The role of medicines in traffic accidents in the European countries

The prevalence of medicines in the driving population and their role in traffic accidents is mostly unknown in the European countries. Larger roadside studies focusing on medicines with detrimental effects on road traffic safety should be organised, so results could be compared to the corresponding compounds detected in samples from accident drivers. In order to perform such studies, equipment with necessary sensitivity for detection of the most relevant compounds in appropriate biological media (e.g. saliva or sweat) is highly needed. Further studies on blood/saliva (or sweat) concentration ratios are therefore recommended. Collaboration studies with participation from different countries are thus important in order to obtain sufficient data for the calculation of reliable risk factors. Standard protocols covering biological medium to be used for analyses, compounds covered by the analytical program and their cut-off limits are thus recommended. Sub-division by groups of drivers responsible for the accidents (responsibility analysis) gives the most valuable data for accident risk calculations. Special focus must be paid to accident-involved drivers with more than one compound detected in their blood samples, or to those with blood drug concentrations reflecting doses higher than normally recommended for therapeutic use. Organisation of a common European database covering the prevalence of alcohol, illegal drugs and medicines among injured and fatal accident drivers provided by the different countries would be highly valuable. Routines should be considered for the exchange of information from accident studies to uncover "new" medicines that may have detrimental effects on traffic safety. Introduction Statistics on traffic accidents in the European Union (EU) show that more than 40 000 people are killed every year and that 1,7 million persons need medical treatment (1). For those between 15 and 24 years old, fatal traffic accident is the major cause of death. An important contributing factor to the accidents, is the use of alcohol and/or drugs combined with driving. The goal for EU’s new road safety action plan is to halve the number of fatalities within 2010 (1). The focus on drugs as an important accident risk factor has received considerable attention during the last years. Several studies have been carried out in order to document the prevalence of drugs and among accident drivers and other group of drivers, in order to calculate risk factors. Other activities include working groups represented by members from several European countries, seminars and information campaigns focusing on the hazards of drugs combined with driving (2, 3). Research projects on drugs and driving have been/are