The Occupational Risk of Motor Vehicle Collisions for Emergency Medicine Residents

Authors

  • Mark T. Steele MD,

    Corresponding author
    1. Department of Emergency Medicine, Truman Medical Center, University of Missouri, Kansas City School of Medicine, Kansas City, MO
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  • O. John Ma MD,

    1. Department of Emergency Medicine, Truman Medical Center, University of Missouri, Kansas City School of Medicine, Kansas City, MO
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  • William A. Watson PharmD,

    1. Department of Emergency Medicine, Truman Medical Center, University of Missouri, Kansas City School of Medicine, Kansas City, MO
    2. Department of Surgery, University of Texas Health Science Center at San Antonio, San Antonio, TX
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  • Harold A. Thomas Jr. MD,

    1. Oregon Health Sciences Center, Portland, OR
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  • Robert L. Muelleman MD

    1. Department of Emergency Medicine, Truman Medical Center, University of Missouri, Kansas City School of Medicine, Kansas City, MO
    2. University of Nebraska Medical Center, Omaha, NE.
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Department of Emergency Medicine, Truman Medical Center, 2301 Holmes Street, Kansas City, MO 64108. Fax: 816-881-6282; e-mail: msteele@cctr.umkc.edu

Abstract

Abstract. Objective: To determine the prevalence and risk factors associated with motor vehicle collisions (MVCs) and near-crashes as reported by emergency medicine (EM) residents following various ED shifts. Methods: A survey was sent to all allopathic EM-2-EM-4 residents in May 1996 asking whether they had ever been involved in an MVC or near-crash while driving home after an ED shift. The residents night shift schedules, self-reported tolerance of night work, ability to overcome drowsiness, sleep flexibility, and morningness/eveningness tendencies also were collected. Results: Seventy-eight programs participated and 62% of 1,554 eligible residents returned usable surveys. Seventy-six (8%, 95% CI = 6% to 10%) residents reported having 96 crashes and 553 (58%, 95% CI = 55% to 61%) residents reported being involved in 1,446 near-crashes. Nearly three fourths of the MVCs and 80% of the near-crashes followed the night shift. Stepwise logistic regression of all variables demonstrated a cumulative association (R = 0.19, p = 0.0004) that accounted for 4% of the observed variability in MVCs and near-crashes. Univariate analysis showed that MVCs and near-crashes were inversely related to residents shiftwork tolerance (p = 0.019) and positively related to the number of night shifts worked per month (p = 0.035). Conclusions: Residents reported being involved in a higher number of MVCs and near-crashes while driving home after a night shift compared with other shifts. Driving home after a night shift appears to be a significant occupational risk for EM residents.

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