lack of data on amount of walking.

CONCLUSIONS:

Therapeutic classes already identified as impacting the ability to drive, such as benzodiazepines and antihistamines, are also associated with an increased risk of pedestrians being involved in a road traffic crash. This study on pedestrians highlights the necessity of improving awareness of the effect of these medicines on this category of road user.

PMID:
28719606
PMCID:
PMC5515401
DOI:
10.1371/journal.pmed.1002347
[Indexed for MEDLINE]
Free PMC Article

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