|Titre :||Acute cannabis consumption and motor vehicle collision risk: systematic review of observational studies and meta-analysis (2012)|
|Auteurs :||M. ASBRIDGE ; J. A. HAYDEN ; J. L. CARTWRIGHT|
|Type de document :||Article : Périodique|
|Dans :||British Medical Journal (Vol.344, n°7846, 3 March 2012)|
|Article en page(s) :||e536 ; 9 p.|
|Note générale :||
Editorial: HALL W. Driving while under the influence of cannabis. British Medical Journal, 2012;344(7846):e595.
Letter: WINSTOCK A.R. Roadside drug testing would not be much of a deterrent. British Medical Journal, 2012;344(7849):e2133.
Letter: DUNLEAVY D. Cannabis and the DVLA. British Medical Journal, 2012;344(7849):e2134.
|Discipline :||EPI (Epidémiologie / Epidemiology)|
Thésaurus TOXIBASECANNABIS ; ACCIDENT ; CONDUITE DE VEHICULE ; FACTEUR DE RISQUE
Objective: To determine whether the acute consumption of cannabis (cannabinoids) by drivers increases the risk of a motor vehicle collision.
Design: Systematic review of observational studies, with meta-analysis.
Data sources: We did electronic searches in 19 databases, unrestricted by year or language of publication. We also did manual searches of reference lists, conducted a search for unpublished studies, and reviewed the personal libraries of the research team.
Review methods: We included observational epidemiology studies of motor vehicle collisions with an appropriate control group, and selected studies that measured recent cannabis use in drivers by toxicological analysis of whole blood or self report. We excluded experimental or simulator studies. Two independent reviewers assessed risk of bias in each selected study, with consensus, using the Newcastle-Ottawa scale. Risk estimates were combined using random effects models.
Results: We selected nine studies in the review and meta-analysis. Driving under the influence of cannabis was associated with a significantly increased risk of motor vehicle collisions compared with unimpaired driving (odds ratio 1.92 (95% confidence interval 1.35 to 2.73); P=0.0003); we noted heterogeneity among the individual study effects (I2=81). Collision risk estimates were higher in case-control studies (2.79 (1.23 to 6.33); P=0.01) and studies of fatal collisions (2.10 (1.31 to 3.36); P=0.002) than in culpability studies (1.65 (1.11 to 2.46); P=0.07) and studies of non-fatal collisions (1.74 (0.88 to 3.46); P=0.11).
Conclusions: Acute cannabis consumption is associated with an increased risk of a motor vehicle crash, especially for fatal collisions. This information could be used as the basis for campaigns against drug impaired driving, developing regional or national policies to control acute drug use while driving, and raising public awareness.
|Domaine :||Drogues illicites / Illicit drugs|
|Sous-type de document :||Revue de la littérature / Literature review|
|Refs biblio. :||58|
|Affiliation :||Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada|