Risk of traffic accidents after onset of vestibular disease assessed with a surrogate marker
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To determine if the risk of traffic accidents increases after disease onset in patients with acute vestibular disorders. That could provide a valid rationale for guidelines on driving restrictions.
5,260,054 patient data (> 18 years of age) from a statutory health insurer were used to identify traffic injuries in incident cases of Menière’s disease (MD) and vestibular neuritis (VN) in 2010–2013. Incident diagnoses were defined as the absence of such diagnoses in the preceding 5 years. Comparators were insured individuals with no such diagnoses throughout 2005–2017. The surrogate for traffic injuries were whiplash injuries coded in ICD-10 as diagnosis of sprain of ligaments of the cervical spine without structural changes.
We identified 4509 incident patients with Menière’s disease and 25,448 with vestibular neuritis and 5,102,655 controls with no such diagnoses throughout the observation period. The incidence of traffic injuries was increased for both vestibular disorders prior to the time point of diagnosis—MD 0.72 [0.47; 0.97] and VN 0.66 [0.56; 0.76] compared to controls (0.46 [0.46; 0.47]). The temporal course of incidence in whiplash injuries showed no increase and was 0.64 [0.41; 0.88] for MD at diagnosis and 0.73 [0.48; 0.98] after diagnosis, for VN it was 0.81 [0.70; 0.92] at diagnosis and 0.65 [0.55; 0.74] after diagnosis.
Although these data were not originally collected to address the research question, they provide a valid body of evidence. There is no rationale for driving restrictions, which substantially interfere with the individuals’ quality of life, in patients with incident MD and VN.
KeywordsVestibular disease Vestibular neuritis Menière’s disease Traffic accidents Incidence study
The authors thank Dr. Ursula Marshall and Joachim Saam (BARMER) for providing the data and for their tremendous help in dealing with the data structure of the BARMER health insurance data. They also thank Judy Benson and Katie Göttlinger for copyediting the manuscript. This work was supported by funds from the German Federal Ministry of Education and Research (BMBF Grant code 01 EO 0901) and the Hertie Foundation.
Compliance with ethical standards
Conflicts of interest
The authors declare that they have no conflict of interest.
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