A popular guide for physicians on determination of medical fitness to drive is published by the Canadian Medical Association. In the updated seventh edition (available this fall), notable changes from the sixth edition reflect the emergence of evidence-based medical standards, with emphasis on the functional assessment of patients for fitness to drive. In Canada each year, motor vehicle accidents kill about 3000 people and injure another 250 000. Most involve people aged 15–55 years; crashes are a leading cause of death and disability of people in this age range. Among younger people, major contributing factors to crashes include alcohol, speeding, poor judgment (e.g., driving too fast for weather and road conditions; failure to use seat belts and other safety equipment) and inattention. When driving exposure is taken into account, crash rates for older drivers increase significantly after the age of 75 years. The primary reason for such crashes is the accumulation of medical conditions that affect fitness to drive. Compared with drivers aged 30–50, the risk of death per mile driven increases 13-fold for drivers over 80 years of age, a combined effect of increased crash rates and physical fragility. When driving exposure is taken into account, crash rates for drivers over the age of 75 are much higher than average. The primary reason for such crashes is medical conditions that affect fitness to drive. The role of physicians in ensuring road safety through the identification of patients with medical conditions that make it unsafe for them to drive is an important one. (Author/publisher)
Abstract