Prevalence of Substance Use and Sleep-Related Problems Among Driver Victims Involved in Road Traffic Accidents Presenting to a Tertiary Care Hospital in India.

BACKGROUND

Road traffic accidents (RTAs) are a critical public health problem leading to significant morbidity, mortality, and socioeconomic losses. Despite known risk factors like substance use and sleep-related problems, there is limited research on the prevalence of these factors among drivers who met with RTAs. Hence, this study aimed to gain insight into the prevalence of substance use and sleep-related problems among this population attending a trauma center in the northern State of India.

METHODOLOGY

A cross-sectional study was conducted among 383 driver victims (DVs) who presented to a publicly funded tertiary care hospital's trauma emergency department of the Himalayan State of India following RTAs. The hospital's catchment area is vast and caters to people from both hilly and plain areas. Data were collected for sociodemographic characteristics, clinical parameters, and accident-related factors using a semi-structured proforma. Substance use-related problems were assessed through detailed history evaluation, thorough examinations, structured questionnaires, and body fluid (blood and urine) drug analysis. Sleep-related parameters were evaluated in detail, including excessive daytime sleepiness (EDS), the functional outcome of sleepiness, and the chronotype using structured and validated questionnaires. The nature, site of injuries, and their severity were determined using the Abbreviated Injury Severity (AIS) Scale.

RESULTS

Among DVs, 221 (57.7%) tested positive for alcohol; 71 (18.6%) had used other psychotropic substances, with cannabis being the most common among them; and 56 (14.6%) reported using multiple substances. Eighty-three (21.7%) participants had EDS, and 102 (26.6%) experienced fatigue and sleepiness during the accident. The most common type of injuries was fracture and dislocation 206 (53.8%), with the extremities (both upper and lower) being the most common body region (218, 56.9%) involved, along with head traumas in equal proportions. Injuries were predominantly minor, yet a concerning 7.6% of the participants experienced severe trauma.

CONCLUSION

The study highlights the substantial role of substance use and sleep-related problems in RTAs, emphasizing the need for interventions targeting these factors to reduce the burden of RTAs. Policies enforcing stricter substance use regulations and promoting sleep health awareness and sleep assessments for drivers could significantly mitigate RTAs and improve road safety in India.