Acute cannabis consumption and motor vehicle collision risk: systematic review of observational studies and meta-analysis.
Acute cannabis consumption and motor vehicle collision risk: systematic review of observational studies and meta-analysis.
复制标题
DOI：
10.1136/bmj.e536
复制
发表时间：
2012-02-09
期刊：
影响因子：
--
通讯作者：
Cartwright JL
中科院分区：
文献类型：
--
作者：
Asbridge M;Hayden JA;Cartwright JL
目的探讨驾驶员急性吸食大麻是否会增加机动车碰撞风险。设计对观察性研究进行系统评价，并进行meta分析。我们在19个数据库中进行了电子检索，不受出版年份和语言的限制。我们还手动搜索参考文献列表，搜索未发表的研究，并审查研究小组的个人图书馆。我们纳入了机动车碰撞的观察性流行病学研究和适当的对照组，并选择了通过全血毒理学分析或自我报告来测量驾驶员近期大麻使用情况的研究。我们排除了实验或模拟研究。两名独立审稿人使用纽卡斯尔-渥太华量表评估了每项选定研究的偏倚风险，并达成共识。风险评估使用随机效应模型进行组合。我们在综述和荟萃分析中选择了9项研究。与未受影响的驾驶相比，在大麻影响下驾驶与机动车碰撞风险显著增加相关(优势比1.92(95%可信区间1.35至2.73)；P = 0.0003);我们注意到个体研究效果的异质性（I2=81）。在病例对照研究中，碰撞风险估计值更高(2.79 (1.23 - 6.33)；P=0.01)和致命碰撞研究(2.10(1.31至3.36)；P=0.002)高于罪责性研究(1.65 (1.11 ~ 2.46)；P=0.07)和非致命碰撞研究(1.74 (0.88 - 3.46)；P = 0.11)。结论：急性大麻消费与机动车碰撞风险增加有关，特别是致命碰撞。这些信息可作为反对酒后驾驶运动、制定区域或国家政策以控制驾车时急性吸毒以及提高公众认识的基础。
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 We also did manual searches of reference lists, conducted a search for unpublished studies, and reviewed the personal libraries of the research team.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.