BMJ 2002;324:1125 ( 11 May )

Papers

Driver sleepiness and risk of serious injury to car occupants: population based case control study

Jennie Connor, senior lecturer in epidemiology, ^a Robyn Norton, professor of public health, ^b Shanthi Ameratunga, senior lecturer in epidemiology, ^a Elizabeth Robinson, biostatistician, ^a Ian Civil, director of trauma services, ^c Roger Dunn, associate professor, ^d John Bailey, scientist, ^e Rod Jackson, professor of epidemiology. ^a

^a Division of Community Health, University of Auckland, Private Bag 92019, Auckland, New Zealand, ^b Institute for International Health, University of Sydney, Newtown, New South Wales 2042, Australia, ^c Department of Surgery, Auckland Hospital, Private Bag 92024, Auckland, New Zealand, ^d Department of Civil and Environmental Engineering, University of Auckland, ^e Bailey Partnership, Porirua 6006, New Zealand

Correspondence to: J Connor j.connor{at}auckland.ac.nz

Objectives: To estimate the contribution of driver sleepiness to the causes of car crash injuries.
Design: Population based case control study.
Setting: Auckland region of New Zealand, April 1998 to July 1999.
Participants: 571 car drivers involved in crashes where at least one occupant was admitted to hospital or killed ("injury crash"); 588 car drivers recruited while driving on public roads (controls), representative of all time spent driving in the study region during the study period.
Main outcome measures: Relative risk for injury crash associated with driver characteristics related to sleep, and the population attributable risk for driver sleepiness.
Results: There was a strong association between measures of acute sleepiness and the risk of an injury crash. After adjustment for major confounders significantly increased risk was associated with drivers who identified themselves as sleepy (Stanford sleepiness score 4-7 v 1-3; odds ratio 8.2, 95% confidence interval 3.4 to 19.7); with drivers who reported five hours or less of sleep in the previous 24 hours compared with more than five hours (2.7, 1.4 to 5.4); and with driving between 2 am and 5 am compared with other times of day (5.6, 1.4 to 22.7). No increase in risk was associated with measures of chronic sleepiness. The population attributable risk for driving with one or more of the acute sleepiness risk factors was 19% (15% to 25%).
Conclusions: Acute sleepiness in car drivers significantly increases the risk of a crash in which a car occupant is injured or killed. Reductions in road traffic injuries may be achieved if fewer people drive when they are sleepy or have been deprived of sleep or drive between 2 am and 5 am.

What is already known on this topic Driver sleepiness is considered a potentially important risk factor for car crashes and related injuries but the association has not been reliably quantified Published estimates of the proportion of car crashes attributable to driver sleepiness vary from about 3% to 30% What this study adds Driving while feeling sleepy, driving after five hours or less of sleep, and driving between 2 am and 5 am were associated with a substantial increase in the risk of a car crash resulting in serious injury or death Reduction in the prevalence of these three behaviours may reduce the incidence of injury crashes by up to 19%

---

© BMJ 2002
CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    StumbleUpon    Technorati    What's this?

Relevant Articles

Death and injury on roads

Shanthi Ameratunga, Rod Jackson, and Robyn Norton
BMJ 2006 333: 53-54. [Extract] [Full Text] [PDF]

Awareness of driving while sleepy and road traffic accidents: prospective study in GAZEL cohort

Hermann Nabi, Alice Guéguen, Mireille Chiron, Sylviane Lafont, Marie Zins, and Emmanuel Lagarde
BMJ 2006 333: 75. [Abstract] [Full Text] [PDF]

Sleepiness is associated with serious car crash injury
BMJ 2002 324: 0. [Full Text]

Related external webpages:

Paper plus

This article has been cited by other articles:

• Constant, A., Salmi, L. R., Lafont, S., Chiron, M., Lagarde, E. (2009). Road Casualties and Changes in Risky Driving Behavior in France Between 2001 and 2004 Among Participants in the GAZEL Cohort. AJPH 99: 1247-1253 [Abstract] [Full text]  
• Krueger, P. M., Friedman, E. M. (2009). Sleep Duration in the United States: A Cross-sectional Population-based Study. Am J Epidemiol 169: 1052-1063 [Abstract] [Full text]  
• Patil, S. P. (2009). Excessive Daytime Sleepiness: Medicolegal Aspects. ACCP Sleep Med Brd Rev 4: 139-152 [Full text]  
• Volkow, N. D., Wang, G.-J., Telang, F., Fowler, J. S., Logan, J., Wong, C., Ma, J., Pradhan, K., Tomasi, D., Thanos, P. K., Ferre, S., Jayne, M. (2008). Sleep Deprivation Decreases Binding of [11C]Raclopride to Dopamine D2/D3 Receptors in the Human Brain. J. Neurosci. 28: 8454-8461 [Abstract] [Full text]  
• Mulgrew, A T, Nasvadi, G, Butt, A, Cheema, R, Fox, N, Fleetham, J A, Ryan, C F, Cooper, P, Ayas, N T (2008). Risk and severity of motor vehicle crashes in patients with obstructive sleep apnoea/hypopnoea. Thorax 63: 536-541 [Abstract] [Full text]  
• Sorscher, A. J. (2008). How is Your Sleep: A Neglected Topic for Health Care Screening. J Am Board Fam Med 21: 141-148 [Abstract] [Full text]  
• Lam, L. T., Yang, L. (2007). Short Duration of Sleep and Unintentional Injuries among Adolescents in China. Am J Epidemiol 166: 1053-1058 [Abstract] [Full text]  
• Edmonds, J. N., Vinson, D. C. (2007). Three Measures of Sleep, Sleepiness, and Sleep Deprivation and the Risk of Injury: A Case-Control and Case-Crossover Study. J Am Board Fam Med 20: 16-22 [Abstract] [Full text]  
• Ameratunga, S., Jackson, R., Norton, R. (2006). Death and injury on roads. BMJ 333: 53-54 [Full text]  
• Nabi, H., Gueguen, A., Chiron, M., Lafont, S., Zins, M., Lagarde, E. (2006). Awareness of driving while sleepy and road traffic accidents: prospective study in GAZEL cohort. BMJ 333: 75- [Abstract] [Full text]  
• Peri, K. (2006). Review: sedative hypnotics may improve sleep quality but increase adverse effects in elderly people with insomnia. Evid. Based Nurs. 9: 87-87 [Full text]  
• Lauderdale, D. S., Knutson, K. L., Yan, L. L., Rathouz, P. J., Hulley, S. B., Sidney, S., Liu, K. (2006). Objectively Measured Sleep Characteristics among Early-Middle-Aged Adults: The CARDIA Study. Am J Epidemiol 164: 5-16 [Abstract] [Full text]  
• Philip, P., Taillard, J., Moore, N., Delord, S., Valtat, C., Sagaspe, P., Bioulac, B. (2006). The effects of coffee and napping on nighttime highway driving: a randomized trial.. ANN INTERN MED 144: 785-791 [Abstract] [Full text]  
• Furness, S, Connor, J, Robinson, E, Norton, R, Ameratunga, S, Jackson, R (2003). Car colour and risk of car crash injury: population based case control study. BMJ 327: 1455-1456 [Full text]  
• Blows, S, Ivers, R Q, Woodward, M, Connor, J, Ameratunga, S, Norton, R (2003). Vehicle year and the risk of car crash injury. Inj. Prev. 9: 353-356 [Abstract] [Full text]  
• (2002). Sleepy Drivers Are More Likely to Be Injured or Die. JWatch Emergency Med. 2002: 12-12 [Full text]  
• (2002). Reducing Motor Vehicle Deaths. JWatch General 2002: 3-3 [Full text]  
• Roberts, I., Mohan, D., Abbasi, K. (2002). War on the roads. BMJ 324: 1107-1108 [Full text]  

Rapid Responses:

Read all Rapid Responses

Driving after a " night on call"

Avanish P Saklani, et al.
bmj.com, 14 May 2002 [Full text]

Failure of basic Cognitive Mechanisms associated with sleepiness

Michael J. Hogan, et al.
bmj.com, 15 May 2002 [Full text]

A way to cope which works

Leopold Reinecke
bmj.com, 10 Jun 2002 [Full text]

Online poll

Find out more >>