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, 7 (11), e1000366

Prescription Medicines and the Risk of Road Traffic Crashes: A French Registry-Based Study

Collaborators, Affiliations

Prescription Medicines and the Risk of Road Traffic Crashes: A French Registry-Based Study

Ludivine Orriols et al. PLoS Med.


Background: In recent decades, increased attention has been focused on the impact of disabilities and medicinal drug use on road safety. The aim of our study was to investigate the association between prescription medicines and the risk of road traffic crashes, and estimate the attributable fraction.

Methods and findings: We extracted and matched data from three French nationwide databases: the national health care insurance database, police reports, and the national police database of injurious crashes. Drivers identified by their national health care number involved in an injurious crash in France, between July 2005 and May 2008, were included in the study. Medicines were grouped according to the four risk levels of the French classification system (from 0 [no risk] to 3 [high risk]). We included 72,685 drivers involved in injurious crashes. Users of level 2 (odds ratio [OR] = 1.31 [1.24-1.40]) and level 3 (OR = 1.25 [1.12-1.40]) prescription medicines were at higher risk of being responsible for a crash. The association remained after adjustment for the presence of a long-term chronic disease. The fraction of road traffic crashes attributable to levels 2 and 3 medications was 3.3% [2.7%-3.9%]. A within-person case-crossover analysis showed that drivers were more likely to be exposed to level 3 medications on the crash day than on a control day, 30 days earlier (OR = 1.15 [1.05-1.27]).

Conclusion: The use of prescription medicines is associated with a substantial number of road traffic crashes in France. In light of the results, warning messages appear to be relevant for level 2 and 3 medications and questionable for level 1 medications. A follow-up study is needed to evaluate the impact of the warning labeling system on road traffic crash prevention.

Conflict of interest statement

Emmanuel Lagarde is on the Editorial Board of PLoS Medicine.


Figure 1
Figure 1. French medication labeling system.
Figure 2
Figure 2. Flowchart of the inclusion procedure.
*The discrepancy between the number of police reports and the number of records in the national police database of injurious crashes is explained by the fact that a small proportion of unavailable reports were being used for on-going further legal investigations.

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