Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th Street, New York, NY, USA; Department of Anesthesiology, Columbia University College of Physicians and Surgeons, 622 West 168th Street, New York, NY, USA.
Accid Anal Prev. 2013 Nov;60:205-10. doi: 10.1016/j.aap.2013.09.001. Epub 2013 Sep 8.
Drugged driving is a serious safety concern, but its role in motor vehicle crashes has not been adequately studied. Using a case-control design, the authors assessed the association between drug use and fatal crash risk. Cases (n=737) were drivers who were involved in fatal motor vehicle crashes in the continental United States during specific time periods in 2007, and controls (n=7719) were participants of the 2007 National Roadside Survey of Alcohol and Drug Use by Drivers. Overall, 31.9% of the cases and 13.7% of the controls tested positive for at least one non-alcohol drug. The estimated odds ratios of fatal crash involvement associated with specific drug categories were 1.83 [95% confidence interval (CI): 1.39, 2.39] for marijuana, 3.03 (95% CI: 2.00, 4.48) for narcotics, 3.57 (95% CI: 2.63, 4.76) for stimulants, and 4.83 (95% CI: 3.18, 7.21) for depressants. Drivers who tested positive for both alcohol and drugs were at substantially heightened risk relative to those using neither alcohol nor drugs (Odds Ratio=23.24; 95% CI: 17.79, 30.28). These results indicate that drug use is associated with a significantly increased risk of fatal crash involvement, particularly when used in combination with alcohol.
药物驾驶是一个严重的安全问题，但它在机动车事故中的作用尚未得到充分研究。作者采用病例对照设计，评估了药物使用与致命碰撞风险之间的关联。病例（n=737）为 2007 年特定时期在美国大陆发生致命机动车事故的驾驶员，对照组（n=7719）为 2007 年全国酒精和药物使用司机路边调查的参与者。总体而言，31.9%的病例和 13.7%的对照组至少有一项非酒精药物检测呈阳性。与特定药物类别相关的致命碰撞参与的估计比值比为大麻 1.83（95%置信区间：1.39，2.39）、麻醉品 3.03（95%置信区间：2.00，4.48）、兴奋剂 3.57（95%置信区间：2.63，4.76）和抑制剂 4.83（95%置信区间：3.18，7.21）。与既不使用酒精也不使用药物的驾驶员相比，同时检测出酒精和药物呈阳性的驾驶员发生致命碰撞的风险显著升高（比值比=23.24；95%置信区间：17.79，30.28）。这些结果表明，药物使用与致命碰撞风险显著增加相关，尤其是与酒精同时使用时。
