The acute physiological stress response to driving: A systematic review

<div><p>Background</p><p>The experience of driving has been suggested to be detrimental to health. One hypothesis is that each exposure elicits an acute stress response, and that repeated exposures may act as a chronic stressor.</p><p>Objective</p><p>The aim of this review is to evaluate and synthesise the evidence on whether driving elicits an acute physiological stress response.</p><p>Methods</p><p>Electronic databases, including CINAHL, PsycINFO and Medline, were searched for original articles written in English from database inception until March 2016. The inclusion criteria of this review included a quantitative examination of an acute physiological stress response to driving, in either on-road or simulated settings, compared to a comparison or control condition. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting criteria.</p><p>Results</p><p>A total of 27,295 abstracts were screened and 28 full-text manuscripts retrieved. Of these, seven articles met the inclusion criteria including four simulator studies and three on-road studies. All suggested a significant change in at least one physiological outcome, but the strongest evidence was for increases in urine catecholamine and cortisol after driving for long hours on-road; results on other outcomes are limited by the small number of studies or inconsistent findings.</p><p>Conclusions</p><p>Overall, these studies provided moderate evidence to suggest that driving for long hours elicits a stress response over an extended period of time. There is insufficient evidence that driving for a shorter period of time elicits an acute stress response, especially in real, on-road tasks. However, the limited number of studies, small sample sizes, heterogeneity in study objectives, methodologies and physiological outcomes limit conclusions. Future studies could be improved by recruiting a larger sample, utilizing modern stress markers such as heart rate variability, and primarily focusing on the acute physiological stress response to on-road driving.</p></div

Acute stress response pathways.

<p>Abbreviations: ACTH = Adrenocorticotropic hormone; BP = blood pressure; CRF = Corticotropin releasing factor; SNS = sympathetic nervous system; TPR = total peripheral resistance.</p

Summary of the physiological outcomes measured in the included studies.

<p>Summary of the physiological outcomes measured in the included studies.</p

Summary of included studies that assess the acute physiological changes in response to either on-road or simulated driving.

<p>Summary of included studies that assess the acute physiological changes in response to either on-road or simulated driving.</p