France has a high rate of road traffic crashes. Although driver fatigue may be an important factor, it has not been investigated in France, and no comparisons have been made with alcohol related crashes. The authors investigated the role of fatigue in serious road crashes using the French national database. They obtained data from the French Ministry of Transport on all road crashes during 1994-8 (640 670) in which at least one person was severely injured (confirmed by paramedics) or died. Crashes were attended by police officers, who completed a standard ministry questionnaire that covered time of incident, location, road and weather conditions, vehicles involved, mechanical defects, health of driver, and alcohol consumption as well as giving summaries of interviews and probable causes. As crashes related to fatigue can be difficult to identify, the strict criteria were applied of Horne and Reyner to eliminate many of the confounding factors. Only single vehicle crashes were assessed that occurred during good weather and road conditions on roads unrestricted by junctions. This excluded most urban road crashes (comprising most crashes), crashes involving pedestrians, and those in which the driver reported taking medication or was suspected to have used illicit drugs. This left 67 671 crashes for analysis. Four categories of crash were identified: (i) Alcohol related - blood alcohol concentration >100 mg ethanol/1 l blood (breathalyser or blood analysis); (ii) Fatigue related - driver could have avoided crash but no avoidance taken (no braking or swerving), with blood alcohol concentration <100 mg/l; (iii) Alcohol and fatigue related - fatigue related crash with driver's blood alcohol concentration >100 mg/l; and (iv) No alcohol or fatigue no fatigue; blood alcohol concentration<100 mg/l. The authors found that fatigue, especially when combined with alcohol, presents a particularly high risk of road crashes resulting in death or serious injury. This has been largely unrecognised in France and elsewhere. There was also a strong relation between time of day and cause of crash, with many alcohol related crashes occurring at night. However, it is likely that police officers will attribute such crashes only to alcohol, even when fatigue is present. (Author/publisher)
Abstract