Abstract
Driving a motor vehicle is a complex task requiring a reasonable level of physical fitness, accurate perception, and appropriate judgment. All these factors can be affected by drugs and alcohol, greatly increasing the risk of accidents. Many medical conditions (and their treatments) may impair fitness to drive and will first be considered.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Finucane AK (1999) Legal aspects of epilepsy. Neurol Clin 17:235–243
Austroads (2006) Assessing fitness to drive: for commercial and private vehicle drivers, Sydney
Fitten LJ (1997) The demented driver: the doctor’s dilemma. Alzheimer Dis Assoc Disord 11(suppl 1):57–61
Driver and Vehicle Licensing Agency (2010) For medical practitioners: at a glance guide to the current medical standards of fitness to drive. Drivers medical unit. DVLA, Swansea
Osawa M, Nagasawa T, Yukawa N, Nakajima Y, Seto Y, Ohki T et al (1998) Sudden natural death in driving: case studies in the western area of Kanagawa. Nippon Hoigaku Zasshi 52:315–318
Cheng LH, Whittington RM (1998) Natural deaths while driving: would screening for risk be ethically justified? J Med Ethics 24:248–251
Belkic K, Emdad R, Theorell T (1998) Occupational profile and cardiac risk: possible mechanisms and implications for professional drivers. Int J Occup Med Environ Health 11:37–57
Conti JB, Woodard DA, Tucker KJ, Bryant B, King LC, Curtis AB (1997) Modification of patient driving behavior after implantation of a cardioverter defibrillator. Pacing Clin Electrophysiol 20(9 Pt 1):2200–2204
Bansch D, Brunn J, Castrucci M, Weber M, Gietzen F, Borggrefe M et al (1998) Driving and arrhythmias. J Am Coll Cardiol 31(3):608–615
Medical Research Council Antiepileptic Drug Withdrawal Study Group (1993) Prognostic index for recurrence of seizures after remission of epilepsy. BMJ 306:1374–1378
Krumholz A (1994) Driving and epilepsy: a historical perspective and review of current Âregulations. Epilepsia 35:668–674
MacLeod KM (1999) Diabetes and driving: towards equitable, evidence-based decision-making. Diab Med 16:282–290
Ehrlich EN (1991) Diabetes and the license to drive. Wis Med J 90:115–118
Distiller LA, Kramer BD (1996) Driving and diabetics on insulin therapy. S Afr Med J 86(8 suppl):1018–1020
Charman WN (1997) Vision and driving – a literature review and commentary. Ophthalmic Physiol Opt 17:371–391
General Medical Council (2009) Guidance for doctors. Confidentiality: supplementary Âguidance. GMC, London
Ellenhorn MJ et al (1997) Ellenhorn’s medical toxicology: diagnosis and treatment of human poisoning. Williams & Wilkins, Baltimore
Jones A, Pounder D (1998) Measuring blood-alcohol concentration for clinical and forensic purposes. In: Karch S (ed) Drug abuse handbook. CRC Press, Boca Raton, pp 327–356
Noordzij PC, Roszbach R (1987) Alcohol, drugs, and traffic safety, in T86: Proceedings of the 10th International Conference on Alcohol, Drugs, and Traffic Safety, Amsterdam, September 9–12, 1986. Excerpta Medica, New York
Borkenstein RF, Dale A (1964) The role of the drinking driver in traffic accidents. Department of Police Administration. Indiana University, Bloomington
Allsop RE (1996) Alcohol and road accidents: a discussion of the Grand Rapids study. Road Research Laboratory. (RRL Report No 6), Harmondsworth.
Compton RP, Blomberg RD, Moskowitz H, Burns M, Peck RC, Fiorentino D (2002) Crash Risk of Alcohol Impaired Driving in T2002 Proceedings of the 16th International Conference on Alcohol, Drugs and Traffic Safety, Montreal
California Code of Regulations (1999) Title 13, Motor Vehicles, State of California
Pounder D, Jones G (1998) Measuring alcohol post-mortem. In: Karch S (ed) Drug abuse handbook. CRC Press, Boca Raton, pp 356–374
Aberg L (1993) Behaviours and opinions of Swedish drivers before and after the 0.02% legal BAC limit of 1990, in T9: proceedings of the 12th International Conference on Alcohol, Drugs, and Traffic Safety; Cologne, 1992. In: Utzelmann HD, Berghaus G (eds)
Department of Environment, Transport and the Regions (1998) Combating drunk-driving – next steps. A consultation document. DETR, UK
Dunbar JA, Penttila A, Pikkarainen J (1987) Drinking and driving: success of random breath testing in Finland. BMJ 295:101–103
Marsden A (1996) Accidental injury and traffic medicine. In: McLay WDS (ed) Clinical Forensic Medicine. Greenwich Medical Media, London, p 231
Coben JH, Larkin GL (1999) Effectiveness of ignition interlock devices in reducing drunk driving recidivism. Am J Prev Med 16(1 suppl):81–87
Sheldrake v Director of Public Prosecutions (2003) EWHC 273 (Admin)
Pugh v Knipe. R.T.R. 286 (1972)
Wallwork v. Giles. 114 S.J. 36 (1969)
Krause KR, Howells GA, Bair HA, Bendick PJ, Glover JL (1998) Prosecution and conviction of the injured intoxicated driver. J Trauma 45:1069–1073
McArthur DL, Kraus JF (1999) The specific deterrence of administrative per se laws in Âreducing drunk driving recidivism. Am J Prev Med 16(1 suppl):68–75
Faculty of Forensic and Legal Medicine/British Medical Association (2010) Taking blood specimens from incapacitated drivers. Guidance for doctors
Kaye S, Cardona E (1969) Errors of converting a urine alcohol value into a blood alcohol level. Am J Clin Pathol 52:577–584
Winek CL, Esposito FM (1981) Comparative study of ethanol levels in blood versus bone Âmarrow, vitreous humor, bile and urine. Forensic Sci Int 17:27–36
North P (2010) Report of the review of drink drug driving law. Department for Transport. DfT Publications, London
Carter PG, McConnell AA (1990) Alcohol in drink driving swabs: does it make any Âdifference? [letter]. Med Sci Law 30:90
Chief Constable of Avon and Somerset v. Singh. R.T.R. 107 (1988)
D.P.P. v Kinnersley. The Times, December 29 D.C (1992)
D.P.P. v Pearman. R.T.R. 407 (1992)
Young v D.P.P. R.T.R. 328 (1992)
Gomm PJ, Osselton MD, Broster CG, Johnson NM, Upton K (1991) Study into the ability of patients with impaired lung function to use breath alcohol testing devices. Med Sci Law 31:221–225
Gomm PJ, Broster CG, Johnson NM, Hammond K (1993) Study into the ability of healthy people of small stature to satisfy the sampling requirements of breath alcohol testing instruments. Med Sci Law 33:311–314
Odell M, McDonald C, Farrar J, Natsis JS, Pretto JF (1998) Breath testing in patients with respiratory disability. J Clin Forensic Med 5:45–48
Honeybourne D, Moore AJ, Butterfield AK, Azzan L (2000) A study to investigate the ability of subjects with chronic lung diseases to provide evidential breath samples using the Lion Intoxilyzer ® 6000 UK breath alcohol testing device. Respir Med 94:684–688
Logan BK, Gullberg RG (1998) Lack of effect of tongue piercing on an evidential breath alcohol test. J Forensic Sci 43:239–240
Kuldip Singh Gill v D.P.P. January 16 (1995)
Solesbury v Pugh. 1 W.L.R. 1114 (1969)
Bayliss v. Thames Valley Police Chief Constable (1978) Criminal Law Review. p 363
Beck v Watson. R.T.R. 91 (1980)
Robinson SP (1996) Road traffic offences. In: Robinson SP (ed) Principles of forensic medicine. Greenwich Medical Media, London. Distributed world-wide by Oxford University Press, pp 139–147
R v Bolton JJ. Ex p Scally 1 Q.B. 537 (1991)
R v Harding. R.T.R. 325 (1974)
Stark MM, Brener N (2000) Needle Phobia. J Clin Forensic Med 7:35–38
Rix K (1996) Blood or needle phobia as a defence under the Road Traffic Act of 1988. J Clin Forensic Med 3:173–177
Jones AW (1991) Top ten defence challenges among drinking drivers in Sweden. Med Sci Law 31:229–238
Jones A, Logan B (1998) DUI defenses. In: Karch S (ed) Drug abuse handbook. CRC Press, Boca Raton, pp 1006–1046
DDP v Mukandiwa (2005) EWHC 2977
Rowland v. Thorpe. 3 All E.R. 195 (1970)
Acevedo CG, Tamayo L, Contreras E (1986) Effects of morphine in the isolated mouse urinary bladder. Gen Pharmacol 17:449–452
Davis AR, Lipson AH (1986) Central nervous system tolerance to high blood alcohol levels. Med J Aust 144:9–12
Felby S, Olsen J (1969) Comparative studies of postmortem ethyl alcohol in vitreous humor, blood, and muscle. J Forensic Sci 14:93–101
Seppala T, Linnoila M, Mattila MJ (1979) Drugs, alcohol and driving. Drugs 17:389–408
Mattila MJ, Vanakoski J, Kalska H, Seppala T (1998) Effects of alcohol, zolpidem and some other sedatives and hypnotics on human performance and memory. Pharmacol Biochem Behav 59:917–923
Ramaekers JG (1998) Behavioural toxicity of medicinal drugs. Practical consequences, incidence, management and avoidance. Drug Saf 18:189–208
Rowe D (1999) Personal communication. DETR
Osselton MD, Owen P, Fysh R (1996) Drugs and driving, Forensic Science Service Report No. TN816. Forensic Science Service, London, p 3
Tunbridge RJ, Keigan M, James FJ (2001) The incidence of drugs in road accident fatalities. TRL report 495. Crowthorne, England. TRL Ltd
Myant K, Hope S, McIntosh J, O’Brien Y, McKeganey N, Stradling S (2006) Illicit drugs and driving. Transport Research Series. Scottish Executive Social Research, Edinburgh
Berghaus G, Scheer N, Schmidt P (1995) Effects of cannabis on psychomotor skills and Âdriving performance – a meta-analysis of experimental studies, in T95 Proceedings of the 13th International Conference on Alcohol, Drugs, and Traffic Safety, Adelaide, 1994
Chait L, Pierri J (1992) Effects of smoked marijuana on human performance: a critical review. In: Murphy L, Bartke A (eds) Marijuana/Cannabinoids: neurobiology and neurophysiology. CRC Press, Boca Raton
Heishman S, Karch S (2000) Drugs and driving. In: Siegel J, Saukko P, Knupfer G (eds) Encyclopaedia of forensic sciences. Academic, London
Heishman SJ, Singleton EG, Crouch DJ (1998) Laboratory validation study of drug evaluation and classification program: alprazolam, d-amphetamine, codeine, and marijuana. J Anal Toxicol 22:503–514
Sexton BF, Tunbridge RJ, Brook-Carter N, Jackson PG, Wright K, Stark MM, Engelhart K (2000) The influence of cannabis on driving. TRL Report 477. TRL Limited
Lenné MG, Dietze PM, Triggs TJ, Walmsley S, Murphy B, Redman JR (2010) The effects of cannabis and alcohol on simulated arterial driving. Accid Anal Prev 42(3):859–866
Karschner EL, Schwilke EW, Lowe RH, Darwin WD, Herning RI, Cadet JL, Huestis MA (2009) Implications of plasma Delta9-tetrahydrocannabinol, 11-hydroxy-THC, and 11-nor-9-carboxy-THC concentrations in chronic cannabis smokers. Addiction 104(12):2041–2048
Chesher G, Lemon J, Gomel M, Murphy G (1989) The effects of methadone, as used in methadone maintenance program, on driving related skills. National Drug and Research Centre, Sydney
Friedel B, Berghaus S (1995) Methadone and driving. In: T95 Proceedings of the 13th International Conference on Alcohol, Drugs and Traffic Safety, Adelaide, Australia
Bernard JP, Morland J, Khiabani HZ (2009) Methadone and impairment in apprehended Âdrivers. Addiction 1004:457–464
Koelega HS (1993) Stimulant drugs and vigilance performance: a review. Psychopharmacology 111:1–16
Farre M, Llorente M, Ugena B, Lamas X, Cami J (1991) Interaction of cocaine with ethanol. NIDA Res Monogr 105:570–571
Logan BK (1996) Methamphetamine and driving impairment. J Forensic Sci 41:457–464
De Waard D, Brookhuis KA, Pernot LMC (2001) A driving simulator study on the effects of MDMA (Ecstasy) on driving performance and traffic safety in T2000 Proceedings of the International Conference on Alcohol, Drugs, and Traffic Safety, Stockholm, 2000
Burns M (1993) Cocaine effects on performance. In: Utzelmann H, Berghaus G, Ktoj G (eds) Alcohol, drugs and traffic safety, T92, Band 2. TUV Rheinland, Cologne
Soderstrom CA, Dischinger PC, Kufera JA, Ho SM, Shepard A (2005) Crash culpability Ârelative to age and sex for injured drivers using alcohol, marijuana or cocaine. Annu Proc Assoc Adv Automot Med 49:327–341
Musshoff F, Madea B (2010) Cocaine and benzoylecgonine concentrations in fluorinated plasma samples of drivers under suspicion of driving under influence. Forensic Sci Int 200(1–3):67–72
O’Hanlon JF, Vermeeren A, Uiterwijk MM, van Veggel LM, Swijgman HF (1995) Anxiolytics’ effects on the actual driving performance of patients and healthy volunteers in a standardized test. An integration of three studies. Neuropsychobiology 31:81–88
Barbone F, McMahon AD, Davey PG, Morris AD, Reid IC, McDevitt DG et al (1998) Association of road-traffic accidents with benzodiazepine use [see comments]. Lancet 352:1331–1336
Bramness JG, Skurtveit S, Mørland J (2003) Clinical impairment of benzodiazepines – relation between benzodiazepine concentrations and impairment in apprehended drivers. Pompidou Group, Strasbourg
Chesher GB, Dauncey H, Crawford J, Horn K (1996) The interaction between alcohol and Marijuana. Report to the Australian Federal Office of Road Safety. Department of Pharmacology. University of Sydney, Sydney
Sexton BF, Tunbridge RJ, Brook-Carter N, Jackson PG, Wright K, Stark MM, Engelhart K (2002) The influence of cannabis and alcohol on driving. TRL Report 543. TRL Limited
Hindmarch I (1993) Psychiatry in Practice. Winter: 23–25.
O’Hanlon JF, Robbe HW, Vermeeren A, van Leeuwen C, Danjou PE (1998) Venlafaxine’s effects on healthy volunteers’ driving, psychomotor, and vigilance performance during 15-day fixed and incremental dosing regimens. J Clin Psychopharmacol 18:212–221
Bhatti JZ, Hindmarch I (1989) The effects of terfenadine with and without alcohol on an aspect of car driving performance. Clin Exp Allergy 19:609–611
Choi H, Baeck S, Kim E, Lee S, Jang M, Lee J (2009) Analysis of cannabis in oral fluid specimens by GC-MS with automatic SPE. Sci Justice 49(4):242–246
Tunbridge RJ, Keigan M, James FJ (2001) Recognising drug use and drug related impairment in drivers at the roadside. TRL report 464. Crowthorne, England. TRL Ltd
Burns M, Adler E (1995) Study of a drug recognition expert (DRE) program, in T95: Proceedings of the 13th International Conference on Alcohol, Drugs, Traffic Safety, Adelaide, 1994
Kidwell DA, Holland JC, Athanaselis S (1998) Testing for drugs of abuse in saliva and sweat. J Chromatogr B Biomed Sci Appl 713:111–135
Beck O, Leine K, Palmskog G, Franck J (2010) Amphetamines detected in exhaled breath from drug addicts: a new possible method for drugs-of-abuse testing. J Anal Toxicol 34(5):233–237
Tunbridge RJ, Rowe DJ (1999) Roadside identification of drug impaired drivers in Great Britain. 10th International Conference on Road safety in Europe, Malmo
O’Keefe M (2001) Drugs driving – standardized field sobriety tests: a survey of police surgeons in Strathclyde. J Clin Forensic Med 8:57–65
Leetham v. D.P.P. Q.B. 488 (1998)
Angel v Chief Constable of South Yorkshire (2010) EWHC 883 (Admin)
Oliver JS, Seymour J, Wylie FM, Torrance H, Anderson RA (2006) Monitoring the effectiveness of UK Field Impairment Tests. Road Safety Research Report No. 63. Department for Transport, London
Odell MS (2002) Expert Opinion in DUID Cases Based on Interpretation and Observation and Toxicology in T2002 Proceedings of the 16th International Conference on Alcohol, Drugs and Traffic Safety, Montreal
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2011 Springer Science+Business Media, LLC
About this chapter
Cite this chapter
Wall, I.F., Karch, S.B. (2011). Traffic Medicine. In: Stark, M. (eds) Clinical Forensic Medicine. Humana Press. https://doi.org/10.1007/978-1-61779-258-8_14
Download citation
DOI: https://doi.org/10.1007/978-1-61779-258-8_14
Published:
Publisher Name: Humana Press
Print ISBN: 978-1-61779-257-1
Online ISBN: 978-1-61779-258-8
eBook Packages: Biomedical and Life SciencesBiomedical and Life Sciences (R0)