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Donald Redelmeier Suggests Clinical Actions against Drunk Driving

ITMA's Regional Director in North America, Dr. Donald Redelmeier recently published his work on PLOS Medicine to describe how drunk driving could be prevented through efforts from different domains.  

Following specific strategies were proposed for physicians to help their patients to prevent drunk driving.

  • Alcohol screening and brief interventions for patients with alcohol problems 
  • Physician warnings for patients who sometimes drink and drive
  • Treatment of patients diagnosed with alcohol dependence
  • Counseling of patients not to ride with drunk drivers
  • Supporting enforcement of laws against drunk driving
  • Promoting sobriety checkpoints in local communities
  • Lending voice to mass media campaigns against drunk driving
  • Joining multicomponent interventions in coalitions of community group members

Click to see the full length paper: "Clinical Actions against Drunk Driving".

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Important EU Document on Driver Fitness

The European Commission and its unit for Road Safety, DG MOVE, Unit C2 has recently published a new report that contains important aspects of medical driver fitness issues. It can be found on http://bookshop.europa.eu/is-bin/INTERSHOP.enfinity/WFS/EU-Bookshop-Site/en_GB/-/EUR/ViewPublication-Start?PublicationKey=MI0417247 and is free to download.

It is a systematic quality assessment of papers and a review of the best scientific evidence of effectiveness for different approaches to training, testing and graduated licensing for Category B (car) drivers, graduated licensing for higher motorcycle categories, driving instructor competencies, and requirements on medical fitness to drive (including its relevance for older drivers). The primary focus of the reviews was on road safety outcomes.

The review was produced with international cooperation and the institutions included are Transport Research Laboratory (UK), SWOV (Netherlands), BASt (Germany) Monash University (Australia) and Loughborough University (UK). A short summary by Lars Englund can be found below.

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Traffic crashes during pregnancy can lead to cerebral palsy during infancy

A recent publication from ITMA's Regional Director in North America, Dr. Donald Redelmeier assessed the incidence of cerebral palsy among children born to mothers who had their pregnancy complicated by a motor vehicle crash through a retrospective longitudinal cohort analysis. Results highlight a specific role for traffic safety advice in in prenatal care. 

Click to see the full length paper: "Motor vehicle crashes during pregnancy and ceberal palsy during infancy: a longitudinal cohort analysis". 

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ITMA Board Members Published Analysis of Traffic Deaths Before and After Birth

Using national datasets and applying plausible assumptions about rates of pregnancy and traffic fatalities, Evans and Redelmeier, the President Emeritus and North America Regional Director estimated the number of fetuses killed per year in traffic crashes in the USA. Two main assumptions were: (1) pregnant and non-pregnant women of the same age have equal chances of becoming traffic fatalities; (2) the death of a pregnant woman leads to the death of her unborn child. They computed that 227 pregnant women died in US traffic in 2012, implying also 227 fetus deaths. This contrasts with 60 babies aged less than one year killed in traffic crashes in 2012, equivalent to 45 deaths in the nine month period corresponding to pregnancy. Thus the risk of fetal death during pregnancy is 227/45 = 5.04 times the risk after birth for equal exposure times. This ratio likely underestimates the disparity because the risk of crashing increases during pregnancy, and the 5.04 ratio ignores the many cases in which the mother survives but the fetus does not.

Complete text at http://www.scienceservingsociety.com/p/200.pdf

The International Traffic and Medicine Association