Prescription drugs and the risk of road traffic crashes in Bordeaux, France: a study matching emergency department health reports and a pharmaceutical reimbursement registry
5 affiliations
- 1professor of pharmacology
- 2Emergency Department Unit, INSERM, U1219, F-33000, CHU de Bordeaux, Bordeaux, France
- 31 U1219, INSERM, Bordeaux, Nouvelle-Aquitaine, France
- 41 ISPED, Université de Bordeaux, Bordeaux, France
- 5INSERM, BPH, U1219, Team AHeaD, F-33000, Université de Bordeaux, Bordeaux, France
Abstract
Introduction Prescription medications may impair driving ability and increase the risk of road traffic crashes (RTC). This study aimed to estimate the association between prescription medication use and RTC risk among patients attending the adult emergency department of Bordeaux University Hospital, France, assess trends in psychotropic medication use, and estimate the proportion of RTCs attributable to medication exposure.Methods Emergency department records were linked with the French National Health Data System from 2013 to 2021. The study included 17 296 individuals aged 15 years or older presenting within 24 hours of an RTC. Drivers of motorised vehicles and vulnerable road users were included, whereas passengers were excluded. Acute and chronic effects were assessed using case-crossover and matched case–control designs, respectively. Medication exposure was classified according to the French pictogram-based driving risk classification (levels 0–3). ORs were estimated using conditional and multivariable logistic regression, and population attributable fractions were calculated using national prescription data.Results On the day of the RTC, 32.9% of individuals were exposed to at least one prescription medication. In the case-crossover analysis, level 3 medications were associated with increased RTC risk, particularly anxiolytics, opioids and antidepressants. In the case-control analysis, level 2 medications were associated with increased RTC risk (adjusted OR 1.27, 95% CI 1.17 to 1.38), as were level 3 medications (1.43, 95% CI 1.30 to 1.57). The highest risk was observed for centrally acting muscle relaxants (2.26, 95% CI 1.46 to 3.51). The population attributable fraction for level 2 and 3 medications decreased from 4.5% in 2013 to 3.8% in 2021.Conclusions Prescription medications with a high driving-risk classification, particularly those acting on the nervous system, significantly increase RTC risk. Despite a slight decline in psychotropic use, a substantial burden of RTCs remains attributable to high-risk medication exposure, highlighting the need for continued public health interventions.
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BibTeX
@article{pariente2026prescription,
title = {{Prescription drugs and the risk of road traffic crashes in Bordeaux, France: a study matching emergency department health reports and a pharmaceutical reimbursement registry}},
author = {Antoine Pariente and Cedric Gil-Jardine and Benjamin Contrand and Emmanuel Lagarde and Marta Avalos and Océane Dorémus and Ariel Guerra-Adames},
journal = {BMJ Public Health},
year = {2026},
month = nov,
doi = {10.1136/bmjph-2025-004033},
url = {https://doi.org/10.1136/bmjph-2025-004033},
note = {CC BY},
}
RIS
TY - JOUR
TI - Prescription drugs and the risk of road traffic crashes in Bordeaux, France: a study matching emergency department health reports and a pharmaceutical reimbursement registry
AU - Antoine Pariente
AU - Cedric Gil-Jardine
AU - Benjamin Contrand
AU - Emmanuel Lagarde
AU - Marta Avalos
AU - Océane Dorémus
AU - Ariel Guerra-Adames
PY - 2026
DA - 2026/11/08
JO - BMJ Public Health
DO - 10.1136/bmjph-2025-004033
UR - https://doi.org/10.1136/bmjph-2025-004033
AB - Introduction Prescription medications may impair driving ability and increase the risk of road traffic crashes (RTC). This study aimed to estimate the association between prescription medication use and RTC risk among patients attending the adult emergency department of Bordeaux University Hospital, France, assess trends in psychotropic medication use, and estimate the proportion of RTCs attributable to medication exposure.Methods Emergency department records were linked with the French National Health Data System from 2013 to 2021. The study included 17 296 individuals aged 15 years or older presenting within 24 hours of an RTC. Drivers of motorised vehicles and vulnerable road users were included, whereas passengers were excluded. Acute and chronic effects were assessed using case-crossover and matched case–control designs, respectively. Medication exposure was classified according to the French pictogram-based driving risk classification (levels 0–3). ORs were estimated using conditional and multivariable logistic regression, and population attributable fractions were calculated using national prescription data.Results On the day of the RTC, 32.9% of individuals were exposed to at least one prescription medication. In the case-crossover analysis, level 3 medications were associated with increased RTC risk, particularly anxiolytics, opioids and antidepressants. In the case-control analysis, level 2 medications were associated with increased RTC risk (adjusted OR 1.27, 95% CI 1.17 to 1.38), as were level 3 medications (1.43, 95% CI 1.30 to 1.57). The highest risk was observed for centrally acting muscle relaxants (2.26, 95% CI 1.46 to 3.51). The population attributable fraction for level 2 and 3 medications decreased from 4.5% in 2013 to 3.8% in 2021.Conclusions Prescription medications with a high driving-risk classification, particularly those acting on the nervous system, significantly increase RTC risk. Despite a slight decline in psychotropic use, a substantial burden of RTCs remains attributable to high-risk medication exposure, highlighting the need for continued public health interventions.
SN - 2753-4294
ER -