This Article
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Lertzman, M.
Right arrow Articles by Sharma, S.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Lertzman, M.
Right arrow Articles by Sharma, S.
Related Collections
Right arrow Medicine and the Law (including Forensic Medicine)
Right arrow Epilepsy
Right arrow Sleep disorders
CMAJ • September 21, 1999; 161 (6)
© 1999 Canadian Medical Association or its licensors

Letters
Correspondance

Driving for safety on our roads

Morley Lertzman, MD and Satyendra Sharma, MD

Section of Respiratory Medicine; University of Manitoba; Winnipeg, Man.

The questionnaire used by Shawn Marshall and Nathalie Gilbert to assess the knowledge of Saskatchewan physicians of risk factors related to medical fitness to drive1 has 2 significant omissions.

First, it is well documented that patients with sleep disorders have more motor vehicle accidents than control groups. The prevalence of obstructive sleep apnea in the North American population is between 2% and 4% and increases with age.2 The odds ratios for vehicular accidents have been reported as 1.5-4,3 2.99,4 and 7.3.5 Furthermore, the accident rate decreases significantly when patients are treated with nasal continuous positive air pressure (CPAP) therapy (from 0.8 to 0.15 per 100 000 km).6

Second, epilepsy should have been considered. There is certainly abundant information on this subject, including recommendations regarding fitness to drive.7

References

  1. Marshall SC, Gilbert N. Saskatchewan physicians' attitudes and knowledge regarding assessment of medical fitness to drive. CMAJ 1999;160(12):1701-4.[Abstract]
  2. Lertzman M, Wali SO, Kryger M. Sleep apnea a risk factor for poor driving [letter]. CMAJ 1995;153(8):1063.
  3. Aldrich MS. Automobile accidents in patients with sleep disorders. Sleep 1989;12:487-94.[Medline]
  4. Wu H, Yan-Go F. Self-reported automobile accidents involving patients with obstructive sleep apnea. Neurology 1996;46:1254-7.[Abstract/Free Full Text]
  5. Young T, Blustein J, Finn L, Palta M. Sleep-disordered breathing and motor vehicle accidents in a population-based sample of employed adults. Sleep 1997;20:608-12.[Medline]
  6. Cassel W, Ploch T, Becker C, Dugnus D, Peter JH, von Wichert P. Risk of traffic accidents in patients with sleep-disordered breathing: reduction with nasal CPAP. Eur Respir J 1996;9:2606-11.[Abstract]
  7. Fauci AS, Braunwald E, Isselbacher Kj, Wilson JD, Martin JB, Kasper DL, et al. Harrison's principles of internal medicine. New York: McGraw-Hill; 1998. p. 2324.




This Article
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Lertzman, M.
Right arrow Articles by Sharma, S.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Lertzman, M.
Right arrow Articles by Sharma, S.
Related Collections
Right arrow Medicine and the Law (including Forensic Medicine)
Right arrow Epilepsy
Right arrow Sleep disorders