Driver health and traffic safety: An overview

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. © 2009 Birkhéuser Verlag/Switzerland.