法国道路交通事故涉事司机尿液中滥用药物的流行情况：一项合作研究。
Prevalence of drugs of abuse in urine of drivers involved in road accidents in France: a collaborative study.
作者信息
Marquet P, Delpla P A, Kerguelen S, Bremond J, Facy F, Garnier M, Guery B, Lhermitte M, Mathé D, Pelissier A L, Renaudeau C, Vest P, Seguela J P
机构信息
Department of Pharmacology-Toxicology and Emergency Care Unit, University Hospital, Limoges, France.
出版信息
J Forensic Sci. 1998 Jul;43(4):806-11.
The collaborative, anonymous, case-control study was intended to determine the prevalence of opiates, cocaine metabolites, cannabinoids and amphetamines in the urine of drivers injured in road accidents and to compare these values with those of non-accident subjects ("patients") in France. Recruitment was performed nationwide in the emergency departments of five hospitals and comprised 296 "drivers" aged 18 to 35 and 278 non-traumatic "patients" in the same age range. Females represented 28.4% of "drivers" and 44.2% of "patients." Screening for drugs in urine was performed by fluorescence polarization immunoassays in each center. Each positive result was verified using gas chromatography-mass spectrometry (GC-MS), in a single laboratory. Statistical analysis comprised single-step logistic regression and simultaneously took account of confounding factors and the final differences in prevalence values between the two populations or different subgroups. Cannabinoids were found in 13.9% of drivers (16.0% of males and 8.3% of females, p < 0.05) and 7.5% of patients (12.3% of males, 1.6% of females, p < 0.0001); only in females was this prevalence higher in injured drivers than in patients (p < 0.05). Opiates were present in 10.5% of drivers' and 10.4% of patients' urine samples (NS), and were more frequent in urine samples positive for cannabinoids, in drivers (p < 0.01) as well as in patients (p < 0.001). The prevalence of cocaine metabolites in drivers and patients was 1.0 and 1.1% and that of amphetamines 1.4 and 2.5%, respectively. No causal relationship between drugs and accidents should be inferred from this retrospective study. Nevertheless, the high prevalence of cannabis and opiate (licit or illicit) use in young people, whether injured drivers or patients, has potential implications for road traffic safety in France. Cocaine and amphetamines did not appear to be a major problem, unlike the experience in other countries.
这项合作开展的匿名病例对照研究旨在确定道路交通事故中受伤司机尿液中阿片类药物、可卡因代谢物、大麻素和苯丙胺的流行情况，并将这些数值与法国非事故受试者（“患者”）的数值进行比较。研究在全国五家医院的急诊科进行招募，包括296名年龄在18至35岁之间的“司机”和278名同年龄范围内的非创伤性“患者”。女性在“司机”中占28.4%，在“患者”中占44.2%。每个中心通过荧光偏振免疫分析法对尿液进行药物筛查。每个阳性结果都在单个实验室使用气相色谱 - 质谱联用仪（GC - MS）进行验证。统计分析包括单步逻辑回归，并同时考虑了混杂因素以及两个人群或不同亚组之间流行率值的最终差异。在13.9%的司机中检测到大麻素（男性为16.0%，女性为8.3%，p < 0.05），在7.5%的患者中检测到（男性为12.3%，女性为1.6%，p < 0.0001）；仅在女性中，受伤司机中的大麻素流行率高于患者（p < 0.05）。阿片类药物在10.5%的司机尿液样本和10.4%的患者尿液样本中出现（无统计学差异），并且在大麻素检测呈阳性的尿液样本中，在司机（p < 0.01）以及患者（p < 0.001）中更为常见。司机和患者中可卡因代谢物的流行率分别为1.0%和1.1%，苯丙胺的流行率分别为1.4%和2.5%。不应从这项回顾性研究中推断出药物与事故之间存在因果关系。然而，年轻人（无论是受伤司机还是患者）中大麻和阿片类药物（合法或非法）的高使用率对法国的道路交通安全具有潜在影响。与其他国家的情况不同，可卡因和苯丙胺似乎不是主要问题。
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