Family Medicine

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World Book of Family Medicine – European Edition 2015 cocaine, cannabis, designer drugs. The Driving under the Influence of Drugs, Alcohol and Medicines project has the acronym DRUID. Sleep apnoea syndrome has been identified as the major cause of habitual drowsy driving with a relative risk op six than can be reduced five times with continuous positive airway pressure and a major increase in health care expenses. Restless legs syndrome, periodic limb movement in sleep, acute and chronic insomnia are preventable causes which cause dozing and micro-sleep at the wheel. Focusing on these illnesses in primary care could reduce the toll of often very severe vehicle accidents up to 20 to 30%. The EQUINOX cross-sectional study was carried out by primary care physicians across ten countries. It highlighted the link between insomnia and domestic accidents, work accidents and car accidents. Karolinska Drowsiness Score and Karolinska Sleepiness score correlate well with on-board expert driving instructor’s judgement of prematurely terminated night drive as a result of sleep-related imminent danger. Open window or loud music have little effect. Two or three cups of coffee, about 200 mg caffeine, can delay drowsiness for half an hour after nil sleep and up to two hours following sleep restriction. Prophylactic naps are effective, especially during night work. JOSE 2013, Vol. 19, No. 2 p.303 An additional but until now never published caveat: many countries introduce a driving licence with points. The younger generation who have caused a single car accident while intoxicated with cocaine, cannabis, designer drugs, alcohol and most often a cocktail of these can press elderly to declare they were drowsy drivers. Take home messages Family Doctors, surgeons, and police-officers are especially at risk; Not all single car accidents are suicide attempts; Sometimes, elderly drivers declare having fallen asleep at the wheel to hide alcohol and drug use of youngsters; As obesity increases, sleep apnoea increases accordingly; Family practitioners should motivate people to use CPAP. Original abstract http://www.woncaeurope.org/content/293-contribution-drugs-and-somnolence-car-accidents-victims-family-practice-study 214
References World Book of Family Medicine – European Edition 2015 De Mello, MT., Narciso, FV., Tufik, S.,Paiva, T., Spence, DW. e a. (Mar 2003) Sleep Disorders as a Cause of Motor Vehicle Collisions. Int J Prev Med. 4(3):246-257 Jamroz, K., Smolarek, L. (2013) Driver Fatigue and Road Safety on Poland’s National Roads. Int J of Occupational Safety and Ergonomics (JOSE) 19(2):297-309 Radun, I., Ohisalo, J., Radun, J., Kecklund, G. (2011) Night Work, Fatigued Driving and Traffic Law: The case of Police Officers. Industrial Health 49:389-392 Frchtman, Y., Moser, AM., Perry, ZH. (2011) Fatigue in medical residents: lessons to be learned. Med Lav 102(5):455-463 WHO Global Plan for the Decade of Action for Road Safety 2011-2020 Consulted on August 21,2014 http://www.roadsafetyfund.org/UnDecadeOfAction/Documents/global_plan_en.pdf ROSPA (June 2011) Driver Fatigue and Road Accidents Consulted on August 21, 2014 http://www.rospa.com/roadsafety/info/driver_fatigue_2011.pdf © imnewtryme on Flickr 215
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Family Medicine

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