This study investigates the fitness to drive among Spanish drivers. Spanish regulations following EU rules (CD 91/439/CEE) establish that all drivers wishing to obtain or renew their driving licence must undergo a medical examination of their fitness to drive. The renewal of a driving licence is mandatory every ten years up to 45, every 5 years between 46 and 70, and every two years from 70 onwards for non-professional drivers; professional drivers renew every five years up to 45, every three years between 46 and 60 and every two years from 60 onwards). Following the medical examination (carried out by a team of a general practitioner, an ophthalmologist and a psychologist) drivers are considered fit, fit with restrictions (allowed to drive but with some sort of restriction) or unfit (not allowed to drive). The study includes 5234 drivers who attended two Medical Driver Test Centres in Spain. The following figures are noteworthy. 1. One out of every 6 drivers (16.65%) was considered fit with restrictions, while only 0.65% was found not fit. 2. Among those wishing to obtain the driving licence for the first time, 4.7% were considered fit with restrictions and none unfit. 3. Regarding elderly people (over 64 years of age) 1 out 3 (31.5%) were considered fit with restrictions and 2.2% not fit. 4. As regards the kind of restriction imposed on these 871 drivers, in 647 cases there was a reduction of the duration of the validity of the licence, in 260 there was a speed restriction, in 233 a mechanical restriction and in 91 another kind of restriction. These data show that a relevant part of the driver population have some restriction in their driving licence, and not only those who are elderly. It thus seems appropriate to evaluate the fitness to drive of the population. 5. Drivers were followed during one year after the medical examination of their fitness to drive regarding their involvement in traffic accidents and sanctions for traffic violations. No statistically significant differences were found among fit and fit with restriction drivers in their risk of involvement in accidents as drivers (RR 1.310, 95% CI: 0.934-1.837) or receiving sanctions for traffic violations (RR 0.966, 95% CI: 0.789-1.182). Only in the medical evaluation (in which ophthalmologic, hearing and psychological causes are not taken into consideration) were significant differences seen, there being a greater risk of involvement as a driver in accidents for those drivers who were found to be fit with respect to those found fit with restrictions (RR 2.740, 95% CI: 1.230-6.106). 6. Apart from the results of the medical evaluation of the fitness to drive, the medical examination shows that 1 out 3 suffers some kind of pathology (32.6%) and are taking some kind of medication (34.1%). Diseases and medication use increase with age. These data show that (like the general population) not all drivers are healthy, and that the use of medication is linked to the diseases the driver suffers. Therefore, disease/medication should be analysed jointly from the point of view of fitness to drive (Author/publisher) For the complete IMMORTAL web site see http://www.immortal.or.at/
Samenvatting