Prescription Medicines and the Risk of Road Traffic Crashes: A French Registry-Based Study
DOI: 10.1371/journal.pmed.1000366
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Summary
This study investigates the association between prescription medicine use and the risk of being responsible for road traffic crashes in France. Motivated by inconsistent prior research on drugs other than benzodiazepines and the implementation of a standardized French medication classification system (levels 0–3) regarding driving impairment, the authors aimed to quantify this risk and estimate the attributable fraction of crashes. The researchers conducted a registry-based study linking three nationwide databases: police reports, the national police database of injurious crashes, and the national health care insurance database. The study population comprised 72,685 drivers involved in injurious crashes between July 2005 and May 2008, identified via their national health care number. Medication exposure was determined from dispensing records within six months prior to the crash, categorized by the French risk classification system. Crash responsibility was assigned using a standardized scoring method accounting for road, vehicle, and driving conditions. The analysis employed logistic regression to compare responsible drivers (cases) with nonresponsible drivers (controls), adjusting for confounders such as age, gender, alcohol use, and long-term chronic diseases. Additionally, a within-person case-crossover analysis compared medication exposure on the crash day versus a control day 30 days earlier. The results indicated that users of level 2 (moderate risk) and level 3 (high risk) prescription medicines had a significantly higher risk of being responsible for a crash, with odds ratios of 1.31 (95% CI: 1.24–1.40) and 1.25 (95% CI: 1.12–1.40), respectively. These associations persisted after adjusting for long-term chronic diseases. The fraction of road traffic crashes attributable to the use of level 2 and 3 medications combined was estimated at 3.3% (95% CI: 2.7%–3.9%). Specifically, level 2 medicines accounted for 3.0% and level 3 medicines for 0.7% of attributable crashes. The case-crossover analysis confirmed a significant association for level 3 medications (OR = 1.15; 95% CI: 1.05–1.27) but not for levels 0, 1, or 2. Risk increased with the number of high-risk medications used, and specific drug classes such as antiepileptics, psycholeptics, and psychoanaleptics showed significant associations. The study concludes that prescription medicines classified as level 2 and 3 are associated with a substantial number of road traffic crashes in France. The findings support the relevance of warning labels for these medication levels, while suggesting that warnings for level 1 medications may be less justified. The authors recommend further studies to evaluate the impact of the warning labeling system on crash prevention.
Provenance
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| Stage | Outcome | Tool | Model | Prompt | Attempts | Completed |
|---|---|---|---|---|---|---|
| discover | success | Crossref | — | — | 1 | 2026-06-18 |
| archive | success | canonical_url | — | — | 1 | 2026-06-25 |
| extract | success | cached | — | — | 2 | 2026-06-26 |
| clean | success | clean | — | — | 1 | 2026-06-20 |
| chunk | success | chunk | — | — | 1 | 2026-06-20 |
| embed | success | embed | Qwen/Qwen3-Embedding-8B | — | 1 | 2026-06-20 |
| enrich | success | openalex | — | — | 1 | 2026-06-20 |
| promote | success | — | — | — | 1 | 2026-06-18 |
| summarize | success | llm | qwen3.6-27b-prismaquant | summ-v5 | 1 | 2026-06-26 |
| tag | success | vector_similarity | — | — | 6 | 2026-06-20 |
| verify | success | — | — | — | 1 | 2026-06-26 |
Summary generated by qwen3.6-27b-prismaquant on 2026-06-26; verification: verified.
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Information type
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- Empirical Findings: crash risk outcomes, observational prevalence