Alex G Raman, Neil Parikh, Radhika Gupta, Raj Swaroop Lavadi, Raghav Gupta, Robert F Heary, Kristopher Kimmell, Justin Singer, Nitin Agarwal
Augmenting Career Longevity: An Analysis of Ergonomics Training Among 134 Neurological Surgeons
World neurosurgery
many medications impair driving skills yet influence collision risk remains uncertain aimed systematically investigate risk collision responsibility associated common classes prescription medications populationbased casecontrol study analysed linked driving health records british columbia canada jan 1 1997 dec 31 2016 study cohort included drivers involved incident collision defined first collision 3 collisionfree years resulted police report scored police collision reports classified drivers responsible collision cases responsible controls drivers indeterminate scores excluded used logistic regression determine odds collision responsibility drivers current prescriptions medications interest versus drivers without prescriptions explore whether risk collision responsibility related medication effect driver factors compared risk current medication users versus past users study whether drivers developed tolerance medication effects compared risk new first 30 days prescription versus established users study period 4 906 925 drivers driving licence linked health records drivers 747 662 unique drivers involved 837 919 incident collisions jan 1 2000 dec 31 2016 382 685 drivers responsible collision cases 332 259 drivers responsible controls included final analysis 122 975 drivers indeterminate responsibility excluded found increased risk collision responsibility drivers prescribed sedating antipsychotics adjusted odds ratio aor 135 9875 ci 125146 longacting benzodiazepines aor 130 122138 shortacting benzodiazepines aor 125 120131 highpotency opioids aor 124 117130 among medications used medical indications highest risk seen drivers prescribed neurological medications cholinergic drugs aor 183 139240 anticholinergic agents parkinsons disease aor 145 108196 dopaminergic agents aor 120 104138 anticonvulsants aor 120 114126 people currently taking benzodiazepines nonsedating antidepressants highpotency opioids anticonvulsants increased risk compared past users find increased risk new compared established users drugs drivers prescribed benzodiazepines highpotency opioids increased risk responsible collisions risk decrease time several classes medications associated increased risk association might independent medication effect findings guide medication warnings prescription choices inform public education campaigns targeting impaired driving canadian institutes health research