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Prescription medicine use by pedestrians and the risk of injurious road traffic crashes: A case-crossover study
PLOS Medicine ( IF 15.8 ) Pub Date : 2017-07-18 , DOI: 10.1371/journal.pmed.1002347
Mélanie Née , Marta Avalos , Audrey Luxcey , Benjamin Contrand , Louis-Rachid Salmi , Annie Fourrier-Réglat , Blandine Gadegbeku , Emmanuel Lagarde , Ludivine Orriols

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.



中文翻译:

行人使用处方药和造成道路交通事故伤害的风险:案例研究

背景

虽然已经发现一些药物会影响驾驶能力,但尚无研究调查这些药物与行人撞车之间是否存在关系。这项研究的目的是探索药物的使用与作为行人发生道路交通事故的风险之间的关系。

方法和发现

对来自3个法国全国数据库的数据进行了匹配。我们使用案例交叉设计,通过将每个案例作为自己的控件来控制时间不变因素。为了执行多变量分析并限制假阳性结果,我们实现了Lasso的引导版本。为了避免不可估量的时变因素的影响,我们将冲刷期的长度从撞车前的30天更改为119天。通过匹配程序,从2005年7月1日至2011年12月31日,有16458名行人参与了道路交通事故伤害事故。我们发现48种与事故风险呈正相关的药品类别,中位优势比为1.12至2.98。 。其中,苯二氮卓类药物和苯二氮卓类相关药物,抗组胺药,抗炎和抗风湿药是16458名行人最常使用的10种药物。研究的局限性包括:在更严重的交通事故中受伤的行人人数略有增加;缺乏有关自我药物治疗和非处方药使用的信息;以及缺乏步行量的数据。

结论

已经被确定会影响驾驶能力的治疗类别,例如苯二氮卓类和抗组胺药,也与行人卷入道路交通事故的风险增加有关。这项关于行人的研究强调了必须提高对这些药物对这类道路使用者的影响的认识。

更新日期:2017-08-03
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