Grant: Project Grant

Motor vehicle crashes result in 1.3 million deaths and 78 million injuries worldwide each year. Some individuals have a higher crash risk because medical conditions such as sleep apnea and seizures may briefly impair driving ability. Once a potential risk has been identified, patients, doctors and regulators can work together to develop driving recommendations that protect all road users without unduly limiting patients' independence. Syncope (commonly known as "fainting") is responsible for 1% of all North American emergency department visits. Tens of thousands of these patients will have a repeat episode within a year. A crash is likely to result if syncope recurs while driving, potentially resulting in harm to the patient and other road users. International guidelines recommend that patients at higher risk of syncope recurrence stop driving for one or more weeks, yet these recommendations are based on small, uncontrolled studies whose results are not applicable to most patients. No studies provide reliable estimates of the absolute or relative crash risk after syncope. BC's provincial health and driving insurance databases provide a unique opportunity to assemble the largest group of patients ever evaluated to determine the relationship between syncope and subsequent crash risk. This study will compare the records of 10,000 patients with an emergency department visit for syncope to those of 40,000 patients with a visit for another condition. After adjusting for differences in health and driving history, we will determine if crash risk is higher in the syncope patients. We will also determine which groups of patients are at highest risk. This study will generate the first robust evidence on the risks associated with driving after syncope. The results will have immediate implications for licensing authorities, road safety policy, and international clinical practice guidelines and have the potential to avert thousands of crashes annually worldwide.