Working conditions and risk exposure of employees whose occupations require driving on public roads - Factorial analysis and classification

Several studies of the working conditions of drivers, and in particular on their pace of work, have enabled a better understanding of the risk factors for road accidents that occur during work. However, few studies are available on the risk exposure and working conditions of employees whose occupations involve driving. The purpose of this paper is to identify the different groups of employees occupationally exposed to road risk and to classify them according to working conditions. Methodology A Multiple Correspondence Analysis (MCA) was implemented on the 41,727 individuals from the SUMER 2010 survey (Medical Monitoring of Occupational Risk Exposure: SUrveillance Médicale des Expositions aux Risques professionnels) and for 45 variables about working conditions. The analysis used 5 categories of weekly driving exposure as a supplementary variable (variable which is not used to perform the MCA): Non-exposure; Exposed 20?h. The results of the MCA were used to construct an ascending hierarchical classification. Results The first factorial axis differentiates between conventional and unconventional work schedules. Axis 2 differentiates modalities corresponding to the working hours of the most recent working week. The third axis chiefly contrasts persons who have rules to follow with those who have none. An ascending hierarchical classification distinguishes 10 clusters of individuals according to working conditions. Four clusters of employees were excessively exposed to occupational driving. Clusters also have distinct demographic, occupational and psychosocial characteristics. Conclusion Analysis of data from the SUMER survey confirms that employees exposed to road risk are particularly affected by atypical work time characteristics, but can be found in all activity sectors and in all types of job

Estimation of the number of seriously injured road users in France, 2006-2015

European Congress of Epidemiology, LYON, FRANCE, 04-/07/2018 - 06/07/2018Background The European Commission requests its member states to provide the number of serious road injuries, according to MAIS 3+=Maximum AIS 3+, where AIS=Abbreviated Injury Scale. This challenges in all countries the issue of under-reporting of road injuries in the official police data and the issue of using a medical trauma scale. Methods In France, as in most countries, police data provide the frequency of road casualties, but they suffer from large under-reporting and strong selection bias (on severity, mode of transport, etc). In the Rhone county (pop 1.6M inhabitants). Other data are available: a road trauma registry has been set up in 1996. It covers fatalities, hospitalized, and those attending the Emergency departments only. All injuries are directly coded into the Abbreviated Injury Scale, by the registry physician. At the Rhône county level, both databases are linked. Annually, on the 2006-2012 period, the police reports 2800 casualties, the road trauma registry 7400 by the registry and 1700 are identified as common to both sources. A capture-recapture approach is then used, so that we can estimate the real number of road casualties (in the Rhône). More importantly the corrections factors between the police data and the estimated real subgroup of road causalities in the Rhône. In particular, to account for some conditions for applying capture-recapture, a multivariate model is used, including the variables that are associated with lower probability of reporting by the police: type of police, road network, severity measured by hospitalised (yes/no), MAIS3+, road user type (pedestrian, cyclist, car occupant...), whether the crash involved a crash opponent or not, etc. The police correction factors are finally applied to the national police data with the assumption that police recording practices are rather homogenous across France, by type of police force, and type of road casualties, This corresponds to indirect standardization, not on age and sex as usual but on the characteristics influencing police reporting. Results The national number of injured road casualties, respectively for all severity, and for MAIS3+, are estimated at 285,000 and 24,000 resp. in 2015. The 2015 frequency of sMAIS3+ roadusers consists of 6850 motorized two-wheel users, 6500 car occupants, 3550 cyclists, 3500 pedestrians and 800 others (van, bus, truck users). This confirms the heavy burden suffered by Motorized two-wheel users. Moreover, they only account for 2% of traveled kilometers whereas car occupants account for 70% of traveled kilometers. Also, these results show a different pattern than the number of fatalities, where it is the number of killed car occupants that is the highest. Conclusions The frequency of injured road users, all severities, has been confirmed by other sources, namely: the French national Travel Survey, and by the annual firemen data (they provide first aid on crash scene). Concerning the number of seriously injured road users, the ratio of the number of MAIS3+ casualties divided by the number of fatalities enables country to country comparison

Work

Road accidents are the leading type of work-related fatalities, but the impact of work-related travel on overall traffic safety has been scarcely studied. The main objective of the present study was to assess drivers' relative road accident risk between work-related and personal journeys. A responsible/non-responsible case-control study was performed on a sample of 7,051 road accidents in France from the VOIESUR project. Logistic regression determined odds-ratios according to work-related versus personal travel, and identified risk factors for responsibility, specific to each of the two sub-groups. Drivers traveling on duty or commuting home were significantly less often responsible for accidents than drivers on personal journeys: OR = 0.75 [0.63; 0.89] and 0.65 [0.53; 0.80] respectively. Responsibility was significantly more frequent in commuting to versus from work: OR = 1.38 [1.06; 1.78]. Among on-duty drivers, professional passenger-transport drivers had the lowest risk of responsibility (OR = 0.25 [0.11; 0.58]), while those on temporary or work/study contracts and professional light goods vehicle drivers had the highest risk (OR = 11.64 [2.15; 62.94] and OR = 29.83 [5.19; 171.38] respectively). When driving under the influence of alcohol, risk of responsibility was higher in commuting home than in personal journeys. On-duty drivers showed lower risk of responsibility for an accident than other drivers. However, on-duty drivers on temporary or work/study contracts, who are usually not subject to specific regulations, showed higher risk, and should be the subject of particular attention regarding occupational risk prevention.Vehicule Occupant Infrastructure Etudes de la Sécurité des Usagers de la Rout

Estimation du nombre de blessés graves de la route, au sens MAIS3+, en Ile de France

En termes de blessés de la route, la Commission Européenne demande dorénavant à ses États Membres d'estimer le nombre de blessés graves selon un critère médical, le MAIS3+ (Maximum Abbreviated Injury Score). Le Registre du Rhône des victimes d'accidents de la circulation fournit directement ce critère, et permet par modélisations successives, basées sur la coexistence de ce Registre et des données des forces de l'ordre, d'estimer le nombre de blessés graves MAIS3+ au niveau national. Il est ainsi estimé à 25 400 en 2016, au niveau national, et à 5000 en Ile de France. Les estimations sur l'Ile de France, et encore plus sur Paris, sont à lire avec prudence, car les pratiques d'enregistrement des forces de l'ordre, notamment de la préfecture de Police de Paris, peuvent différer de celles du Rhône. Il ressort un fort effectif de blessés graves des usagers de deux-roues motorisés, et un effectif important de blessés graves piétons et cyclistes

Estimation du nombre de blessés graves de la route, au sens MAIS3+, France métropolitaine, 2006-2016

En termes de blessés de la route, la Commission Européenne demande dorénavant à ses États Membres d'estimer le nombre de blessés graves selon un critère médical, le MAIS3+ (Maximum Abbreviated Injury Score). Le Registre du Rhône des victimes d'accidents de la circulation fournit directement ce critère, et permet par modélisations successives, basées sur la coexistence de ce Registre et des données des forces de l'ordre, d'estimer le nombre de blessés graves MAIS3+ au niveau national. Il est ainsi estimé à 25 400 en 2016, et correspond à 7 fois le nombre de tués en moyenne chaque année (sur 2006-2016). Le nombre de blessés graves à deux-roues motorisé est depuis 2004 supérieur à celui des automobilistes : ils sont respectivement 10 000/an et 6 500/an sur 2013-2016, alors que les tués sont au nombre de 800/an et 1 800/an respectivement. Les piétons et cyclistes blessés MAIS3+ sont tous les deux au nombre de 3 500 /an (sur 2013-2016), alors que les tués sont respectivement 500/an et 150/an. Le nombre de blessés, tous usagers et toutes gravités, est estimé à 298 300 (2016). L'estimation des blessés toutes gravités est confirmée par l'Enquête Nationale Transport et Déplacements (ENTD 2007-2008), basée sur 23000 enquêtés, et par ailleurs, par les chiffres des Services Départementaux d'Incendie et de Secours (SDIS)

The burden of road traffic accidents in a French Departement: the description of the injuries and recent changes

International audienceBACKGROUND: A significant reduction in road traffic accidents has been observed since prevention measures were introduced by the French public authorities in 2002. The goals of this study are to describe the burden of road traffic accidents in a French Departement, and to identify changes if any between the periods 1997-2001 and 2002-2006 on the basis of the disability adjusted life years (DALY). METHODS: Years of lost life (YLL) and years lived with disability (YLD) were calculated for two periods using the mortality and incidence data in the Rhone Departement Registry of Road Traffic Accident Casualties. RESULTS: YLD and YLL that are related to road traffic accidents are at their maximum value between 15 and 24 years of age. For men, intracranial fractures and intracranial injuries dominate, and for women it is spinal cord injuries that account for highest rates of YLD. A reduction in the rates of YLL and YLD has been observed for both genders and all age groups between 1997-2001 and 2002-2006. CONCLUSION: The reduction in DALY between the two periods is explained both by the reduction in the number of fatalities and injuries but also by an increase in the age at which they occur

Prescription Medicines and the Risk of Road Traffic Crashes: A French Registry-Based Study

Using three nationwide databases in France, Ludivine Orriols, Emmanuel Lagarde, and colleagues provide evidence that prescribed medicines contribute to the risk of experiencing a road traffic crash

Les conséquences des accidents de la route sur la santé

Depuis 1995 fonctionne le Registre des victimes d'accidents de la circulation routière dans le département du Rhône. Il s'agit, pour la première fois en Europe, d'enregistrer en continu, les lésions et le parcours hospitalier de l'ensemble des victimes d'accidents de la route sur une zone géographiquement délimitée. L'ensemble des services de secours et de soins prenant en charge des victimes signale au Registre toute personne consultant à la suite d'un accident de la circulation sur une voie publique ou privée du département du Rhône (accident impliquant au moins un moyen mécanique de locomotion, y compris planches ou patins à roulettes). Des renseignements concernant la victime, son accident, ses lésions, et son devenir médical sont recueillis. Les résultats présentés concernent les 32 671 victimes recensées par le Registre pour les années 2007 à 2010

Rapid responses Topic collections

Main outcome measures The cases were the 6766 drivers considered at fault in their crash; the controls were 3006 drivers selected from the 3982 other drivers. Positive detection of cannabis was defined as a blood concentration of 9 tetrahydrocannabinol of over 1 ng/ml. The prevalence of positive drivers in the driving population was estimated by standardising controls on drivers not at fault who were involved in crashes resulting in slight injuries. Results 681 drivers were positive for cannabis (cases 8.8%, controls 2.8%), including 285 with an illegal blood alcohol concentration ( ≥ 0.5 g/l). Positive cannabis detection was associated with increased risk of responsibility (odds ratio 3.32, 95% confidence interval 2.63 to 4.18). A significant dose effect was identified; the odds ratio increased from 2.18 (1.22 to 3.89) if 0 < 9 tetrahydrocannabinol < 1 ng/ml to 4.72 (3.04 to 7.33) if 9 tetrahydrocannabinol ≥ 5 ng/ml. The effect of cannabis remains significant after adjustment for different cofactors, including alcohol, with which no statistical interaction was observed. The prevalence of cannabis (2.9%) estimated for the driving population is similar to that for alcohol (2.7%). At least 2.5% (1.5% to 3.5%) of fatal crashes were estimated as being attributable to cannabis, compared with 28.6% for alcohol (26.8% to 30.5%). Conclusions Driving under the influence of cannabis increases the risk of involvement in a crash. However, in France its share in fatal crashes is significantly lower than that associated with positive blood alcohol concentration