Association of main driver-dependent risk factors with the risk of causing a vehicle collision in Spain, 1990-1999

PURPOSE: To assess the strength of association of main driver-dependent risk factors with the risk of causing a collision between vehicles in Spain, from 1990 to 1999. METHODS: The data for this paired-by-collision, case-control study were obtained from the Spanish Direccion General de Trafico traffic crash database. The study included all 220,284 collisions involving two or more vehicles with four or more wheels, in which only one of the drivers involved committed an infraction. Infractor drivers comprised the case group; noninfractor drivers involved in the same collision were their corresponding paired controls. RESULTS: All driver-dependent factors were associated with the risk of causing a collision. The highest adjusted odds ratio estimates were obtained for sleepiness (64.35; CI, 45.12-91.79), inappropriate speed (28.33; CI, 26.37-30.44), and driving under the influence of alcohol with a positive breath test (22.32; CI, 19.64-25.37). An increase in the number of years in possession of a driving license showed a protective effect, albeit the strength of the effect decreased as age increased. CONCLUSIONS: Our results emphasize the urgent need to implement strategies aimed mainly at controlling speeding, sleepiness, and alcohol consumption before driving-the main driver-dependent risk factors for causing a vehicle collision. Ann Epidemiol 2003;13:509-517. (C) 2003 Elsevier Inc. All rights reserved.