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MEDRIL workshop 2: The medical condition of the category B driving population

MEDRIL workshop 2: The medical condition of the category B driving population. Hotel Eurovillage, Brussels 25 November 2005. MEDRIL MEDical testing for the DRIving Licence EU project 2003-2006. MEDRIL Objectives. Survey of medical condition of the category B driving population

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MEDRIL workshop 2: The medical condition of the category B driving population

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  1. MEDRIL workshop 2:The medical condition of the category B driving population Hotel Eurovillage, Brussels 25 November 2005 MEDRIL MEDical testing for the DRIving Licence EU project 2003-2006

  2. MEDRIL Objectives • Survey of medical condition of the category B driving population • Design of a medical screening test for category B drivers / periodicity of testing • Analyse the benefits of practical (on-road) fitness-to-drive assessments for drivers with ‘borderline’ medical problems MEDRIL MEDical testing for the DRIving Licence EU project 2003-2006

  3. Medical survey (and screening test form) • Objective of survey: 10000 medical tests in Finland, Spain, Luxembourg & the Netherlands • Using a standardised medical form • To be carried out by the relevant doctor in each country (GP, specialist centre) MEDRIL MEDical testing for the DRIving Licence EU project 2003-2006

  4. Why Finland, Spain, Luxembourg & NL? = Testing at different ages, with different procedures and methods • Spain:every 10 yrs until the age of 45, every 5 years until 70, every two years from 70 • Luxembourg: every 10 yrs for 50-70 yrs old, 70+ = every 3 yrs, 80+ = every year • Finland: eyetest at 45, medical exam every 5 yrs from 70+ (AND reporting requirement of GP) • Netherlands: Testing from 70+, ever 5 years. Personal declaration plus medical certificate from GP. MEDRIL MEDical testing for the DRIving Licence EU project 2003-2006

  5. MEDRIL test form (anonymous)

  6. Content of MEDRIL test form • Personal data (age, sex, residence, education, living alone/with a partner) • Medical history / anamnesis (diseases, impairments, medication, alcohol consumption, health problems) • Medical test (visual acuity/field, blood pressure, strength, balance & reflexes, cognitive impairment, etc) • Accompanied by guidelines for practitioners (target group, methods, thresholds…) • Forms filled out at the same time as normal medical testing for category B drivers in country in question MEDRIL MEDical testing for the DRIving Licence EU project 2003-2006

  7. Difficulties in achieving samples • Difficult to convince GPs to take part. 10 minutes is a long time for a doctor! • Problems related to payment of doctors • Small number of drivers visiting individual GPs for medical testing • Exception: Spain. ASECEMP = network of specialised medical testing centres for drivers MEDRIL MEDical testing for the DRIving Licence EU project 2003-2006

  8. MEDRIL: final samples MEDRIL MEDical testing for the DRIving Licence EU project 2003-2006 (XXXX) = original objective

  9. MEDRIL: final sample MEDRIL MEDical testing for the DRIving Licence EU project 2003-2006 n. = 5056

  10. Tests for representativeness • Samples were tested for representativeness of the category B population in each respective country (distribution of age and sex) • Only Finland was found to be ~representative • Other samples (ESP, NL, LUX) were statistically re-weighted (performed by Traffic Test, NL) • Samples are now representative, in terms of age and sex distribution, of category B populations. MEDRIL MEDical testing for the DRIving Licence EU project 2003-2006

  11. Results per country MEDRIL MEDical testing for the DRIving Licence EU project 2003-2006

  12. Results: FINLAND

  13. Results: SPAIN

  14. Results: LUXEMBOURG

  15. Results: NETHERLANDS

  16. Results per medical condition MEDRIL MEDical testing for the DRIving Licence EU project 2003-2006

  17. Abnormal visual acuity MEDRIL MEDical testing for the DRIving Licence EU project 2003-2006

  18. Abnormal visual acuity (2) MEDRIL MEDical testing for the DRIving Licence EU project 2003-2006

  19. Visual acuity: comparative data • Visual impairments in elderly European drivers study (A, B, D, ESP, NL): 5,3% of 75+ age category failed the 0.5 requirement (best corrected acuity in best eye). MEDRIL MEDical testing for the DRIving Licence EU project 2003-2006

  20. Restricted visual field MEDRIL MEDical testing for the DRIving Licence EU project 2003-2006

  21. Restricted visual field: comparative data • Visual impairments in elderly European drivers study (A, B, D, ESP, NL): 2,7% of over 75 year olds unsuited; 2,4% questionnable MEDRIL MEDical testing for the DRIving Licence EU project 2003-2006

  22. Problems with night vision (‘glare’) MEDRIL MEDical testing for the DRIving Licence EU project 2003-2006

  23. Problems with night vision (2) MEDRIL MEDical testing for the DRIving Licence EU project 2003-2006

  24. Glare / stray light: comparative data • Visual impairments in elderly European drivers study (A, B, D, ESP, NL): 29.5% of over 75 yr olds have stray light of 1.4+ MEDRIL MEDical testing for the DRIving Licence EU project 2003-2006

  25. High blood pressure MEDRIL MEDical testing for the DRIving Licence EU project 2003-2006

  26. Cardio-vascular disease MEDRIL MEDical testing for the DRIving Licence EU project 2003-2006

  27. Cardio-vascular: comparative data MEDRIL MEDical testing for the DRIving Licence EU project 2003-2006 Source: RIVM (NL)

  28. Neurological problems MEDRIL MEDical testing for the DRIving Licence EU project 2003-2006

  29. Neurological: comparative data Netherlands (Prevalence of diseases in the Netherlands, 1996): • 6-10% of 80+ category suffer strokes Finland (Health 2000 data): • 9,6% of men and 6,7% of women over 65 have suffered strokes MEDRIL MEDical testing for the DRIving Licence EU project 2003-2006

  30. Mental health MEDRIL MEDical testing for the DRIving Licence EU project 2003-2006

  31. Mental health: anti-depressants MEDRIL MEDical testing for the DRIving Licence EU project 2003-2006

  32. Depression: comparative data Source: Health 2000 report AWMF (Germany): 2-7% of the population require treatment as a result of severe depression. MEDRIL MEDical testing for the DRIving Licence EU project 2003-2006

  33. Alcohol consumption / abuse MEDRIL MEDical testing for the DRIving Licence EU project 2003-2006

  34. Alcohol consumption (3): do you consume 6 or more portions of alcohol daily or almost daily? 0% MEDRIL MEDical testing for the DRIving Licence EU project 2003-2006

  35. Alcohol abuse: comparative data • Approximately 12% of European adults consume alcohol at harmful levels, defined as 40g of alcohol or more per day for men and 20g of alcohol or more for women (10mg = 1 portion of alcohol) Source: PHEPA Project. European clinical guidelines on the management of alcohol problems in primary care. MEDRIL MEDical testing for the DRIving Licence EU project 2003-2006

  36. Male / female alcohol consumption (NL) MEDRIL MEDical testing for the DRIving Licence EU project 2003-2006

  37. Medication MEDRIL MEDical testing for the DRIving Licence EU project 2003-2006

  38. Medication: analgesics MEDRIL MEDical testing for the DRIving Licence EU project 2003-2006

  39. Medication: sedatives MEDRIL MEDical testing for the DRIving Licence EU project 2003-2006

  40. Medication: narcoleptics MEDRIL MEDical testing for the DRIving Licence EU project 2003-2006

  41. Medication: hypnotics MEDRIL MEDical testing for the DRIving Licence EU project 2003-2006

  42. Medicine: comparative data (LEHO) MEDRIL MEDical testing for the DRIving Licence EU project 2003-2006 LEHO project (2003-2005)

  43. Medicine: comparative data (2) • Psycho-active medicines are consumed particularly in 50+ age category of women (IMMORTAL project, WP4.2), and men in early retirement (IMMORTAL, Danish study) MEDRIL MEDical testing for the DRIving Licence EU project 2003-2006

  44. Male / female consumption of psycho-active medicines MEDRIL MEDical testing for the DRIving Licence EU project 2003-2006

  45. Sleeping disorders MEDRIL MEDical testing for the DRIving Licence EU project 2003-2006

  46. Sleeping disorders: comparative data • High prevalence among middle-aged men (4-5 %) – sleep apnoea • Narcolepsy: prevalence 1 in 2000 Source: Institute of Transport Economics, Norway MEDRIL MEDical testing for the DRIving Licence EU project 2003-2006

  47. Epilepsy MEDRIL MEDical testing for the DRIving Licence EU project 2003-2006

  48. Epilepsy: comparative data “The prevalence of active epilepsy in the adult population is 4 to 10 in 1000 people (Hauser et al. 1996; Goodridge et al. 1983). For the European union we assumed a value of 6 in 1000. Of these patients, a substantial number hold a drivers licence (Sonnen 1995).” Source: Epilepsy working group of the EU Driving Licence Committee MEDRIL MEDical testing for the DRIving Licence EU project 2003-2006

  49. Diabetes MEDRIL MEDical testing for the DRIving Licence EU project 2003-2006

  50. Diabetes: comparative data Source:Prevalence of disease in the Netherlands, 2003 (types 1 and 2) MEDRIL MEDical testing for the DRIving Licence EU project 2003-2006

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