INTRODUCTION: The influence of medical conditions on the ability to drive safely is a matter of concern to both physicians and society. Obviously, the symptoms in multiple sclerosis (MS) are of relevance when driving a car. Nevertheless this problem has never before been subject to scientific investigations. MATERIAL AND METHODS: A 10-year historical cohort register study on 197 patients with MS and 545 controls individually matched for age, gender, place of residence, and period of exposure. Persons with other neurological diseases, diabetes, or abuse were excluded. The outcome measure was treatment at an emergency department after an accident as a car driver. RESULTS: Five patients and four controls had been treated. The rate per 1,000 person-years with exposure was 3.4 times higher (CI 0.73-17.15) in the patients than in the control cohort. The difference is significant in a one-sided test (p = 0.04). DISCUSSION: This study showed that drivers with MS were more often treated at a casualty department after having a road traffic accident than healthy controls. In view of the small numbers, the results should be interpreted cautiously, and no drastic measures should be taken regarding patients' driving until the results have been further substantiated.

Accidents, Traffic↗

PubMed2002

[WHO's phone book analysis].

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Accidents, Traffic↗

PubMed2002

[Increased frequency of driving accidents in epilepsy].

INTRODUCTION: The influence of medical conditions on the ability to drive safely is a matter of concern to both physicians and society. Satisfactory answers to the many questions are not yet available, because of methodological difficulties, including the inability to collect sufficiently large and representative samples of drivers with specific diseases, and to acquire reliable accident data. For epilepsy, the conclusions of scientific reports vary from "there is little to worry about" to an increased relative risk of 1.9. As a consequence, attitudes and regulations vary greatly throughout the world. MATERIAL AND METHODS: A ten-year historical cohort register study of 159 patients with epilepsy and 559 controls individually matched for age, gender, place of residence, and exposure period. Recorded diagnoses of other relevant diseases led to exclusion. The outcome measure was treatment at the casualty department after an accident as a car driver. RESULTS: Ten patients and five controls had been treated at the casualty department, the rate ratio per 1,000 person-years with exposure being 7.01 (CI 2.18-26.13). DISCUSSION: This study showed that drivers with epilepsy seven times more often than healthy controls were treated at a casualty department after having a road traffic accident. In view of the small numbers of accidents and the surprising findings, the results must be interpreted cautiously. It is not advisable at this time to liberalize demands, but, on the other hand, drastic inferences regarding the patients' automobile driving should be avoided until the results have been further substantiated.

Accidents, Traffic↗

PubMed2002

["Crisis intervention"].

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Crisis Intervention↗

PubMed2002

[Does sitting at work cause low back pain?].

INTRODUCTION: Low back pain (LBP) is a common condition that, according to standard textbooks and several review articles, is associated with sitting-while-at-work. However, to our knowledge, no meta-analysis or critical systematic literature reviews have been published. MATERIALS AND METHODS: The Medline, Embase, and OSH-ROM databases were searched for articles dealing with sitting at work in relation to low back pain for the years 1985-1997. Original studies were divided into those dealing with sitting-while-working and those dealing with sedentary occupations. Each article was systematically abstracted for core items. The quality of each article was determined on the representativeness of the study sample, response rate, the definition of LBP, and the statistical analysis. RESULTS: Thirty-five reports were identified: 14 dealing with sitting-while-working and 21 with sedentary occupations. Eight studies were found to fulfill the above-mentioned criteria. Regardless of quality, all but one of the studies failed to find a positive association between sitting-while-working and LBP. High quality studies showed a marginally negative association for sitting compared to diverse workplace exposures, for instance standing, driving, lifting, bending, and compared to diverse occupations. One low quality study associated sitting in a poor posture with LBP. DISCUSSION: Out of 35 studies, only eight fulfilled the very basic quality criteria. Nevertheless, both high-quality and low-quality studies are consistently in agreement about the lack of positive association, and we conclude that the extensive recent epidemiological literature does not support the popular opinion that sitting-while-at-work is associated with LBP.

Global Health↗